Radions brytningstid : Public-service bolagens stora kanalreform i Norge, Sverige och Finland

Only abstract. Paper copies of master’s theses are listed in the Helka database (http://www.helsinki.fi/helka). Electronic copies of master’s theses are either available as open access or only on thesis terminals in the Helsinki University Library.Vain tiivistelmä. Sidottujen gradujen saatavuuden voit tarkistaa Helka-tietokannasta (http://www.helsinki.fi/helka). Digitaaliset gradut voivat olla luettavissa avoimesti verkossa tai rajoitetusti kirjaston opinnäytekioskeilla.Endast sammandrag. Inbundna avhandlingar kan sökas i Helka-databasen (http://www.helsinki.fi/helka). Elektroniska kopior av avhandlingar finns antingen öppet på nätet eller endast tillgängliga i bibliotekets avhandlingsterminaler.In the early 1990s, the public service broadcasting companies of Norway, Sweden & Finland carried out a comprehensive reform of programme profiles, with a view to adapting their radio programming to the changed competitive situation. The developments in the Nordic region are associated with the general process of deregulation of the European media branch in the period from the 1970s through to the 1990s. The emergence of commercial radio obliged the traditional public broadcasting companies to re-examine their relationship with their audiences. In all three countries the public broadcasters arrived at a solution by which the radio channels were profiled to different sections of the total audience. As one aspect of the programming reforms each company established a radio channel directed at youth and young adults. In this study the reorganization is examined primarily from the perspective of these youth channels. The study seeks through comparisons to determine the reasons why the three Nordic public broadcasters initiated their channel reforms, what forces influenced the changes, and how the reforms were carried out in practice. In the first part of the research there is a description of the structural change that took place in European radio broadcasting, and the author presents the basic concepts and theoretical framework of the development in the medium. In the second section the historical framework of events is presented, leaning for the most part on research literature from this branch, publications by national authorities, and on documents released by the public broadcasting companies themselves. The third section examines the process of change in the public broadcasting companies and the causes bearing on it from the perspective of decision-makers interviewed after the event. In these interviews, the individuals who were instrumental in planning and carrying out the profiling changes report on the background to and implementation of the reforms. In the conclusions the study observes that the channel reforms in all three countries were put into effect as a kind of hybrid system, in which weight was placed both on the traditional considerations of quality and on the audience figures thrown into sharp focus by the new competitive situation. The increase in competition was a pivotal cause for the reforms. The reorganization was marked by audience-segment thinking, with the youth audience and youth channels given a spearhead role. The reforms emphasised independent decision-making within the channels, alongside a new working culture. The company's strengths and weaknesses were recognised differently in the respective broadcasting organizations. For the Norwegians it was values that took pride of place, for the Swedes it was know-how, and the Finns placed resources in the forefront. On the basis of the phenomena examined, a conflicting situation can be seen within the public broadcasting companies, emerging out of the division between the public service obligations and the search for a broad audience. Attempts were made to temper the tension between these two aims by means of programming policy. The underlying thrust of the entire change in radio was that the old static image defended itself against a perceived new dynamism. By means of the reforms, all three public broadcasters were able to preserve their share of listeners at a high level in the 1990s.Norjan, Ruotsin ja Suomen julkisen palvelun yleisradiot toteuttivat 1990-luvun alussa suuren ohjelmistouudistuksen, jolla yhtiöt pyrkivät sopeuttamaan radio-ohjelmistonsa muuttuneeseen kilpailutilanteeseen. Pohjoismainen kehitys liittyy osaksi eurooppalaista viestintäkentän sääntelyn purkamista eli deregulaatiota 1970 - 90-luvuilla. Kaupallisen radion synty pakotti yleisradioyhtiöt arvioimaan uudestaan yleisösuhteensa. Kaikissa kolmessa maassa yleisradioyhtiöt päätyivät ratkaisuun, jossa radiokanavat