Aineellista ja aineetonta turvaa : Ruokakunnat, ekologis-taloudelliset resurssit ja kontaktinmuodostus Valkealassa 1630 1750

Material and immaterial security. Households, ecological and economic resources and formation of contacts in Valkeala parish from the 1630s to the 1750s. The geographical area of the thesis, Valkeala parish in the region of Kymenlaakso, is a very interesting area owing to its diversity, both in terms of natural setting and economic and cultural structure. The study begins by outlining the ecological and economic features of Valkeala and by analysing household structures. The main focus of the research lies in the contacts of the households with the outside world. The following types of contacts are chosen as indicators of the interaction: trade and credit relations, guarantees, co-operation, marriages and godparentage. The main theme of the contact analysis is to observe the significance of three factors, namely geographical extent, affluence level and kinship, to the formation of contacts. It is also essential to chart the interdependencies between ecological and economic resources, changes in the structure of households and the formation of contacts during the period studied. The time between the 1630s and the 1750s was characterized by wars, crop losses and population changes, which had an effect on the economic framework and on the structural variation of households and contact fields. In the 17th and 18th centuries Valkeala could be divided, economically, into two sections according to the predominant cultivation technique. The western area formed the field area and the eastern and northern villages the swidden area. Multiple family households were dominant in the latter part of the 17th century, and for most of the study period, the majority of people lived in the more complex households rather than in simple families. Economic resources had only a moderate impact on the structure of contacts. There was a clear connection between bigger household size and the extent and intensity of contacts. The jurisdictional boundary that ran across Valkeala from the northwest to the southeast and divided the parish into two areas influenced the formation of contacts more than the parish boundaries. Support and security were offered largely by the primary contacts with one s immediate family, neighbours and friends. Economic support was channelled from the wealthier to the less well off by credits. Cross-marriages, cross-godparentage and marital networks could be seen as manifestations of an aim towards stability and the joining of resources. It was essential for households both to secure the workforce needed for a minimum level of subsistence and to ensure the continuation of the family line. These goals could best be reached by complex households that could adapt to the prevailing circumstances and also had wider and more multi-layered contacts offering material and immaterial security.

Näkökulmia eurooppalaiseen sosiaalipolitiikkaan : malli, väestö, resurssit ja kommunikaatio

The study analyses European social policy as a political project that proceeds under the guidance of the European Commission. In the name of modernisation, the project aims to build a new idea for the welfare state. To understand the project, it is necessary to distance oneself from both the juridical competence of the European Union and the traditional national welfare state models. The question is about sharing problems, as well as solutions to them: it is the creation and sharing of common views, concepts and images that play a key role in European integration. Drawing on texts and speeches produced by the European Commission, the study throws light on the development of European social policy during the first years of the 2000s. The study "freeze-frames" the welfare debate having its starting points in the nation states in the name of the entity of Europe. The first article approaches the European social model as a story in itself, a preparatory, persuasive narrative that concerns the management of change. The article shows how the audience can be motivated to work towards a set target by using discursive elements in a persuasive manner: the function of a persuasive story is to convince the target audience of the appropriateness of the chosen direction and to shape their identity so that they are favourably disposed to the desired political targets. This is a kind of "intermediate state" where the story, despite its inner contradictions and inaccuracies, succeeds in appearing as an almost self-evident path towards a modern social policy that Europe is currently seen to be in need of. The second article outlines the European social model as a question of governance. Health as a sector of social policy is detached from the old political order, which was based on the welfare state, and is closely linked to economy. At the same time the population is primarily seen as an economic resource. The Commission is working towards a "Europe of Health" that grapples with the problem of governance with the help of the "healthisation" of society, healthy citizenship and health economics. The way the Commission speaks is guided by the Union's powerful interest to act as "Europe" in the field of welfare policy. At the same time, the traditional separateness of health policy is effaced in order to be able to make health policy reforms a part of the Union's wider modernisation targets. The third article then shows the European social policy as its own area of governance. The article uses an approach based on critical discourse analysis in examining the classification systems and presentation styles adopted by Commission communications, as well as the identities that they help build. In analysing the "new start" of the Lisbon strategy from the perspective of social policy, the article shows how the emphasis has shifted from the persuasive arguments for change with necessary common European targets in the early stages of the strategy towards the implementation of reforms: from a narrative to a vision and from a diagnosis to healing. The phase of global competition represents "the modern" with which European society with its culture and ways of life now has to be matched. The Lisbon strategy is a way to direct this societal change, thus building a modern European social policy. The fourth article describes how the Commission uses its communications policy to build practices and techniques of governance and how it persuades citizens to participate in the creation of a European project of change. This also requires a new kind of agency: agents for whom accountability and responsibilities mean integration into and commitment to European society. Accountability is shaped into a decisive factor in implementing the European Union's strategy of change. As such it will displace hierarchical confrontations and emphasise common action with a view to modernising Europe. However, the Union's discourse cannot be described as being a political language that would genuinely rouse and convince the audience at the level of everyday life. Keywords: European social policy, EU policy, European social model, European Commission, modernisation of welfare, welfare state, communications, discoursiveness.

