La història de la llengua contemporània davant les escriptures populars de l'exili

The studies that have been carried out about the history of contemporary Catalan have used, generally, sources coming from literary, intellectual and politician fields. Often, sources from common people have been omitted. However, they are documents which provide a very important proof to notice not only the Catalan vitality but also the level of the application of the current rules. This article proposes to highlight ordinary writings as an object of study that will allow us analyze several aspects related to the history of language and sociolinguistics. The study focuses on the ordinary writings that emerged in the Republican exile in 1939, a capital period in the production of such documents

Lateral periodontal cysts: a retrospective study of 11 cases

Objective: To describe the clinical, radiological and histopathological features of lateral periodontal cysts among patients diagnosed in different centers (Vall d"Hebron General Hospital, Granollers General Hospital, the Teknon Medical Center, and the Master of Oral Surgery and Implantology of the University of Barcelona Dental School; Barcelona, Spain). Study design: A retrospective observational study was made of 11 lateral periodontal cysts, all of which were diagnosed following a thorough clinical examination, radiological study and posterior histological study. Results: The mean patient age was 37 years, and males predominated over females. The mean lesion size was 1.25 cm. A single relapse was recorded 7 years after removal of the initial lesion. All the cysts were surgically removed. Discussion and conclusions: Lateral periodontal cysts are very infrequent, and are characterized by the preserved vitality of the adjacent teeth. Identification of the lesion is initially based on the clinical findings, though histological study is required to confirm the diagnosis. The treatment of choice is the surgical removal, though occasional relapses have been documented

Elämänlaatu ja iäkkäiden kaatumisten ehkäisy

Quality of life and fall prevention among the aged Improvement of quality of life is considered to be one of the most important goals of prevention, treatment and rehabilitation among the aged. The study aimed to describe and assess fall prevention interventions as a quality of life indicator, and to describe the social dimension of health-related quality of life among the aged. In addition, it aimed to assess the effects of fall prevention intervention on quality of life among the aged. The study was implemented by using a methodological triangulation. The data in the systematic review was retrieved from the databasis of medical and nursing sciences. Home-dwelling aged (n=19) participated in the qualitative study of a social dimension of quality of life. The data was gathered by the thematic interview method. The quantitative multifactorial fall prevention study comprised 591 participants, either the aged living at home or in sheltered housing, showing an increased risk of falling. Participants were randomized into an intervention or a control group. Follow-up measurements were carried out after a 12 month intervention. The data was collected by the 15D quality of life instrument and a structured questionnaire. Based on the systematic review, only in a few studies fall prevention produced positive effects on dimensions of quality of life (physical function, social function, vitality, mental health, environmental domain). Based on the thematic interview the social dimension of quality of life consisted of three themes: personal values, personal milieu and personal daily life. Based on the fall prevention program, depressive symptoms and distress decreased, managing in usual activities improved, sexual activity and phone contacts increased among men. In women, managing in usual activities improved, socializing increased and discomfort and symptoms decreased. Within the groups, self-perceived health improved among women in the intervention group and among men in the control groups. In addition, fear of falling and feelings of insecurity reduced among women in the intervention group. Personal daily life with its activities opened up new perspectives into the social dimension of good quality of life, which was emphasized especially in the interviews of the oldest participants. Multifactorial fall prevention can affect positively some physical and psychosocial dimensions of quality of life among the community-dwelling aged. Additional studies with larger sample sizes, longer follow-up periods and multiple outcome measures are needed. Fall prevention intervention may affect quality of life by different mechanisms, and the quantitative and qualitative assessment of its effects should also be included in the interventions of randomized controlled trials.

El territorio y la ciudad de Tarraco

This paper presents a brief description of the archaeological research in the territory and in the city of Tarraco, the ancient capital of provincia Hispania Tarraconensis and one of the main centres for the spread of Hispanic Christianity. Althoug Tarraco was the last capital under imperial control and the firs Hispanic metropolitan see, the city had only a secondary role by comparison with other Hispanic cities during late antiquity. This evolution shaped the development of Tarraco during the 7th century, but archaeologists identify an important architectural vitality still in the 6th century at the same time as other episcopal cities were evolving. During this period, the final Christianization of the symbolic spaces of ancient paganism took place, establishing the ideological basis of medieval urbanism that is still preserved today. The paper also interprets the sites through raising key questions as well as describing rural settlements, where archaeological knowledge is not so far advanced, due in part to the difficult nature of archaeological research, and in part to the need to study new construcitve models, as well as to the systematic collection of the relevant material culture.

