Rintamamiesten muonitus Suomessa sotavuosina 1939-1945

This study analyzes the war-time rations the Finnish soldiers received on the front from 1939 until 1945. The main objective was to determine the contents of the rations and how they affected the soldiers' nutrition and morale. The information concerning food and feeding is mainly based on the official documents found in the Military Archives. Some additional material was from the historical literature, some from memoirs, or from the veterans who personally experienced the front. The documents in the Archives of Military Medicine provided information on the soldiers' deficiencies. During the Winter War, which took place from 30 November 1939 until 13 March 1940, ample food was available. The cold climate caused problems and the fresh food got frozen. However, no severe deficiency cases were reported and the morale was high. By contrast, during the Continuation War, which began in June, 1941 and ended in September, 1944, difficulties were experienced. At the time farming in the country faced serious problems due to the shortage of labour, fuel, etc. Furthermore, importing food was generally not possible. However, importing food mainly from Germany saved the Finns from hunger. In addition, the self activity of the soldiers on the front added somewhat to the food production. But the rations had to be reduced. Their energy values were consequently low, especially for the young men. Food was monotonous and occasionally caused complaints. The main sources of protein, vitamins and minerals were the whole cereal foods. Butter was fortified with vitamin A and vitamin C tablets were also distributed, to compensate for the scant food sources. Only approximately 300 serious deficiency cases required hospital care during the three years time, out of a total of 400 000 soldiers. Feeding the young soldiers during the war (1944 - 1945) in Lapland, which had been destroyed, was problematic but the increased rations also saved them from deficiencies. In spite of the severe difficulties experienced occasionally in feeding the soldiers during the wars, the system worked all the time. The soldiers were fed, the cases of nutritional deficiency and epidemics caused by food were kept very limited and the morale of soldiers remained high.

Ravinnon hiilihydraattien glykemiaindeksin vaikutus keskiglukoosipitoisuuteen ja glukoosikäyrän alaiseen pinta-alaan henkilöillä, joilla on heikentynyt glukoosinsieto

Johdanto Korkeat aterianjälkeiset veren glukoosipitoisuushuiput ovat haitallisia verisuonille jo ennen varsinaisten diabeteskriteerien täyttymistä. Valitsemalla alhaisen glykemiaindeksin (GI) hiilihydraatteja ruokavalioon, voidaan veren glukoosipitoisuutta alentaa diabeetikoilla. Tyypin 2 diabeteksen lisääntymisen takia on tarpeellista etsiä keinoja ehkäistä sairauden puhkeamista riskiryhmissä. Glukoosimonitorilla on mahdollista seurata aiempaa tarkemmin glykemiaindeksin vaikutusta veren glukoosipitoisuuteen. Tavoitteet Selvittää, miten korvaamalla ruokavalion tavanomaiset hiilihydraatit joko korkean tai alhaisen GI:n hiilihydraateilla voidaan vaikuttaa vuorokauden keskiglukoosipitoisuuteen. Lisäksi tavoitteena oli selvittää, voidaanko vain hiilihydraattien laatua muuttamalla, puuttumatta niiden määrään tai muuhun ruokavalioon, vaikuttaa glukoosiaineenvaihduntaan henkilöillä, joilla on heikentynyt glukoosin sieto. Tutkittavat ja menetelmät Tutkimus toteutettiin satunnaistettuna vaihtovuorokokeena, jossa tutkittavina oli 56 51-73-vuotiasta henkilöä, joista naisia oli 41 ja miehiä 15. Tutkittavilla oli heikentynyt glukoosinsieto tai ruokavaliohoitoinen tyypin 2 diabetes. Tutkittavat korvasivat ruokavalionsa päähiilihydraatit 7-10 vuorokauden ajaksi glykemiaindeksiltään joko alhaiseksi (GI = 38) tai korkeaksi (GI = 72) arvioiduilla tutkimushiilihydraateilla. Kolmen viimeisen vuorokauden ajaksi tutkittaville asennettiin glukoosimonitoriin kytketty ihonalainen sensori, joka mittasi kudosnesteen glukoosipitoisuutta ja tutkimusjaksojen lopuksi tutkittaville tehtiin oraalinen glukoosirasituskoe. Tulokset Alhaisen GI:n ruokavaliolla kahden vuorokauden glukoosikäyrien alainen pinta-ala oli pienempi kuin korkean GI:n ruokavaliolla (16487 vs. 17270 mmol/l*48h; p = 0,009, n = 47). Vastaavasti kahden vuorokauden keskiglukoosipitoisuudet olivat 5,7 mmol/l ja 6,0 mmol/l, p = 0,009, n = 47. Glykosyloitunut hemoglobiini oli alhaisen GI:n ruokavalion jälkeen pienempi (5,33% vs. 5,38 %, p = 0,017, n = 53). Tutkittavien paino pieneni kummallakin ruokavaliolla; alhaisen GI:n ruokavaliolla 1,02 kg ja korkean GI:n ruokavaliolla 0,31 kg (p alle 0,001, n = 56). Vaikutusta plasman paastoglukoosiin ja seerumin paastoinsuliiniin ei ollut. Johtopäätökset Korvaamalla ruokavalion päähiilihydraatit alhaisen GI:n hiilihydraateilla, voidaan pitkäaikaista glukoositasoa pienentää ja näin ollen mahdollisesti ehkäistä heikentyneen glukoosinsiedon kehittymistä tyypin 2 diabetekseksi. Koska paastoglukoosipitoisuus ja paastoinsuliinipitoisuus eivät muuttuneet, lienee erityisesti aterianjälkeisillä glukoosihuipuilla merkitystä elimistön pitkäaikaiselle glukoositasolle henkilöillä, joilla on heikentynyt glukoosinsieto.

