308 research outputs found
Cardiovascular comorbidity in rheumatoid arthritis : studies on venous thromboembolism
No full textIndividuals with rheumatoid arthritis (RA) are at around 50-100% increased risk of venous thromboembolism (VTE). In 2019, signals emerged suggesting an increased risk of VTE in RA patients treated with JAK inhibitors (JAKi), a new and highly efficacious class of disease- modifying antirheumatic drug (DMARD). In this thesis, we aimed to further disentangle the associations between RA, its treatment, and VTE risk in a series of observational studies. We used data from the Swedish rheumatology quality register and other national registers, thereby including a majority of all Swedish patients with RA, as well as a general population comparator cohort.Study I was a study validating International classification of diseases (ICD) 10 codes for VTE registered in the National patient register specifically in patients with RA, through manual review of medical records. Based on review of 269 registered VTE events at hospitals in Region Stockholm from 2009 through 2018, 235 were confirmed as incident VTE. This resulted in a positive predictive value (PPV) of 87% for incident VTE, which ranged from 80% to 98% when we applied various restrictions to our definition of VTE. The majority of the confirmed events were diagnosed independently of RA (only 17 cases involved initial work- up by a rheumatologist, and in 3 cases there was an initial suspicion af an RA-related symptom). This study demonstrates a high validity for registered ICD-10 codes for VTE specifically in patients with RA, and suggests a low degree of surveillance or diagnostic bias.Study II was a cohort study on the association between RA disease activity, measured by the Disease activity score 28 (DAS28), and the risk of VTE. Based on 322,601 rheumatologist visits in 46,316 patients with RA from 2006 through 2018, we identified 2,241 incident VTE events during the year following the rheumatologist visit. This resulted in a cumulative 1- year incidence of 0.52% for DAS28 remission, and 1.08% for high disease activity, with a corresponding adjusted risk ratio of 2.03 (95% CI 1.73-2.38) for high DAS28 vs. remission. Compared to the general population, the risk ratio of VTE for the overall RA population was 1.88 (95% CI 1.65-2.05). The study demonstrates a significant association between RA disease activity and VTE risk, thereby underscoring the importance of VTE risk stratification in patients with RA, and that treating RA to remission is important to minimize VTE risk.Study III was an active comparator, new user design cohort study on the risk of VTE in patients with RA treated with JAKi, TNFi and other biologic DMARDs (bDMARDs) from 2010 through 2021. Based on 32,737 treatment episodes and 559 incident VTE events, the adjusted hazard ratio (HR) for the risk of VTE for JAKi vs. TNFi was 1.73 (95% CI 1.24-2.42). Regarding VTE subtypes, the corresponding HR was 3.21 (95% CI 2.11-4.88) for pulmonary embolism and 0.83 (95% CI 0.47-1.45) for deep vein thrombosis. The incidence of VTE was doubled with use of JAKi compared to the entire RA population, and tripled compared to the general population. The study demonstrates an increased risk of VTE for patients with RA treated with JAKi in clinical practice, an increase confined to pulmonary embolism rather than deep vein thrombosis.Study IV was a cohort study on the potential impact of channeling bias for biologic and targeted synthetic DMARD (b/tsDMARD) drug classes when new on the market, compared to when established, in patients with RA from 2006 through 2022. We identified 33,550 b/tsDMARD initiations and 5,862 composite safety events (first of: major adverse cardiovascular event, VTE, cancer or serious infection). b/tsDMARD treatments initiated >5 years since market entry of the drug class in question (vs. List of scientific papersI. Validation and characterization of venous thromboembolism diagnoses in the Swedish National Patient Register among