profiloitiin erilaisille osayleisöille. Osana uudistusta kukin yhtiö perusti nuorille ja nuorille aikuisille suunnatun radiokanavan. Tässä tutkimuksessa uudistuksia tarkastellaan lähinnä nuorisokanavien näkökulmasta. Tutkimus pyrkii selvittämään vertaillen, miksi kolme pohjoismaista julkisradiota teki kanavauudistuksensa, minkälaiset voimat muutokseen vaikuttivat ja miten muutos toteutettiin. Tutkimuksen ensimmäisessä osassa kuvaillaan Eurooppalaisen radion rakennemuutosta ja esitellään radion muutoksen käsitteistö ja teoreettinen kehys. Toisessa osassa esitellään tapahtumien historiallinen kehys, joka nojaa pääosin tutkimuskirjallisuuteen, viranomaisjulkaisuihin ja yhtiöiden omiin dokumentteihin. Kolmannessa osassa tutkitaan julkisradioiden muutosprosessia ja siihen johtaneita syitä haastateltujen päättäjien näkökulmasta. Haastatteluissa muutoksen suunnitelleet ja toteuttaneet avainhenkilöt kertovat kanavauudistuksen taustasta ja toteutuksesta. Johtopäätöksissä todetaan, että kanavauudistus toteutui kaikissa kolmessa maassa sekajärjestelmänä, jossa olivat esillä sekä perinteiset laatunäkökohdat että kilpailun esille nostamat kuuntelijaluvut. Kilpailun lisääntyminen oli keskeinen syy uudistuksiin. Uudistusta leimasi kohderyhmäajattelu, jonka kärjeksi nostettiin nuorisokanavat. Uudistuksissa korostui kanavien itsenäinen päätöksenteko ja uusi työkulttuuri. Oman yhtiön vahvuudet ja heikkoudet koettiin eri tavoin eri yhtiöissä. Norjalaisilla olivat päällimmäisinä arvot, ruotsalaisilla osaaminen ja suomalaisilla resurssit. Käsiteltyjen ilmiöiden pohjalla on julkisen palvelun yleisradion ristiriitatilanne, joka syntyy julkisen palvelun velvoitteen ja laajan yleisön tavoittelun välillä. Näiden kahden pyrkimyksen välinen jännite pyrittiin hallitsemaan ohjelmapolitiikan keinoin. Koko radion murroksen yleisvire oli, että vanha staattinen puolustautuu uutta dynaamista vastaan. Uudistuksen avulla kaikki kolme yleisradioyhtiötä pystyivät säilyttämään kuunteluosuutensa korkeana 1990-luvulla.Norges, Sveriges och Finlands rundradiobolag förverkligade i början av 1990-talet en reform av radioprogrammen för att anpassa sitt programutbud till den förändrade konkurrenssituationen. Den nordiska utvecklingen hänför sig till dereguleringen av radioverksamheten i Europa under 1970-90 talen. Efter den kommersiella radions uppkomst tvingades rundradiobolagen att omdefiniera sin relation till lyssnarna. I alla tre länder beslöt rundradiobolagen sig för en lösning där man satsade på radiokanaler profilerade för olika publikgrupper. Som en del av reformen grundade alla bolagen en kanal riktad till unga och unga vuxna lyssnare. I denna undersökning granskas reformerna snarast ur ungdomskanalernas synvinkel. Undersökningen strävar till att genom komparation reda ut varför tre nordiska public-service bolag gjorde sina kanalreformer, vilka krafter som påverkade förändringen och hur den genomfördes. I undersökningens första del beskrivs den europeiska radions strukturomvandling. Dessutom presenteras begreppssamlingen och den teoretiska ramen som hänför sig till processen. I den andra delen presenteras den historiska ramen, som huvudsakligen baseras på forskning inom området, myndigheters publikationer och bolagens egen dokumentation. I den tredje delen granskas public-service bolagens förändringsprocess och de orsaker som ledde till förändringen ur de intervjuade beslutsfattarnassynvinkel. I intervjuerna berättar de nyckelpersoner som planerat och förverkligat kanalreformerna om händelseförloppet. I slutsatserna konstateras att kanalreformen förverkligades som ett blandsystem i de tre nordiska länder som undersökts. Man tog hänsyn till, dels de traditionella kvalitetssynpunkterna, dels de lyssnarsiffror som aktualiserats av den nya konkurrenssituationen. Den ökade konkurrensen var den centrala orsaken till reformerna. Reformerna präglades av ett målgruppstänkande där ungdomskanalerna fick en dominerande roll. Kanalernas självständiga rätt till beslutsfattande och nya arbetskultur underströks. Det egna bolagets styrka och svaghet upplevdes på olika sätt i de olika bolagen. Norrmännen ville främst betona värden, svenskarna kunnande och finländarna resurser. Som grund för de fenomen som granskas finns radiobolagens konfliktsituation, den som föds i korstrycket mellan public-service uppdraget och försöken att nå en bred publik. Spänningen mellan dessa två målsättningar har man genom reformen försökt kontrollera med programpolitik. En vanlig konstellation i förnyelseprocessen är den gamla statiska modellens försvar mot den nya dynamiska. Genom reformen lyckades alla tre rundradiobolag hålla kvar sin lyssnarandel på en hög nivå under 1990-talet.ISBN 952-10-0171-