Moderneja ryijyjä, metritavaraa ja käsityötä : Tekstiilitaide ja nykyaikaistuva taideteollisuus Suomessa maailmansotien välisenä aikana

Modern ryijys, fabric by the yard and handicrafts. Finnish textile art and modernizing applied art during the inter-war years Textile art was in the 1920s and 1930s in the front rank of Finnish applied art and design. Modern ryijys, tapestries and fabrics by the yard by contemporary textile artists were on show in Finland and abroad. Textile art had also become interesting commercially, especially in interior textiles of modern homes. The research uses sources of the Ornamo Association of Decorative Artists, for example the Ornamo year books published from 1927, the Finnish Society of Crafts and Design and the country s only school of applied arts, the Central School of Arts and Crafts and the Museum of Applied Arts maintained by the society and also the national specialist organisation the Friends of Finnish Handicraft. It also refers to the magazines Käsiteollisuus and Kotiliesi. The art historical dissertation studies the renaissance of weaving art of the inter-war years in Finland. It problematizes the relation of the succesfull and appreciated textile art to the concept of breakthrough of Modernism (Functionalism). With the material from textile artists activities it questions the prevailing idea of slow modernization of Finnish applied art and design and challenges the polarization of craft and industry in the discourses of Modernisms of design. The public discussions about modernization of design and applied art where textile art and especially the ryijy got sometimes into difficult positions are interpreted as power struggles. After taking independence in 1917 the Finnish tradition of ryijy rugs was set as a symbol of the original culture of the young nation. The research studies the development of the so called art ryijy and the notions and meanings of hand weaving in the national context and also in relation to contemporary events in international applied art and design. It highlights the continuity of hand crafted production of textiles and the strong position of textile artists working in this field. The research opens new perspectives to Finnish textile artists by showing their activities as entrepreneurs in their own weaving studios or design studios and referring to their many relations and functions as pattern designers and educators in the growing handicraft industries.

Kesken jäänyt vallankumous : Sosiaalinen mobilisaatio Helsingissä vuoden 1905 suurlakosta Viaporin kapinaan 1906

