1000 resultados para OSA


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Multiple sclerosis (MS) is the most common cause of neurological disability in young adults, affecting more than two million people worldwide. It manifests as a chronic inflammation in the central nervous system (CNS) and causes demyelination and neurodegeneration. Depending on the location of the demyelinated plaques and axonal loss, a variety of symptoms can be observed including deficits in vision, coordination, balance and movement. With a typical age of onset at 20-40 years, the social and economic impacts of MS on lives of the patients and their families are considerable. Unfortunately the current treatments are relatively inefficient and the development of more effective treatments has been impeded by our limited understanding of the causes and pathogenesis of MS. Risk of MS is higher in biological relatives of MS patients than in the general population. Twin and adoption studies have shown that familial clustering of MS is explained by shared genetic factors rather than by shared familial environment. While the involvement of the human leukocyte antigen (HLA) genes was first discovered four decades ago, additional genetic risk factors have only recently been identified through genome-wide association studies (GWAS). Current evidence suggests that MS is a highly polygenic disease with perhaps hundreds of common variants with relatively modest effects contributing to susceptibility. Despite extensive research, the majority of these risk factors still remain to be identified. In this thesis the aim was to identify novel genes and pathways involved in MS. Using genome-wide microarray technology, gene expression levels in peripheral blood mononuclear cells (PBMC) from 12 MS patients and 15 controls were profiled and more than 600 genes with altered expression in MS were identified. Three of five selected findings, DEFA1A3, LILRA4 and TNFRSF25, were successfully replicated in an independent sample. Increased expression of DEFA1A3 in MS is a particularly interesting observation, because its elevated levels have previously been reported also in several other autoimmune diseases. A systematic review of seven microarray studies was then performed leading to identification of 229 genes, in which either decreased or increased expression in MS had been reported in at least two studies. In general there was relatively little overlap across the experiments: 11 of the 229 genes had been reported in three studies and only HSPA1A in four studies. Nevertheless, these 229 genes were associated with several immunological pathways including interleukin pathways related to type 2 and type 17 helper T cells and regulatory T cells. However, whether these pathways are involved in causing MS or related to secondary processes activated after disease onset remains to be investigated. The 229 genes were also compared with loci identified in published MS GWASs. Single nucleotide polymorphisms (SNP) in 17 of the 229 loci had been reported to be associated with MS with P-value less than 0.0001 including variants in CXCR4 and SAPS2, which were the only loci where evidence for correlation between the associated variant and gene expression was found. The CXCR4 variant was further tested for association with MS in a large case-control sample and the previously reported suggestive association was replicated (P-value is 0.0004). Finally, common genetic variants in candidate genes, which had been selected on the basis of showing association with other autoimmune diseases (MYO9B) or showing differential expression in MS in our study (DEFA1A3, LILRA4 and TNFRSF25), were tested for association with MS, but no evidence of association was found. In conclusion, through a systematic review of genome-wide expression studies in MS we have identified several promising candidate genes and pathways for future studies. In addition, we have replicated a previously suggested association of a SNP variant upstream of CXCR4 with MS. Keywords: autoimmune disease, common variant, CXCR4, DEFA1A3, HSPA1A,gene expression, genetic association, GWAS, MS, multiple sclerosis, systematic review

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The study is the outcome of two research projects on the North American Indian traditions: the role of the shields within the Plains Indians traditional culture and religion, and the bear ceremonialism of the Native North America, especially the significance of the bear among the Plains Indians. This article-based dissertation includes seven separately published scholar papers, forming Chapters 6 12. The introduction formulates the objectives and frame of reference of the study and the conclusions pulls together its results. The study reconsiders the role of the Plains Indian shields with bear motifs. Such shields are found in rock art, in the Plains Indian s paintings and drawings, and in various collections, the main source material being the shields in European and North American museums. The aim is not only to study shields with bear power motifs and the meanings of the bear, but also to discuss appropriate methods for studying these subjects. There are three major aims of the study: to consider methodical questions in studying Plains Indian shields, to examine the complexity of the Plains Indian shields with the bear power motifs, and to offer new interpretations for the basic meanings of the bear among the Plains Indians and the interrelationship between individualism and collectivism in the Plains Indians visionary art that show bear power motifs on the shields. The study constructs a view on the bear shields taking account of all sources of information available and analysing the shields both as physical artefacts and religious objects from different perspectives, studying them as a part of the ensemble of Plains culture and religious traditions. The bear motifs represented the superhuman power that medicine men and warriors could exploit through visions. For the Plains Indians, the bear was a wise animal from which medicine men could get power for healing but also a dangerous animal from which warriors could get power for warfare. The shields with bear motifs represented the bear powers of the owners of the shields. The bear shield was made to represent the vision, and the principal interpretation of the symbolism was based on the individual experience of spiritual world and its powers. The study argues that the bear shield as personal medicine object is based on wider tribal traditions, and the basic meaning is derived from the collective tradition. This means that the bear seen in vision represented particular affairs and it was represented on the shield surface using conventional ways of traditional artistry. In consequence of this, the bear shields reflect not only the individual experiences of bear power but whole field of tribal traditions that legitimated the experiences and offered acceptable interpretations and conventional modes for the bear symbols.