Makt som fullmakt : ett vårdvetenskapligt perspektiv

The aim of this study is to deepen understanding and knowledge of the concepts and phenomenaof power and authority from the standpoint of caring science. The overall questions of the research are: What is power? What is authority? How do power and authority manifest themselves in the context of caring? How are power and authorityto be understood as caring science concepts? The overall research inception is determination of the concepts in accordance with the hermeneutic approach based on Eriksson's model. The process of understanding follows Gadamer's (1999) hermeneutics. The thesis consists of three part studies. An ontological determinationof the character of the concepts is carried out where a hermeneutic interpretation is made of texts in the Old and the New Testaments in the Bible. The pragmatic features of the concepts are studied on the basis of nurses' written stories of authority and patients' written stories of power and authority. Beside the review of literature concerning power and authority a qualitative meta-analysis ofthe concept and the phenomenon of empowerment are made. The ontological determination shows how a human being's power is the authority to hold every living thing in trust, to tend and care life. To anyone using this authority, serving onesfellow-being is the purpose. Understanding the pragmatical features of authority in the stories of nurses reveals the life-giving nature of serving. By serving the nurse draws near her true mission as a human being, her authority to care for life with love. The service of the nurse and her ability to see and confirm the patient's otherness creates confidence and results in her authority. The nursedoes not abandon the responsibility associated with authority. When the patientdoes not entrust the nurse with authority the nurse employs her inherent authority to alleviate the suffering of the patient. The pragmatical features of the concepts of power and authority in the patients' stories indicate how the nurse puts her power to an improper use if she only makes use of the authority conferred by the hierarchy of power in the organisation, assumes all power and fails to use her faculty for loving care. Patients feel that their existence is threatened when the nurse tries to deprive them of their authority; they experience homelessness, despair and impotence. Patients' struggle for existence and absolute dignity deprives their health processes of strength, and their suffering becomes unbearable. Patients recognize their vitality when encountering a nurse who uses her authority to alleviate the patients' suffering. The power of compassion is strong, and the patients' dignity is recreated when they are able to serve fellowpatients or nurses. The purpose of human life can be understood as the use of one's own inner power and strength. Love.