Effect of Botulinum Toxin Injection on EMG Activity and Bite Force in Masticatory Muscle Disorder: A Randomized Clinical Trial

Botulinum toxin type A (BoNT-A) is increasingly used in treating masticatory muscle pain disorder; however, safe doses and reinjection intervals still need to be established. The purpose of this randomized clinical trial was to evaluate the degree and duration of the impairment of masticatory muscle performance. Fifty-seven subjects were randomly divided into two groups: one of which received BoNT-A first (n = 28) while the other received saline first (n = 29), with the cross-over being in week 16, and a total follow-up period of 32 weeks. A total dose of 50 U of BoNT-A was injected in the masseter and temporal muscles bilaterally. Electromyographic (EMG) activity and bite forces were assessed. A significant reduction in EMG activity was observed up to week 18 (p ≤ 001), with total recovery at week 33. A significant reduction in maximum bite force was observed up to week 11 (p ≤ 005), with total recovery at week 25. In conclusion, when treating masticatory muscle pain disorder with 50 U of BoNT-A, a reinjection interval of 33 weeks can be considered safe since the recovery of muscle function occurs by that time

Effect of Botulinum Toxin Injection on EMG Activity and Bite Force in Masticatory Muscle Disorder: A Randomized Clinical Trial

Botulinum toxin type A (BoNT-A) is increasingly used in treating masticatory muscle pain disorder; however, safe doses and reinjection intervals still need to be established. The purpose of this randomized clinical trial was to evaluate the degree and duration of the impairment of masticatory muscle performance. Fifty-seven subjects were randomly divided into two groups: one of which received BoNT-A first (n = 28) while the other received saline first (n = 29), with the cross-over being in week 16, and a total follow-up period of 32 weeks. A total dose of 50 U of BoNT-A was injected in the masseter and temporal muscles bilaterally. Electromyographic (EMG) activity and bite forces were assessed. A significant reduction in EMG activity was observed up to week 18 (p ≤ 001), with total recovery at week 33. A significant reduction in maximum bite force was observed up to week 11 (p ≤ 005), with total recovery at week 25. In conclusion, when treating masticatory muscle pain disorder with 50 U of BoNT-A, a reinjection interval of 33 weeks can be considered safe since the recovery of muscle function occurs by that time

A Prospective Comparison of F-18-prostate-specific Membrane Antigen-1007 Positron Emission Tomography Computed Tomography, Whole-body 1.5 T Magnetic Resonance Imaging with Diffusion-weighted Imaging, and Single-photon Emission Computed Tomography/Computed Tomography with Traditional Imaging in Primary Distant Metastasis Staging of Prostate Cancer (PROSTAGE)

