12 resultados para Enxaqueca sem aura

em Helda - Digital Repository of University of Helsinki


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Common migraine, i.e. migraine with (MA) or without aura (MO), is a chronic neurological disorder affecting about 10% of the Caucasian population. In MA, migraine headache is preceded by visual, sensoric and/or dysphasic reversible aura symptoms. Twin and family studies have suggested a multifactorial mode of inheritance for common migraine, and a stronger genetic component for MA than for MO. Since there is no biological or genetic marker to identify common migraine, aura symptoms provide a distinctive character to identify those suspected of suffering from migraine. The aim of this study was to identify MA susceptibility loci in well-phenotyped migraine samples with familial predisposition using different gene mapping methods. Genes coding for endothelin1 and its receptors EDNRA and ENDRB are potential candidate genes for cortical spreading depression (CSD), which is considered to be the underlying mechanism of migraine aura. The role of these genes in MA was studied in 850 Finnish migraine cases and 890 control individuals. Rare homozygous EDNRA SNPs showed nominal association with MA and with the age of onset trait (20 years). This result was also detected in the pooled analysis on 648 German MA cases and 651 control individuals when the test was adjusted for gender and sample origin. Evaluation of SNP genotyping reactions with two different DNA polymerase enzymes ensured that the genotype quality was high, and thus the discovered associations are considered reliable. The role of the 19p13 region was studied in a linkage analysis of 72 Finnish MA families. This region contains two migraine-associated genes: CACNA1A, which is associated with a predisposition to a rare Mendelian form of MA, familial hemiplegic migraine (FHM), and the insulin receptor gene (INSR) that is associated with common migraine. No evidence of linkage between the 19p13 and MA was detected. A novel visual aura locus was mapped to chromosome 9q21-q22 with significant evidence of linkage using a genome-wide linkage approach in 36 Finnish MA families. Five additional, potential loci were also detected. The 9q21-q22 region has previously been linked to occipitotemporal lobe epilepsy and MA, both of which involve prominent visual symptoms. Our result further supports a shared background for these episodic disorders.

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Professor Knud Lyne Rahbek was a novelist, playwright, poet, magazine editor, journalist, socialite person, host of the Bakkehus , historian, theatre manager, translator, publisher etc., but his versatility either side of 1800 is better known than read and more despised than understood. In terms of methodology, the thesis is based on biographical, historical and philological research, while at the same time making use of formalistic and close reading methods. This study begins and ends with 7th of February 1800, when Kamma and Knud Lyne Rahbek join the exiled P.A. Heiberg at the inn near Frederiksberg Castle. What falls between is an interpretation of Rahbek s works in the service of democracy, human rights and freedom of the press as a pragmatic navigation between activities - both subversive and legitimate. Posterity mistook this range as mere spinelessness, and Rahbek was relegated to the literary and historical margins as an anachronism and as a jack of all trades, who did not know what he really wanted and therefore flitted about in so many fields just to be present. But Rahbek s problem was not one of standpoint, but rather how to find a balance between totalizing attitudes and confrontations between rebellious idealism and deep-rooted absolutism, without foregoing his belief in enlightenment, humanism and tolerance. In this way, and also through his personal conduct, which at that time was seen as jovial bonhommie, he made his contribution to the development of modern democratic Denmark in the full awareness of a popular, peaceful and down-to-earth community. Rahbek s principal work about the event of the French Revolution, which provides the focus for the above, is Camill og Constance. Et Revolutions Skilderie (1799). For today s reader, the novel about the revolution is an obvious example of a historical novel, as it does not only provide fictionalized information about past events placing them in a generally accepted perspective of historical development, but also gives the characters qualities, which, in Rahbek s words, allows the real events to influence the fictional characters. From this point of view, the novel of the revolution has shifted the benchmark for the first real historical novel on the European literary scene back by fifteen years. Lacking the aura so easily foisted on fearless iconoclasts or tragic losers, Rahbek s contribution may seem modest in spite of its enormous volume; but only when it is not evaluated in its full context, which is the development of Denmark towards an international democratic society.

