Linnunkiikut ja kallen kaulukset : Kotitekoiset kuukautissiteet 1900-luvun alkupuolen Suomessa

The aim of this thesis was to study what kind of home-made menstrual pads were used in the early 20th century in Finland, how the home-made pads were made and which techniques and materials were used. The use and taking care of menstrual pads were also explored. The history of menstrual pads has been studied in Sweden, Germany and United States but none of those studies has concentrated on home-made pads. Instead, there are many studies about womanhood and menstruation. In many studies home-made menstrual pads are only briefly mentioned. Menstrual pads were not commonly used in Finland at the beginning of the 20th century, but already in the 1940s the use of menstrual pads had become common in every stratum of society. Home-made menstrual pads were used even until the 1960s. In Finland, factory-made disposable menstrual pads became common only in the 1930s and they were only slowly accepted. The study material consisted of nine interviews, three archival inquiries, health care guidebooks from 1893 to 1943 and authentic menstrual pads, menstrual belts and other objects related to them. The interviewed women were born between 1915 and 1939. The narrative approach was used in the study and it also guided the analysis. The interview and archival data were studied according to the basic rules of oral history studies. Literature consisted of publications from several disciplines. The extensive primary material played the most important role in this study. The reconstructions of the menstrual pads were made according to the interviewed women s advice. In Finland there were innumerable variations of home-made menstrual pads. The pads were most commonly crocheted and knitted either by hand or by knitting machine. Pads were also sewn of cloth, old bed linen or old underwear. The menstrual pads were self-made or made by a female relative. Word of mouth was important in spreading information on how to make pads, because there were hardly any instructions available. The biggest pads were 54 cm long and 13 cm wide. The most widely used pad model was a rectangle, which had triangle-shaped ends with a buttonhole or a loop. The pad was attached to the menstrual belt or to the buttons of the suspender belt. Knitted and crocheted pads had one, two or three layers. In sewn pads, there could be even more layers. Cellulose wadding or pieces of cloth could be placed inside the pad to increase the absorption ability. The experiences of the comfort of self-made pads varied. The crocheted and sewn pads were found chafing, knitted ones were found soft and comfortable. The menstrual pads were laborious to wash and boil in lye water. Therefore disposable pads made everyday life easier. The home-made menstrual pads were part of a unique tradition of handicrafts and folk culture. Hand-made pads were one of the most common handicraft products and were a part of every woman s life. Even so, the menstrual pads were unnoticeable. The large number of variations was probably caused by the silence around menstrual topics and by the lack of instructions for making pads. Variations are also explained by the uniqueness of every handicraft product. In Finland the home-made pads were used until relatively recent times. This was caused by the conditions of wartime and the following years and the rarity of commercial pads. Furthermore, until the late 20th century Finland was an agricultural society where all innovations spread slowly. Home-made menstrual pad was a secret handicraft of women and every woman needed to know how to make it by herself.

Levosimendan: Studies on its mechanisms of action and beyond

Acute heart failure syndrome represents a prominent and growing health problem all around the world. Ideally, medical treatment for patients admitted to hospital because of this syndrome, in addition to alleviating the acute symptoms, should also prevent myocardial damage, modulate neurohumoral and inflammatory activation, and preserve or even improve renal function. Levosimendan is a cardiac enhancer having both inotropic and vasodilatory effects. It is approved for the short-term treatment of acutely decompensated chronic heart failure, but it has been shown to have beneficial clinical effects also in ischemic heart disease and septic shock as well as in perioperative cardiac support. In the present study, the mechanisms of action of levosimendan were studied in isolated guinea-pig heart preparations: Langendorff-perfused heart, papillary muscle and permeabilized cardiomyocytes as well as in purified phosphodiesterase isoenzyme preparations. Levosimendan was shown to be a potent inotropic agent in isolated Langendorff-perfused heart and right ventricle papillary muscle. In permeabilized cardiomyocytes, it was demonstrated to be a potent calcium sensitizer in contrast to its enantiomer, dextrosimendan. It was additionally shown to be a very selective phosphodiesterase (PDE) type-3 inhibitor, the selectivity factor for PDE3 over PDE4 being 10000 for levosimendan. Irrespective of this very selective PDE3 inhibitory property in purified enzyme preparations, the inotropic effect of levosimendan was demonstrated to be mediated mainly through calcium sensitization in the isolated heart as well as the papillary muscle preparations at clinically relevant concentrations. In the isolated Lagendorff-perfused heart, glibenclamide antagonized the levosimendan-induced increase in coronary flow (CF). Therefore, the main vasodilatory mechanism in coronary veins is believed to be the opening of the ATP-sensitive potassium (KATP) channels. In the paced hearts, CF did not increase in parallel with oxygen consumption (MVO2), thus indicating that levosimendan had a direct vasodilatory effect on coronary veins. The pharmacology of levosimendan was clearly different from that of milrinone, which induced an increase in CF in parallel with MVO2. In conclusion, levosimendan was demonstrated to increase cardiac contractility by binding to cardiac troponin C and sensitizing the myofilament contractile proteins to calcium, and further to induce coronary vasodilatation by opening KATP channels in vascular smooth muscle. In addition, the efficiency of the cardiac contraction was shown to be more advantageous when the heart was perfused with levosimendan in comparison to milrinone perfusion.