patients with rheumatoid arthritis. Viktor Molander, Hannah Bower, Johan Askling. Scand J Rheumatol 2023;52:111-117. https://doi.org/10.1080/03009742.2021.2001907II. Risk of venous thromboembolism in rheumatoid arthritis, and its association with disease activity: a nationwide cohort study from Sweden. Viktor Molander, Hannah Bower, Thomas Frisell, Johan Askling. Annals of the Rheumatic Diseases 2021;80:169-175. https://doi.org/10.1136/annrheumdis-2020-218419III. Risk of venous thromboembolism with JAK inhibitors and other immune- modulatory drugs: a Swedish comparative safety study among patients with rheumatoid arthritis. Viktor Molander, Hannah Bower, Thomas Frisell, Bénédicte Delcoigne, Daniela Di Giuseppe, Johan Askling. Annals of the Rheumatic Diseases 2023;82:189-197. https://doi.org/10.1136/ard-2022-223050IV. Do newly approved drugs have a worse observed safety profile than once established? A study on time-trends in observed risks of key safety outcomes with immune-modulatory drugs against rheumatoid arthritis. Viktor Molander, Hannah Bower, Thomas Frisell, Johan Askling. [Manuscript]</p
sj-docx-1-asm-10.1177_10731911221147038 – Supplemental material for Assessing Gambling Disorder Using Semistructured Interviews or Self-Report? Evaluation of the Structured Clinical Interview for Gambling Disorder Among Swedish Gamblers
No full textSupplemental material, sj-docx-1-asm-10.1177_10731911221147038 for Assessing Gambling Disorder Using Semistructured Interviews or Self-Report? Evaluation of the Structured Clinical Interview for Gambling Disorder Among Swedish Gamblers by Olof Molander, Viktor Månsson, Anne H. Berman, Jon E. Grant and Peter Wennberg in Assessment</p
sj-docx-2-asm-10.1177_10731911221147038 – Supplemental material for Assessing Gambling Disorder Using Semistructured Interviews or Self-Report? Evaluation of the Structured Clinical Interview for Gambling Disorder Among Swedish Gamblers
No full textSupplemental material, sj-docx-2-asm-10.1177_10731911221147038 for Assessing Gambling Disorder Using Semistructured Interviews or Self-Report? Evaluation of the Structured Clinical Interview for Gambling Disorder Among Swedish Gamblers by Olof Molander, Viktor Månsson, Anne H. Berman, Jon E. Grant and Peter Wennberg in Assessment</p
sj-docx-3-asm-10.1177_10731911221147038 – Supplemental material for Assessing Gambling Disorder Using Semistructured Interviews or Self-Report? Evaluation of the Structured Clinical Interview for Gambling Disorder Among Swedish Gamblers
No full textSupplemental material, sj-docx-3-asm-10.1177_10731911221147038 for Assessing Gambling Disorder Using Semistructured Interviews or Self-Report? Evaluation of the Structured Clinical Interview for Gambling Disorder Among Swedish Gamblers by Olof Molander, Viktor Månsson, Anne H. Berman, Jon E. Grant and Peter Wennberg in Assessment</p
The author's dream on the stage : Harald Molander as a director and writer
No full textThe thesis is a structural biography of Harald Molander (1858-1900), stage manager, author, translator and critic.The investigation is based on his literary works and the reviews of these. Articles, letters and the director's comprehensive manuscripts and other documents are analyzed. The reactions of the audience are studied.Molander's authorship and directing were artistically coherent. In accordance with the theories of Felix Vodicka and Jan Mukarovsky a model of description is formulated for the study of the period norm. The structure of Molander's literary works, the reception of them, and the modern conception of stage management are related to the changes in the norm.As an. author Molander successively associated himself with tradition, with the realism of the modern breakthrough and the interest in historical subject. His works were often shaped by literary impressions. His works as an author and stage manager were frequently religiously tinged.As a director Molander was a transitional figure. He began as an author-director and gradually took up modern