Tutkielmassani käsittelen vuoden 1905 suurlakon ja Viaporin kapinan välistä aikaa vallankumouksellisena prosessina Helsingissä. Miten vallankumouksellisuus ilmeni suurlakon aikana ja sen jälkeen Helsingissä? Miten tavalliset työläiset reagoivat tapahtumiin? Metodisina apuvälineinä minulla on ensinnäkin Charles Tillyn määritelmä vallankumoukselliselle tapahtumalle. Keskeistä tälle määritelmälle on, että vallankumouksellista tapahtumaa pitää tutkia sen lähtökohdista käsin eikä lopputuloksen kautta. Vallankumouksellinen tilanne syntyy, kun olemassa oleva hallitus saa kilpailijan ja vastaavasti se on ohi, kun jompikumpi jää jäljelle. Toiseksi apunani ovat olleet sosiaalihistorialliset tutkimukset Venäjän vallankumouksesta, joissa aihetta käsitellään ruohonjuuritason näkökulmasta. Tällöin polttopisteessä ovat lakot ja niiden aikana esitetyt vaatimukset. Oleellista näistä tutkimuksissa on, ettei työläisiä nähdä tahdottomana massana, joka sokeasti tottelee poliittisten johtajien käskyjä. Työläisillä oli omia, lähinnä ammatillisia vaatimuksia, jotka ilmensivät toisaalta huolta jokapäiväisestä toimeentulosta ja toisaalta ne heijastivat demokraattisten vaatimusten ulottamista laajemmalle kuin pelkästään valtiolliselle tasolle eli myös työpaikoille. Suurlakon aikana Helsingin työläiset johtivat käytännössä kaupungin julkista elämää. Vallan keskuksena toimi kansallislakon keskuskomitea. Näkyvintä valtaa käytti kansalliskaarti. Kaarti toimi vahvana poliisivoimana koko lakon ajan. Se pyrki kontrolloimaan liikennettä ja kauppaa sekä sensuroimaan muiden tahojen tiedonvälitystä. Raittiusväellä oli myös oma kaartin osasto, jonka avulla kaupunkiin säädettiin kieltolaki sekä kiellettiin prostituutio. Keskeinen elementti lakon onnistumisen kannalta oli niinikään avustustoiminnan järjestäminen lakon vuoksi hätään joutuneille. Näin turvattiin, ettei lakkorintamassa sattuisi ennenaikaisia repeämiä. Suurlakon jälkeen työväestö aktivoitui ennennäkemättömällä tavalla. Lakkojen lukumäärä ja niihin osallistuneiden työläisten määrä moninkertaistui. SDP:n virallinen tavoite eli poliittinen kansalaisuus ei riittänyt työläisjoukoille, vaan lakoilla pyrittiin saamaan aikaiseksi demokraattinen yhteiskunta laajemminkin. Lyhytikäisiksi jääneet työehtosopimukset eivät tilannetta korjanneet. Demokratia saatiin poliittisella tsolla, mutta ruohonjuurinäkökulmasta uudistukset jäivät kesken ja tyytymättömyys säilyi. Tässä mielessä työväenliike ei integroitunut yhteiskuntaan. Suomessa vallankumouksellinen toivo asetettiin Venäjän vallankumoustapahtumien etenemiseen. Suomalaisen radikalismin päätepisteenä voi pitää epäonnistunuttta Viaporin kapinaa, johon osallistui myös suomalaisia punakaartilaisia. Punakaartilaiset olivat suurelta osin nuoria, muualta Helsinkiin muuttaneita ja vähän järjestökokemusta omaavia henkilöitä. Nuoruus, juurettomuus ja liittyminen työväentyöväenpuolueeseen tai sen järjestöihin vasta perustamisvaiheen 1899-1903 jälkeen olivatkin leimallisia piirteitä radikaalien aineksien keskuudessa. Tutkielmassani osoitan, että ruohonjuuritason tutkimuksella voidaan kuvaa vuosisadan alun työläisistä, heidän toiveistaan ja haluistaan täsmentää. Vuosien 1905 ja 1906 poliittisessa murroksessa oli myös ammatillisilla seikoilla tärkeä sija työväestön pyrkimyksissä. Ne osoittavat omalta osaltaan työläisten vallankumouksellisia ja radikaaleja vaatimuksia. Punakaartilaisradikalismi oli läheistä sukua tälle toiminnalle. Avainsanat: Sosiaalihistoria, vallankumous, työväenliike, suurlakko 1905, Viaporin kapina.

Psychological consequences of cancer from the salutogenic and dyadic perspective

Previous empirical research has shown that positive, i.e. salutogenic, psychological resources and social support, have health-promoting effects in stressful life situations. In the present study the associations between sense of coherence (SOC), dispositional optimism, partner support, psychological distress, and quality of life among cancer patients and their partners were examined. The data was collected from Helsinki University Central Hospital in 1997 2000 by self-report questionnaires approximately 2, 8, and 14 months post diagnosis. Participants in studies I-IV were 155, 123, 153, and 147 cancer patients and their partners, respectively. The sample of the present study consisted of physically relatively well-functioning patients, whose overall psychological wellbeing was generally good as compared to the healthy population. Partners in this study, however, reacted more strongly to their partners illness and treatment. The partners displayed e.g. higher levels of anxiety and depression than the patients. The results of this study indicated that cancer patients and their partners with strong SOC and who are optimistic report fewer symptoms of distress. Moreover, patients who display an optimistic attitude to life, who receive support from their partner, and who control how they express anger have a better quality of life. The findings also confirmed that the role of the partner is significant in coping with cancer. The symptoms of depression and anxiety in patients and partners were associated, and the partner s optimism seemed to protect also the patient from elevated levels of anxiety. The role of the partner was also highlighted in the couples anger-expression styles. The patients and partners tendency to inhibit anger was associated with decreased partner support and worse patient quality of life. Finally, in the present study we found substantial gender differences. For the patients, partner support was more significant for the women than for the men. Furthermore, for the female patients, the husband s tendency to openly express anger (anger-out) had a negative impact on their psychological quality of life, whereas the wives high anger-out seemed to predict good psychological quality of life in the men. Also, in this study the female partners reported higher levels of anxiety and depression as compared to the male partners. The results of the present study extend the previous literature on positive psychological resources and psychological wellbeing among cancer couples. Furthermore, these findings support the theory on SOC and optimism as health-promoting factors. However, the construct of SOC seems to include other important elements besides optimism. The findings of this study are applicable in designing new rehabilitation programmes for cancer patients and their partners.