Den vårdande och helande bilden: möten med bildkonst i vårdandets värld

Denna vårdvetenskapliga avhandling syftar till att avtäcka och belysa en vårdande och helande dimension vid existentiellt lidande patienters möten med bildkonst inom vårdkontext. Kunskapssökandet sker i två studier. Den första (studie I) är en ikonografi sk tolkning av konstnären Matthias Grünewalds (ca 1460–1528) senmedeltida altarskåpsmålningar. I studien uttolkas lidandets uttryck och narrativa budskap samt symboliska gestaltningar av vårdande och helande i valda delar av detta s.k. Isenheimaltares bildprogram. Tolkningen utgår från rekonstruktionen av altarskåpets ursprungskontext, det medeltida Isenheimklostret, där svårt sjuka och döende patienter vårdades. I studie två (II) fortsätter sökandet i den moderna hospicevårdens kontext med hjälp av en kvalitativ intervjustudie som utforskar patienters meningsskapande vid möten med självvald bildkonst (oljemålningar och akvareller av fi nländska konstnärer som donerats till det sjukhus där intervjustudien gjordes). Forskningsansatsen är inspirerad av Hans-Georg Gadamers (1901–2002) hermeneutik. Vidare används några nyare tolkningsteoretiska ansatser inom bildkonstens område. Forskningens tolkningsresultat visar att bildkonsten har potentialer såväl på ett miljöestetiskt plan som på en djupare individuell symbolnivå. Som designkomponent i vårdmiljöns rumsliga gestaltning bygger bildkonsten in estetiska, etiska och andliga kvaliteter utifrån tidsmässiga och kulturella koder. I den medeltida klostervårdens kontext sammanföll bildkonstens dekorativa betydelse med andliga och helande syften. När det gäller självvalda konstverk i den moderna vårdkontexten bidrar de till det enskilda patientrummets atmosfär på ett unikt sätt utifrån patientens personlighet och behov. På en fördjupad mötesnivå, i samspel med bildens symboliska funktion, sker en inlevelsemässig förfl yttning in i bildens värld. Betraktarens inlevelse aktiveras till en transcenderande rörelse som går bortom det faktiska rummets och den reella tidens gränser. Vid resor i konstens bildvärld spelas minnesvärda händelser upp från det förgångna, men även framtiden kommer betraktaren till mötes. I en existentiell livssituation söker människan i konstverkets bildinnehåll efter symbolisk mening som kan ge svar på lidandets frågor. Bilderna iscensätter då helande motbilder som utgör korrektiv i symboliska former när olika existentiella förluster hotar. När livet förbleknats av sjukdom besvarar bildvärlden den lidandes blick med lysande violer som blommar upp, ger livskraft och bekräftar personens värdighet mitt i det förvissnande människolivet. När ångest och otrygghet nalkas inbjuds betraktaren till besök i landskap som utvidgar sjukhusrummets väggar mot hemgårdens trygghet. Där livet hotas av förgänglighet tar bildvärlden människan med sig till naturens eviga återfödelse. Upplevelsen av att vara delaktig i ett större och heligt sammanhang öppnar vägen ut ur lidandets avskurenhet. I medeltidens vårdkontext erbjöd den sakrala bilden en kollektiv och helande Symbolon som genom sin representationskraft synliggjorde det osynliga. Vid bildmöten i den moderna hospicevårdens kontext var det naturteman som gläntade på dörren till ”det hemliga rummet i djupet av hjärtat”. Forskningen antyder att även om meningsskapandet i ett bildmöte är avhängigt tidsepok, betraktarens förförståelse och kulturella kontext samt typen av bilder kan bildsymboliken, generellt förstådd som den saknade formen eller det saknade livssammanhanget, framvisa en helande och hoppingivande ordning i lidandets kaos.

Reconstrução da parede torácica nos defeitos adquiridos

Acquired chest wall defects present a challenging problem for thoracic surgeons. Many of such defects can be repaired with the use of local and regional musculocutaneous flaps, but larger defects compromising skeletal structure require increasingly sophisticated reconstructive techniques. The following discussion will review the options for repair acquired chest wall defects based in literature. The authors searched the Pubmed (www.pubmed.com) and found citations from January 1996 to February 2008. By reading the titles and the abstracts most of the citations were discharged because they focused in congenital chest wall defects or were cases report. However, many papers were found describing the outcome of large series of patients with acquired chest wall deformities. A review of recent literature shows that the repair of chest wall defects with soft tissues, if possible, remains the treatment of choice. Large chest wall defects require skeletal reconstruction to prevent paradoxical respiration. The selection of the most appropriate flap is primary dictated by the location and the size of the defect. It is important to transfer tissue with good vitality, so understanding the vascular supply is imperative. Autogenous grafts have been used in the past for skeletal reconstruction but a combination of synthetic materials with musculocutaneous flaps has been used lately. Based in the literature, the use of prosthetic material in chest wall reconstruction does not significantly increases the risk of wound infection.