stage management. In this thesis his work as a director is studied as part of the division of labour in the theatre, as staging-procedure and as an expression of principles of style and artistic viewpoint. His directing was chiefly aimed at realizing the author's vision on the stage. He wanted to transform the possibilities of the drama into scenic reality.As a stage manager Molander was influenced by the Meininger Company and Wagner. As a director he was very systematic. He distanced himself from the kind of theatre which was dominated by the actors, from Romanticism and ideal realism, and he studied naturalism. Tradition, fidelity to authors, realism, historicism, ensemble-acting and the harmonization of the means of expression of the theatre characterized his stage managing. Molander also had a didactic view of the theatre; he wanted to discuss societal and psychological problems and he wanted to amuse his audience.Molanderwas active both in Sweden and in Finland. The highlight of his early period was the staging of Goethe's Faust (1889). He shaped it into a realistic-fantastic Gesamtkunstwerk. He made pictorially attractive stagings of Strindberg's historical dramas, Mäster Olof (1897), Gustaf Vasa and Erik XIV (1899). The staging of Hauptmann's The Weavers was his masterpiece. The instruction of the masses in this strike drama was consistent. The Swedish labour movement greeted the play with enthusiasm.digitalisering@um
Is all that is new therefore good? The Swedish author Lars Gyllensten and ecocritical tendencies of today
No full textThe article want to raise the awareness of some urgent questions that is concerned with the development of new theory and methods in the service of addressing the problematic situation of the Anthropocene. With the aid of the 20th century Swedish author Lars Gyllensten’s general ideas of the function of critique (iconoclasm) and creativity (iconoplasm), the aim is to point to two basic patterns when moving towards new, and hopefully better paradigms
Neljän sisäkorvaistutetta käyttävän lapsen sanapainon havaitsemisen ja sananlöytämisen kehitys puhemusiikki-intervention aikana
No full textTiedekunta - Fakultet
Lääketieteellinen tiedekunta Laitos - Institution
Medicum, psykologian ja logopedian osasto
Tekijä - Författare
Mikaela Molander
Työn nimi - Arbetets titel
Neljän sisäkorvaistutetta käyttävän lapsen sanapainon havaitsemisen ja sananlöytämisen kehitys
puhemusiikki-intervention aikana
Oppiaine - Läroämne
Logopedia
Työn laji/ Ohjaaja - Arbetets art/Handledare
Pro gradu -tutkielma/Ritva Torppa, Eila Lonka Aika – Datum
04/2020 Sivumäärä – Sidoantal
59 sivua + 9 liitettä
Tiivistelmä – Referat
Tavoitteet. Sisäkorvaistutteen (SI) avulla kuulevien lasten (SI-lasten) fonologinen ja leksikaalinen kehitys on usein heikompaa kuin normaalikuuloisten (NK) ikätoverien kehitys. SI-lasten sananlöytämisen (SL) kehitystä on tutkittu vasta vähän. Koska lapsuuden kielellisen kehityksen aikaikkuna on kapea ja kuuroina syntyneiden lasten kielen kehitys usein viivästynyt, on tärkeää tutkia, miten näiden lasten varhaista puheen havaitsemista ja tuottoa voitaisiin tukea. Tutkimuksen tarkoituksena on selvittää, kehittyykö SI-lasten sanapainojen (äänen korkeuden ja keston) havaitseminen ja sananlöytäminen puhemusiikki-intervention aikana.
Menetelmät. Tässä monitapaustutkimuksessa seurattiin vuoden ajan neljän 5–7 -vuotiaan sisäkorvaistutteen avulla kuulevan lapsen osallistumista puhemusiikkiryhmätoimintaan (PM), jossa yhdistettiin musiikin ja puheterapian menetelmiä ja leikinomaisia toimintatapoja. Ryhmä oli sairaalan kuulokeskuksen kokoama. Seurannan aikana lapset suorittivat äänen korkeuden ja keston havaitsemisen tehtäviä neljästi (mittaushetket: 0 kk, 3 kk, 7 kk ja 12 kk) ja Sananlöytämistestin kahdesti (mittaushetket: 3 kk ja 12 kk). Kokeiden kvantitatiivisia tuloksia verrattiin aiempaan suomalaiseen tutkimusaineistoon (SI-lasten puheen painotusten havaitseminen) ja suomenkielisille lapsille normitetun testin tausta-aineistoon (sananlöytäminen).