Visuaalisen työmuistin vapaasti jaettavat resurssit : muistiedustusten lukumäärä ja tarkkuus ääriviivakuvioilla

According to the most prevalent view, there are 3-4 fixed "slots" in visual working memory for temporary storage. Recently this view has been challenged with a theory of dynamic resources which are restricted in their totality but can be freely allocated. The aim of this study is to clarify which one of the theories better describes the performance in visual working memory tasks with contour shapes. Thus in this study, the interest is in both the number of recalled stimuli and the precision of the memory representations. Stimuli in the experiments were radial frequency patterns, which were constructed by sinusoidally modulating the radius of a circle. Five observers participated in the experiment and it consisted of two different tasks. In the delayed discrimination task the number of recalled stimuli was measured with 2-interval forced choice task. Observer was shown serially two displays with 1, 5 s ISI (inter stimulus interval). Displays contained 1-6 patterns and they differed from each other with changed amplitude in one pattern. The participant s task was to report whether the changed pattern had higher amplitude in the first or in the second interval. The amount of amplitude change was defined with QUEST-procedure and the 75 % discrimination threshold was measured in the task. In the recall task the precision of the memory representations was measured with subjective adjustment method. First, observer was shown 1-6 patterns and after 1, 5 s ISI one location of the previously shown pattern was cued. Observer s task was to adjust amplitude of a probe pattern to match the amplitude of the pattern in working memory. In the delayed discrimination task the performance of all observes declined smoothly when the number of presented patterns was increased. The result supports the resource theory of working memory as there was no sudden fall in the performance. The amplitude threshold for one item was 0.01 0.05 and as the number of items increased from 1 to 6 there was a 4 15 -fold linear increase in the amplitude threshold (0.14 0.29). In the recall adjustment task the precision of four observers performance declined smoothly as the number of presented patterns was increased. The result also supports the resource theory. The standard deviation for one item was 0.03 0.05 and as the number of items increased from 1 to 6 there was a 2 3 -fold linear increase in the amplitude threshold (0.06 0.11). These findings show that the performance in a visual working memory task is described better according to the theory of freely allocated resources and not to the traditional slot-model. In addition, the allocation of the resources depends on the properties of the individual observer and the visual working memory task.

Motiivit ja resurssit kuntavaaliehdokkuuden taustalla ja niiden rooli poliittisessa rekrytoitumisessa

Tässä tutkimuksessa selvitetään yksilötason tekijöiden vaikutusta poliittisen rekrytoitumisen prosessissa. Keskeisimpia kysymyksiä ovat mikä motivoi asettumaan ehdolle kunnallisvaaleissa ja mikä rooli ehdokkaan motivaatiolla ja resursseilla on poliittisessa rekrytoitumisessa. Tutkimuksessa selvitetään myös, miten ehdokkaat kiinnostuivat politiikasta ja mitkä ovat heidän poliittiset urasuunnitelmansa. Tutkimusta varten on tehty keväällä 2013 kyselytutkimus Turussa vuonna 2012 kuntavaaliehdokkaana olleille. Kysely toteutettiin Webropol-kyselynä ja vastausprosentti oli 35,9. Tutkimuksessa selvisi, että asettuminen ehdolle kuntavaaleissa on ennen kaikkea tapa toimia aktiivisena yhteiskunnan jäsenenä. Valituksi tulemista useat ehdokkaat pitivät paitsi epätodennäköisenä myös toissijaisena päämääränä. Poliittisten urasuunnitelmien suhteen ehdokkaat jakautuivat kolmeen ryhmään: osa oli ehdolla vain kokeilumielellä, valtaosa aikoi tulevaisuudessakin keskittyä vain kuntatason vaikuttamiseen ja osa piti kuntavaaliehdokkuuden ohella myös eduskuntavaaliehdokkuutta omalla kohdallaan todennäköisenä. Näiden ryhmien välillä oli eroa motivaation sisällössä, esimerkiksi muutoksen aikaansaaminen ehdokkuusmotiivina oli tärkeämpi kokeilijoiden ja eduskuntavaalilaisten ryhmässä kuin kuntavaalilaisten ryhmässä. Tuloksista päätellen ehdokkaan motivaation ja resurssien rooli rekrytoitumisessa on suuri. Puolueiden tehtävä kuntavaaliehdokkaiden rekrytoinnissa on paremminkin haalintaa kuin seulontaa. Myös valituksi tulemisessa yksilö on avainasemassa: valitut käyttivät huomattavasti muita enemmän rahaa ja aikaa kampanjaansa.