Yliopiston reunalla. Tutkimus suomalaisen avoimen yliopiston muotoutumisesta

Avoin yliopisto on koulutusmuoto, johon kuka tahansa voi osallistua ja jossa voi suorittaa yliopistotasoisia opintoja. Avoimen yliopiston ideassa keskeistä on koulutuksellisen tasa-arvon edistämisen tavoite. Tämän tutkimuksen tehtävänä on kuvata ja analysoida suomalaisen avoimen yliopiston muotoutumista. Tutkimuksella etsitään vastauksia kolmeen kysymykseen: 1. Millaisten vaiheiden kautta avoin yliopisto on muotoutunut? Mitä avoimen yliopiston historiassa on tapahtunut ja millaista keskustelua näistä tapahtumista on käyty? 2. Millaisia diskursseja avointa yliopistoa koskeneessa keskustelussa voidaan tunnistaa ja miten eri toimijatahot ovat näihin puhetapoihin kiinnittyneet? 3. Millaisena koulutuksellisen tasa-arvon toteuttajana avoin yliopisto näyttäytyy tutkimusaineiston valossa? Tutkimuksen aineisto koostuu erilaisista julkisista teksteistä. Aineistossa on mukana useita erilaisia tekstityyppejä: komiteanmietintöjä ja työryhmäraportteja, korkeakoululaitoksen kehittämissuunnitelmia, muita suunnitteluasiakirjoja, tutkimuksia, selvityksiä, puheenvuoroja ja esitelmiä sekä lehtikirjoituksia. Täydentävänä aineistona on lisäksi käytetty tilastoja. Tutkimusaineistoa on analysoitu diskurssianalyysillä. Keskeisenä lähtökohtana analyysissa on, että tekstien avulla tuotetaan avointa yliopistoa koskevia käsityksiä ja merkityksiä. Nämä merkitykset myös muuttuvat ajassa. Aineiston analyysin tuloksena avoimen yliopiston historiassa voidaan erottaa erilaisia vaiheita ja näiden vaiheiden välisiä taitekohtia. Ensimmäiseksi murrokseksi avoimen yliopiston historiassa voidaan paikantaa avoimen yliopiston synty, joka ajoittui 1970-luvun alkupuoliskolle. Avoin yliopisto sai vakiintuneet puitteensa vasta 1980-luvun puolivälissä, jolloin se organisoitiin osaksi yliopistojen täydennyskoulutusta. Tämä voidaan nähdä avoimen yliopiston historian toisena murroksena. Kolmas murros ajoittui 1990-luvulle, jolloin avoimen yliopiston resursointi muuttui ja nuoret tulivat sen näkyväksi opiskelijaryhmäksi. Tämä murros problematisoi avoimen yliopiston ja tutkintokoulutuksen suhteen aiemmasta poikkeavalla tavalla ja avoimen yliopiston tutkintoväylä nousi keskeiseksi keskusteluteemaksi. Tämä jännite purkautui tultaessa 2000-luvulle, ja tutkinnonuudistuksen yhteydessä avoimen yliopiston väylä sai paikkansa suhteessa kahden syklin tutkintoihin. Nyt elämme tutkinnonuudistuksen jälkeistä aikaa, jolloin avoimen yliopiston väylä vertautuu paljolti maisterikoulutuksiin. Kysymys aikuisten asemasta suhteessa tutkintokoulutukseen on kuitenkin edelleen ajankohtainen. Esillä ovat etenkin kysymykset aiemmin opitun tunnustamisesta, aikuisten ohjauksesta sekä avoimen yliopiston suhteesta työ- ja elinkeinoelämään. Keskustelussa avoimesta yliopistosta on paikannettavissa erilaisia positioita, jotka määrittävät avoimen yliopiston merkitystä ja tehtävää. Näitä positioita voidaan nimittää diskursseiksi, jotka konstituoivat avoimen yliopiston paikkaa yliopistokoulutuksen kentällä. Aineistosta on paikannettu neljä eri diskurssia: (1) akateemisia arvoja painottava yliopistollinen diskurssi, (2) osallistumisen tasa-arvoa korostava sivistyksellisen demokratian