Tulokset ja johtopäätökset. PM-ryhmään osallistuneiden SI-lasten äänen korkeuksien ja kestojen muutoksin tuotettujen sanapainojen havaitseminen tarkentui lähes jokaisessa osatehtävässä ryhmäkohtaisen keskimääräisen suoriutumisen sekä verrokkiryhmävertailun perusteella. Myös jokaisen lapsen SL-taidot kehittyivät ainakin yhdessä osatehtävässä, vaikka muutoksissa korostuikin hyvin yksilöllinen vaihtelu. Vain yhden lapsen suoriutumisen (sekä positiivisten että negatiivisten) muutosten nopeus ylitti normatiiviset odotukset. Muiden lasten suoriutumisen muutokset kuuluivat normaalivaihtelun piiriin. SL-täsmällisyyden suoritukset paranivat enemmän kuin SL-nopeuden suoritukset.
PM-intervention aikana tapahtuneet muutokset sanapainon havaitsemisessa ja sananlöytämisen täsmällisyydessä tukevat oletusta, että musiikkiharrastuksella saattaa olla hyviä vaikutuksia SI-lasten sanapainojen havaitsemiseen ja edelleen kielelliseen kehitykseen. Musiikin käytön lisäämistä SI-lasten perheiden kuntoutusvalmennuksessa ja SI-lasten puheterapiassa tulisi harkita.
Avainsanat – Nyckelord
sisäkorvaistute, musiikki, sanapaino/tavupaino, sananlöytäminen, lapset
Säilytyspaikka - Förvaringsställe
Helsingin yliopiston kirjasto – Helda / E-thesis (opinnäytteet) ethesis.helsinki.fiFaculty
Faculty of Medicine Department
Department of Psychology and Logopedics
Author
Mikaela Molander
Title
Development of syllable stress perception and word finding in children with cochlear implant
during speech-music -intervention
Subject
Logopedics
Level/Instruct
Master’s Thesis / Ritva Torppa, Eila Lonka Month and year
April 2020 Number of pages
59 pages + 9 appendices
Abstract
Aims. Phonological and lexical development of children with a cochlear implant (CI-children) is often poorer compared to children with normal hearing. There have been only a few studies on word finding (WF) skills of CI-children. As the time frame of childhood language development is narrow and language development of prelingually deaf children is often delayed, it is important to study how to support early speech perception and production of these children. The aim of this study is to find out whether syllable stress perception and WF skills of CI-children develop during a speech-music -intervention.
Methods. In this multicase study, four CI-children, aged 5–7 years, were followed through a group intervention with methods and procedures from music and speech therapy. The group was chosen by a public hospital hearing center. Children performed tasks on discrimination of fundamental frequency (F0) and duration four times (at 0, 3, 7 and 12 months) and a test of word finding (accuracy and speed) two times (at 3 and 12 months) during the 12 months follow-up. Quantitative results were compared with previous research data on syllable stress perception of Finnish CI-children and with Finnish background data on the normative WF test used in the follow-up.
Results and conclusions. Perception of fundamental frequency (F0) and duration of CI-children improved in almost every task and comparison during the follow-up period. WF skills improved at least in one part-task per child, however individual variation was evident. Only one child showed (both positive and negative) changes quicker than expected according to WF normative data. Changes in WF performance of other children fell within normal variation. There was more positive development in WF accuracy than in WF speed.
The reported changes, coincided with the speech-music -intervention, support the assumption that music may have positive effects on syllable stress perception and further on language development of CI-children. Music in family rehabilitation coaching and as part of speech therapy of young CI-children should be encouraged.