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Aims: To examine the characteristics, incidence, treatment and outcome of presumed opioid, γ-hydroxybutyrate (GHB) and γ-butyrolactone (GBL) overdoses involving users of illicit drugs in Helsinki. GHB/GBL were included in this study, despite not being opioids, due to the relative ease with which they can cause potentially fatal respiratory depression. The incidence and time interval of recurrent opioid toxicity after prehospital administration of naloxone, an opioid antagonist, was studied in presumed heroin overdose patients. Naloxone has been reported to have many adverse effects and the effects of naloxone administered during an opioid overdose on the cardiovascular system and catecholamine levels in piglets were studied. Materials and methods: Patients included in these published retrospective studies were from the following time periods: Study I: 1995-2002, II: 1997-2000, III: 1995-2000, V: 2006-2007. Presumed opioid overdose patients were examined in studies I, II and III. GHB/GBL overdoses among injecting drug users was examined in study V. Recurrent opioid toxicity after prehospital naloxone administration in heroin overdose patients was examined in study III. The effects of naloxone (80 μg/kg i.v.) on the cardiovascular system and catecholamine levels administered during morphine overdose (8mg/kg i.v.) and under propofol anesthesia with spontaneous breathing were studied in eight piglets (IV). In this thesis, previously unpublished data on the incidence of opioid overdose between 2001-2007 and comparison of the characteristics of buprenorphine and heroin overdose patients encountered in 1995-2005 are also included. Results: Helsinki Emergency Medical Service (EMS) ambulances were dispatched annually to 34,153- 45,118 calls from 1995 to 2007. Of them, 7-8% were coded as intoxications or overdoses. During this time, 436 patients were treated by the EMS for presumed opioid overdose. The peak incidence of opioid overdoses was in the year 2000 (113 cases), after which they declined to 6-26 cases annually. The annual incidence of buprenorphine related overdoses increased from 4 (4% of opioid overdoses) in the year 2000 to 8 (30% of opioid overdoses) in 2007. The annual number of GHB related overdose patients treated by Helsinki EMS increased from 21 to 73 between 2004-2007. There appeared to be a peak in the incidence of both GHB/GBL and opioid related overdoses on Saturdays. Characteristics of opioid overdose patients The median age of opioid overdose patients was 28 years (22;33, 25- and 75-percentiles), and 84% were male. Buprenorphine overdose patients had more polydrug, such as alcohol and/or benzodiazepines, use in comparison with heroin overdose patients, 70% versus 33%, respectively. Severe respiratory depression was reported less often with buprenorphine overdoses compared to heroin overdoses, in 67.0% versus 85.4%, respectively. Outcome of heroin overdose patients with cardiac arrest Ninety four patients suffered cardiac arrest due to acute drug poisoning/overdose and were thus considered for resuscitation. Resuscitation was attempted in 72 cases. Cardiac arrest was caused by heroin overdose for 19 patients of which three (16%) were discharged alive. Other agents also induced cardiac arrest in 53 patients, of which six (11%) were discharged alive. The arrest was either EMS witnessed or occurring after the emergency call for all survivors of heroin induced cardiac arrest. Characteristics of GHB/GBL overdose patients The records of 100 GHB/GBL related overdose patients from 2006-2007 were retrieved. The median age of GHB/GBL overdose patients encountered on weekend nights was 24 years (22;27, 25- and 75-percentiles) and 49% were male. Polydrug use was reported in 62-80% of the cases. Thirty nine patients were encountered on Friday-Saturday or Saturday-Sunday night between 11 pm-6 am. The remaining sixty one patients were outside this time frame. There was a statistically significant difference between these two groups in history of chronic injecting drug use (33% vs. 59%, respectively, p=0.012). Recurrent heroin toxicity after prehospital naloxone administration Study III included 145 presumed heroin overdose patients. After prehospital care, 84 patients refused further care and were not transported to an Emergency Department (ED). Seventy one (85%) of them were administered naloxone by the EMS. During a 12-h follow up period, none of these patients developed severe recurrent opioid toxicity. The remaining 61 patients were transported to an ED. Prior to transportation, 52 (85%) patients were administered naloxone by the EMS. Fifteen of them were administered naloxone also in the ED and recurrent opioid toxicity was evident either on arrival at the ED or shortly thereafter. Prehospital naloxone was administered either intravenously, intramuscularly (i.m.) or subcutaneously (s.c.). There was a tendency for more frequent recurrent heroin toxicity among the patients with only intravenous administration of prehospital naloxone (13/36) compared with the patients with intramuscular or subcutaneous prehospital naloxone (2/16), p=0.106. The effects of naloxone on the cardiovascular system and catecholamine levels in piglets The administration of morphine to piglets resulted in an obvious respiratory depression, which was reversed by naloxone. Two severely hypoxemic piglets developed cardiac arrest after naloxone administration. In the other six animals, the administration of naloxone did not provoke arrhythmias, cardiac ischemia or visible evidence of pulmonary edema. There was a statistically significant (p=0.012) increase in norepinephrine levels after morphine administration and before naloxone administration: from 1.9 (1.3-2.3) ng/ml at baseline, to 31.7 (8.3-83.0) ng/ml (median, 25 and 75 percentiles parentheses) after morphine administration. After the administration of naloxone, the catecholamine levels continued to increase in only one of the animals. Conclusions: The incidence of buprenorphine related overdoses increased during the study period, but was still lower in comparison to those involving heroin. Injecting drug users have also started to use GHB/GBL. While recreational drug users use GHB/GBL during weekend nights, a GHB/GBL overdose patient encounter during weekdays has a more probable history of injecting drug use. Patients with cardiac arrest after heroin overdose have a poor prognosis. It appears to be safe to leave heroin overdose patients on scene after prehospital treatment with naloxone. Although no statistically significant difference was observed, it seems prudent to administer part of the total naloxone dose s.c. or i.m. to reduce the risk of recurrent respiratory depression. If transported to an ED, an observation period of one to two hours after the last naloxone dose seems adequate. The treating physician must be vigilant, however, due to the high prevalence of polydrug use and high morbidity after non fatal heroin overdose. Furthermore, care should be taken regarding possible chronic disorders and drug rehabilitation should be addressed. In the experimental animal study, two animals developed cardiac arrest after receiving naloxone while in hypoxemia and bradycardia. Further studies are required to assess the effect of naloxone during opioid-induced hypercapnia and hypoxemia in animals addicted to opioids.

