The Representation of Queer Identities in Terry Pratchett’s Discworld

My thesis offers an analysis and queer reading of a selection of novels from Terry Pratchett’s Discworld series. I have divided my analysis into chapters concerning different groups of characters within the series such as the witches, the undead, and the dwarfs, as well as dedicating a separate chapter for the novel Monstrous Regiment. I aim to show that the Discworld series features a rich and diverse queer minority, as well as stories that explore queer themes related to gender and the development of queer identities. My analysis leans primarily on queer theory, specifically on Judith Butler’s theory on gender performativity, as well as other literature related to both Discworld itself as well as queer themes in literature, and the lived experiences of the queer minority. In my thesis I conclude that in his writing Pratchett showcases the normative and restrictive nature of societal norms related to gender and sexuality. He writes about queer identities in a positive light and normalizes identities beyond the heteronormative and cisnormative narratives of society. These normative structures result in the assumption that heterosexuality and not being transgender are the default and baseline of normalcy and thus place identities beyond these in the position of the Other. Pratchett’s work brings these norms to question and works to dismantle them by the means of parody and humour, as well as the creative adaptation of some of the common tropes of fantasy literature

Allasharjoittelun vaikutukset nivelrikkoasiakkailla

Opinnäytetyön tarkoituksena oli selvittää 12 viikkoa kestävän ryhmämuotoisen allasharjoittelun vaikutuksia nivelrikkoa sairastavien toimintakykyyn. Työn tilasi Nokian kaupungin terveyskeskuksen fysioterapiaosasto. Opinnäytetyön tavoitteena oli tuottaa tietoa allasharjoittelun vaikutuksista nivelrikko- ja tekonivelasiakkailla. Suomessa sadat tuhannet ihmiset kärsivät nivelrikosta, eikä siihen ole parantavaa hoitoa. Opinnäytetyössä haettiin vastausta kysymykseen, miten allasharjoittelu vaikuttaa nivelrikkoa sairastavan fyysiseen toimintakykyyn, lihasvoimaan ja kipuun. Opinnäytetyössä käytettiin tutkimusstrategiana tapaustutkimusta ja tutkimusmenetelmänä kvantitatiivista tutkimusta. Allasharjoitteluryhmään valikoitui 11 alaraajojen nivelrikkoa sairastavaa henkilöä Nokian kaupungin terveyskeskuksen asiakkaiden joukosta. Näistä kaksi jätti tutkimuksen kesken henkilökohtaisista syistä. Toimintakykyä mitattiin ennen allasharjoittelujaksoa ja sen jälkeen. Fyysisen toimintakyvyn testeihin kuului tuoliltanousu-, 10 metrin kävely- ja 10 portaan nousu -testit. Näissä testeissä kaikki tutkimushenkilöt paransivat tuloksiaan. Polvinivelen isometrisissä maksimivoimatesteissä tutkimusjoukon ojennus- ja koukistusvoimien keskiarvot paranivat tilastollisesti merkitsevästi. Tutkimushenkilöiden kokema kipu lievittyi keskimäärin, mutta ero testien välillä ei ollut tilastollisesti merkitsevä. Opinnäytetyön tulosten perusteella voidaan todeta, että 12 viikon allasharjoittelu parantaa nivelrikkoa sairastavan toimintakykyä. Opinnäytetyön tulokset ovat samansuuntaisia aiempien aihetta koskevien tutkimusten kanssa. Keräämällä tarkemmat esitiedot muun muassa nivelrikon sijainnista ja mahdollisista tekonivelleikkauksista sekä lisäämällä tutkimukseen osallistuvien määrää saisi luotettavampia tuloksia. Mielenkiintoinen jatkotutkimusaihe olisi, kuinka kauan allasharjoittelun vaikutukset toimintakykyyn säilyvät. Lisäksi voisi tutkia, voiko allasharjoittelulla ennaltaehkäistä tekonivelleikkausta.The purpose of this study was to examine the effects of a 12-week group-form aquatic training period in clients suffering from osteoarthritis. The study was requested by the physiotherapy unit of Nokia health centre. This study was conducted as a case study and the data were analysed using quantitative content analysis. Eleven clients with lower limb osteoarthritis were selected to participate in the aquatic training group. Two of them did not complete the study. Functional capacity was measured before and after the aquatic training period. All participants improved their results in tests of physical function; chair stand test, 10-metre walk test and stair climb test. Isometric knee extensor and flexor strength improved statistically significantly. The pain was relieved at a general level. The findings indicate that a 12-week aquatic training period improves the functional capacity of people suffering from osteoarthritis. The results are consistent with those of previous studies. More reliable results could be obtained by examining a larger group of participants and by gathering more specific details from them such as the location of osteoarthritis and possible joint replacement surgeries. Further research is required to examine how long the effects of aquatic training last and whether the need for joint replacement surgeries can be prevented by aquatic training