Ulkomaisen kirjallisuuden tuonti Suomeen 1800-luvun alkupuolella : Waseniuksen kirjakaupan kansainväliset yhteydet 1823-1836

Opinnäytetyöni tarkastelee eurooppalaisen kulttuurin kannalta keskeistä kommunikaatiovälinettä, painettua kirjaa, ja sen kansainvälistä luonnetta ja liikkumista. Teemaan perehdytään helsinkiläisen Gustaf Otto Waseniuksen (1789-1852) kirjakaupan toiminnan avulla keskittyen tarkastelemaan ulkomaisen kirjallisuuden tuomista Suomeen 1800-luvun alkupuolella. Tutkielma käsittelee ensisijaisesti itse kauppiastoimintaa: mitä kirjakauppayhteyksiä Waseniuksella oli sekä miten ja keiden ehdoilla ne toimivat. Näiden kysymysten ohessa pohdin myös itse kirjojen välityksellä tapahtunutta tiedonvälitystä. Työn tavoitteena on paljastaa, minkälaisia suomalaisten kirjakauppiaiden ja lukijoiden kirjallisuudenhankinnan sekä lukemisen kontekstit ja resurssit olivat 1800-luvun alkupuolella. Tutkielman lähteinä on käytetty Waseniuksen kirjakaupan kirjeitä ja kuitteja sekä sensuuriviranomaisten arkistoja. Tutkielmani jakautuu kolmeen osaan. Ensiksi paneudun Waseniuksen kauppaverkoston syntyyn ja sen esittelyyn: Waseniuksen kansainväliset yhteydet keskittyivät kolmelle kulttuurialueelle. Ruotsista hän sai kirjoja kaikilta merkittäviltä kustantajilta, kauppiailta sekä itsenäisesti toimivilta kirjailijoilta. Saksankielisen kulttuurin tarjontaa Wasenius pystyi hankkimaan Leipzigin kansainvälisten kirjakauppiaiden avulla. Ranskalaisen kirjallisuuden osalta Wasenius omasi toimivat yhteydet Pariisin kirjakauppiaisiin. Sen sijaan Brittein saaret jäivät vielä Waseniuksen kontaktiverkoston ulkopuolelle, samoin myös Pietarin huomattava kulttuurikeskus. Tämän jälkeen keskityn yhteyksien toimintaan. Wasenius solmi kauppakumppaniensa kanssa yleiseurooppalaisen komissionääri-sopimuksen, jonka valtuuttamana hän sai myydä kunkin ulkomaisen kauppiaan tuotteita liikkeessään. Ensiksi tarkastelen kauppiaiden välisten etäisyyksien ylittämistä. Aikakauden kuljetustavat huomioonottaen suuret etäisyydet eivät Waseniuksen kirjojen hankintaa juuri haitanneet, vaan suurkauppiaana hän pystyi käyttämään aikansa parhaat resurssit lähetystensä kuljettamiseen. Toiseksi pohdin aikakauden kauppiastoimintojen ja kulttuuripiirteiden vaikutusta kirjakauppaan. Waseniuksen toiminta kirjakauppiaana perustui taloudellisen voiton tavoittelulle, mikä tarkoitti mm. sitä, että lähetysten sisältö määrättiin etukäteen hyvin tarkasti. Ennen Suomeen saapumistaan kirjoilla piti olla varma ostaja, minkä Wasenius useimmiten varmisti ennakkotilausluetteloin ja etumaksuin. Kolmanneksi esiin nousevat 1800-luvun alun poliittiset tapahtumat, jotka osaltaan, kauppiaan silmiin kaikkein näkyvimmin, vaikuttivat kirjojen tuontiin. Sensuurin piti periaatteessa estää useiden satojen vaarallisena pidetyn kirjan levittäminen ja lukeminen Suomessa, mutta Wasenius ei suinkaan lopettanut kiellettyjen kirjojen tuontia, vaan salakuljetti sensuroitavia teoksia jatkuvasti liikkeeseensä myytäväksi. Suomalaiset viranomaiset hyväksyivät usein tämänkaltaisen toiminnan, joten venäläistä sensuuriasetusta tai hallintoa ei juuri kunnioitettu. Vertailu eurooppalaiseen kirjakauppatoimintaan osoittaa Waseniuksen omanneen erittäin hyvät kansainväliset suhteet. Tämä kuitenkin johtui niin kirjakauppatoiminnan keskittymisestä harvojen kauppiaiden käsiin kuin myös oman kustannustoiminnan vähyydestä. Tiedonvälityksen kehityksen ja kulttuurihistorian kannalta Waseniuksen kansainvälinen toiminta osoittautuu noudattelevan vielä vanhan eliittikulttuurin muotoja, mutta kirjakauppainstituution kehittyminen aivan uudenlaiseen kukoistukseen valmisteli jo kansallisen kulttuurin nousemista lähivuosikymmeninä.