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This thesis studies the basic income grant proposal in Namibia. The proposal suggests a monthly grant of N$100 (approximately 10€) to all those Namibian citizens who do not receive the state pension. This thesis concentrates on the Basic Income Grant (BIG) Coalition and on its work. The formation and transformation of the coalition during the time period between 2003 and 2009 is analyzed with the help of data collected during two field work periods in 2008 and 2009. The data includes interviews, newspaper articles, observations and other background material. The analysis of this material is mainly conducted from organizational viewpoint. The final part of the thesis applies the results to the theory of Mosse, whose propositions about policy and practice will be discussed in relation to the basic income grant pilot project. The thesis argues that social legitimacy has been a vital resource for the work of the BIG Coalition and it has sought for it in various ways. The concept of social legitimacy originates from the resource dependence perspective of Pfeffer and Salancik, who propose that organizations are dependent on their environments, and on the resources provided by the surrounding environment. This thesis studies the concept of social legitimacy in the context of resource dependence theory. Social legitimacy is analyzed in the relations between the coalition and its environment, in the formation of the coalition, in the responses towards criticism, and finally in relation to the propositions concerning policy and practice. The work of the coalition in the pilot project will be analyzed through the propositions of Mosse concerning policy and practice. The results will describe and analyze key events in the formation of the BIG Coalition from the South African proposal until the end of the basic income pilot project. This BIG pilot project conducted in 2008-2009 is one of the most well-known activities of the coalition. The clashes between the coalition and its environment will be analyzed through four case studies. It will be shown that the project has been conducted in order to gain more legitimacy to the basic income grant proposal. The conclusion questions the legitimacy of the BIG Coalition as a research and development organization, and requests for more transparent research on the basic income proposal in Namibia.

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Tämän pro gradu- tutkielman tavoitteena oli löytää kuluttajien palvelukokemukseen vaikuttavat tekijät lastenvaatteiden- ja tarvikkeiden -verkkokaupassa. Empiirinen tutkimus lähestyi aihetta netnografian avulla. Aineistoksi tähän tutkielmaan valittiin sosiaalisen median keskustelut. Tutkimuksen teoreettinen osa muodostui kolmesta aiheesta: verkko-ostamisesta ja palvelun laadusta, sosiaalisesta mediasta sekä word-of-mouth-viestinnästä. Verkko-ostamisessa käsiteltiin ostamisen eri vaiheet, kuluttajien motivaatiot verkosta ostamiseen, sekä siihen liittyvät riskit ja tarkasteltiin sähköisen palvelun laatua. Sosiaalinen media-luku kertoi sosiaalisen median käytöstä sekä eri medioista. Word-of-mouth-viestintä esitteli perinteisen word-of-mouth-viestinnän lisäksi sähköisen WOM-viestinnän ulottuvuudet. Empiirinen tutkimus oli laadullinen ja se toteutettiin netnografisesti. Netnografia on etnografiaan perustuva menetelmä, jota käytetään internet-aineistoissa. Aineiston analysoinnissa käytettiin teemoittelua. Aihetta lähestyttiin faktanäkökulmasta, eli tutkimuksessa oltiin kiinnostuneita niistä tosiasioista joita keskustelijat kertoivat. Aineisto kerättiin perhe-aiheisten lehtien keskustelupalstoilta sekä blogeista Google-haun avulla. Sosiaalisen median keskustelut valittiin aineistoksi, koska niistä uskottiin saatavan kaikkein totuudenmukaisinta tietoa, johon tutkijan kysymyksen asettelu ei vaikuta. Spontaanit keskustelut antavat erilaista tietoa kuin suoran kysymyksen vastaukset. Tutkimuksen tuloksena löytyi seitsemän teemaa, joita keskusteluissa käsiteltiin. Nämä ovat toimitus, palvelu, palautus ja normalisointi, ulkoasu ja toimivuus, hinta, maksaminen sekä tuotteet ja valikoima. Sen sijaan teorian pohjalta odotettavissa olleet turvallisuus ja yksityisyys eivät tulleet aineistosta lainkaan esiin. Erityisen huonona palveluna asiakkaat pitivät varastosaldojen paikkansapitämättömyyttä, hitaita toimituksia sekä epäystävällistä palvelua. Hyvää palvelua olivat nopeat toimitukset sekä yksilöllinen palvelu ja reklamaatioiden hyvä hoito.