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From the field to the academic sphere how teachers professional identities and roles have changed in post-war Finland This study explores teacher autobiographies. The span of the writings extends mainly from the Second World War to the new millennium. The autobiographers are mostly elementary and secondary school teachers in Finland, although there are a few who have worked in vocational schools, polytechnic institutes or one of the various adult education centres. The researcher is aware of the diversity among those educational institutions and their teachers, but wanted to concentrate on similarities rather than differences. The autobiographers have been explored with four different research questions in view. The first was to identify professional and personal elements and themes mentioned by teachers in writing about themselves. The second was to identify the factors that have affected those elements and themes. The third was to examine the kinds of literary forms teachers used in their autobiographies. The fourth was the most crucial and an endeavour to connect the previous questions: how teachers professional identities and roles have changed during the period studied. In the first five chapters the teachers voices come through clearly. Two of these chapters are organized in chronological order. The first is about childhood, youth and the time spent in school, the second deals with the years studying in university or teachers college and finally being recruited to the teachers. In these chapters the rural background of many teachers stands out, an issue that also emerged symbolically or de facto in the autobiographies. The chronological scheme changes to a thematic order, in which social matters (students, parents, colleagues) and teachers working circumstances are dealt with. Four selected autobiographies are examined closely. In these autobiographies five different types of teacher narratives can be identified. To begin with, teachers stressed their vocation, which is quite a normal work orientation for those working in the educational field. Others emphasised how they were looking for professional development; a few wrote about personal advancement as well. There are also narratives by teachers who simply drifted into the profession of teaching, while a few teachers felt unwelcome in their own schools. As for the changes that teachers have witnessed, there are also some themes that are widely shared. Most pointed out how the teacher has become more foster parent than educator, as real parents have withdrawn from their responsibilities of raising children. This theme was frequently broached, although attitude towards it and ways of handling the phenomenon differed substantially. Teachers also stressed how their profession has lost the aura and prestige it once had. At the same time teachers are being expected to collaborate more with their colleagues, which is not in line with the centuries-old tradition of working alone. Teachers seem to be in a state of flux, buffeted by elements of stability and change interacting simultaneously. Many teachers are demanding a re-examination of their working reality. Teachers long and intimate relationship with society and the state may be at a crossroads. Key words: teachers professional identity and role, autobiographical study, post-war Finland

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Migraine is the common cause of chronic episodic headache, affecting 12%-15% of the Caucasian population (41 million Europeans and some half a million Finns), and causes considerable loss of quality of life to its sufferers, as well as being linked to increased risk for a wide range of conditions, from depression to stroke. Migraine is the 19th most severe disease in terms of disability-adjusted life years, and 9th among women. It is characterized by attacks of headache accompanied by sensitivity to external stimuli lasting 4-72 hours, and in a third of cases by neurological aura symptoms, such as loss of vision, speech or muscle function. The underlying pathophysiology, including what triggers migraine attacks and why they occur in the first place, is largely unknown. The aim of this study was to identify genetic factors associated with the hereditary susceptibility to migraine, in order to gain a better understanding of migraine mechanisms. In this thesis, we report the results of genetic linkage and association analyses on a Finnish migraine patient collection as well as migraineurs from Australia, Denmark, Germany, Iceland and the Netherlands. Altogether we studied genetic information of nearly 7,000 migraine patients and over 50,000 population-matched controls. We also developed a new migraine analysis method called the trait component analysis, which is based on individual patient responses instead of the clinical diagnosis. Using this method, we detected a number of new genetic loci for migraine, including on chromosome 17p13 (HLOD 4.65) and 10q22-q23 (female-specific HLOD 7.68) with significant evidence of linkage, along with five other loci (2p12, 8q12, 4q28-q31, 18q12-q22, and Xp22) detected with suggestive evidence of linkage. The 10q22-q23 locus was the first genetic finding in migraine to show linkage to the same locus and markers in multiple populations, with consistent detection in six different scans. Traditionally, ion channels have been thought to play a role in migraine susceptibility, but we were able to exclude any significant role for common variants in a candidate gene study of 155 ion transport genes. This was followed up by the first genome-wide association study in migraine, conducted on 2,748 migraine patients and 10,747 matched controls followed by a replication in 3,209 patients and 40,062 controls. In this study, we found interesting results with genome-wide significance, providing targets for future genetic and functional studies. Overall, we found several promising genetic loci for migraine providing a promising base for future studies in migraine.