Sairaanhoitajien kokemuksia naisiin kohdistuvan lähisuhdeväkivallan tunnistamisesta ja puheeksi ottamisesta sairaanhoitajan vastaanotolla perusterveydenhuollossa

Tutkimuksen tarkoituksena oli kuvailla sairaanhoitajien kokemuksia lähisuhdeväkivallan tunnistamisesta, puheeksi ottamisesta, omista valmiuksista väkivaltatyöhön sekä lisäkoulutuksen tarpeesta. Tavoitteena oli saada kokemuksellista tietoa sairaanhoitajien valmiuksista tunnistaa ja puheeksi ottaa lähisuhdeväkivalta. Lisäksi otimme lisäkoulutuksen tarpeen yhdeksi osaksi tätä. Tutkimuksen toteutimme erään kunnan terveysaseman vastaanotolla. Tutkimuksen aineisto on kerätty teema- eli puolistrukturoidun haastattelun avulla. Haastattelimme kahta eri sairaanhoitajaa, joilla työkokemusta oli yhteensä 9-22 vuotta. Aineiston analysoinnissa käytimme sisällönanalyysia. Tutkimuksemme pääkategoriat ovat tunnistaminen, puheeksiottaminen, sairaanhoitajan omat valmiudet väkivaltatyöhön ja lisäkoulutus. Tutkimustulosten mukaan sairaanhoitajat kokevat tunnistamisen ja puheeksi ottamisen vaikeaksi ja hankalaksi ilman selviä näkyviä fyysisiä merkkejä. Tiedostettiin kyllä, mitkä eri asiat voivat herättää epäilyn väkivallasta, kuten jatkuva vastaanotolla käynti erinäisistä syistä. Sairaanhoitajat toivat ilmi, että kokemus tilanteista helpottaisi tunnistamista ja puheeksiottoa. Sairaanhoitajien koulutuksessa asiaa ei juuri oteta laisinkaan esille, joten lisäkoulutusta kaivattiin. Kaivattiin konkreettisia neuvoja ja oppaita kuinka asia voidaan ottaa esille ja kuinka jatkaa mikäli asia tulee esille potilaan kohdalla. Riippuen vastaanotosta jonkinlai-sia kaavakkeita oli käytössä ja ne koettiin hyväksi lähisuhdeväkivallan tunnistamisessa ja puheeksi ottamisessa. Koettiin myös, että asiasta ei ole tarjolla juuri laisinkaan koulutuksia. Tutkimustulosten perusteella lisäkoulutusta on vähän ja sitä kaivattaisiin lisää. Erilaiset kaavakkeet koettiin hyväksi puheeksi ottamisen tukena. Jatkossa sairaanhoitajille voisi kehitellä projek-timuotoisena opinnäytetyönä oppaan tai koulutuspäivän lähisuhdeväkivallan tunnistamisesta ja puheeksi ottamisesta. Lisäksi jatkossa voisi tutkia myös lasten kokemuksia väkivaltaisessa perheessä elämisestä tai sairaanhoitajan taustojen tai omien kokemusten vaikutuksesta puheeksi ottamiseen.The purpose of the study was to describe the experiences of registered nurses working in the reception of primary health care about their own abilities of recognizing and broaching violence against women in relationships. We also included the necessity of further education to the study. The material was collected by using the methods of focused interview by interviewing two registered nurses in the reception of primary health care who have been working 9-22 years. The acquired materials were analyzed by inductive material-oriented analyzing method. Results show that registered nurses experience recognition and broaching of domestic violence challenging and difficult without physical signs. Registered nurses experience that they need more charges and education about domestic violence. The use of questionnaires about violence was seen useful. Experience of domestic violence issues were seen helpful and important. Based on the results there is a small amount of further education and it was needed. Different kind of questionnaires was seen useful for broaching. In the future there could be developed a thesis as a project about recognition and broaching of domestic violence. The thesis could be a guide book or an education day. It would be also interesting to study from children´s perspectives the experiences of living in a violent family or the effects of registered nurse´s own background and own experiences to broaching