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In this dissertation I study language complexity from a typological perspective. Since the structuralist era, it has been assumed that local complexity differences in languages are balanced out in cross-linguistic comparisons and that complexity is not affected by the geopolitical or sociocultural aspects of the speech community. However, these assumptions have seldom been studied systematically from a typological point of view. My objective is to define complexity so that it is possible to compare it across languages and to approach its variation with the methods of quantitative typology. My main empirical research questions are: i) does language complexity vary in any systematic way in local domains, and ii) can language complexity be affected by the geographical or social environment? These questions are studied in three articles, whose findings are summarized in the introduction to the dissertation. In order to enable cross-language comparison, I measure complexity as the description length of the regularities in an entity; I separate it from difficulty, focus on local instead of global complexity, and break it up into different types. This approach helps avoid the problems that plagued earlier metrics of language complexity. My approach to grammar is functional-typological in nature, and the theoretical framework is basic linguistic theory. I delimit the empirical research functionally to the marking of core arguments (the basic participants in the sentence). I assess the distributions of complexity in this domain with multifactorial statistical methods and use different sampling strategies, implementing, for instance, the Greenbergian view of universals as diachronic laws of type preference. My data come from large and balanced samples (up to approximately 850 languages), drawn mainly from reference grammars. The results suggest that various significant trends occur in the marking of core arguments in regard to complexity and that complexity in this domain correlates with population size. These results provide evidence that linguistic patterns interact among themselves in terms of complexity, that language structure adapts to the social environment, and that there may be cognitive mechanisms that limit complexity locally. My approach to complexity and language universals can therefore be successfully applied to empirical data and may serve as a model for further research in these areas.

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This study explores labour relations between domestic workers and employers in India. It is based on interviews with both employers and workers, and ethnographically oriented field work in Jaipur, carried out in 2004-2007. Combining development studies with gender studies, labour studies, and childhood studies, it asks how labour relations between domestic workers and employers are formed in Jaipur, and how female domestic workers trajectories are created. Focusing on female part-time maids and live-in work arrangements, the study analyses children s work in the context of overall work force, not in isolation from it. Drawing on feminist Marxism, domestic labour relations are seen as an arena of struggle. The study takes an empirical approach, showing class through empiria and shows how paid domestic work is structured and stratified through intersecting hierarchies of class, caste, gender, age, ethnicity and religion. The importance of class in domestic labour relations is reiterated, but that of caste, so often downplayed by employers, is also emphasized. Domestic workers are crucial to the functioning of middle and upper middle class households, but their function is not just utilitarian. Through them working women and housewives are able to maintain purity and reproduce class disctinctions, both between poor and middle classes and lower and upper middle classes. Despite commodification of work relations, traditional elements of service relationships have been retained, particularly through maternalist practices such as gift giving, creating a peculiar blend of traditional and market practices. Whilst employers of part-time workers purchase services in a segmented market from a range of workers for specific, traditional live-in workers are also hired to serve employers round the clock. Employers and workers grudgingly acknowledged their dependence on one another, employers seeking various strategies to manage fear of servant crime, such as the hiring of children or not employing live-in workers in dual-earning households. Paid domestic work carries a heavy stigma and provide no entry to other jobs. It is transmitted from mothers to daughters and working girls were often the main income providers in their families. The diversity of working conditions is analysed through a continuum of vulnerability, generic live-in workers, particularly children and unmarried young women with no close family in Jaipur, being the most vulnerable and experienced part-time workers the least vulnerable. Whilst terms of employment are negotiated informally and individually, some informal standards regarding salary and days off existed for maids. However, employers maintain that workings conditions are a matter of individual, moral choice. Their reluctance to view their role as that of employers and the workers as their employees is one of the main stumbling blocks in the way of improved working conditions. Key words: paid domestic work, India, children s work, class, caste, gender, life course

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This dissertation is a broad study of factors affecting perceptions of CSR issues in multiple stakeholder realms, the main purpose being to determine the effects of the values of individuals on their perceptions regarding CSR. It examines perceptions of CSR both at the emic (observing individuals and stakeholders) and etic levels (conducting cross-cultural comparison) through a descriptive-empirical research strategy. The dissertation is based on quantitative interview data among Chinese, Finnish and US stakeholder groups of industry companies (with an emphasis on the forest industries) and consists of four published articles and two submitted manuscripts. Theoretically, this dissertation provides a valuable and unique philosophical and intellectual perspective on the contemporary study of CSR `The Harmony Approach to CSR'. Empirically, this dissertation does values assessment and CSR evaluation of a wide variety of business activities covering CSR reporting, business ethics, and three dimensions of CSR performance. From the multi-stakeholder perspective, this dissertation use survey methods to examine the perceptions and stakeholder salience in the context of CSR by describing, comparing the differences between demographic factors as well as hypothetical drivers behind perceptions. The results of study suggest that the CSR objective of a corporation's top management should be to manage the divergent and conflicting interests of multiple stakeholders, taking others than key stakeholders into account as well. The importance of values as a driver of ethical behaviour and decision-making has been generally recognized. This dissertation provides more empirical proof of this theory by highlighting the effects of values on CSR perceptions. It suggests that since the way to encourage responsible behaviour and develop CSR is to develop individual values and cultivate their virtues, it is time to invoke the critical role of moral (ethics) education. The specific studies of China and comparison between Finland and the US contribute to a common understanding of the emerging CSR issues, problems and opportunities for the future of sustainability. The similarities among these countries can enhance international cooperation, while the differences will open up opportunities and diversified solutions for CSR in local conditions.