Oral Actinomyces Species in Health and Disease: Identification, Occurence and Importance of Early Colonization

The genus Actinomyces consists of a heterogeneous group of gram-positive, mainly facultatively anaerobic or microaerobic rods showing various degrees of branching. In the oral cavity, streptococci and Actinomyces form a fundamental component of the indigenous microbiota, being among initial colonizers in polymicrobial biofilms. The significance of the genus Actinomyces is based on the capability of species to adhere to surfaces such as on teeth and to co-aggregate with other bacteria. Identification of Actinomyces species has mainly been based on only a few biochemical characteristics, such as pigmentation and catalase production, or on the use of a single commercial kit. The limited identification of oral Actinomyces isolates to species level has hampered knowledge of their role both in health and disease. In recent years, Actinomyces and related organisms have attracted the attention of clinical microbiologists because of a growing awareness of their presence in clinical specimens and their association with disease. This series of studies aimed to amplify the identification methods for Actinomyces species. With the newly developed identification scheme, the age-related occurrence of Actinomyces in healthy mouths of infants and their distribution in failed dental implants was investigated. Adhesion of Actinomyces species to titanium surfaces processed in various ways was studied in vitro. The results of phenotypic identification methods indicated a relatively low applicability of commercially available test kits for reliable identification within the genus Actinomyces. However, in the study of conventional phenotypic methods, it was possible to develop an identification scheme that resulted in accurate differentiation of Actinomyces and closely related species, using various different test methods. Genotypic methods based on 16S rRNA sequence analysis of Actinomyces proved to be a useful method for genus level identification and further clarified the species level identification with phenotypic methods. The results of the study of infants showed that the isolation frequency of salivary Actinomyces species increased according to age: thirty-one percent of the infants at 2 months but 97% at 2 years of age were positive for Actinomyces. A. odontolyticus was the most prominent Actinomyces colonizer during the study period followed in frequency by A. naeslundii and A. viscosus. In the study of explanted dental implants, Actinomyces was the most prevalent bacterial genus, colonizing 94% of the fixtures. Also in the implants A. odontolyticus was revealed as the most common Actinomyces species. It was present in 84% of Actinomyces -positive fixtures followed in frequency by A. naeslundii, A. viscosus and A. israelii. In an in vitro study of titanium surfaces, different Actinomyces species showed variation regarding their adhesion to titanium. Surface roughness as well as albumin coating of titanium had significant effects on adhesion. The use of improved phenotypic and molecular diagnostic methods increased the accuracy of the identification of the Actinomyces to species level. This facilitated an investigation of their occurrence and distribution in oral specimens in both health and disease.

Pain among employees : risk factors and consequences

The overall objective of this study was to gain epidemiological knowledge about pain among employee populations. More specifically, the aims were to assess the prevalence of pain, to identify socio-economic risk groups and work-related psychosocial risk factors, and to assess the consequences in terms of health-related functioning and sickness absence. The study was carried out among the municipal employees of the City of Helsinki. Data comprised questionnaire survey conducted in years 2000-2002 and register data on sickness absence. Altogether 8960 40-60 year old employees participated to the survey (response rate 67%). Pain is common among ageing employees. Approximately 29 per cent of employees reported chronic pain and 15 per cent acute pain, and about seven per cent reported moderately or severely limiting disabling chronic pain. Pain was more common among those with lower level of education or in a low occupational class. -- Psychosocial work environment was associated with pain reports. Job strain, bullying at workplace, and problems in combining work and home duties were associated with pain among women. Among men combining work and home duties was not associated with pain, whereas organizational injustice showed associations. Pain affects functional capacity and predicts sickness absence. Those with pain reported lower level of both mental and physical functioning than those with no pain, physical functioning being more strongly affected than mental. Bodily location of pain or whether pain was acute or chronic had only minor impact on the variation in functioning, whereas the simple count of painful locations was associated with widest variation. Pain accounted for eight per cent of short term (1-3 day) sickness absence spells among men and 13 per cent among women. Of absence spells lasting between four and 14 days pain accounted for 23 per cent among women and 25 per cent among men, corresponding figures for over 14 day absence spells being 37 and 30 per cent. The association between pain and sickness absence was relatively independent of physical and psychosocial work factors, especially among women. The results of this study provide a picture of the epidemiology of pain among employees. Pain is a significant problem that seriously affects work ability. Information on risk groups can be utilized to make prevention measures more effective among those at high risk, and to decrease pain rates and thereby narrow the differences between socio-economic groups. Furthermore, the work-related psychosocial risk factors identified in this study are potentially modifiable, and it should be possible to target interventions on decreasing pain rates among employees.