Expert Identity in Development of Core-Task-Oriented Working Practices for Mastering Demanding Situations

The point of departure in this dissertation was the practical safety problem of unanticipated, unfamiliar events and unexpected changes in the environment, the demanding situations which the operators should take care of in the complex socio-technical systems. The aim of this thesis was to increase the understanding of demanding situations and of the resources for coping with these situations by presenting a new construct, a conceptual model called Expert Identity (ExId) as a way to open up new solutions to the problem of demanding situations and by testing the model in empirical studies on operator work. The premises of the Core-Task Analysis (CTA) framework were adopted as a starting point: core-task oriented working practices promote the system efficiency (incl. safety, productivity and well-being targets) and that should be supported. The negative effects of stress were summarised and the possible countermeasures related to the operators' personal resources such as experience, expertise, sense of control, conceptions of work and self etc. were considered. ExId was proposed as a way to bring emotional-energetic depth into the work analysis and to supplement CTA-based practical methods to discover development challenges and to contribute to the development of complex socio-technical systems. The potential of ExId to promote understanding of operator work was demonstrated in the context of the six empirical studies on operator work. Each of these studies had its own practical objectives within the corresponding quite broad focuses of the studies. The concluding research questions were: 1) Are the assumptions made in ExId on the basis of the different theories and previous studies supported by the empirical findings? 2) Does the ExId construct promote understanding of the operator work in empirical studies? 3) What are the strengths and weaknesses of the ExId construct? The layers and the assumptions of the development of expert identity appeared to gain evidence. The new conceptual model worked as a part of an analysis of different kinds of data, as a part of different methods used for different purposes, in different work contexts. The results showed that the operators had problems in taking care of the core task resulting from the discrepancy between the demands and resources (either personal or external). The changes of work, the difficulties in reaching the real content of work in the organisation and the limits of the practical means of support had complicated the problem and limited the possibilities of the development actions within the case organisations. Personal resources seemed to be sensitive to the changes, adaptation is taking place, but not deeply or quickly enough. Furthermore, the results showed several characteristics of the studied contexts that complicated the operators' possibilities to grow into or with the demands and to develop practices, expertise and expert identity matching the core task. They were: discontinuation of the work demands, discrepancy between conceptions of work held in the other parts of organisation, visions and the reality faced by the operators, emphasis on the individual efforts and situational solutions. The potential of ExId to open up new paths to solving the problem of the demanding situations and its ability to enable studies on practices in the field was considered in the discussion. The results were interpreted as promising enough to encourage the conduction of further studies on ExId. This dissertation proposes especially contribution to supporting the workers in recognising the changing demands and their possibilities for growing with them when aiming to support human performance in complex socio-technical systems, both in designing the systems and solving the existing problems.

Psychological resources, their social antecedents, and association with well-being and health behaviour in early adulthood

The success of entering work life, young people s psychological resources and self-reported well-being were studied in a longitudinal setting from a life-span developmental-contextual perspective in early adulthood. The aim was to analyse how psychosocial characteristics in early childhood and adolescence predict successful entrance into work life, how this is associated with well-being, and to assess the level of psychological resources such as dispositional optimism, personal meaning of work and coping in early adulthood. The role of these and social support, in the relationship between regional factors (such as place of residence and migration), self-reported health and life satisfaction was studied. The association between a specific coping strategy, i.e. eating and drinking in a stressful situation and eating habits, was studied to demonstrate how coping is associated with health behaviour. Multivariate methods, including binary logistic regression analyses and ANOVA, were used for statistical analyses. The subjects were members of the Northern Finland 1966 Birth Cohort, which consists of all women and men born in 1966 in the two northernmost provinces of Finland (n= 12,058). The most recent follow-up, at the age of 31 years when 11,637 subjects were alive, took place in 1997-1998. The results show, first, that social resources in the childhood family and adolescence school achievement predict entrance into the labour market. Secondly, psychosocial resources were found to mediate the relationship between migration from rural to urban areas, and subjective well-being. Thirdly, psychological resources at entrance into the labour market were found to develop from early infancy on. They are, however, influenced later by work history. Fourthly, stress-related eating and drinking, as a way of coping, was found to be directly associated with unhealthy eating habits and alcohol use. Gender differences were found in psychosocial resources predicting, and being associated with success in entering the labour market. For men, the role of attitudinal and psychological factors seems to be especially important in entrance into work life and in the development of psychological resources. For women, academic attainment was more important for successfully entering work life, and lack of emotional social support was a risk factor for stress-related eating only among women. Stress-related eating and drinking habits were predicted by a long history of unemployment as well as a low level of education among both genders, but not excluding an academic degree among men. The results emphasize the role of childhood psychosocial factors in preventing long-term unemployment and in enhancing psychological well-being in early adulthood. Success in entering work life, in terms of continuous work history, plays a crucial role for well-being and the amount of psychological resources in early adulthood. The results emphasize the crucial role of enhancing psychological resources for promoting positive health behaviour and diminishing regional differences in subjective well-being.