Suuria käännekohtia vai tasaista kehitystä? Tutkimus Suomen terveydenhuollon suuntaviivoista

Tutkimuksessa selvitetään Suomen terveydenhuollon kehityslinjoja 1800-luvulta nykyaikaan pääasiassa institutionalismin, polkuriippuvuuden ja funktionalismin teorioita hyväksi käyttäen. Tutkimuksen keskiössä ovat instituutiot ja niiden vaikutus terveydenhuoltoon. Miten terveyspoliittiset periaatteet ja arvot ovat muuttuneet ja mitkä tahot ovat muutokset toteuttaneet? Huomiota on kiinnitetty myös politiikkaan ja maan taloudellisessa tilanteessa tapahtuneisiin muutoksiin. Tutkimuksen empiirisessä osassa terveydenhuolto ja siihen tehdyt muutokset on jaettu neljään ajanjaksoon. Kunnilla on velvollisuus järjestää terveydenhuolto ja mahdollisuus päättää laajasti sen toteutuksesta. Valtion rooli on ohjaava ja kuntien rahoitusta tukeva. Merkittävä muutos tapahtui 1960luvulla, kun terveydenhuolto jakaantui kunnalliseen terveydenhoitojärjestelmään sekä sairausvakuutukseen ja työterveyshuoltoon. Yksityisten ja julkisten terveyspalvelujen vuorovaikutusta ei ole pystytty ratkaisemaan. Talouden ohella terveydenhuoltoa ovat ohjanneet politiikka ja instituutiot. Vaihtoehtoiset terveydenhuollon järjestämismallit ovat jääneet vähälle huomiolle. Kuntien itsehallinnon korostaminen terveyspalvelujen toteutuksessa on johtanut hajautettuun, pirstoutuneeseen järjestelmään. Paikallisilla päätöksillä on ollut etusija, mikä on vaikeuttanut keskitettyä ohjausta.

Periodontal and dental health and oral self-care among adults with diabetes mellitus.

ABSTRACT Bakhshandeh, Soheila. Periodontal and dental health and oral self-care among adults with diabetes mellitus. Department of Oral Public Health, Institute of Dentistry, Faculty of Medicine, University of Helsinki, Helsinki, Finland. 2011. 49 pp. ISBN 978-952-10-7193-5(paperback). The aim of the present study was to assess oral health and treatment needs among Iranian adults with diabetes according to socio-demographic status, oral hygiene, diabetes related factors, and to investigate the relation between these determinants and oral health. Moreover, the effect of an educational oral health promotion intervention on their oral health and periodontal treatment needs was studied. The target population comprised adults with diabetes in Tehran, Iran. 299 dentate patients with diabetes, who were regular attendants to a diabetic clinic, were selected as the study subjects. Data collection was performed through a clinical dental examination and self-administered structured questionnaire. The questionnaire covered information of the subject s social background, medical history, oral health behaviour and smoking. The clinical dental examinations covered the registration of caries experience (DMFT), community periodontal index (CPI) and plaque index (PI). The intervention provided the adults with diabetes dental health education through a booklet. Reduction in periodontal treatment needs one year after the baseline examination was used as the main outcome. A high prevalence of periodontal pockets among the study population was found; 52% of the participants had periodontal pockets with a pocket depth of 4 to 5 mm and 35% had periodontal pockets with pocket depth of 6 mm or more. The mean of the DMFT index was 12.9 (SD=6.1), being dominated by filled teeth (mean 6.5) and missing teeth (mean 5.0). Oral self-care among adults with diabetes was inadequate and poor oral hygiene was observed in more than 80% of the subjects. The educational oral health promotion decreased periodontal treatment needs more in the study groups than in the control group. The poor periodontal health, poor oral hygiene and insufficient oral self-care observed in this study call for oral health promotion among adult with diabetes. An educational intervention showed that it is possible to promote oral health behaviour and to reduce periodontal treatment needs among adults with diabetes. The simplicity of the model used in this study allows it to be integrated to diabetes programmes in particular in countries with a developing health care system.

