Predictors of remission in the treatment of major depressive disorder: real-world evidence from a 6-month prospective observational study

BACKGROUND: This study examined potential predictors of remission among patients treated for major depressive disorder (MDD) in a naturalistic clinical setting, mostly in the Middle East, East Asia, and Mexico. METHODS: Data for this post hoc analysis were taken from a 6-month prospective, noninterventional, observational study that involved 1,549 MDD patients without sexual dysfunction at baseline in 12 countries worldwide. Depression severity was measured using the Clinical Global Impression of Severity and the 16-item Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR16). Depression-related pain was measured using the pain-related items of the Somatic Symptom Inventory. Remission was defined as a QIDS-SR16 score ≤5. Generalized estimating equation regression models were used to examine baseline factors associated with remission during follow-up. RESULTS: Being from East Asia (odds ratio [OR] 0.48 versus Mexico; P<0.001), a higher level of depression severity at baseline (OR 0.77, P=0.003, for Clinical Global Impression of Severity; OR 0.92, P<0.001, for QIDS-SR16), more previous MDD episodes (OR 0.92, P=0.007), previous treatments/therapies for depression (OR 0.78, P=0.030), and having any significant psychiatric and medical comorbidity at baseline (OR 0.60, P<0.001) were negatively associated with remission, whereas being male (OR 1.29, P=0.026) and treatment with duloxetine (OR 2.38 versus selective serotonin reuptake inhibitors, P<0.001) were positively associated with remission. However, the association between Somatic Symptom Inventory pain scores and remission no longer appeared to be significant in this multiple regression (P=0.580), (P=0.008 in descriptive statistics), although it remained significant in a subgroup of patients treated with selective serotonin reuptake inhibitors (OR 0.97, P=0.023), but not in those treated with duloxetine (P=0.182). CONCLUSION: These findings are largely consistent with previous reports from the USA and Europe. They also highlight the potential mediating role of treatment with duloxetine on the negative relationship between depression-related pain and outcomes of depression.

”The music the world makes has no words”: Musiikillisen tradition funktiot ja merkitys Toni Morrisonin romaanissa Jazz

Pro gradu -tutkielmassani tarkastelen niitä merkityksiä, joita afrikkalaisamerikkalainen musiikillinen esitystraditio saa Nobel-kirjailija Toni Morrisonin romaanissa Jazz (1992).Morrison on toistuvasti löytänyt vertailukohdan omalle kirjoittamiselleen mustasta musiikkitraditiosta. Kuvaillessaan Jazz-romaanin luomisprosessia hän on kertonut pyrkineensä rakentamaan teoksen improvisatorisen jazz-performanssin muotoon. Tutkielmassa kysyn, millä tavalla tämä jazz-improvisatorinen kerrontamuoto ilmenee Jazz-romaanissa ja miksi musiikki ja kerronnan musiikillisuus on saanut niin merkittävän roolin afrikkalaisamerikkalaisen kirjallisuuden traditiossa. Keskeiselle sijalle tutkielmassani nousee ajatus improvisatorisesta jazz-performanssista sekä romaania ohjaavana kerronnallisena periaatteena että mustan diasporisen kulttuurin ja identiteetin rakentamisen välineenä. Tukeutumalla muun muassa Ralph Ellisonin, James Baldwinin, Albert Murrayn, Henry Louis Gates Jr:n, Houston A. Baker Jr:n, Paul Gilroyn, Kimberly W. Benstonin ja Nathaniel Mackeyn kirjoituksiin mustasta esitystraditiosta tarkastelen, mitä eri merkityksiä jazz- ja blues-musiikille on annettu afrikkalaisamerikkalaisessa kirjallisuudessa. Jazzissa musiikki toimii ensisijaisesti keinona työstää menneisyyttä: musiikillinen improvisaatio avaa tien ihmisen henkilökohtaisten muistojen ja menneisyyden konfliktien tarkastelulle. Kyse on identiteettiprosessista, joka ohjaa toistuvasti määrittelemään uudelleen ne rakenteet, joissa ihmisen minuus kehittyy. Samalla musiikillisuuden taustalta voidaan löytää pyrkimys vapauttaa teos kertovuudesta ja kohdistaa lukijan huomio tekstin tuottamaan liikkeeseen, romaaniin performanssina. Tämä ohjaa kirjallisuuden kohti rituaalista: musiikillisuuden funktiona on tuoda tarina voimakkaammin osaksi lukijan kokemuksellista nykyhetkeä. Morrisonin romaanikirjoittamista ohjaa halu kehittää jatkuvasti uusia mahdollisuuksia ymmärtää ja lähestyä menneisyyttä sekä rakentaa kriittinen suhde afrikkalaisamerikkalaista kulttuuria määrittäneisiin historiallisiin narratiiveihin. Jazzromaanin tapahtumat sijoittuvat keskelle afrikkalaisamerikkalaisen urbaanin kulttuurin ja amerikkalaisen modernismin kehityksen keskeisintä vuosikymmentä, 1920-lukua. Romaanin sisällön analyysissa tarkastelen muun muassa romaanin kaupunkitilan kuvausta ja sen kiinnittymistä urbaanin kulutuskulttuurin tuottamaan visuaaliseen spektaakkeliin. Jazzissa Morrisonin voidaan nähdä työstävän suhdetta tiettyyn historialliseen aikakauteen, joka on merkittävällä tavalla muokannut sekä afrikkalaisamerikkalaista kulttuurista yhteisöllisyyttä että tiettyjä ”mustan” tai ”mustuuden” representaatioita osana amerikkalaista urbaania ympäristöä.