Datorstödda studier i hälso- och socialvård : MuPSiNet-projektet

The aim of the study was to explore why the MuPSiNet project - a computer and network supported learning environment for the field of health care and social work - did not develop as expected. To grasp the problem some hypotheses were formulated. The hypotheses regarded the teachers' skills in and attitudes towards computing and their attitudes towards constructivist study methods. An online survey containing 48 items was performed. The survey targeted all the teachers within the field of health care and social work in the country, and it produced 461 responses that were analysed against the hypotheses. The reliability of the variables was tested using the Cronbach alpha coefficient and t-tests. Poor basic computing skills among the teachers combined with a vulnerable technical solution, and inadequate project management combined with lack of administrative models for transforming economic resources into manpower were the factors that turned out to play a decisive role in the project. Other important findings were that the teachers had rather poor skills and knowledge in computing, computer safety and computer supported instruction, and that these skills were significantly poorer among female teachers who were in majority in the sample. The fraction of teachers who were familiar with software for electronic patient records (EPR) was low. The attitudes towards constructivist teaching methods were positive, and further education seemed to utterly increase the teachers' readiness to use alternative teaching methods. The most important conclusions were the following: In order to integrate EPR software as a natural tool in teaching planning and documenting health care, it is crucial that the teachers have sufficient basic skills in computing and that more teachers have personal experience of using EPR software. In order for computer supported teaching to become accepted it is necessary to arrange with extensive further education for the teachers presently working, and for that further education to succeed it should be backed up locally among other things by sufficient support in matters concerning computer supported teaching. The attitudes towards computing showed significant gender differences. Based on the findings it is suggested that basic skills in computing should also include an awareness of data safety in relation to work in different kinds of computer networks, and that projects of this kind should be built up around a proper project organisation with sufficient resources. Suggestions concerning curricular development and further education are also presented. Conclusions concerning the research method were that reminders have a better effect, and that respondents tend to answer open-ended questions more verbosely in electronically distributed online surveys compared to traditional surveys. A method of utilising randomized passwords to guarantee respondent anonymity while maintaining sample control is presented. Keywords: computer-assisted learning, computer-assisted instruction, health care, social work, vocational education, computerized patient record, online survey

Routine Measurement of Health-Related Quality of Life in Assessing Cost-Effectiveness in Secondary Health Care

Aims: The aims of this study were 1) to identify and describe health economic studies that have used quality-adjusted life years (QALYs) based on actual measurements of patients' health-related quality of life (HRQoL); 2) to test the feasibility of routine collection of health-related quality of life (HRQoL) data as an indicator of effectiveness of secondary health care; and 3) to establish and compare the cost-utility of three large-volume surgical procedures in a real-world setting in the Helsinki University Central Hospital, a large referral hospital providing secondary and tertiary health-care services for a population of approximately 1.4 million. Patients and methods: So as to identify studies that have used QALYs as an outcome measure, a systematic search of the literature was performed using the Medline, Embase, CINAHL, SCI and Cochrane Library electronic databases. Initial screening of the identified articles involved two reviewers independently reading the abstracts; the full-text articles were also evaluated independently by two reviewers, with a third reviewer used in cases where the two reviewers could not agree a consensus on which articles should be included. The feasibility of routinely evaluating the cost-effectiveness of secondary health care was tested by setting up a system for collecting HRQoL data on approximately 4 900 patients' HRQoL before and after operative treatments performed in the hospital. The HRQoL data used as an indicator of treatment effectiveness was combined with diagnostic and financial indicators routinely collected in the hospital. To compare the cost-effectiveness of three surgical interventions, 712 patients admitted for routine operative treatment completed the 15D HRQoL questionnaire before and also 3-12 months after the operation. QALYs were calculated using the obtained utility data and expected remaining life years of the patients. Direct hospital costs were obtained from the clinical patient administration database of the hospital and a cost-utility analysis was performed from the perspective of the provider of secondary health care services. Main results: The systematic review (Study I) showed that although QALYs gained are considered an important measure of the effectiveness of health care, the number of studies in which QALYs are based on actual measurements of patients' HRQoL is still fairly limited. Of the reviewed full-text articles, only 70 reported QALYs based on actual before after measurements using a valid HRQoL instrument. Collection of simple cost-effectiveness data in secondary health care is feasible and could easily be expanded and performed on a routine basis (Study II). It allows meaningful comparisons between various treatments and provides a means for allocating limited health care resources. The cost per QALY gained was 2 770 for cervical operations and 1 740 for lumbar operations. In cases where surgery was delayed the cost per QALY was doubled (Study III). The cost per QALY ranges between subgroups in cataract surgery (Study IV). The cost per QALY gained was 5 130 for patients having both eyes operated on and 8 210 for patients with only one eye operated on during the 6-month follow-up. In patients whose first eye had been operated on previous to the study period, the mean HRQoL deteriorated after surgery, thus precluding the establishment of the cost per QALY. In arthroplasty patients (Study V) the mean cost per QALY gained in a one-year period was 6 710 for primary hip replacement, 52 270 for revision hip replacement, and 14 000 for primary knee replacement. Conclusions: Although the importance of cost-utility analyses has during recent years been stressed, there are only a limited number of studies in which the evaluation is based on patients own assessment of the treatment effectiveness. Most of the cost-effectiveness and cost-utility analyses are based on modeling that employs expert opinion regarding the outcome of treatment, not on patient-derived assessments. Routine collection of effectiveness information from patients entering treatment in secondary health care turned out to be easy enough and did not, for instance, require additional personnel on the wards in which the study was executed. The mean patient response rate was more than 70 %, suggesting that patients were happy to participate and appreciated the fact that the hospital showed an interest in their well-being even after the actual treatment episode had ended. Spinal surgery leads to a statistically significant and clinically important improvement in HRQoL. The cost per QALY gained was reasonable, at less than half of that observed for instance for hip replacement surgery. However, prolonged waiting for an operation approximately doubled the cost per QALY gained from the surgical intervention. The mean utility gain following routine cataract surgery in a real world setting was relatively small and confined mostly to patients who had had both eyes operated on. The cost of cataract surgery per QALY gained was higher than previously reported and was associated with considerable degree of uncertainty. Hip and knee replacement both improve HRQoL. The cost per QALY gained from knee replacement is two-fold compared to hip replacement. Cost-utility results from the three studied specialties showed that there is great variation in the cost-utility of surgical interventions performed in a real-world setting even when only common, widely accepted interventions are considered. However, the cost per QALY of all the studied interventions, except for revision hip arthroplasty, was well below 50 000, this figure being sometimes cited in the literature as a threshold level for the cost-effectiveness of an intervention. Based on the present study it may be concluded that routine evaluation of the cost-utility of secondary health care is feasible and produces information essential for a rational and balanced allocation of scarce health care resources.