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Määräaikaisiin työsuhteisiin liittyvä epävarmuus on useiden tutkimusten mukaan yhteydessä stressiin ja vähentää psyykkistä hyvinvointia. Suomessa määräaikaiset työsuhteet ovat hieman yleisempiä kuin EU:ssa keskimäärin. Erityistä Suomen tilanteelle on se, että suomalaiset määräaikaiset palkansaajat ovat varsin koulutettuja eurooppalaisiin vertaisiinsa verrattuna. Yliopistoissa poikkeuksellisen suuri osa tekee työtä määräaikaisessa työsuhteessa. TUULI-kehittämishanke (2008–2011) toteutettiin Kuntoutussäätiön Malminkartanon kuntoutuskeskuksessa (syksystä 2010 Avire-Kuntoutus Oy), ja se oli tarkoitettu Helsingin yliopistossa määräaikaisissa palvelussuhteissa tai apurahalla työskenteleville henkilöille. Hankkeen rahoittivat Kela ja Työsuojelurahasto. Hankkeen arviointi toteutettiin Kuntoutussäätiön tutkimus- ja kehittämisyksikössä, ja arvioinnin rahoitti Kela. Hanke liittyi laajempaan Kelan toteuttamaan työhönkuntoutuksen kehittämishankkeeseen. Kuntoutusmalli TUULIn kohderyhmänä olivat Helsingin yliopiston akateemisesti koulutetut henkilöt, jotka ovat määräaikaisissa ja usein projektiluonteisissa työtehtävissä. Tämän kohderyhmän kuntoutustarvetta ei arvioida systemaattisesti työterveyshuollossa eikä työvoimatoimistossa. Osa kohderyhmään kuuluvista henkilöistä ei ole oikeutettu käyttämään työterveyshuollon palveluja, ja määräaikaisten työsuhteiden vuoksi he eivät myöskään valikoidu varhaiskuntoutukseen. Kuntoutusmalli TUULIn tavoitteena oli löytää kohderyhmälle soveltuvia kuntoutustarpeen arviointikeinoja (hyvinvointianalyysi). Tavoitteena oli myös kehittää kohderyhmälle soveltuva varhaiskuntoutusmuoto, johon määräaikaisissa työsuhteissa olevien on käytännössä mahdollista osallistua. Arvioinnissa keskeistä oli kehittävä arviointi, toisin sanoen tavoitteena oli myös tukea hankkeen toimintaa sen tavoitteiden toteuttamisessa ja kuntoutusmallin kehittämisessä. Arviointitutkimuksen tavoitteena oli tuottaa kokonaisarviointi TUULI-kuntoutusmallista. Hankkeen aluksi koottiin perustiedot sekä varsinaiseen interventioon osallistuvilta että ainoastaan hyvinvointianalyysiin osallistuneilta asiakkailta. Myös hankkeen päättyessä koottiin seurantatiedot molemmilta ryhmiltä. Jokainen kuntoutusryhmä on lisäksi haastateltu viimeisen seitsemän vuorokauden intensiivijaksoon kuuluvan päivän aikana. Arvioinnin aikana tehtiin osallistavaa yhteistyötä erityisesti hankkeen toteuttajien, ohjausryhmän ja rahoittajatahojen kanssa. Hyvinvointianalyysiin ja kuntoutusinterventioon saatiin rekrytoitua tavoiteltu määrä osallistujia. He kokivat määräaikaisuuteen liittyvän epätietoisuuden haittaavan työssä jaksamista. Hieman vajaa kolmasosa koki tämän haittaavan paljon. Selvä enemmistö raportoi työn henkisen kuormituksen ongelmista. Hyvinvointianalyysin ohjelma koostui sydämen sykevariaatioanalyysistä, psykologisista testeistä, lääkärin tutkimuksesta ja palautekeskustelusta. Hyvinvointianalyysi koettiin osallistujien keskuudessa varsin hyödylliseksi toimenpiteeksi. Koettu hyöty näyttäisi olevan samalla tasolla myös yhdeksän kuukautta hyvinvointianalyysin päättymisestä. Hyvinvointianalyysi toimi kuntoutustarpeen arviointivälineenä ja itsenäisenä mini-interventiona. Kuntoutusinterventiossa keskeisiä osa-alueita olivat stressin hallinnan ja rentoutumisen opetteleminen, oman työn kuormitustekijöiden tunnistaminen sekä psyykkisen hyvinvoinnin ja omien voimavarojen vahvistaminen. Myös kuntoutusintervention jälkeen osallistujien kokemukset olivat enimmäkseen positiivisia: he kokivat intervention kohentavan kykyään huolehtia omasta hyvinvoinnistaan sekä vahvistavan psyykkisiä ja sosiaalisia voimavarojaan ja stressin hallintaa. Myös työkyvyn koettiin kohentuneen. Sen sijaan osallistujat eivät kokeneet toiminnan ja työn tehokkuuden taitojen kohenneen. Toteuttajat arvioivat hankkeen saavuttaneen keskeisimmät tavoitteensa. Pätkätyöläisen ammatillisen identiteetin hahmottaminen ja työstäminen koettiin ongelmalliseksi; kehittämishankkeen aikana ei löydetty varteenotettavaa lähestymistapaa aiheeseen. Kuntoutusjärjestelmää tulee kehittää huomioiden työn ja työelämän muutokset. TUULI-hanke oli hyvä avaus tällä saralla, mutta hanke oli suunnattu vain pienelle osalle epätyypillistä työtä tekevien joukkoa. Koska määräaikainen työ on vakiintunut osaksi työmarkkinoita ja pätkistä koostuvaan työuraan liittyy työttömyysjaksoja, tulisi myös työttömyyskaudella olevat saada kuntoutusjärjestelmän piiriin. Arvioinnin kehittämissuositukset huomioiva TUULI-kuntoutusmalli tulisi toteuttaa ainakin kertaalleen Suomen yliopistoissa.