Terveyteen liittyvä elämänlaatu laitoskuntoutuksen vaikuttavuuden arvioinnissa : RAND-36-mittarin soveltuvuus työikäisten laitoskuntoutuksen ongelmaprofiilin määrittämiseen ja kuntoutuksen vaikutusten arvioimiseen

The aim of the present research was to examine the validity of the RAND-36 measure of health-related quality of life among the working age rehabilitation clients. The research included two cross-sectional studies and one follow-up study. The subjects of the first study (n = 794) participated in the first period of the five following types of rehabilitation: occupationally oriented medical rehabilitation, musculoskeletal rehabilitation, medical rehabilitation for job burnout, rehabilitation for supporting the work ability and capacity of disabled subjects (vocational rehabilitation) and individualized rehabilitation between October 2000 and October 2001. The subjects of the second study (n = 990) participated in the same rehabilitation during their first rehabilitation period between May 2007 and May 2008. The first subjects participated in a follow-up period no later than May 2003 with the exception of the individual rehabilitation clients (n = 588). Based on the ICF classification, the RAND-36 provides a diverse measure of the health-related quality of life and of the capacity for subjective, perceived physical and psycho-social functioning. The construct properties of the RAND-36 measure proved to be very consistent on the basis of both the cluster and confirmatory factor analyses. At the group level, the RAND-36 measure was shown to be illustrative and sensitive in differentiating the clients’ rehabilitation needs. The results of cluster analyses with the two cross-sectional data indicated a consistent five-cluster solution of rehabilitation groups on the basis of the eight subscales of health-related quality of life. Each of these clusters represented a clear difference in their need for rehabilitation. The RAND-36 measure proved to be sensitive to change. The changes observed in the pre- and post-conditions in relation to all the subscales of quality of life were statistically significant. Depending on the rehabilitation type, different changes in the subscales of the measure were observed, and these changes corresponded to the different emphasis and goals of the specific type of rehabilitation intervention. Similarly, changes in the subscales of the measure were observed in relation to the RAND groups formed by cluster analysis, which were logical and corresponded to the problem profiles of these groups. The confirmatory factor analysis indicated a two-factor solution: an index of the capacity for physical functioning (self-rated general health, bodily pain, physical functioning, physical role functioning) and an index of the capacity for psycho-social functioning (psychological well-being, social functioning, psychological role functioning and energy). These two indices describing functional capacity proved also to be sensitive to change. This two-factor solution seems to be usable for group level analyses when assessing the effects of rehabilitation. The moderately strong correlation between the RAND-36 and work ability index suggests that they partly measure the same phenomenon: perceived health-related quality of life, subjective capacity for activity and perceived work ability have strong links. As expected, the capacity for physical functioning had a stronger correlation with work ability index than with the capacity for psycho-social functioning. According to the present research, the RAND-36 measure can be considered as a screening method for rehabilitation orientation in relation to rehabilitation needs and as a follow-up measure for the health-related quality of life among the working age clients. The RAND-36 measure is also shown to be a useful instrument in estimating the benefits of rehabilitation as well as in effectiveness research.

Genetics of Cardiovascular Disease: A Candidate Gene Study of USF1

Cardiovascular diseases (CVD) are major contributors to morbidity and mortality worldwide. Several interacting environmental, biochemical, and genetic risk factors can increase disease susceptibility. While some of the genes involved in the etiology of CVD are known, many are yet to be discovered. During the last few decades, scientists have searched for these genes with genome-wide linkage and association methods, and with more targeted candidate gene studies. This thesis investigates variation within the upstream transcription factor 1 (USF1) gene locus in relation to CVD risk factors, atherosclerosis, and incidence and prevalence of CVD. This candidate gene was first identified in Finnish families ascertained for familial combined hyperlipidemia, a common dyslipidemia predisposing to coronary heart disease. The gene is a ubiquitously expressed transcription factor regulating expression of several genes from lipid and glucose metabolism, inflammation, and endothelial function. First, we examined association between USF1 variants and several CVD risk factors, such as lipid phenotypes, body composition measures, and metabolic syndrome, in two prospective population cohorts. Our data suggested that USF1 contributes to these CVD risk factors at the population level. Notably, the associations with quantitative measurements were mostly detected among study subjects with CVD or metabolic syndrome, suggesting complex interactions between USF1 effects and the pathophysiological state of an individual. Second, we investigated how variation at the USF1 locus contributes to atherosclerotic lesions of the coronary arteries and abdominal aorta. For this, we used two study samples of middle-aged men with detailed measurements of atherosclerosis obtained in autopsy. USF1 variation significantly associated with areas of several types of lesions, especially with calcification of the arteries. Next, we tested what effect the USF1 risk variants have on sudden cardiac death and incidence of CVD. The atherosclerosis-associated risk variant increased the risk of sudden cardiac death of the same study subjects. Furthermore, USF1 alleles associated with incidence of CVD in the Finnish population follow-up cohorts. These associations were especially prominent among women, suggesting a sex specific effect, which has also been detected in subsequent studies. Finally, as some of the low-yield DNA samples of the Finnish follow-up study cohort needed to be whole-genome amplified (WGA) prior to genotyping, we evaluated whether the produced WGA genotypes were of good quality. Although the samples giving genotype discrepancies could not be detected before genotyping with standard laboratory quality control methods, our results suggested that enhanced quality control at the time of the genotyping could identify such samples. In addition, combining two WGA reactions into one pooled DNA sample for genotyping markedly reduced the number of discrepancies and samples showing them. In conclusion, USF1 seems to have a role in the etiology of CVD. Additional studies are warranted to identify functional variants and to study interactions between USF1 and other genetic or environmental factors. This USF1 study, and other studies with low DNA yield of some samples, can benefit from whole genome amplification of the low-yield samples prior to genotyping. Careful quality control procedures are, however, needed in WGA genotyping.

