Raju leikkauslista : Tiedotteiden referointi uutisteksteissä

Tutkielmassa tarkastellaan moniäänisyyden osoittamista tiedotteissa ja verkkolehtien kirjoittamissa uutisteksteissä. Tutkimuskysymyksenä on, miten Keskuskauppakamarin tiedotteiden ääni muuttuu tiedotteen matkalla uutiseksi. Tarkastelussa on uutistekstit, jotka on kirjoitettu lähinnä tiedotteiden pohjalta. Tutkimuskysymyksen käsittelyssä hyödynnetään systeemis-funktionaalisen kielenteorian suhtautumisen teoriaa ja intertekstuaalisuuden tutkimusta. Aineistona on Keskuskauppakamarin viisi julkista sektoria koskevaa tiedotetta vuodelta 2014 ja tiedotteista kirjoitetut uutistekstit valtakunnallisissa verkkolehdissä. Verkkolehdistä kolme on poliittisesti sitoutunutta, kuusi sitoutumattomia. Uutistekstejä on yhteensä 13. Tutkielman keskeisinä havaintoina on lähdemainintojen runsas käyttö uutisissa. Lehdet käyttävät useimmiten neutraaleja lähdeviittauksia. Johtoilmauksilla projisoidaan myös sellaisia väittämiä, jotka tiedotteessa on esitetty yksiäänisinä. Uutisteksteissä osoitetaan tiedotteiden myötäilyä lainaamalla tiedotetta suoraan. Muutamissa tapauksissa lehdet muuttavat vain joitakin sanajärjestyksiä ja otsikon. Tiedotteissa osoitettuja suoria evaluointeja käytetään uutisissa sellaisinaan ääneen myös ilman lähdeviitteitä. Etäännytystä osa aineiston lehdistä osoittaa käyttämällä asenteellisia kielenilmauksia, referoivaa konditionaalia tai etäännyttäviä lainausmerkkejä. Otsikoissa lehdet usein tuovat esiin lehden näkökulman uutiseen. Suurimmassa osassa verkkolehtiä muotoilu on näkyvästi erilainen, vaikka aineiston kaikissa tapauksissa otsikon ajatus on sama kuin tiedotteissa. Tiedotteiden ääni pääsee uutisissa kuuluviin sekä neutraalisti että myötäilevin ja etäännyttävin referoinnin keinoin. Pääasiassa uutisissa käytetyt puheen esittämisen keinot ovat neutraalimpia kuin tiedotteissa. Tuloksista kuitenkin havaitaan, että suhtautumista voi objektiivisilta vaikuttavissa teksteissä esittää monin tavoin niin tiedotteissa kuin uutisissakin

Left Ventricular Hypertrophy is a predictor of cardiovascular events in elderly hypertensives: hypertension in the the very elderly trial (HYVET)

Objective: We assessed the prognostic value of electrocardiographic left ventricular hypertrophy (LVH) using Sokolow-Lyon (SL-LVH), Cornell Voltage (CV-LVH) or Cornell Product (CP-LVH) Criteria in 3043 hypertensive people aged 80 years and over enrolled in the Hypertension in the Very Elderly Trial. Methods: Multivariate Cox proportional hazard models were used to estimate hazard ratios (HR) with 95% confidence intervals (CI) for all-cause mortality, cardiovascular diseases, stroke and heart failure in participants with and without LVH at baseline. The mean follow-up was 2.1 years. Results: LVH identified by CV- or CP-LVH Criteria was associated with a 1.6 to 1.9-fold risk of cardiovascular disease and stroke. The presence of CP-LVH was associated with an increased risk of heart failure (HR 2.38, 95% CL 1.16-4.86). In gender specific analyses, CV-LVH (HR 1.94, 95%Cl 1.06-3.55) and CP-LVH (HR 2.36, 95% CI 1.25-4.45) were associated with an increased risk of stroke in women and of heart failure in men, CV-LVH (HR 6.47, 95 % Cl 1.41-29.79) and CP-LVH (10.63, 95Cl % 3.58-31.57), respectively. There was no significant increase in the risk of any outcomes associated with SL LVH. LVH identified by these three methods was not a significant predictor of all-cause mortality. Conclusions: Use of Cornell Voltage and Cornell Product criteria for LVH predicted the risk of cardiovascular disease and stroke. Only Cornell Product was associated with an increased the risk of heart failure. This was particularly the case in men. The identification of electrocardiographic LVH proved to be important in very elderly hypertensive people

Demokratian synnystä moderniin moniarvoisuuteen 1900-luvulla

Aineisto on Opiskelijakirjaston digitoimaa ja Opiskelijakirjasto vastaa aineiston käyttöluvist

Eutanasia ei ole sallittua Suomessa

Kommentti Juha Hännisen kirjoitukseen SLL 71(21):1508-1509, 2016Non peer reviewe

Antihypertensive treatment decreases arterial stiffness at night but not during the day. Results from the Hypertension in the Very Elderly Trial