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Migraine is a highly prevalent disease, and despite several important breakthroughs there are still a many questions unanswered in the clinical, genetic and pathophysiological aspects of migraine research. Migraine has been linked to several other diseases such as epilepsy and stroke, but there are still unsolved issues concerning the true nature of these associations. Three genes predisposing to hemiplegic migraine and several loci associated to migraine have been identified, but so far no genes responsible for common forms of migraine have been recognized. Triptans have provided an important step in migraine treatment, but their usefulness in rare forms of migraine have been controversial. The Finnish Migraine Gene Project (FMGP) includes more than 1600 families and 7500 individuals. We evaluated comorbidity from 1000 consecutive subjects in the FMGP. To search for novel loci, we performed a genome-wide linkage scan in 36 families with high prevalences of migraine with visual aura. We collected 76 subjects from the FMGP who suffer from hemiplegic migraine and have used triptans. Finally, to study possible links between stroke and migraine we evaluated the prevalence of migraine in subjects with cervical artery dissection (CAD) and healthy controls. Migraine was associated with increased prevalence of allergy, hypotension and psychiatric diseases. Additionally, men suffering from migraine with aura had increased prevalence of epilepsy and stroke. Further evidence of association between migraine and epilepsy was found in our linkage study. The parametric two-point linkage analysis showed significant evidence of linkage between migraine aura and a locus on 9q21-q22. Interestingly, the same locus has been associated with occipitotemporal epilepsy. CAD seems to be a migraine risk factor, and therefore a link between stroke and migraine. Notably, CAD seems to alleviate migraine activity further indicating the association between these two conditions. Despite the contraindications of triptans, it seems that they are safe and effective in the abortive treatment of hemiplegic migraine.

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Women and Marital Breakdown in South India: Reconstructing Homes, Bonds and Persons is an ethnographic analysis of the situation of divorced and separated women and their families in the South Indian city of Bangalore. The study is based on 16 months of anthropological fieldwork, i.e., participant observation and life history interviews among 50 divorced and separated women from different socio-religious backgrounds in their homes, in the women s organisations and in the Family Court. The study follows the divorced and separated women from their natal homes to their affinal homes through homelessness and legal battles to their reconstructed natal, affinal or single homes in order to find out what it means to be a person within hierarchical gender and kinship relations in South India. Marital breakdown impacts on kin relations and discloses the existing gender relations and power structure through its consequences. It makes the transformability of relational personhood as well as the transformability of relational society and culture visible. Although the study reveals the painful history of women s ill-treatment in marriage, family and kinship systems, it also demonstrates the women s rejection of the domination; and shows their ability to re-negotiate and promote changes not only to their own positions but to the whole hierarchical system as well. The study explores the divorced and separated women s manifold dilemmas, complicated legal battles, and endless arrangements when they have to struggle with the very practical problems of supporting themselves financially, finding and making a new home for themselves, and re-arranging relationships with their kin and friends. As marital breakdown fundamentally transforms the women s relational field, it forces them to recreate substitutive relations in a flexible way and, simultaneously, to re-construct themselves and their lives without a ready or positive cultural or behavioural template. This process reveals the agency of the divorced and separated women as well as shedding light on issues of gender and the cultural construction of the person in South India. This topical study explores the previously neglected subject of marital breakdown in India and shows the new meaning of kinship in South India.

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Migraine is the common cause of chronic episodic headache, affecting 12%-15% of the Caucasian population (41 million Europeans and some half a million Finns), and causes considerable loss of quality of life to its sufferers, as well as being linked to increased risk for a wide range of conditions, from depression to stroke. Migraine is the 19th most severe disease in terms of disability-adjusted life years, and 9th among women. It is characterized by attacks of headache accompanied by sensitivity to external stimuli lasting 4-72 hours, and in a third of cases by neurological aura symptoms, such as loss of vision, speech or muscle function. The underlying pathophysiology, including what triggers migraine attacks and why they occur in the first place, is largely unknown. The aim of this study was to identify genetic factors associated with the hereditary susceptibility to migraine, in order to gain a better understanding of migraine mechanisms. In this thesis, we report the results of genetic linkage and association analyses on a Finnish migraine patient collection as well as migraineurs from Australia, Denmark, Germany, Iceland and the Netherlands. Altogether we studied genetic information of nearly 7,000 migraine patients and over 50,000 population-matched controls. We also developed a new migraine analysis method called the trait component analysis, which is based on individual patient responses instead of the clinical diagnosis. Using this method, we detected a number of new genetic loci for migraine, including on chromosome 17p13 (HLOD 4.65) and 10q22-q23 (female-specific HLOD 7.68) with significant evidence of linkage, along with five other loci (2p12, 8q12, 4q28-q31, 18q12-q22, and Xp22) detected with suggestive evidence of linkage. The 10q22-q23 locus was the first genetic finding in migraine to show linkage to the same locus and markers in multiple populations, with consistent detection in six different scans. Traditionally, ion channels have been thought to play a role in migraine susceptibility, but we were able to exclude any significant role for common variants in a candidate gene study of 155 ion transport genes. This was followed up by the first genome-wide association study in migraine, conducted on 2,748 migraine patients and 10,747 matched controls followed by a replication in 3,209 patients and 40,062 controls. In this study, we found interesting results with genome-wide significance, providing targets for future genetic and functional studies. Overall, we found several promising genetic loci for migraine providing a promising base for future studies in migraine.