Keywords
cochlear implant, music, prosody, word stress/syllable stress, word finding, children
Where deposited
Helsingin yliopiston kirjasto – Helda / E-thesis (opinnäytteet) ethesis.helsinki.f
Författarens dröm på scenen [Elektronisk resurs] : Harald Molanders regi och författarskap
No full textThe thesis is a structural biography of Harald Molander (1858-1900), stage manager, author, translator and critic.The investigation is based on his literary works and the reviews of these. Articles, letters and the director's comprehensive manuscripts and other documents are analyzed. The reactions of the audience are studied.Molander's authorship and directing were artistically coherent. In accordance with the theories of Felix Vodicka and Jan Mukarovsky a model of description is formulated for the study of the period norm. The structure of Molander's literary works, the reception of them, and the modern conception of stage management are related to the changes in the norm.As an. author Molander successively associated himself with tradition, with the realism of the modern breakthrough and the interest in historical subject. His works were often shaped by literary impressions. His works as an author and stage manager were frequently religiously tinged.As a director Molander was a transitional figure. He began as an author-director and gradually took up modern stage management. In this thesis his work as a director is studied as part of the division of labour in the theatre, as staging-procedure and as an expression of principles of style and artistic viewpoint. His directing was chiefly aimed at realizing the author's vision on the stage. He wanted to transform the possibilities of the drama into scenic reality.As a stage manager Molander was influenced by the Meininger Company and Wagner. As a director he was very systematic. He distanced himself from the kind of theatre which was dominated by the actors, from Romanticism and ideal realism, and he studied naturalism. Tradition, fidelity to authors, realism, historicism, ensemble-acting and the harmonization of the means of expression of the theatre characterized his stage managing. Molander also had a didactic view of the theatre; he wanted to discuss societal and psychological problems and he wanted to amuse his audience.Molanderwas active both in Sweden and in Finland. The highlight of his early period was the staging of Goethe's Faust (1889). He shaped it into a realistic-fantastic Gesamtkunstwerk. He made pictorially attractive stagings of Strindberg's historical dramas, Mäster Olof (1897), Gustaf Vasa and Erik XIV (1899). The staging of Hauptmann's The Weavers was his masterpiece. The instruction of the masses in this strike drama was consistent. The Swedish labour movement greeted the play with enthusiasm.</p
Music Box – Den Haag: Transforming a vacant office building into a public space for music and culture
No full textSpaces for music does often have to move out to fringe areas of the cities while the city centres are devoted to retail and office buildings. However, due to the financial crisis and shifting demands from coorporations, there are around 8,5 million m2 of vacant office space in the Netherlands today. Office buildings in city centres are potential candidates for new types of culture centres / creative business hubs and by utilizing these buildings, new life can be brought to the street and different forms of culture practises can reach more people. Since 2013, Many culture institutions in the Netherlands have been affected by dramatic cuts in the countries budget for culture. The diminished funding hasorganisational changes and downsizing. Many voices have been raised that the governments acting is a serious threat to the diversity and quality of music, dance and art. In 2013, the Dutch government, led by Mark Rutte cut the funding for culture by ca 25 %. Many culture institutions in the Netherlands have been affected by these dramatic cuts with organisational changes and downsizing. While the Rutte government is putting pressure on the culture sector to be increasingly self-reliant in terms of financing, the right wing populist Geert Wilders (who is currently in the lead for the coming election) wants to completely stop all governmental funding towards culture. The project is an exploration of how to create a consolidating building for different music organisations which have experienced problems due to a shifting political agenda towards culture. A second aspect of the project is how to maintain a diverse music environment in the centre of Den Haag for the public as well as for musicians. Because of economic issues, spaces for music does often have to move out to fringe areas of the cities while the city centres are devoted to retail and office buildings. Currently, however, there are around 8,5 million m2 of vacant office space in the Netherlands. By utilizing one of these buildings close to the central station of Den Haag, new life can be brought to the street and more versatile music climate can be maintained.<br/
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