diskurssi, (3) yksilöllisiä mahdollisuuksia ja innovatiivisuutta korostava joustavuuden diskurssi sekä (4) työelämää, taloudellisuutta ja statusta korostava tehokkuuden diskurssi. Nämä diskurssit käyvät aineiston teksteissä keskinäisiä neuvotteluja ja kantavat merkityksiä suhteessa toisiinsa. Diskurssien välisiä suhteita voidaan kuvata kahden eri dimension kautta. Yhtäältä vastakkaisiksi arvoiksi asettuvat akateeminen eksklusiivisuus ja koulutuksellinen tasa-arvo. Toisena ulottuvuutena on koulutuksen arvottaminen sivistyksen versus hyödyn näkökulmasta. Avoimen yliopiston tehtävä tasa-arvon edistäjänä on eri aikoina mielletty eri tavoin. Avoimen yliopiston historiassa sen merkitystä ja tehtävää on kehystetty erilaisin puhetavoin, ja eri diskurssipositioiden vuoropuhelun kautta myös avoimen yliopiston tasa-arvotehtävästä on eri aikoina keskusteltu eri tavoin. Avoimen yliopiston alkuvaiheessa sen tehtävänä näyttäytyi sivistyksellisen demokratian turvaajana toimiminen. Kun avoimen yliopiston kurssit käynnistyivät, määrittyi toiminta selkeästi aikuisten koulutukseksi. Avoin yliopisto määrittyikin nyt aikuisten toiseksi mahdollisuudeksi hankkia koulutusta, jota vaille he olivat nuorempina jääneet. Avoimen yliopiston puitteiden lukkoonlyömisen jälkeen keskustelussa nousi vahvasti esiin toiminnan ja opetusmuotojen kehittäminen. Avoin yliopisto määrittyikin nyt aikuisten monipuoliseksi ja joustavaksi koulutusmahdollisuudeksi. Tasa-arvoisten mahdollisuuksien luominen näyttäytyi innovatiivisena, dynaamisena ja eteenpäinpyrkivänä toimintana, jossa otettiin huomioon aikuisten erilaiset tarpeet. Relander-ohjelman myötä avoimen yliopiston julkilausuttu tehtävä nimenomaan aikuisten kouluttajana kuitenkin muuttui. Avoin yliopisto näyttäytyi nyt yksilöllisiä tarpeita palvelevana mahdollisuuksien talona, jossa oli sijaa kaikille. Tärkeäksi määrittyi myös opiskelun tavoitteiden ja motiivien moninaisuus. Tutkinnon suorittamisen avoimen yliopiston opintojen kautta tuli olla realistisesti mahdollista. Viimeisimmän murroksen jälkeen avoin yliopisto määrittyy yhä selvemmin työelämän sekä alueellisten tarpeiden kautta. Avoin yliopisto näyttäytyy joustavana ja erilaisia tarpeita palvelevana opiskelufoorumina. Avoin yliopisto palvelee paitsi yksilöiden, myös työelämän ja yritysten tarpeita sekä on osaltaan turvaamassa alueiden kilpailukykyä ja elinvoimaisuutta. Tässä tutkimuksessa tarkastellaan avointa yliopistoa, sen historiaa ja siitä käytyä keskustelua erityisesti tasa-arvon näkökulmasta. Yhtenä keskeisenä tuloksena on, että avoimen yliopiston paikka on ollut aina jollakin tavalla marginaalissa. Tätä ilmentää mm. yliopistollisuuden ja tasa-arvon välinen jännite, jonka ympärille avointa yliopistoa koskeva keskustelu paljolti on järjestynyt. Ylipäätään aikuisten asemaa yliopistossa määrittää tietty epämukavuus ja täyden legitimiteetin puute erityisesti suhteessa tutkintokoulutukseen. Aikuisten koulutuksesta puhutaan yliopiston yhtenä perustehtävänä ja retorisesti voidaan todeta tämän tehtävän tärkeys. Aikuinen opiskelija aiempine osaamisineen ja osaamistarpeineen positioituu kuitenkin yliopistokoulutuksen ja työelämän väliselle rajapinnalle. Aikuisen paikka määrittyykin yliopiston ytimeen nähden selvästi marginaaliin.