Kauppaketjun yrityskorttiasiakkaiden tyytyväisyyden kartoittaminen

Tämä opinnäytetyö on tutkimus, jossa kartoitetaan Kauppaketjun yrityskorttiasiakkaiden asiakastyytyväisyyttä. Tutkimus on toteutettu suomalaiselle päivittäistavarakaupan piiriin kuuluvalle yritykselle, jota tullaan tässä työssä kutsumaan Kauppaketjuksi sen anonymiteetin säilyttämiseksi. Tutkimuksen tarkoituksena oli selvittää Kauppaketjun yrityskorttiasiakkaiden asiakastyytyväisyys sekä tuoda esille mahdolliset kehittämistarpeet. Tutkimusongelmaksi muodostui seuraavanlainen kysymys: Kuinka hyvin Kauppaketjun yrityskortti palvelee yrityskorttiasiakkaiden tarpeita? Tavoitteena oli saada selville tyytymättömyyttä aiheuttavat tekijät ja laatia niiden pohjalta kehitysehdotukset. Tutkimuksen teoreettisiksi tarkastelukohteiksi nousevat asiakasuskollisuuden merkitys B2B-kaupankäynnissä, asiakastyytyväisyydessä sekä asiakassuhteiden kehittämisessä ja ylläpitämisessä. Työssä perehdytään myös yrityksen menestyksellisyyden kannalta olennaisiin markkinoinnin kilpailukeinoihin. Tutkimus suoritettiin kvantitatiivisella kyselyllä, joka perustui asiakasnäkökulmaan. Kyselyn avulla selvitettiin yrityskortin käyttöön ja sen toimivuuteen liittyviä tekijöitä. Otanta muodostui 405 eri toimialan yrityskorttiasiakkaasta, joista kyselyyn vastasi 114 organisaatiota. Tutkimustulokset analysoitiin kuvioiden ja taulukoiden avulla teoriaan viitaten. Suurimmiksi vastaajaryhmiksi nousivat osakeyhtiö ja toiminimi. Tuloksista selvisi, että valtaosalla vastaajista on käytössään kaksi yrityskorttia ja että suosituin korttityyppi on käteiskortti. Asiakkaat kokivat saaneensa eniten tietoa yrityskortista lehti-ilmoittelun kautta ja vähiten Kauppaketjun omista lehdistä ja Internetistä. Enemmistö vastaajista kertoi hankkineensa tuotteita pääsääntöisesti sisustuksen tuoteryhmästä. Vastaajat olivat osittain samaa mieltä siitä, että yrityskortti tarjoaa rahanarvoisia etuja. Yrityskorttitarjouksien houkuttelevuuden kanssa oltiin vastaavasti jonkin verran eri mieltä. Myymälän henkilökunnan sekä asiakasrekisterin tarjoama palvelu koettiin hyväksi. Kuitenkin yhteydenottojen määrä asiakasrekisteriin oli tulosten perusteella jäänyt suhteellisen vähäiseksi. Tulokset osoittavat, että kehitystä kaipaavat erityisesti yrityskortin markkinointikanavat. Tämän lisäksi yrityskorttitarjouksien houkuttelevuutta sekä Kauppaketjun asiakasrekisterin käyttöä tulisi pyrkiä lisäämään. Kyselystä saatujen tulosten pohjalta laadittiin toimeksiantajalle kehitysehdotus yrityskortin parantamiseksi.The survey of chain of stores business card customers satisfaction This thesis is a research on business card customer satisfaction and it was conducted for a Finnish grocery store. In this thesis company is called chain of stores to preserve the anonymity. The purpose of the study was to clear up customer satisfaction of the business card customers and find out the potential improvements. The research problem is the following: How well does the business card serve the needs of business card customers? The aim was to reveal those factors which are causing dissatisfaction and compile the improvements. The frame of reference consisted of the meaning of customer loyalty in B2B –commerce and customer satisfaction. The theory also deals with development and maintaining of customerships and marketing mix. The study was conducted using a quantitative survey which was based on the customer perspective. A questionnaire was used to determine the factors of business card use and functionality. The sampling consisted of 405 various industries business card customers of whom 114 responded to the survey. The results were analyzed by figures and tables and referred to existing theories. The biggest group of respondents was Limited Liability Company and Sole Trader. The results showed that the vast majority of the respondents had two business cards and the most popular type of card is a debit card. Customers felt that they get the most information from newspaper advertising and the least from the journal of chain of store and Internet. The majority of respondents buy products mainly from interior design category. The respondents were partially agreed with the fact that the business card provides valuable benefits. However there was some disagreement about business card offers appeal. The quality of service was good by store staff and customer service. However the number of contacts to the customer service was quite small. The results show that the business card marketing channels needs development. In addition the appeal of business card offers and the customer service at the chain of stores would need to develop. A development proposal which was based on the results was made to improve the business card