The Importance of Semantics: Visual World Studies on Drawing Inferences and Resolving Anaphors

The present thesis investigated the importance of semantics in generating inferences during discourse processing. Three aspects of semantics, gender stereotypes, implicit causality information and proto-role properties, were used to investigate whether semantics is activated elaboratively during discourse comprehension and what its relative importance is in backward inferencing compared to discourse/structural cues. Visual world eye-tracking studies revealed that semantics plays an important role in both backward and forward inferencing: Gender stereotypes and implicit causality information is activated elaboratively during online discourse comprehension. Moreover, gender stereotypes, implicit causality and proto-role properties of verbs are all used in backward inferencing. Importantly, the studies demonstrated that semantic cues are weighed against discourse/structural cues. When the structural cues consist of a combination of cues that have been independently shown to be important in backward inferencing, semantic effects may be masked, whereas when the structural cues consist of a combination of fewer prominent cues, semantics can have an earlier effect than structural factors in pronoun resolution. In addition, the type of inference matters, too: During anaphoric inferencing semantics has a prominent role, while discourse/structural salience attains more prominence during non-anaphoric inferencing. Finally, semantics exhibits a strong role in inviting new inferences to revise earlier made inferences even in the case the additional inference is not needed to establish coherence in discourse. The findings are generally in line with the Mental Model approaches. Two extended model versions are presented that incorporate the current findings into the earlier literature. These models allow both forward and backward inferencing to occur at any given moment during the course of processing; they also allow semantic and discourse/structural cues to contribute to both of these processes. However, while the Mental Model 1 does not assume interactions between semantic and discourse/structural factors in forward inferencing, the Mental Model 2 does assume such a link.

NĀGĀRJUNA AND SCHELLING: OUTLINES OF A DIALOGUE ON SELF, WORLD, AND VIEWPOINTS

ABSTRACT The paper intends to build a dialogue between Nāgārjuna and Schelling on Self, world, and standpoints, taking as main references Nāgārjuna's The Fundamental Verses of the Middle Way and Schelling's Philosophical Letters on Dogmatism and Criticism. Whereas Nāgārjuna criticizes the substantialization of beings by resorting to the discourse of the dependent co-origination in order to overcome suffering, Schelling, on his turn, refutes the fanaticism based on dogmatism's tenets in favor of the criticism interpreted according to its spirit, and not according to its letter, in order to emancipate humanity. Starting with a succint contextualization of the Eastern and Western philosophical discourse, proceeding further to discuss the philosophies of both thinkers, the paper is concluded by assessing their theories.

Conditions for different autonomy regimes in the world : a fuzzy-set application

Avhandlingen behandlar temat territoriell autonomi ur ett globalt perspektiv. Syftet är dels att kartlägga de territoriella autonomierna i världen och dels att visa hur en ny metod som fuzzy-set kan användas inom ämnesområdet jämförande politik. Forskningsproblemet är att försöka finna de bakgrundsfaktorer som förklarar uppkomsten av territoriell autonomi som sådant. Territoriella autonomier ses som särlösningar inom stater. Dessa regioner har erhållit en specialställning i förhållande till andra regioner inom respektive stat och även i förhållande till centralmakten i övrigt. Regionerna kan därför ses som undantag inom det enhetliga federala, regionala eller decentraliserade systemet inom en viss stat ifråga. En kartläggning visar att det finns 65 specialregioner fördelade på 25 stater i världen. De flesta av dessa utgörs av öar. Resultaten visar att det finns två vägar vilka leder till territoriell autonomi i allmänhet. Den ena vägen är en kombination av etnisk särprägel och liten befolkningsmängd, medan den andra vägen utgörs av kombinationen av historiska orsaker och geografiskt avstånd. Båda vägar är lika giltiga och förutsättningen är en demokratisk miljö.