The main Hypertension in the Very Elderly Trial (HYVET) demonstrated a very marked reduction in cardiovascular events by treating hypertensive participants 80 years or older with a low dose, sustained release prescription of indapamide (indapamide SR, 1.5 mg) to which was added a low dose of an angiotensin converting enzyme inhibitor in two-thirds of cases (perindopril 2–4 mg). This report from the ambulatory blood pressure sub-study investigates whether changes in arterial stiffness and ambulatory blood pressure (BP) could both explain the benefits observed in the main trial. A total of 139 participants were randomized to placebo [67] and to active treatment [72] and had both day and night observations of BP and arterial stiffness as determined from the Q wave Korotkoff diastolic (QKD) interval. The QKD interval was 5.6 ms longer (p = 0.017) in the actively treated group at night than in the placebo group. This was not true for the more numerous daytime readings so that 24-h results were similar in the two groups. The QKD interval remained longer at night in the actively treated group even when adjusted for systolic pressure, heart rate and height. The reduced arterial stiffness at night may partly explain the marked benefits observed in the main trial

Smoking and cancer, cardiovascular and total mortality among older adults: The Finrisk Study

Little information is available about the deleterious effect of smoking in older adults The objective of this study was to assess the relationship of smoking habits with cancer, CVD and all-cause mortality in late middle-age (45–64 years) and older (65–74) people. This cohort study of 6516 men and 6514 women studied the relationship of smoking habits with cancer, cardiovascular disease (CVD) and all-cause mortality among middle-aged and older Finnish men and women during 1997–2013. The study cohort was followed up until the end of 2013 (median follow-up time was 11.8 years). Mortality data were obtained from the National Causes of Death Register and data on incident stroke events from the National Hospital Discharge Register. Adjusted Hazard ratios (HR) for total mortality were 2.61 (95% Confidence interval 2.15–3.18) among 45–64 years-old men and 2.59 (2.03–3.29) in 65–74 years-old men. The corresponding HRs for women 45–64 years-of-age were 3.21 (2.47–4.19) and 3.12 (2.09–4.68) for those 65–74 years-old, respectively. Adjusted HRs for CVD mortality in the 45–64 years-old and 65–74 years-old groups were 2.67 (1.92–2.67) and 1.95 (1.33–2.86) in men, and 4.28 (2.29–7.99) and 2.67 (1.28–5.58) in women, respectively. Among men, the risk difference between never and current smokers was 108/100.000 in the age-group 45–64 years, and 324/100.000 in the age group 65–74 years. Among women the differences were 52/100.000 and 196/100.000, respectively. In conclusion, absolute risk difference between never and current smokers are larger among the older age group. Smoking cessation counseling should routinely target also older adults in primary health-care.Peer reviewe

Vanhus ja helle : suojaudu, viilennä, nesteytä

TiivistelmäSuomessa helteet (lämpötila yli +25 °C) ovat yleistyneet 2010-luvulla, ja ne tulevat haittaamaan etenkin ikääntyneitä (1). Terveydenhuollon ammattilaisten on tärkeää ymmärtää kuuman ympäristön terveysvaikutukset, kun he antavat ohjeita ja huolehtivat ikääntyneiden tarkoituksenmukaisesta suojautumisesta. Kuvaamme artikkelissamme helteestä aiheutuvia riskejä ikääntyneen terveydelle ja keinoja hallita niitä.AbstractOlder people and hot spells : protect, cool and hydrateClimate warming increases the occurrence of hot spells with detrimental health effects especially on older people. Hot spells cause heat illnesses and worsen chronic diseases, resulting in increased morbidity and mortality. The ageing population is susceptible to these effects because of their altered thermoregulation (reduced capacity to lose heat), high prevalence of chronic diseases and related medication, as well as due to behavioural, environmental, housing and social factors. Heat action plans are needed for systematic long- and short-term preparedness and require national, regional and local multisector co-operation. These activities include developing early warning systems, practising long-term urban planning, reducing indoor heat exposure, increasing preparedness of health care, caring for vulnerable populations and developing real-time surveillance and monitoring. Increasing awareness among the elderly themselves, as well as among their caretakers, is crucial for protection from the health risks of hot spells. Older people need instructions regarding adequate and sustained hydration, how their health condition can be affected by heat, use of appropriate clothing, how and when to engage in physical activity and how to cool their homes or cool themselves by regular cool showers or baths. Equally important is to increase awareness among caretakers of older people in healthcare facilities or care homes. During hot spells the personnel in healthcare facilities need to identify symptoms of heat illnesses and apply cooling methods and related treatment, consider the use and monitor the effects of medication, as well as monitoring water intake. In addition, the indoor temperature of healthcare facilities needs to be kept below 25°C. If air conditioning is not available, facilities can be cooled through increasing ventilation and passive cooling methods. In the worst case, older people need to be evacuated from the healthcare facilities or homes.Tiivistelmä Suomessa helteet (lämpötila yli +25 °C) ovat yleistyneet 2010-luvulla, ja ne tulevat haittaamaan etenkin ikääntyneitä (1). Terveydenhuollon ammattilaisten on tärkeää ymmärtää kuuman ympäristön terveysvaikutukset, kun he antavat ohjeita ja huolehtivat ikääntyneiden tarkoituksenmukaisesta suojautumisesta. Kuvaamme artikkelissamme helteestä aiheutuvia riskejä ikääntyneen terveydelle ja keinoja hallita niitä.Abstract Older people and hot spells : protect, cool and hydrate Climate warming increases the occurrence of hot spells with detrimental health effects especially on older people. Hot spells cause heat illnesses and worsen chronic diseases, resulting in increased morbidity and mortality. The ageing population is susceptible to these effects because of their altered thermoregulation (reduced capacity to lose heat), high prevalence of chronic diseases and related medication, as well as due to behavioural, environmental, housing and social factors. Heat action plans are needed for systematic long- and short-term preparedness and require national, regional and local multisector co-operation. These activities include developing early warning systems, practising long-term urban planning, reducing indoor heat exposure, increasing preparedness of health care, caring for vulnerable populations and developing real-time surveillance and monitoring. Increasing awareness among the elderly themselves, as well as among their caretakers, is crucial for protection from the health risks of hot spells. Older people need instructions regarding adequate and sustained hydration, how their health condition can be affected by heat, use of appropriate clothing, how and when to engage in physical activity and how to cool their homes or cool themselves by regular cool showers or baths. Equally important is to increase awareness among caretakers of older people in healthcare facilities or care homes. During hot spells the personnel in healthcare facilities need to identify symptoms of heat illnesses and apply cooling methods and related treatment, consider the use and monitor the effects of medication, as well as monitoring water intake. In addition, the indoor temperature of healthcare facilities needs to be kept below 25°C. If air conditioning is not available, facilities can be cooled through increasing ventilation and passive cooling methods. In the worst case, older people need to be evacuated from the healthcare facilities or homes