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War children were sent away to shelter without their parents to other Nordic countries, mainly to Sweden. The phenomenon was remarkable. During the Second World War nearly 80,000 children were sent from their homes by trains or boats. These children travelled to foster homes where they were placed with new parents looking after them. After the conclusion of the peace, for some months or sometimes years later, orders were given to send the children back to their families in Finland. Returning back to Finland and to their biological parents and families was not always easy. Deep bonds between the children and their foster families were created and leaving caused grief to those small travellers once again. In some cases, distances were created in the relations between Mothers and their daughters. Many had forgotten their Finnish, and returning to school proved difficult. Some of the war children felt rootlessness, a result of being torn away from their family and culture. The aim of this study is to describe how former war children became mothers by themselves, and later on grandmothers. The study also explores how they describe the meaning of the war and their childhood in their own parenthood and what were their experiences of time in foster homes. Seven former war children and three daughters were interviewed for this study. Interviews were biographical. A narrative approach and thematic reading (by Riessman 2008) has guided the analysis of the texts. According to the results of this study, the importance of having your own home , family and security in childhood relationships is significant. Caring and having responsibility for disadvantaged others was important for former war children. What come from the detailed experiences of the 'war childhood' most of all were the difficulties they found on returning to Finland. Some of them had become very attached to their foster parents. There were varying degrees of language problems among the returnees. Some of the interviewees had completely forgotten their native language. Given that, starting the school at home was difficult. They also remembered continuous travelling.When asked on the outcome of their relationship with their biological mother, most interviewees were happy, with a few experiencing some distance in this relationship. Security and being available to protect their children were important in their own motherhood and grand motherhood. In difficult family situations like divorce, they wanted to give their time and support for helping with grandchildren. Another important aspect in family life is interaction between all its members. Talking things through in families and also in War Child Associations was highly valued. However, talking of war childhood had been silenced in some families. In conclusion, the experiences of former war children should take in consideration when difficult situations between parents and children or children s positions in war zones are resolved. War children also have a lot to give for further educational study.

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The world of mapping has changed. Earlier, only professional experts were responsible for map production, but today ordinary people without any training or experience can become map-makers. The number of online mapping sites, and the number of volunteer mappers has increased significantly. The development of the technology, such as satellite navigation systems, Web 2.0, broadband Internet connections, and smartphones, have had one of the key roles in enabling the rise of volunteered geographic information (VGI). As opening governmental data to public is a current topic in many countries, the opening of high quality geographical data has a central role in this study. The aim of this study is to investigate how is the quality of spatial data produced by volunteers by comparing it with the map data produced by public authorities, to follow what occurs when spatial data are opened for users, and to get acquainted with the user profile of these volunteer mappers. A central part of this study is OpenStreetMap project (OSM), which aim is to create a map of the entire world by volunteers. Anyone can become an OpenStreetMap contributor, and the data created by the volunteers are free to use for anyone without restricting copyrights or license charges. In this study OpenStreetMap is investigated from two viewpoints. In the first part of the study, the aim was to investigate the quality of volunteered geographic information. A pilot project was implemented by following what occurs when a high-resolution aerial imagery is released freely to the OpenStreetMap contributors. The quality of VGI was investigated by comparing the OSM datasets with the map data of The National Land Survey of Finland (NLS). The quality of OpenStreetMap data was investigated by inspecting the positional accuracy and the completeness of the road datasets, as well as the differences in the attribute datasets between the studied datasets. Also the OSM community was under analysis and the development of the map data of OpenStreetMap was investigated by visual analysis. The aim of the second part of the study was to analyse the user profile of OpenStreetMap contributors, and to investigate how the contributors act when collecting data and editing OpenStreetMap. The aim was also to investigate what motivates users to map and how is the quality of volunteered geographic information envisaged. The second part of the study was implemented by conducting a web inquiry to the OpenStreetMap contributors. The results of the study show that the quality of OpenStreetMap data compared with the data of National Land Survey of Finland can be defined as good. OpenStreetMap differs from the map of National Land Survey especially because of the amount of uncertainty, for example because of the completeness and uniformity of the map are not known. The results of the study reveal that opening spatial data increased notably the amount of the data in the study area, and both the positional accuracy and completeness improved significantly. The study confirms the earlier arguments that only few contributors have created the majority of the data in OpenStreetMap. The inquiry made for the OpenStreetMap users revealed that the data are most often collected by foot or by bicycle using GPS device, or by editing the map with the help of aerial imageries. According to the responses, the users take part to the OpenStreetMap project because they want to make maps better, and want to produce maps, which have information that is up-to-date and cannot be found from any other maps. Almost all of the users exploit the maps by themselves, most popular methods being downloading the map into a navigator or into a mobile device. The users regard the quality of OpenStreetMap as good, especially because of the up-to-dateness and the accuracy of the map.