Nutrition and Nutritional Care of Elderly People in Finnish Nursing Homes and Hospitals

Background: Malnutrition is a common problem for residents of nursing homes and long-term care hospitals. It has a negative influence on elderly residents and patients health and quality of life. Nutritional care seems to have a positive effect on elderly individuals nutritional status and well-being. Studies of Finnish elderly people s nutrition and nutritional care in institutions are scarce. Objectives: The primary aim was to investigate the nutritional status and its associated factors of elderly nursing home residents and long-term care patients in Finland. In particular, to find out, if the nursing or nutritional care factors are associated with the nutritional status, and how do carers and nurses recognize malnutrition. A further aim was to assess the energy and nutrient intake of the residents of dementia wards. A final objective was to find out, if the nutrition training of professionals leads to changes in their knowledge and further translate into better nutrition for the aged residents of dementia wards. Subjects and methods: The residents (n=2114) and patients (n=1043) nutritional status was assessed in all studies using the Mini Nutritional Assessment test (MNA). Information was gathered in a questionnaire on residents and patients daily routines providing nutritional care. Residents energy and nutrient intake (n=23; n=21) in dementia wards were determined over three days by the precise weighing method. Constructive learning theory was the basis for educating the professionals (n=28). A half-structured questionnaire was used to assess professionals learning. Studies I-IV were cross-sectional studies whereas study V was an intervention study. Results: Malnutrition was common among elderly residents and patients living in nursing homes and hospitals in Finland. According to the MNA, 11% to 57% of the studied elderly people suffered from malnutrition, and 40-89% were at risk of malnutrition, whereas only 0-16% had a good nutritional status. Resident- and patient-related factors such as dementia, impaired ADL (Activities of Daily Living), swallowing difficulties and constipation mainly explained the malnutrition, but also some nutritional care related factors, such as eating less than half of the offered food portion and not receiving snacks were also related to malnutrition. The intake of energy and some nutrients by the residents of dementia wards were lower than those recommended, although the offered food contained enough energy and nutrients. The proportion of residents receiving vitamin D supplementation was low, although there is a recommendation and known benefits for the adequate intake of vitamin D. Nurses recognized malnutrition poorly, only one in four (26.7%) of the actual cases. Keeping and analysing food diaries and reflecting on nutritional issues in small group discussions were effective training methods for professionals. The nutrition education of professionals had a positive impact on the energy and protein intake, BMIs, and the MNA scores of some residents in dementia wards. Conclusions: Malnutrition was common among elderly residents and patients living in nursing homes and hospitals in Finland. Although residents- and patient related factors mainly explained malnutrition, nurses recognized malnutrition poorly and nutritional care possibilities were in minor use. Professionals nutrition education had a positive impact on the nutrition of elderly residents. Further studies describing successful nutritional care and nutrition education of professionals are needed.

Petusta pitsaan : Ruokahuollon järjestelyt kriisiaikojen Suomessa

From bark bread to pizza - Food and exceptional circumstances: reactions of Finnish society to crises of food supply This study on the food supply under exceptional circumstances lies within the nutritional, historical and social sciences. The perspective and questions come under nutrition science, but are part of social decision-making. The study focuses on the first and second world wars as well as on contemporary society at the beginning of the 21st century. The main purpose of this study is to explore how Finnish society has responded to crises and what measures it has taken to sustain institutional food services and the food supply of households. The particular study interests include the school catering and food services in hospitals during the world wars. The situation in households is reflected in the counseling work carried out by state-run or civic organisations. Interest also focuses on the action of the scientific community. The decisions made in Finland are projected onto the solutions developed in some other European countries. The study is based primarily on the archive documents and annual reports prepared by food and health care authorities. Major source materials include scientific and professional publications. The evaluation of the situation in contemporary Finnish society is based on corresponding emergency plans and guidelines. The written material is supplemented by discussions with experts. Food rationing during the WWI and WWII differed in extent, details and unity. The food intake of some population groups was occasionally inadequate both in quantity, quality and safety. The counseling of the public focused on promoting self-sufficiency, improving cooking skills and widening food habits. One of the most vulnerable groups in regard to nutrition was long-term patients in institutions. As for future development, the world wars were never-theless important periods for public food services and counseling practices. WWII was also an important period for product development in the food industry. Significant work on food substitutes was carried out by Professor Carl Tigerstedt during WWI. The research of Professors A. I. Virtanen and Paavo Simola during WWII focused on vitamins. Crises threatening societies now differ from those faced a hundred years ago. Finland is bet-ter prepared, but in many ways more vulnerable to and dependent on other actors. Food rationing is a severe means of handling the scarcity of food, which is why contemporary society relies primarily on preparedness planning. Civic organisations played a key role during the world wars, and establishing an emergency food supply remains on their agenda. Although the objective of protecting the population remains the same for nutrition, food production, and food consumption, threat scenarios and the knowledge and skill levels of citizens are constantly changing. Continuous monitoring and evaluation is therefore needed.