Determining the timing of pubertal onset via a multicohort analysis of growth

Objective Growth-based determination of pubertal onset timing would be cheap and practical. We aimed to determine this timing based on pubertal growth markers. Secondary aims were to estimate the differences in growth between cohorts and identify the role of overweight in onset timing. Design This multicohort study includes data from three Finnish cohorts-the Type 1 Diabetes Prediction and Prevention (DIPP, N = 2,825) Study, the Special Turku Coronary Risk Factor Intervention Project (STRIP, N = 711), and the Boy cohort (N = 66). Children were monitored for growth and Tanner staging (except in DIPP). Methods The growth data were analyzed using a Super-Imposition by Translation And Rotation growth curve model, and pubertal onset analyses were run using a time-to-pubertal onset model. Results The time-to-pubertal onset model used age at peak height velocity (aPHV), peak height velocity (PHV), and overweight status as covariates, with interaction between aPHV and overweight status for girls, and succeeded in determining the onset timing. Cross-validation showed a good agreement (71.0% for girls, 77.0% for boys) between the observed and predicted onset timings. Children in STRIP were taller overall (girls: 1.7 [95% CI: 0.9, 2.5] cm, boys: 1.0 [0.3, 2.2] cm) and had higher PHV values (girls: 0.13 [0.02, 0.25] cm/year, boys: 0.35 [0.21, 0.49] cm/year) than those in DIPP. Boys in the Boy cohort were taller (2.3 [0.3, 4.2] cm) compared with DIPP. Overweight girls showed pubertal onset at 1.0 [0.7, 1.4] year earlier compared with other girls. In boys, there was no such difference. Conclusions The novel modeling approach provides an opportunity to evaluate the Tanner breast/genital stage-based pubertal onset timing in cohort studies including longitudinal data on growth but lacking pubertal follow-up.Peer reviewe

Dietary fatty acid intake in childhood and the risk of islet autoimmunity and type 1 diabetes : the DIPP birth cohort study

Publisher Copyright: © 2022, The Author(s).Purpose The aim was to study the associations between dietary intake of fatty acids in childhood and the risk of islet autoimmunity and type 1 diabetes (T1D). Methods The prospective Finnish Type 1 Diabetes Prediction and Prevention (DIPP) Study included children with genetic susceptibility to T1D born between 1996 and 2004. Participants were followed up every 3 to 12 months up to 6 years for diet, islet autoantibodies, and T1D. Dietary intake of several fatty acids at the age of 3 months to 6 years was assessed 1-8 times per participant with a 3-day food record. Joint models adjusted for energy intake, sex, HLA genotype and familial diabetes were used to investigate the associations of longitudinal intake of fatty acids and the development of islet autoimmunity and T1D. Results During the 6-year follow-up, 247 (4.4%) children of 5626 developed islet autoimmunity and 94 (1.7%) children of 5674 developed T1D. Higher intake of monounsaturated fatty acids (HR 0.63; 95% CI 0.47, 0.82), arachidonic acid (0.69; 0.50, 0.94), total n-3 fatty acids (0.64; 0.48, 0.84), and long-chain n-3 fatty acids (0.14; 0.04, 0.43), was associated with a decreased risk of islet autoimmunity with and without energy adjustment. Higher intake of total fat (0.73; 0.53, 0.98), and saturated fatty acids (0.55; 0.33, 0.90) was associated with a decreased risk of T1D only when energy adjusted. Conclusion Intake of several fatty acids was associated with a decreased risk of islet autoimmunity or T1D among high-risk children. Our findings support the idea that dietary factors, including n-3 fatty acids, may play a role in the disease process of T1D.Peer reviewe