Chinese immigrants to Finland: A qualitative study of housing, employment, access to health care and child care as sociological dimensions in their settlement process

The Master’s thesis is qualitative research based on interviews of 15 Chinese immigrants to Finland in order to provide a sociological perspective of the migration experience through the eyes of Chinese immigrants in the Finnish social welfare context. This research is mainly focused upon four crucial aspects of life in the settlement process: housing, employment, access to health care and child care. Inspired by Allardt’s theoretical framework ‘Having, Loving and Being’, social relationships and individual satisfaction are examined in the case of Chinese interviewees dealing with the four life aspects. Finland was not perceived as an attractive migration destination for most Chinese interviewees in the beginning. However, with longer residence in Finland, the Finnish social welfare system gradually became a crucial appealing factor in their permanent settlement in Finland. And meanwhile, social responsibility of attending their old parents in China, strong feelings of being isolated in Finland, and insufficient integration into the Finnish society were influential factors for their decision of returning to China. Social relationships with personal friends, migration brokers, schools, employers and family relatives had great influences in the four life aspects of Chinese immigrants in Finland. The social relationship with the Finnish social welfare sector is supportive to Chinese immigrants, but Chinese immigrants do not heavily rely on Finnish social protection. The housing conditions were greatly improved over time while the upward mobility in the Finnish labour market was not significant among Chinese immigrants. All Chinese immigrants were satisfied with their current housing by the time I interviewed them while most of them had subjective feelings of being alienated in the Finnish labour market, which seriously prevented them from integrating into the Finnish society. In general, Chinese immigrants were satisfied with the low cost of accessing the Finnish public health care services and affordable Finnish child day care services and financial subsidies for children from the Finnish social welfare sector. This research also suggests that employment is the central basis in well-being. Support from the Finnish social welfare sector can improve the satisfaction levels among immigrants, especially when it mitigates the effects of low-paid employment. As well, my empirical study of Chinese immigrants in Finland shows that Having (needs for materials), Loving (needs for social relations) and Being (needs for social integration) are all involved in the four concrete aspects (housing, employment, access to health care and child care).

Kotitalouksien sisäinen resurssienjako, työmarkkinat ja sukupuolittuneet investoinnit lasten inhimilliseen pääomaan 1920-luvun Suomessa