Factors affecting farmland prices in Finland

The purpose of the study was to analyse factors affecting the differences in land prices between regions. The key issue was to find out the policy effects on farmland prices. In addition to comprehensive literature review, a theoretical analysis as well as modern panel and spatial econometric techniques were utilized. The study clearly pointed out the importance of taking into account the possible spatial dependence. The data were exceptionally large, comprising more than 6 000 observations. Thus, it allowed a thorough econometric estimation including the possibility to take into account the spatial nature of the data. This study supports the view that there are many other factors that affect farmland prices besides pure agricultural returns. It was also found that the support clearly affects land prices. However, rather than assuming the discount rates for support and market returns to be similar, the rough analysis refers to the discount rate for support being a little lower. If this were true it would indicate that farmers rely more on support income than market returns. The results support the view presented in literature that land values are more responsive to government payments when these payments are perceived to be permanent. An important result of this study is that the structural differences between regions and the structural change in agriculture seemed to have a considerable role in affecting land prices. Firstly, the present structure affects the competition in the land market: the more dense farms are in the region the more there are potential buyers, and the land price increases. Secondly, the change in farm structure (especially in animal husbandry) connected to the policy changes that increase area-based support affects land prices. The effect comes from two sources. Growing farms need more land for the manure, and the proportion of retiring farmers may be lower. The introduction of the manure density variable proved to be an efficient way to aggregate the otherwise very difficult task of taking into account the environmental pressure caused by structural change in animal husbandry. Finally, infrastructure also has a very important role in determining the price level of agricultural land. If other industries are prospering in the surrounding area, agricultural viability also seems to improve. The non-farm opportunities offered to farm families make continuing and developing farming more tempting.

Lake sediment research as a part of lake management - case studies and implications from southern Finland

In Finland one of the most important current issues in the environmental management is the quality of surface waters. The increasing social importance of lakes and water systems has generated wide-ranging interest in lake restoration and management, concerning especially lakes suffering from eutrophication, but also from other environmental impacts. Most of the factors deteriorating the water quality in Finnish lakes are connected to human activities. Especially since the 1940's, the intensified farming practices and conduction of sewage waters from scattered settlements, cottages and industry have affected the lakes, which simultaneously have developed in to recreational areas for a growing number of people. Therefore, this study was focused on small lakes, which are human impacted, located close to settlement areas and have a significant value for local population. The aim of this thesis was to obtain information from lake sediment records for on-going lake restoration activities and to prove that a well planned, properly focused lake sediment study is an essential part of the work related to evaluation, target consideration and restoration of Finnish lakes. Altogether 11 lakes were studied. The study of Lake Kaljasjärvi was related to the gradual eutrophication of the lake. In lakes Ormajärvi, Suolijärvi, Lehee, Pyhäjärvi and Iso-Roine the main focus was on sediment mapping, as well as on the long term changes of the sedimentation, which were compared to Lake Pääjärvi. In Lake Hormajärvi the role of different kind of sedimentation environments in the eutrophication development of the lake's two basins were compared. Lake Orijärvi has not been eutrophied, but the ore exploitation and related acid main drainage from the catchment area have influenced the lake drastically and the changes caused by metal load were investigated. The twin lakes Etujärvi and Takajärvi are slightly eutrophied, but also suffer problems associated with the erosion of the substantial peat accumulations covering the fringe areas of the lakes. These peat accumulations are related to Holocene water level changes, which were investigated. The methods used were chosen case-specifically for each lake. In general, acoustic soundings of the lakes, detailed description of the nature of the sediment and determinations of the physical properties of the sediment, such as water content, loss on ignition and magnetic susceptibility were used, as was grain size analysis. A wide set of chemical analyses was also used. Diatom and chrysophycean cyst analyses were applied, and the diatom inferred total phosphorus content was reconstructed. The results of these studies prove, that the ideal lake sediment study, as a part of a lake management project, should be two-phased. In the first phase, thoroughgoing mapping of sedimentation patterns should be carried out by soundings and adequate corings. The actual sampling, based on the preliminary results, must include at least one long core from the main sedimentation basin for the determining the natural background state of the lake. The recent, artificially impacted development of the lake can then be determined by short-core and surface sediment studies. The sampling must be focused on the basis of the sediment mapping again, and it should represent all different sedimentation environments and bottom dynamic zones, considering the inlets and outlets, as well as the effects of possible point loaders of the lake. In practice, the budget of the lake management projects of is usually limited and only the most essential work and analyses can be carried out. The set of chemical and biological analyses and dating methods must therefore been thoroughly considered and adapted to the specific management problem. The results show also, that information obtained from a properly performed sediment study enhances the planning of the restoration, makes possible to define the target of the remediation activities and improves the cost-efficiency of the project.