Solving Challenging Real-World Scheduling Problems

This work contains a series of studies on the optimization of three real-world scheduling problems, school timetabling, sports scheduling and staff scheduling. These challenging problems are solved to customer satisfaction using the proposed PEAST algorithm. The customer satisfaction refers to the fact that implementations of the algorithm are in industry use. The PEAST algorithm is a product of long-term research and development. The first version of it was introduced in 1998. This thesis is a result of a five-year development of the algorithm. One of the most valuable characteristics of the algorithm has proven to be the ability to solve a wide range of scheduling problems. It is likely that it can be tuned to tackle also a range of other combinatorial problems. The algorithm uses features from numerous different metaheuristics which is the main reason for its success. In addition, the implementation of the algorithm is fast enough for real-world use.

World Heritage of the Kvarken Archipelago : Echoes of the Ice Age

The Kvarken Archipelago is Finland’s first Unesco Natural Heritage Site. The story of the Kvarken Archipelago began about 10.000 years ago when the melting of the continental ice sheet as it retreated gave rise to this unique archipelago. The land once forced down by the mass of ice is now gradually rising and continuously creating new landscapes. People, animals and plants have learnt to adjust to their changing conditions in exceptional ways. The Ice Age may be over in Kvarken, but the drama still continues to unfold.

Olemisen soinnit : heideggerilainen tulkinta musiikin ja äänen merkityksistä Terrence Malickin elokuvassa The New World

Elokuva filosofiana ja soivana taiteena ; Kaksi maailmaa, kaksi olemisenymmärrystä ; Puutteenalainen aika ja runoilijan tehtävä ; Runollinen kieli ja fenomenologisuus ; Ääniherkkyys, musiikki ja olemisen kuuntelu ; Wagnerin Reininkulta : olla vai omistaa? ; Mozartin pianokonserton nro 23 hidas osa : miltä olemisenymmärtäminen kuulostaa?.

The world & ourselves

kuv., 14 x 21 cm

Building a creative city brand through an international mega-event : Case: Helsinki World Design Capital 2012

In order to grow, cities are increasingly competing for attention, jobs, investments, visitors, residents and significant events. Cities need to come up with creative solutions to keep up with the competition; they ought to become creative cities. Attracting talented and diverse inhabitants is a key factor in developing a creative city, which on is characterized by openness, tolerance, vibrancy and diversity. Along the need for renewed city images city brand building has become popular. Helsinki is the World Design Capital 2012 (WDC 2012) and this mega-event presents a meaningful opportunity for the city to broadcast itself globally. The purpose of this study is to evaluate how Helsinki brands itself as a creative city through an international mega-event. The sub-aims are to: 1) Map the factors behind the creative city and their relation to the city of Helsinki, 2) Describe the city branding process, 3) Evaluate the role of the Helsinki World Design Capital 2012 mega-event in Helsinki’s creative city brand building. First, the theory discusses the concept of the creative city that has gained growing attention during the past decade. Then, the city branding process is described and the benefits of hosting a mega-event are presented. Finally, co-branding a city and a mega-event in order to generate maximum benefit from the mega-event, is reviewed. This is a qualitative research for which data was collected through three face-to-face interviews, the World Design Capital 2012 bid, Helsinki’s economic development strategy, a consulting firm’s research report on the case city and web-pages. The research reveals that Helsinki has shown interest in the creative city discussion. The terminology around the concept is however approached carefully. Helsinki fits many of the creative city characteristics and recognizes its flaws for which improvement strategies have been planned. Bottlenecks keeping the city from promoting a more open mind were mainly revealed in its organizational structures. Helsinki has no official brand strategy; nonetheless pressure to develop one is present. The World Design Capital 2012 mega-event is seen as a meaningful stepping board to strengthen Helsinki’s identity and image, and start thinking about a city brand. The brand strategies of the mega-event support the values and virtues of the city itself, which enables benefits of co-branding introduces in the theory part. Helsinki has no official brand and doesn’t call itself a creative city, however this study shows signs of the city taking steps towards building a creative city brand with the help of the Helsinki World Design Capital 2012 mega-event.