Livets källa kärleken : hälsans urkraft

This basic research focuses on the ethos of health and the human being's becoming in health. The theoretical perspective consists of the caring tradition within caring science developed at Åbo Akademy University. The aim of the present doctoral thesis is to uncover a new understanding as well as to deepen and attain a more nuanced understanding of the ethos of health, the essence of health, by penetrating to the core of what gives the human being the strength for experiencing a becoming in health. The research questions are as follows: l) What is the human being's source of strength? and 2) What reveals the source of strength so that the human being can perceive it and dedicate its strength in order to experience a becoming in health? The primary methodology used in the dissertation is hermeneutical. The material consists of the work Kärlekens gerningar by Kierkegaard, texts from focused interviews with respondents who have lived through severe personal suffering, as well as the book Det bländande mörkret by Wikström. These texts are interpreted through hermeneutical reading. The new horizon of understanding that emerges is reflected towards Eriksson's caritative theory, towards prior research within the tradition of caring science at Åbo Akademy University and towards previous national and international studies within this field. The new understanding shows that the human being's source of strength is love, the essence and origin of life. The substance of health is love, which, through the trinity of faith, hope and love, also makes possible the existence of the source of strength. Love has a deeper dignity than faith and hope, is connected with eternity and is the uniting link between temporality and eternity. The human being's inner longing entails an ontological attraction towards the source of strength. This source of strength is hidden, which provides and maintains its force, like a mystery connected with the darkness of suffering that hides the secret representing the source of strength, life's mystery, bu t w hi ch is revealed in both the darkness of suffering and in the light of joy. The dedication of strength requires freedom, willingness and courage to see the light, despite awareness of shame and guilt. Creative acts liberate the human being for the dedication of strength, which is preceded by a holy presence where, in solitude, the human being makes sacrifices for the sake of his or her human smallness and weakness, and allows himself or herself to be enclosed by the darkness of suffering to discover the light from the source. This entails being enraptured in a quiet "doing" in order to experience the beauty that bears witness to the holy which creates unity. The source of strength is revealed through beauty. The ethos of the human being and the ethos of health have the same fundamental substance, whilst the ethos of life possesses the deepest dimension and concerns the mysterious and infinite eternity. The ethos of life, eternity, which is a wellspring of strength, is not in itself strength-giving unless it is allied with love. Health can be understood in the light of life, of which death is an inevitable part. Life itself constitutes and creates the source which, through its alliance with eternity' s primordial wellspring of strength, generates strength from which the human being's source of strength, love, receives its eternal fervour. The human being is fundamentally interconnected with an abstract other, the first love, a universal wellspring of strength. Through Communion with this abstract other a dedication of the strength to experience a becoming in health becomes possible. Love for one's neighbour is the fundamental substance in the movement of becoming in health. Becoming in health presupposes a simultaneous movement in which the human being practices the human calling through ethos. As one loves one's neighbour through actions the still forces of eternity are in motion. When life emerges in the foreground and becomes the home of the human being, a dedication of the power of love is possible. Life itself determines the human being's becoming in health. A humble fundamental attitude towards life constitutes the basis for a continuous dedication of vitality from this source.

Comparison of two questionnaires which measure the health-related quality of life of idiopathic pulmonary fibrosis patients

The objective of the present study was to determine if there is a health-related quality of life (HRQL) instrument, generic or specific, that better represents functional capacity dysfunction in idiopathic pulmonary fibrosis (IPF) patients. HRQL was evaluated in 20 IPF patients using generic and specific questionnaires (Medical Outcomes Short Form 36 (SF-36) and Saint George's Respiratory Questionnaire (SGRQ), respectively). Functional status was evaluated by pulmonary function tests, 6-min walking distance test (6MWDT) and dyspnea indexes (baseline dyspnea index) at rest and after exercise (modified Borg scale). There was a restrictive pattern with impairment of diffusion capacity (total lung capacity, TLC = 71.5 ± 15.6%, forced vital capacity = 70.4 ± 19.4%, and carbon monoxide diffusing capacity = 41.5 ± 16.2% of predicted value), a reduction in exercise capacity (6MWDT = 435.6 ± 95.5 m) and an increase of perceived dyspnea score at rest and during exercise (6 ± 2.5 and 7.1 ± 1.3, respectively). Both questionnaires presented correlation with some functional parameters (TLC, forced expiratory volume in 1 s and carbon monoxide diffusing capacity) and the best correlation was with TLC. Almost all of the SGRQ domains presented a strong correlation with functional status, while in SF-36 only physical function and vitality presented a good correlation with functional status. Dyspnea index at rest and 6MWDT also presented a good correlation with HRQL. Our results suggest that a specific instead of a generic questionnaire is a more appropriate instrument for HRQL evaluation in IPF patients and that TLC is the functional parameter showing best correlation with HRQL.

Relationship between the quality of life and the severity of obstructive sleep apnea syndrome