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In a framework of Intellectual Capital (IC), the effects and interactions of a Worksite Fitness Program (WFP) policy was studied with a multidisciplinary approach. In a preliminary study, indicators for physical activity (PAI), physical fitness (PFI), activity in WFP on a regular (WFPI) and on a events basis (WFPE) were created in line with positive findings regarding the associations between physical activity and fitness patterns and sick leave, perceived health, and self-assessed work ability. The intensity of physical activity was found to be the most important variable to predict positive associations with the above mentioned wellness parameters. In four case study follow-up settings, the effects and interactions of physical activity and fitness patterns and the company’s WFP-policy on different elements of IC were studied. Qualitative methods were applied in constructing indicators and a descriptive IC measure for each case company. In cross-sectional and follow-up settings, several findings with respect to IC were found regarding physical activity in general and activity in WFP in particular. Findings were relatively strong in health and wellness related indicators in Human Capital, where, as also in Structural Capital indicators such as the company climate and employee-superior relationship, revealed positive associations. Physical activity patterns were found to act in minor role in Relational Capital. Overall, WFP was seen to be an integrated part of Structural Capital. From the viewpoint of Worksite Fitness Program as a phenomenon, this study positioned WFP as an active element of Intellectual Capital. The literature in the field of WFP emphasizes the role of WFP as an instrument to activate employees in physical activity, and thus promote their health and wellbeing. With the wider perspective the active and long range WFP policy can support a company’s Structural and Relational Capital in line with the fundamental role it has on Human Capital.