Associations of CAIDE Dementia Risk Score with MRI, PIB-PET measures, and cognition

Background: CAIDE Dementia Risk Score is the first validated tool for estimating dementia risk based on a midlife risk profile. Objectives: This observational study investigated longitudinal associations of CAIDE Dementia Risk Score with brain MRI, amyloid burden evaluated with PIB-PET, and detailed cognition measures. Methods: FINGER participants were at-risk elderly without dementia. CAIDE Risk Score was calculated using data from previous national surveys (mean age 52.4 years). In connection to baseline FINGER visit (on average 17.6 years later, mean age 70.1 years), 132 participants underwent MRI scans, and 48 underwent PIB-PET scans. All 1,260 participants were cognitively assessed (Neuropsychological Test Battery, NTB). Neuroimaging assessments included brain cortical thickness and volumes (Freesurfer 5.0.3), visually rated medial temporal atrophy (MTA), white matter lesions (WML), and amyloid accumulation. Results: Higher CAIDE Dementia Risk Score was related to more pronounced deep WML (OR 1.22, 95% CI 1.05-1.43), lower total gray matter (beta- coefficient -0.29, p = 0.001) and hippocampal volume (beta- coefficient -0.28, p = 0.003), lower cortical thickness (beta-coefficient -0.19, p = 0.042), and poorer cognition (beta-coefficients -0.31 for total NTB score, -0.25 for executive functioning, -0.33 for processing speed, and -0.20 for memory, all p <0.001). Higher CAIDE Dementia Risk Score including APOE genotype was additionally related to more pronounced MTA (OR 1.15,95% CI 1.00-1.30). No associations were found with periventricular WML or amyloid accumulation. Conclusions: The CAIDE Dementia Risk Score was related to indicators of cerebrovascular changes and neurodegeneration on MRI, and cognition. The lack of association with brain amyloid accumulation needs to be verified in studies with larger sample sizes.Peer reviewe

Vanhuksen gerastenia - tunnista riskipotilas

•Gerastenia on useiden elinjärjestelmien toiminnan heikentymisestä ja reservien hiipumisesta aiheutuva oireyhtymä, joka nivoutuu osin päällekkäin monisairastavuuden ja toimintakyvyn laskun kanssa. •Pienikin stressitekijä, kuten infektio tai uusi lääke, voi romahduttaa haurastuneen elimistön tasapainon ja johtaa toimintakyvyn laskuun, deliriumiin, kaatumisiin, sairaalahoitoon ja itsenäisyyden menetykseen. •Gerastenia voidaan määritellä usealla eri tavalla, joista tunnetuimmat ovat fenotyyppimalli ja toiminnan vajeista sekä sairauksista laskettuun Frailty-indeksiin perustuva malli. •Gerastenian varhainen tunnistaminen sekä kokonaisvaltainen geriatrinen arviointi ja yksilöllinen hoito¬suunnitelma auttavat estämään toimintakyvyn laskua entisestään.Peer reviewe