The effects of sleep disorders on the quality of life (QOL) have been documented in the literature. Excessive sleepiness and altered circadian rhythms may negatively affect ability to learn, employment, and interpersonal relations, and directly degrade QOL. The objective of the present study was to evaluate the impact of obstructive sleep apnea syndrome of varying severity on QOL. The study was conducted on 1892 patients aged 18 years or older referred by a physician to the Sleep Institute, São Paulo, with complaints related to apnea (snoring, excessive daytime sleepiness, hyperarousal, and fatigue). They were submitted to overnight polysomnography for the diagnosis of sleep disorders from August 2005 through April 2006. The patients completed the Epworth Sleepiness Scale and QOL SF-36 sleep questionnaires. They were classified as non-physically active and physically active and not-sleepy and sleepy and the results of polysomnography were analyzed on the basis of the apnea hypopnea index (AHI). The apneic subjects showed a reduction in QOL which was proportional to severity. There was a significant decrease in all domains (physical functioning, role physical problems, bodily pain, general health perceptions, vitality, social functioning, emotional problems, general mental health) for apneics with AHI >30, who generally were sleepy and did not participate in physical activities (P < 0.05). The present study provides evidence that the impact of sleep disorders on QOL in apneics is not limited to excessive daytime sleepiness and that physical activity can contribute to reducing the symptoms. Thus, exercise should be considered as an adjunct interventional strategy in the management of obstructive sleep apnea syndrome.

The cytotoxicity of methacryloxylethyl cetyl ammonium chloride, a cationic antibacterial monomer, is related to oxidative stress and the intrinsic mitochondrial apoptotic pathway

Antibacterial monomers incorporated in dentin bonding systems may have toxic effects on the pulp. Thus, the cytotoxicity of antibacterial monomers and its underlying mechanisms must be elucidated to improve the safety of antibacterial monomer application. The influence of an antibacterial monomer, methacryloxylethyl cetyl ammonium chloride (DMAE-CB), on the vitality of L929 mouse fibroblasts was tested using MTT assay. Cell cycle progression was studied using flow cytometry. Production of intracellular reactive oxygen species (ROS) after DMAE-CB treatment was measured using 2,7-dichlorodihydrofluorescein diacetate staining and flow cytometry analysis. Loss of mitochondrial membrane potential, disturbance of Bcl-2 and Bax expression, as well as release of cytochrome C were also measured using flow cytometry analysis or Western blot to explore the possible involvement of the mitochondrial-related apoptotic pathway. DMAE-CB elicited cell death in a dose-dependent manner and more than 50% of cells were killed after treatment with 30 µM of the monomer. Both necrosis and apoptosis were observed. DMAE-CB also induced G1- and G2-phase arrest. Increased levels of intracellular ROS were observed after 1 h and this overproduction was further enhanced by 6-h treatment with the monomer. DMAE-CB may cause apoptosis by disturbing the expression of Bcl-2 and Bax, reducing the mitochondrial potential and inducing release of cytochrome C. Taken together, these findings suggest that the toxicity of the antibacterial monomer DMAE-CB is associated with ROS production, mitochondrial dysfunction, cell cycle disturbance, and cell apoptosis/necrosis.

Human fetal malformations associated with the use of an angiotensin II receptor antagonist: Case Report

Introduction: The potential risks related to drug exposure during pregnancy represent a vast chapter in modern obstetrics and data regarding the safety of antihypertensive drugs during pregnancy are relatively scarce. Case report: A 37-year-old patient discovered her fifth pregnancy at our hospital after 26 weeks and 4 days of gestation. She reported a history of hypertension and was currently being treated with Losartan. Hospitalization was recommended for the patient and further evaluation of fetal vitality was performed. On the fourth day an ultrasound was performed, resulting in a severe oligohydramnios, fetal centralization and abnormal ductus venosus. After 36 hours, the newborn died. Pathologic evaluation: At autopsy, the skullcap had large fontanels and deficient ossification. The kidneys were slightly enlarged. A microscopic examination detected underdevelopment of the tubules and the presence of some dilated lumens. Immunohistochemical detection of epithelial membrane antigen was positive. Immunoreactivity of CD 15 was also assayed to characterize the proximal tubules, and lumen collapse was observed in some regions. Discussion: Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor antagonists (ARAs) are among the most widely prescribed drugs for hypertension. They are often used by hypertensive women who are considering become pregnant. While their fetal toxicity in the second or third trimesters has been documented, their teratogenic effect during the first trimester has only recently been demonstrated. Conclusion: Constant awareness by physicians and patients should be encouraged, particularly in regard to the prescription of antihypertensive drugs in women of childbearing age who are or intend to become pregnant.