Data mining for telecommunications network log analysis

Telecommunications network management is based on huge amounts of data that are continuously collected from elements and devices from all around the network. The data is monitored and analysed to provide information for decision making in all operation functions. Knowledge discovery and data mining methods can support fast-pace decision making in network operations. In this thesis, I analyse decision making on different levels of network operations. I identify the requirements decision-making sets for knowledge discovery and data mining tools and methods, and I study resources that are available to them. I then propose two methods for augmenting and applying frequent sets to support everyday decision making. The proposed methods are Comprehensive Log Compression for log data summarisation and Queryable Log Compression for semantic compression of log data. Finally I suggest a model for a continuous knowledge discovery process and outline how it can be implemented and integrated to the existing network operations infrastructure.

Hyvän hoidon reuna-alueilla : Potilasvahinko lääketieteellisen toiminnan valossa.

Vuonna 2006 Suomessa korvattiin 2331 potilasvahinkoa. Niistä maksettiin korvauksia yhteensä noin 27 miljoonaa euroa. Tässä tutkimuksessa tarkastellaan potilasvahinkoja lääketieteellisen toiminnan valossa. Tutkimuksessa pyritään vastaamaan kysymykseen: Millä eri tavoilla lääkärin toiminta voi epäonnistua potilasvahinkotapauksissa? Tutkimuksessa määriteltiin neljä kategoriaa, joiden avulla analysoitiin esimerkkitapauksia. Kategoriat käsittelivät hoitojärjestelmää, lääkärin toimintaan vaikuttavia normeja, toiminnan intentionaalisuutta sekä toiminnan suhdetta sen lopputuloksiin ja seurauksiin. Ensimmäisessä tutkimusluvussa määriteltiin kategoriat, joiden avulla lääketieteellistä toimintaa voi arvioida. Ensimmäiseksi analysoitiin hoitojärjestelmää, lääkärin toiminnan kontekstia. Hoitojärjestelmästä nostettiin esille potilas-lääkärisuhde, lääkärien välinen yhteistyö, potilaasta saatavat tiedot, toiminnan mahdollistavat resurssit sekä niin kutsuttu systeemivirhe. Hoitojärjestelmän toimiminen on hyvän hoidon ensimmäinen edellytys. Se vaatii eri terveydenhuollon ammattihenkilöiden saumatonta yhteistyötä.Toinen kategoria käsitteli lääkärin toimintaan vaikuttavia normeja. Georg Henrik von Wrightin teoksen Norm and Action normien jaottelua sovellettiin lääkärin toimintaan. Normien pääryhmään kuuluvat säännöt, määräykset ja ohjeet. Lisäksi voidaan määritellä pienempiä normiryhmiä, jotka sijaitsevat pääryhmien välimaastossa. Näihin pienempiin ryhmiin sijoittuvat tottumukset, moraaliset periaatteet sekä ideaalit säännöt. Kolmannessa kategoriassa käsiteltiin intentionaalisuutta osana toimintaa. Teorian päälähde oli G. E. M. Anscomben teos Intention. Toiminnan intentionaalisuutta analysoitiin Anscomben tunnetun, vesikaivon myrkytystä koskevan, esimerkin avulla. Siinä tekoon liittyvä sisäinen tieto on keskeinen intentiota määrittävä tekijä. Viimeisessä kategoriassa arvioitiin toimintaa von Wrightin mukaan. Esille nousi erityisesti kyky toiminnan perusedellytyksenä sekä toiminnan lopputulos ja seuraukset. Potilasvahingoissa on tärkeää arvioida myös potilasvahingon seurauksia, ei vain epäonnistuneen toimenpiteen lopputulosta. Toimintaa analysoitaessa oli myös otettava huomioon kenen näkökulmasta seurauksia arvioitiin, Potilas, lääkäri ja esimerkiksi osastonylilääkäri saattavat nähdä potilasvahingon seuraukset hyvin eri tavoilla.Toisessa tutkimusluvussa arvioitiin neljää Terveydenhuollon oikeusturvakeskuksen ja lääninhallitusten sosiaali- ja terveysosastojen kantelu- ja valvontaratkaisuista valittua esimerkkitapausta. Ensimmäinen käsitteli lääkärin toiminnan epäonnistumista synnytyksessä, toinen psyykkisistä ongelmista ja alkoholiriippuvuudesta kärsivän lääkärin ammatinharjoittamisoikeuksien rajoittamista, kolmas lääketutkimuksen johtajan vakavia virheitä ja neljäs Terveydenhuollon oikeusturvakeskuksen pysyvän asiantuntijan ristiriitaisia asiantuntijalausuntoja. Lääkärin toiminnan epäonnistuminen vaikuttaa helposti hoitojärjestelmään, jonka toimiminen perustuu työntekijöiden yhteistyöhön. Hoitovirheissä rikotaan yleensä lääketieteen sääntöjä. Potilasvahingon sattuessa lääkärin asema muuttuu normiauktoriteetista normisubjektiksi. Lääkäri saattaa toiminnallaan rikkoa myös moraalisia sääntöjä tai lääkärin ihannetta. Puhtaissa vahinkotapauksissa toiminnan lopputulos ei vastaa lääkärin intentiota, potilaan parantamista. Kaikissa potilasvahinkotapauksissa ei voida puhua vahingoista, vaan kyseessä voi olla myös tarkoituksellinen teko. Toiminnan lopputuloksella voi olla laajat seuraukset, jotka tulisi myös ottaa huomioon toimintaa arvioitaessa.