Consumption of differently processed milk products in infancy and early childhood and the risk of islet autoimmunity

Several prospective studies have shown an association between cows’ milk consumption and the risk of islet autoimmunity and/or type 1 diabetes. We wanted to study whether processing of milk plays a role. A population-based birth cohort of 6081 children with HLA-DQB1-conferred risk to type 1 diabetes was followed until the age of 15 years. We included 5545 children in the analyses. Food records were completed at the ages of 3 and 6 months and 1, 2, 3, 4 and 6 years, and diabetes-associated autoantibodies were measured at 3–12-month intervals. For milk products in the food composition database, we used conventional and processing-based classifications. We analysed the data using a joint model for longitudinal and time-to-event data. By the age of 6 years, islet autoimmunity developed in 246 children. Consumption of all cows’ milk products together (energy-adjusted hazard ratio 1·06; 95 % CI 1·02, 1·11; P = 0·003), non-fermented milk products (1·06; 95 % CI 1·01, 1·10; P = 0·011) and fermented milk products (1·35; 95 % CI 1·10, 1·67; P = 0·005) was associated with an increased risk of islet autoimmunity. The early milk consumption was not associated with the risk beyond 6 years. We observed no clear differences based on milk homogenisation and heat treatment. Our results are consistent with the previous studies, which indicate that high milk consumption may cause islet autoimmunity in children at increased genetic risk. The study did not identify any specific type of milk processing that would clearly stand out as a sole risk factor apart from other milk products.Peer reviewe

Kinetics of Neutralizing Antibodies of COVID-19 Patients Tested Using Clinical D614G, B.1.1.7, and B 1.351 Isolates in Microneutralization Assays

Increasing evidence suggests that some newly emerged SARS-CoV-2 variants of concern (VoCs) resist neutralization by antibodies elicited by the early-pandemic wild-type virus. We applied neutralization tests to paired recoveree sera (n = 38) using clinical isolates representing the first wave (D614G), VoC1, and VoC2 lineages (B.1.1.7 and B 1.351). Neutralizing antibodies inhibited contemporary and VoC1 lineages, whereas inhibition of VoC2 was reduced 8-fold, with 50% of sera failing to show neutralization. These results provide evidence for the increased potential of VoC2 to reinfect previously SARS-CoV-infected individuals. The kinetics of NAbs in different patients showed similar decline against all variants, with generally low initial anti-B.1.351 responses becoming undetectable, but with anti-B.1.1.7 NAbs remaining detectable (>20) for months after acute infection

Kinetics of Neutralizing Antibodies of COVID-19 Patients Tested Using Clinical D614G, B.1.1.7, and B 1.351 Isolates in Microneutralization Assays

Increasing evidence suggests that some newly emerged SARS-CoV-2 variants of concern (VoCs) resist neutralization by antibodies elicited by the early-pandemic wild-type virus. We applied neutralization tests to paired recoveree sera (n = 38) using clinical isolates representing the first wave (D614G), VoC1, and VoC2 lineages (B.1.1.7 and B 1.351). Neutralizing antibodies inhibited contemporary and VoC1 lineages, whereas inhibition of VoC2 was reduced 8-fold, with 50% of sera failing to show neutralization. These results provide evidence for the increased potential of VoC2 to reinfect previously SARS-CoV-infected individuals. The kinetics of NAbs in different patients showed similar decline against all variants, with generally low initial anti-B.1.351 responses becoming undetectable, but with anti-B.1.1.7 NAbs remaining detectable (>20) for months after acute infection