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Parkinson´s disease (PD) is a debilitating age-related neurological disorder that affects various motor skills and can lead to a loss of cognitive functions. The motor symptoms are the result of the progressive degeneration of dopaminergic neurons within the substantia nigra. The factors that influence the pathogenesis and the progression of the neurodegeneration remain mostly unclear. This study investigated the role of various programmed cell death (PCD) pathways, oxidative stress, and glial cells both in dopaminergic neurodegeneration and in the protective action of various drugs. To this end, we exposed dopaminergic neuroblastoma cells (SH-SY5Y cells) to 6-OHDA, which produces oxidative stress and activates various PCD modalities that result in neuronal degeneration. Additionally, to explore the role of glia, we prepared rat midbrain primary mixed-cell cultures containing both neurons and glial cell types such as microglia and astroglia and then exposed the cultures to either MPP plus or lipopolysaccharide. Our results revealed that 6-OHDA activated several PCD pathways including apoptosis, autophagic stress, lysosomal membrane permeabilization, and perhaps paraptosis in SH-SY5Y cells. Furthermore, we found that minocycline protected SH-SY5Y cells from 6-OHDA by inhibiting both apoptotic and non-apoptotic PCD modalities. We also observed an inconsistent neuroprotective effect of various dietary anti-oxidant compounds against 6-OHDA toxicity in vitro in SH-SY5Y cells. Specifically, quercetin and curcumin exerted neuroprotection only within a narrow concentration range and a limited time frame, whereas resveratrol and epigallocatechin 3-gallate provided no protection whatsoever. Lastly, we found that molecules such as amantadine may delay or even halt the neurodegeneration in primary cell cultures by inhibiting the release of neurotoxic factors from overactivated microglia and by enhancing the pro-survival actions of astroglia. Together these data suggest that the strategy of dampening oxidative species with anti-oxidants is less effective than preventing the production of toxic factors such as oxidative and pro-inflammatory molecules by pathologically activated microglia. This would subsequently prevent the activation of various PCD modalities that cause neuronal degeneration.

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The p53-family consists of three transcription factors, p53, p73 and p63. The family members have similar but also individual functions connected to cell cycle regulation, development and tumorigenesis. p53 and p73 act mainly as tumor suppressors. During DNA damage caused by anticancer drugs or irradiation, p53 and p73 levels are upregulated in cancer cells leading to apoptosis and cell cycle arrest. p53 is mutated in almost 50 per cent of the cancers, causing the cancer cells unable to undergo cell death. Instead, p73 is rarely mutated in cancer cells and because of that could be more viable target for anticancer therapy. The network surrounding the regulation of p73 is extensive and has several potential targets for cancer therapy. One of the most studied is Itch ligase, the negative regulator of p73 levels. Gene therapy directed towards knockdown of Itch ligase is a potential approach but in need for more in vivo proof. p73 has two isoforms, transactivating TA-forms and dominant-negative ΔN-forms. The specific regulation of these isoforms could also offer a possible way for more effective cancer treatment. The literature work includes information of structures, isoforms, functions and possible therapeutic targets of p73. Also the main therapeutic approaches to date are introduced. The experimental part is based on transfection and cytotoxicity studies done e.g. in pancreatic cancer cells (Mia PaCa-2, PANC1, BxPc-3 and HPAC). The aim of the experimental work was to optimize the conditions for effective transfection with DAB16 dendrimer nanoparticles and to measure the cytotoxicity of plain dendrimers and DAB16-pDNA complexes. Also the protein levels of p73 and Itch ligase were measured by Western blotting. The work was done as a part of a bigger project, which was aiming to down regulate Itch ligase (negative regulator of p73) by siRNA/shRNA. Tranfection results were promising, showing good transfection efficacy with DAB16 N/P30 in pancreatic cancer cells (except in BxPc-3). Pancreatic cancer cells showed recovery in 3 days after they were exposed to plain dendrimer solution or to DAB16-pDNA. Measurement of protein levels by Western blotting was not optimal and the proposals for the improvement regarding e.g. the gels and the extracted protein amounts have been done.