Where and how to conserve: Extending the scope of spatial reserve network design

Ongoing habitat loss and fragmentation threaten much of the biodiversity that we know today. As such, conservation efforts are required if we want to protect biodiversity. Conservation budgets are typically tight, making the cost-effective selection of protected areas difficult. Therefore, reserve design methods have been developed to identify sets of sites, that together represent the species of conservation interest in a cost-effective manner. To be able to select reserve networks, data on species distributions is needed. Such data is often incomplete, but species habitat distribution models (SHDMs) can be used to link the occurrence of the species at the surveyed sites to the environmental conditions at these locations (e.g. climatic, vegetation and soil conditions). The probability of the species occurring at unvisited location is next predicted by the model, based on the environmental conditions of those sites. The spatial configuration of reserve networks is important, because habitat loss around reserves can influence the persistence of species inside the network. Since species differ in their requirements for network configuration, the spatial cohesion of networks needs to be species-specific. A way to account for species-specific requirements is to use spatial variables in SHDMs. Spatial SHDMs allow the evaluation of the effect of reserve network configuration on the probability of occurrence of the species inside the network. Even though reserves are important for conservation, they are not the only option available to conservation planners. To enhance or maintain habitat quality, restoration or maintenance measures are sometimes required. As a result, the number of conservation options per site increases. Currently available reserve selection tools do however not offer the ability to handle multiple, alternative options per site. This thesis extends the existing methodology for reserve design, by offering methods to identify cost-effective conservation planning solutions when multiple, alternative conservation options are available per site. Although restoration and maintenance measures are beneficial to certain species, they can be harmful to other species with different requirements. This introduces trade-offs between species when identifying which conservation action is best applied to which site. The thesis describes how the strength of such trade-offs can be identified, which is useful for assessing consequences of conservation decisions regarding species priorities and budget. Furthermore, the results of the thesis indicate that spatial SHDMs can be successfully used to account for species-specific requirements for spatial cohesion - in the reserve selection (single-option) context as well as in the multi-option context. Accounting for the spatial requirements of multiple species and allowing for several conservation options is however complicated, due to trade-offs in species requirements. It is also shown that spatial SHDMs can be successfully used for gaining information on factors that drive a species spatial distribution. Such information is valuable to conservation planning, as better knowledge on species requirements facilitates the design of networks for species persistence. This methods and results described in this thesis aim to improve species probabilities of persistence, by taking better account of species habitat and spatial requirements. Many real-world conservation planning problems are characterised by a variety of conservation options related to protection, restoration and maintenance of habitat. Planning tools therefore need to be able to incorporate multiple conservation options per site, in order to continue the search for cost-effective conservation planning solutions. Simultaneously, the spatial requirements of species need to be considered. The methods described in this thesis offer a starting point for combining these two relevant aspects of conservation planning.

Dung beetle communities in Madagascar

The traditional aim of community ecology has been to understand the origin and maintenance of species richness in local communities. Why certain species occur in one place but not in another, how ecologically apparently similar species use resources, what is the role of the regional species pool in affecting species composition in local communities, and so forth. Madagascar offers great opportunities to conduct such studies, since it is a very large island that has been isolated for tens of million of years. Madagascar has remarkable faunal and floral diversity and species level endemism reaches 100% in many groups of species. Madagascar is also exceptional for endemism at high taxonomic levels and for the skewed representation of many taxa in comparison with continental faunas. For example, native ungulates that are dominant large herbivorous mammals on the African continent are completely lacking in Madagascar. The largest native Malagasy herbivores, and the main dung producers for Malagasy dung beetles, are the endemic primates, lemurs. Cattle was introduced to Madagascar about 1,000 yrs ago and is today abundant and widespread. I have studied Malagasy dung beetle communities and the distributional patterns of species at several spatial scales and compared the results with comparable communities in other tropical areas. There are substantial differences in dung beetle communities in Madagascar and elsewhere in the tropics in terms of the life histories of the species, species ecological traits, local and regional species diversities, and the sizes of species geographical ranges. These differences are attributed to Madagascar s ancient isolation, large size, heterogeneous environment, skewed representation of the mammalian fauna, and recent though currently great human impact.