Människans liv med sömnbesvär och hur människor med sömnbesvär upplever kognitiv beteendeterapi

Sleep disorders are a common health problem in western countries. Every third working age person suffers from sleep deprivation and that often leads to other health problems as well. One can end up in a vicious circle, which can further decrease mood and ability to function. The aim of this thesis is to illustrate how sleep deprivation affects the lives of working age population and to deepen our understanding of life with sleep deprivation. Study questions are: how does sleep deprivation affect a working age person’s life and what kind of experiences do people have about cognitive-behavioural therapy as a treatment to sleep disorders. Theoretical perspective is based on clinical nursing science theories and the humanist view of man, which sees human as an entity. The methodology used is phenomenological approach and data analysis is conducted by using Ricœur’s hermeneutic phenomenological interpretation method. The empirical part is divided into two different sections. The material of the study consists of interviews and surveys done by people who have experienced sleep deprivation or sleep disorders. Two interviewees talked about their lives with sleep disorders and there are 21 surveys conducted on people’s experiences on cognitive-behavioural therapy. The partakers in the two sections are different people. The results show that people with sleep disorders can end up in a vicious circle of sleep deprivation and in worst cases a sleep disorder can take charge of a person’s whole life. Sleep disorder can cause shame and fear of stigma. Nevertheless, someone suffering from a sleep disorder can find strength and solutions to control the difficult situation. This study proves that both nursing staff and other people have little information about difficulties in sleeping and awareness should be improved in clinical nursing. A health-care provider has an essential role in preventing someone ending up in a vicious circle of sleep deprivation and cognitive-behavioural therapy can contribute to good health. Reflection at the end of cognitive-behavioural sleep therapy course helps patients to continue their learning process. When someone is sleep deprived, it means that they have control over the situation, but when someone has a sleep disorder, that person does not have the strength to control the situation.

In search of good relationships to music : understanding aspiration and challenge in developing music school teacher practices

This study focuses on teacher practices in publicly funded music schools in Finland. As views on the aims of music education change and broaden, music schools across Europe share the challenge of developing their activities in response. In public and scholarly debate, there have been calls for increased diversity of contents and concepts of teaching. In Finland, the official national curriculum for state-funded music schools builds on the ideal that teaching and learning should create conditions which promote ‘a good relationship to music’. The meaning of this concept has been deliberately left open in order to leave room for dialogue, flexibility, and teacher autonomy. Since what is meant by ‘good’ is not defined in advance, the notion of ‘improving’ practices is also open to discussion. The purpose of the study is to examine these issues from teachers’ point of view by asking what music school teachers aim to accomplish as they develop their practices. Methodologically, the study introduces a suggestion for building empirical research on Alperson’s ‘robust’ praxial approach to music education, a philosophical theory which is strongly committed to practitioner perspectives and musical diversity. A systematic method for analysing music education practices, interpretive practice analysis, is elaborated with support from interpretive research methods originally used in policy analysis. In addition, the research design shows how reflecting conversations (a collaborative approach well-known in Nordic social work) can be fruitfully applied in interpretive research and combined with teacher inquiry. Data have been generated in a collaborative project involving five experienced music school teachers and the researcher. The empirical material includes transcripts from group conversations, data from teacher inquiry conducted within the project, and transcripts from follow-up interviews. The teachers’ aspirations can be understood as strivings to reinforce the connection between musical practices and various forms of human flourishing such that music and flourishing can sustain each other. Examples from their practices show how the word ‘good’ receives its meaning in context. Central among the teachers’ concerns is their hope that students develop a free and sustainable interest in music, often described as inspiration. I propose that ‘good relationships to music’ and ‘inspiration’ can be understood as philosophical mediators which support the transition from an indeterminate ‘interest in music’ towards specific ways in which music can become a (co-)constitutive part of living well in each person’s particular circumstances. Different musical practices emphasise different aspects of what is considered important in music and in human life. Music school teachers consciously balance between a variety of such values. They also make efforts to resist pressure which might threaten the goods they think are most important. Such goods include joy, participation, perseverance, solid musical skills related to specific practices, and a strong sense of vitality. The insights from this study suggest that when teachers are able to create inspiration, they seem to do so by performing complex work which combines musical and educational aims and makes general positive contributions to their students’ lives. Ensuring that teaching and learning in music schools remain as constructive and meaningful as possible for both students and teachers is a demanding task. The study indicates that collaborative, reflective and interdisciplinary work may be helpful as support for development processes on both individual and collective levels of music school teacher practices.