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Tutkimuksessa lähestytään oikeusvaltion paradoksia tarkastelemalla sen ilmenemistä valtiopäiväkeskusteluissa, joita käytiin hallituksen esityksistä tasavallan suojelulaiksi vuosina 1930 ja 1936. Oikeusvaltion paradoksin ytimessä on kysymys siitä, miten yksityisen oikeussubjektin myös valtion harjoittamalta mielivallalta nauttima suoja voidaan taata, kun eduskunta on ylin lainsäätäjä ja voi muuttaa myös perustuslakia, jossa tuo suoja taataan. Tämä kysymys korostuu etenkin poikkeusoloissa, jolloin toimeenpanovallalla tulisi olla riittävät valtuudet vaikean tilanteen ratkaisemiseksi. Oikeusvaltion paradoksin kannalta keskeisiä ovat muodollinen, laillisuutta ja muotoja painottava sekä materiaalinen, oikeusjärjestyksen sisällöllisiä periaatteita, kuten perusoikeuksia painottava oikeusvaltiotulkinta. Nämä kaksi tulkintaa ovat vaikeissa tilanteissa toistensa kanssa ristiriidassa ja päättäjät joutuvat tasapainoilemaan niiden välillä: toimiako tehokkaasti yhteiskuntajärjestyksen turvaamiseksi, jolloin on riski valtion sisältä käsin tapahtuvasta oikeusvaltion murenemisesta, vai kunnioittaako perusoikeuksia ja altistaa valtakunta ulkoiselle vallankaappaukselle tai muille järjestyshäiriöille. Tutkimuskysymystä tarkastellaan vuosina 1930 ja 1936 eduskunnalle annettujen hallituksen tasavallan suojelulakiesitysten myötä. Esitykset tasavallan suojelulaiksi antoivat presidentille oikeuden, mikäli valtakuntaa uhkasi vaara tai yleinen järjestys ja turvallisuus olivat uhattuina, rajoittaa tiettyjä hallitusmuodon toisessa luvussa taattuja perusoikeuksia. Vuonna 1930 lapuanliikkeen aiheuttama vallankaappauksen uhka oli todellinen ja hallituksen oli pakko antaa sen vaatimia säädöksiä kommunistisen toiminnan tukahduttamiseksi. Paradoksaalisesti laki oli samanaikaisesti lapuanliikkeen painostuksen tulos että yritys ottaa tilanne haltuun poikkeuslailla. Vuonna 1936 tilanne oli huomattavasti rauhallisempi. Lakia perusteltiin sekä maailmanpoliittisen tilanteen epävakaudella että tarpeella säätää poikkeustilanteista etukäteen osana pysyvää lainsäädäntöä. Valtuuksia ei kuitenkaan haluttu säätää osaksi valtiosääntöä, vaan säädös annettiin erillisenä poikkeuslakina. Eduskuntakeskustelussa kannat jakautuivat yleisesti ottaen siten, että lakien vastustajat esittivät materiaaliseen oikeusvaltiotulkintaan ja kannattajat muodolliseen oikeusvaltiotulkintaan lukeutuvia argumentteja. Vastustajien mielestä oli tärkeää kunnioittaa kansalaisten perusoikeuksia ja perustuslakien pysyvyyttä. He myös pelkäsivät lakien mahdollistamaa hallinnollista mielivaltaa. Lakien kannattajat puolestaan korostivat demokratian itsepuolustuksen tärkeyttä: oli yksilön kannalta parasta oikeusturvaa, että kumoukselliset voimat voitiin pitää kurissa. Vuoden 1930 laki jätettiin lepäämään yli vaalien ja hyväksyttiin lopullisesti syksyllä 1930. Se oli osa kommunistilakipakettia, mutta sitä käytettiin lapuanliikkeen hillitsemiseksi ja Mäntsälän kapinan kukistamiseksi vuonna 1932. Vuoden 1936 laki hylättiin eduskunnassa. Vuonna 1939 annettiin vielä kolmas hallituksen esitys tasavallan suojelulaiksi. Se jätettiin lepäämään yli vaalien ja hyväksyttiin syksyllä 1939. Hallituksen laajennettuja valtuuksia tarvittiin tällä kertaa sellaisia henkilöitä vastaan, joista voisi olla uhkaa Suomen ulkoiselle turvallisuudelle. Lain nojalla tehtiin satoja poliittiseen vasemmistoon kohdistuneita turvasäilöpidätyksiä sodan aikana. Tämä laki on kuitenkin rajattu tutkimuksen ulkopuolelle.

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Fire is an important driver of the boreal forest ecosystem, and a useful tool for the restoration of degraded forests. However, we lack knowledge on the ecological processes initiated by prescribed fires, and whether they bring about the desired restoration effects. The purpose of this study was to investigate the impacts of low-intensity experimental prescribed fires on four ecological processes in young commercial Scots pine (Pinus sylvestris) stands eight years after the burning. The processes of interest were tree mortality, dead wood creation, regeneration and fire scar formation. These were inventoried in twelve study plots, which were 30 m x 30 m in size. The plots belonged to two different stand age classes: 30-35 years or 45 years old at the time of burning. The study was partly a follow-up of study plots researched by Sidoroff et al. (2007) one year after burning in 2003. Tree mortality increased from 183 stems ha-1 in 2003 to 259 stems ha-1 in 2010, corresponding to 15 % and 21 % of stem number respectively. Most mortality was experienced in the stands of the younger age class, in smaller diameter classes and among species other than Scots pine. By 2010, the average mortality of Scots pine per plot was 18%, but varied greatly ranging from 0% to 63% of stem number. Delayed mortality, i.e. mortality that occurred between 2 and 8 years after fire, seemed to become more important with increasing diameter. The input of dead wood also varied greatly between plots, from none to 72 m3 ha-1, averaging at 12 m3 ha-1. The amount of fire scarred trees per plot ranged from none to 20 %. Four out of twelve plots (43 %) did not have any fire scars. Scars were on average small: 95% of scars were less than 4 cm in width, and 75% less than 40 cm in length. Owing to the light nature of the fire, the remaining overstorey and thick organic layer, regeneration was poor overall. The abundance of pine and other seedlings indicated a viable seed source existed, but the seedlings failed to establish under dense canopy. The number of saplings ranged from 0 to 12 333 stems ha-1. The results of this study indicate that a low intensity fire does not necessarily initiate the ecological processes of tree mortality, dead wood creation and regeneration in the desired scale. Fire scars, which form the basis of fire dating in fire history studies, did not form in all cases.