Äidinmaito - terveysjuomaa ja normaalibakteereita

The chemical composition of breast milk has been studied in detail in the past decades. Hundreds of new antibacterial and antiviral components have been found. Several molecules have been found to promote the proper function of neonatal intestine. However, microbiological studies of breast milk have been, until recently, focused mainly on detecting harmful and pathogenic bacteria and viruses. Natural microbial diversity of human milk has not been widely studied before the work reported in this thesis. This is mainly because breast milk has traditionally been thought to be sterile - even if a certain amount of commensal bacteria have usually been detected in milk samples. The first part of this licentiate thesis contains a short literature review about the anatomy and physiology of breast feeding, human milk chemical and microbiological composition, mastitis, intestinal flora and bacteriocins. The second part reports on the experiments of the licentiate work, concentrating on the microbial diversity in the milk of healthy breast-feeding mothers, and the ability of these bacteria to produce antibacterial substances against pathogenic bacteria. The results indicate that human milk is a source of commensal bacteria for infant intestine. 509 random isolates from 40 breast milk samples were isolated and identified by 16S rRNA sequencing. Median bacterial count was about 600 colony forming units per milliliter. Over half of the isolates were staphylococci, and almost one third streptococci. The most common species were skin bacteria Staphylococcus epidermidis and oral bacteria Streptococcus salivarius and Streptococcus mitis. Lactic acid bacteria, identified as members of Lactobacillus-, Lactococcus- and Leuconostoc -genera, were found in five milk samples. Enterococci were found in three samples. A novel finding in this study is the capability of these commensal bacteria to inhibit the growth of pathogens. In 90 precent of the milk samples commensal bacteria inhibiting the growth of Staphylococcus aureus were found. In 40 precent of samples the colonies could block the growth completely. One fifth of the isolated Staph. epidermidis strains, half of Str. salivarius strains, and all lactic acid bacteria and enterococci could inhibit or block the growth of Staph. aureus. In further study also Listeria innocua- and Micrococcus luteus active isolates were found in 33 and 11 precent of milk samples (out of 140). Furthermore, two Lactococcus lactis isolates from the breast milk were shown to produce bacteriocin nisin, which is an antimicrobial molecule used as a food preservative. The importance of these human milk commensal bacteria in the development of newborn intestinal flora and immune system, as well as in preventing maternal breast infections, should be further explored.

Urban energy fluxes in Helsinki and their high frequency spectral corrections

Inadvertent climate modification has led to an increase in urban temperatures compared to the surrounding rural area. The main reason for the temperature rise is the altered energy portioning of input net radiation to heat storage and sensible and latent heat fluxes in addition to the anthropogenic heat flux. The heat storage flux and anthropogenic heat flux have not yet been determined for Helsinki and they are not directly measurable. To the contrary, turbulent fluxes of sensible and latent heat in addition to net radiation can be measured, and the anthropogenic heat flux together with the heat storage flux can be solved as a residual. As a result, all inaccuracies in the determination of the energy balance components propagate to the residual term and special attention must be paid to the accurate determination of the components. One cause of error in the turbulent fluxes is the fluctuation attenuation at high frequencies which can be accounted for by high frequency spectral corrections. The aim of this study is twofold: to assess the relevance of high frequency corrections to water vapor fluxes and to assess the temporal variation of the energy fluxes. Turbulent fluxes of sensible and latent heat have been measured at SMEAR III station, Helsinki, since December 2005 using the eddy covariance technique. In addition, net radiation measurements have been ongoing since July 2007. The used calculation methods in this study consist of widely accepted eddy covariance data post processing methods in addition to Fourier and wavelet analysis. The high frequency spectral correction using the traditional transfer function method is highly dependent on relative humidity and has an 11% effect on the latent heat flux. This method is based on an assumption of spectral similarity which is shown not to be valid. A new correction method using wavelet analysis is thus initialized and it seems to account for the high frequency variation deficit. Anyhow, the resulting wavelet correction remains minimal in contrast to the traditional transfer function correction. The energy fluxes exhibit a behavior characteristic for urban environments: the energy input is channeled to sensible heat as latent heat flux is restricted by water availability. The monthly mean residual of the energy balance ranges from 30 Wm-2 in summer to -35 Wm-2 in winter meaning a heat storage to the ground during summer. Furthermore, the anthropogenic heat flux is approximated to be 50 Wm-2 during winter when residential heating is important.