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Tutkimuksessa tarkastellaan perhevapaista Suomessa käytyä poliittista keskustelua ja sen pitkän aikavälin muutosta. Tutkimuksessa syvennytään 1970-luvun uudistusaaltoon, jolloin isät otettiin mukaan järjestelmään, sekä 2000-lukuun, jolloin isiä on eri keinoin kannustettu vapaiden käyttöön. Tässä yhteydessä selvitetään itse uudistusprosesseja, mutta keskei-nen tutkimuskohde ovat päätöksentekoon osallistuneiden toimijoiden perhevapaita koske-vien näkemysten argumentointitavat. Tutkimuksen aineisto koostuu mm. valtiopäiväasia-kirjoista, työryhmämuistioista, hallitusten ja puolueiden ohjelmista ja työmarkkinajärjestöjen kannanotoista. Aineistoa lähestytään kehysanalyysin sekä argumentaatioteorian menetel-mien avulla. Näillä kiinnitetään huomio niihin tekniikoihin, joilla poliittisessa argumentoin-nissa on pyritty saamaan esitetyille toimenpiteille mahdollisimman laaja kannatus. 1970-luvulla keskustelu vanhempainlomista oli hyvin polarisoitunutta. Isien hoivaajaroolin kas-vattaminen oli osa vasemmiston diskurssia, joka pyrki tasa-arvoon niin kodeissa kuin työ-markkinoillakin. Konservatiivien äidinhoivan diskurssi sitä vastoin piti äitiä luonnostaan pa-rempana hoitajana lapselle ja vaati pitkän äitiysloman jatkeeksi kotihoidon tukea, jota va-semmisto puolestaan vastusti. 2000-luvun pääteemoja ovat olleet vanhemmuuden kus-tannusten tasaisempi jakaminen sekä isien kannustaminen vapaiden käyttöön. Isien kan-nustamiseksi on esitetty erilaisia malleja isäkiintiöistä: perusteina ovat olleet muun muassa isä–lapsi-suhde, tasa-arvo sekä Pohjoismaiden positiiviset kokemukset kiintiöistä. Työnan-tajat ja konservatiivit ovat kuitenkin pitäneet kiintiöitä vanhempien valinnanvapauden rajoit-tamisena, vaikka ne muuten ovatkin argumentoineet tasaarvon ja isien kannustamisen puolesta. Isäkiintiöiden kannattajat taas eivät enää 2000-luvulla ole kyseenalaistaneet ko-tihoidon tukea, joka on pidentänyt naisten katkoja työelämästä ja jolla on suuri merkitys lasten hoidon epätasaiselle jakautumiselle.

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The present cross-sectional study examined the effect of smoking on oral health in a birth cohort of 15 to 16-year-old Finnish adolescents. The hypothesis was that oral health parameters were poorer among smoking than non-smoking subjects and that a tobacco intervention program could be effective among the adolescents. The study was conducted in the Kotka Health Center, Kotka, Finland. Altogether 501 out of 545 subjects (15- to 16-year-old boys [n = 258] and girls [n = 243]) were clinically examined in 2004 and 2005. The sample frame was a birth cohort of all subjects in 1989 and 1990, living in Kotka. A structured questionnaire was also filled in by the participants to record their general health and health habits, such as smoking, tooth brushing, and medication used. The participants were classified into nonsmokers, current smokers, and former smokers. Subgingival pooled plaque samples were taken and stimulated salivary samples were also collected. The subjects were asked from which of seven professional groups (doctors, school nurses, dental nurses, general nurses, dentists, teachers and media professionals) they would prefer to receive information about tobacco. The two most popular groups they picked up were dentists and school nurses. Current smokers (n=127) were then randomly assigned into three groups: the dentist group (n =44), the school-nurse group (n =42), and the control group (n =39). The intervention was based on a national recommendation of evidence based guidelines by The Finnish Medical Society Duodecim ( 5A counseling system). Two months after the intervention, a second questionnaire was sent to the smokers in the intervention groups. Smoking cessation, smoking quantity per week, and self-rated addiction for smoking (SRA) were recorded. The results were analyzed using the R-statistical program. The results showed that 15% of the subjects had periodontitis. Smokers (25%) had more periodontitis than non-smokers (66%) (p < 0.001). Smoking boys (24%) also had more caries lesions than non-smokers (69%) (p < 0.001), and they brushed their teeth less frequently than non-smokers. Smoking significantly impaired periodontal health of the subjects, even when the confounding effects of plaque and tooth brushing were adjusted. Smoking pack-years, intensified the effects of smoking. Periodontal bacteria Prevotella nigrescens, Prevotella intermedia, Tannerella forsythia and Treponema denticola were more frequently detected among the smokers than non-smokers, especially among smoking girls. Smoking significantly decreased the values of both the salivary periodontal biomarkers MMP-8 (p=0.04) and PMN elastase (p=0.02) in boys. The effect was strengthened by pack years of smoking (MMP-8 p=0.04; elastase p0.01). Of those who participated in the intervention, 19 % quit smoking. The key factors associated with smoking cessation were best friend`s influence, nicotine dependence and diurnal type. When the best friend was not a smoker, the risk ratio (RR) of quit smoking after the intervention was 7.0 (Cl 95% 4.6 10.7). Of the diurnal types, the morning people seemed to be more likely to quit (RR 2.2 [Cl 95% 1.4 3.6]). Nicotine dependence also elicited an opposite effect: those who scored between 3 and 5 dependence scores were less likely to quit. In conclusion, smoking appears to be a major etiological risk factor for oral health. However, the early signs of periodontal disease were mild in the subjects studied. Based on the opinions of the adolescent s, dental professionals may have a key position in their smoking cessation. The harmful effects of smoking on oral health could be used in counselling. Best friend`s influence, nicotine dependence and diurnal type, all factors associated with smoking cessation, should be taken more carefully into account in the prevention programs for adolescents.