Tutkimus käsittelee kotitalouksien sisäistä resurssienjakoa suomalaisissa kotitalouksissa 1920-luvulla. Kiinnostuksen kohteena ovat investoinnit tyttö- ja poikalasten inhimilliseen pääomaan: erityisesti koulutukseen, mutta myös terveydenhoitoon ja ravintoon. Tutkimuksessa pyritään selvittämään, suosittiinko toista sukupuolta resurssienjaossa. Tutkimus lainaa menetelmiä ja kysymyksenasetteluja kehitystaloustieteestä, jossa kotitalouksien sisäinen toiminta on noussut keskeiseksi tutkimussuunnaksi ”kadonneiden naisten ongelman” myötä. Useat kehitystaloustieteelliset sekä talous- ja sosiaalihistorialliset tutkimukset ovat havainneet kotitalouksien syrjivän tyttöjä resurssienjaossa, minkä kumulatiiviset vaikutukset ovat johtaneet pahimmillaan naisten kuolleisuuden kasvuun. Useimmissa tapauksissa resurssienjaon on havaittu liittyvän lasten taloudelliseen arvostukseen. Vanhemmat panostavat niihin lapsiin, joiden tulevan ansiotason odotetaan olevan suurin. Tärkein tulevaan ansiotason vaikuttava tekijä ovat tavoitettavissa olevat työmarkkinat. Tutkimuksen keskeisimpänä aineistona hyödynnetään vuonna 1928 Suomessa suoritetun elinkustannustutkimuksen vuosikortteja. Aineisto sisältää 954 kotitalouden kulutustiedot 15 kaupungista ja 14 teollisuuspaikkakunnalta. Aineistoa analysoidaan ekonometrisin menetelmin regressioanalyysin avulla. Engelin lain mukaan kotitalouden tulojen noustessa ruokamenojen osuus kulutuksesta pienenee. Erilaisten Engel-mallin variaatioiden avulla voidaan tutkia epäsuorasti, miten kotitalouden demografinen rakenne vaikuttaa erilaisten hyödykkeiden kulutukseen. Tässä tutkimuksessa sovelletaan Engel-malliin perustuvaa Working-mallia, jonka avulla on mahdollista tarkastella, miten eri sukupuoli-ikäryhmien läsnäolo vaikuttaa koulutus- terveydenhoito- ja ruokamenoihin aineiston kotitalouksissa. Tämän lisäksi tutkimuksessa selvitetään, miten lapsiin kohdistuviin investointeihin vaikuttivat kotitalouksien sosiaaliluokka, asuinpaikan perifeerisyys, paikalliset työmarkkinat ja vanhempien inhimillisen pääoman määrä. Tutkimustulokset paljastavat, että lapsiin kohdistuvia investointeja aineisto kotitalouksissa selitti ensisijaisesti näiden reagoiminen taloudellisiin kannustimiin. Sosiaaliryhmien käyttäytymismalleissa oli kuitenkin eroja: työläisperheissä panostettiin tyttölasten koulutukseen, mutta toimenhaltijaperheissä suosittiin poikia. Tässä tutkimuksessa selityksiä epätasaiselle resurssienjaolle etsitään koulutuksen tuotosta. Vaikuttaa siltä, että vuosi oppikoulussa oli työläistytöille kannattavampaa kuin työläispojille, joille sosiaalisesti hyväksyttyjä ja riittävän hyvin palkattuja töitä löytyi myös ilman muodollista koulutusta. Toimenhaltijaperheissä kouluttautuminen oli puolestaan kannattavampaa pojille, sillä työelämän lasikatot ja sosiaaliset normit rajoittivat tyttöjen mahdollisuuksia työelämässä. Vaikka tutkimustulokset viittaavat siihen, että kotitaloudet pyrkivät tekemään taloudellisesti rationaalisia valintoja, vaikuttivat näihin valintoihin yhteiskunnan sukupuolihierarkiat. Koska tyttöjen ja poikien ”mahdolliset tulevaisuudet” olivat erilaiset, kannatti heidän inhimilliseen pääomaansa investoida eri tavoin. Tutkimuksen johtopäätökset antavat tukea useissa empiirisissä tutkimuksissa esiintyneelle havainnolle siitä, että lapsen asemaan perheen sisällä vaikuttaa hänen ansiomahdollisuutensa kodin ulkopuolella. Tutkimus pohtii myös koulutuksen vaikutusta laajemmassa rakennemuutoksessa. Koulutuksen voi perustellusti olettaa parantaneen työläistyttöjen sosiaalista liikkuvuutta työläispoikiin nähden. Koska naisten on todistettu siirtävän inhimillistä pääomaa lapsilleen miehiä tehokkaammin, oli tällä myös todennäköisesti ylisukupolvisia vaikutuksia suomalaiselle yhteiskunnalle. Kansainvälisessä kehitystaloustieteellisessä tutkimuksessa naisten koulutuksen on todettu liittyvän positiivisesti talouskasvuun ja koko yhteiskunnan sosiaaliseen hyvinvointiin. Vaikka tässä tutkimuksessa tutkitaan ensisijaisesti mikrotaloushistoriallisesti kotitalouksien käyttäytymistä, osallistuu se myös tähän koulutuksen laajempia vaikutuksia käsittelevään keskusteluun.