Puutarhakasvien talvehtiminen Manner-Suomen ilmastossa - nyt ja tulevaisuudessa

Tämä työ käsittelee Suomen ilmastoa puutarhakasvien näkökulmasta painopisteen ollessa lämpöilmastollisissa piirteissä ja kasvien talvehtimiseen liittyvissä tekijöissä. Työssä esitellään puutarhakasvien, erityisesti monivuotisten puuvartisten kasvien selviytymiseen vaikuttavia tekijöitä, ja näiden pohjalta kartoitetaan ilmastollisia olosuhteita eri puolilla Suomea viimeisen noin viiden vuosikymmenen ajalta. Lisäksi pyritään arvioimaan tuleville vuosikymmenille ennustetun lämpenemisen aiheuttamia muutoksia Suomen puutarhatuotannon menestymismahdollisuuksissa. Nykyilmaston osalta tarkastelu perustuu vuosien 1960-2006 päivittäisiin lumi- ja lämpötilahavaintoihin kymmenellä havaintopaikalla lounaisrannikolta Koillismaalle. Puutarhakasvien kannalta hyödyllisiä ja haitallisia ilmaston piirteitä pyrittiin kuvaamaan erilaisilla indekseillä, ns. kynnystapahtumien ajankohdilla ja erinäisten raja-arvojen ylittymisillä. Tulevaisuuden jaksojen 2010-39 ja 2040-69 osalta tilannetta tarkasteltiin A2- ja B1-skenaariossa. Työssä käytettiin ns. delta-menetelmää, missä 19 ilmastomallin keskiarvona saadut arviot kuukausikeskilämpötilojen noususta lisättiin havaintopaikkojen päivittäisiin vuosien 1971-2000 lämpötilahavaintoihin. Olosuhteet puutarhakasvien menestymiselle vaihtelevat paljon tarkastelussa olleella kolmelle kasvimaantieteelliselle vyöhykkeelle sijoittuvalla alueella. 1990-luvun alusta lisääntyneet leudot talvet näkyvät hyvin talvehtimisoloja kuvaavissa muuttujissa. Toisaalta havaintopaikkojen pienilmastolliset tekijät korostuvat erityisesti alueiden hallatilanteita tarkasteltaessa. Tulevaisuuden osalta monien puutarhakasvien talven selviytymisedellytyksiin vaikuttavien tekijöiden voidaan odottaa yleisesti parantuvan ilmaston lämmetessä, tosin Suomen ilmastossa pakkasvahinkojen riski on silti olemassa. Toisaalta entisestään leudontuvat talvet lämpöjaksoineen tulevat lisäämään mahdollisuutta kasvien kylmänkestävyyden heikkenemisestä aiheutuville ongelmille. Myöhäisten hallojen esiintymisen aiheuttamat vahingot riippuvat niitä edeltäneen ajan kasvuolosuhteista. Tällöin kasvukauden alun ajankohdassa, sen alkupuolen lämpimyydessä ja hallojen esiintymisen ajankohdassa tapahtuvien muutosten nettovaikutus ratkaisee myöhäisten hallatilanteiden kukinnalle muodostavan riskin tulevaisuudessa. Tästä ei saatu yksiselitteisiä tuloksia tämän tutkimuksen puitteissa, sillä hallariskiä kuvaavan indeksin käyttäytyminen oli varsin epämääräistä.

Entsymaattisen hydrolyysin vaikutuksista mikrokiteisen selluloosan rakenteeseen

Cellulose can be used as a renewable raw material for energy production. The utilization requires degradation of cellulose into glucose, which can be done with the aid of enzymatic hydrolysis. In this thesis, various x-ray methods were used to characterize sub-micrometer changes in microcrystalline cellulose during enzymatic hydrolysis to clarify the process and factors slowering it. The methods included wide-angle x-ray scattering (WAXS), small-angle x-ray scattering (SAXS) and x-ray microtomography. In addition, the samples were studied with transmission electron microscopy (TEM). The studied samples were hydrolyzed by enzymes of the Trichoderma reesei species for 6, 24, and 75 hours, which corresponded to 31 %, 58 %, and 68 % degrees of hydrolysis, respectively. Freeze-dried hydrolysis residues were measured with WAXS, SAXS and microtomography, whereas some of them were re-wetted for the wet SAXS and TEM measurements. The microtomography measurements showed a clear decrease in particle size in scale of tens of micrometers. In all the TEM pictures similar cylindrical and partly ramified structures were observed, independent of the hydrolysis time. The SAXS results were ambiguous and partly imprecise, but showed a change in the structure of wet samples in scale of 10-30 nm. According to the WAXS results, the degrees of crystallinity and the crystal sizes remained the same. The gained results support the assuption, that the cellulosic particles are hydrolyzed mostly on their surface, since the enzymes are unable to penetrate into the nanopores of wet cellulose. The hydrolysis therefore proceeds quickly in easily accessible particles and leaves the unaccesible particles almost untouched. The structural changes observed in the SAXS measurements might correspond to slight loosening of the microfibril aggregates, which was seen only in the wet samples because of their different pore structure.