Background: Computed tomography (CT) and bone scintigraphy (BS) are the imaging modalities currently used for distant metastasis staging of prostate cancer (PCa). Objective: To compare standard staging modalities with newer and potentially more accurate imaging modalities. Design, setting, and participants: This prospective, single-centre trial (NCT03537391) enrolled 80 patients with newly diagnosed high-risk PCa (International Society of Urological Pathology grade group >= 3 and/or prostate-specific antigen [PSA] >= 20 and/or cT >= T3; March 2018-June 2019) to undergo primary metastasis staging with two standard and three advanced imaging modalities. Outcome measurements and statistical analysis: The participants underwent the following five imaging examinations within 2 wk of enrolment and without a prespecified sequence: BS, CT, Tc-99m-hydroxymethylene diphosphonate (Tc-99m-HMDP) single-photon emission computed tomography (SPECT)-CT, 1.5 T whole-body magnetic resonance imaging (WBMRI) using diffusion-weighted imaging, and F-18-prostate-specific membrane antigen-1007 (F-18-PSMA-1007) positron emission tomography(PET)-CT. Each modality was reviewed by two independent experts blinded to the results of the prior studies, who classified lesions as benign, equivocal, or malignant. Pessimistic and optimistic analyses were performed to resolve each equivocal diagnosis. The reference standard diagnosis was defined using all available information accrued during at least 12 mo of clinical follow-up. Patients with equivocal reference standard diagnoses underwent MRI and/or CT to search for the development of anatomical correspondence. PSMA PET-avid lesions without histopathological verification were rated to be malignant only if there was a corresponding anatomical finding suspicious for malignancy at the primary or follow-up imaging. Results and limitations: Seventy-nine men underwent all imaging modalities except for one case of interrupted MRI. The median interval per patient between the first and the last imaging study was 8 d (interquartile range [IQR]: 6-9). The mean age was 70 yr (standard deviation: 7) and median PSA 12 ng/mL (IQR:7-23). The median follow-up was 435 d (IQR: 378-557). Metastatic disease was detected in 20 (25%) patients. The imaging modality F-18-PSMA-1007 PET-CT had superior sensitivity and highest inter-reader agreement. The area under the receiver-operating characteristic curve (AUC) values for bone metastasis detection with PSMA PET-CT were 0.90 (95% confidence interval [CI]: 0.85-0.95) and 0.91 (95% CI: 0.87-0.96) for readers 1 and 2, respectively, while the AUC values for BS, CT, SPECT-CT, and WBMRI were 0.71 (95% CI: 0.58-0.84) and 0.8 (95% CI: 0.67-0.92), 0.53 (95% CI: 0.39-0.67) and 0.66 (95% CI: 0.54-0.77), 0.77 (95% CI: 0.65-0.89) and 0.75 (95% CI: 0.62-0.88), and 0.85 (95% CI: 0.74-0.96) and 0.67 (95% CI: 0.54-0.80), respectively, for the other four pairs of readers. The imaging method F-18-PSMA-1007 PET-CT detected metastatic disease in 11/20 patients in whom standard imaging was negative and influenced clinical decision making in 14/79 (18%) patients. In 12/79 cases, false positive bone disease was reported only by PSMA PET-CT. Limitations included a nonrandomised study setting and few histopathologically validated suspicious lesions. Conclusions: Despite the risk of false positive bone lesions, F-18-PSMA-1007 PET-CT outperformed all other imaging methods studied for the detection of primary distant metastasis in high-risk PCa. Patient summary: In this report, we compared the diagnostic performance of conventional and advanced imaging. It was found that F-18-prostate-specific membrane antigen-1007 positron emission tomography/computed tomography (F-18-PSMA-1007 PET-CT) was superior to the other imaging modalities studied for the detection of distant metastasis at the time of initial diagnosis of high-risk prostate cancer. PSMA PET-CT also appears to detect some nonmetastatic bone lesions. (C) 2020 The Author(s). Published by Elsevier B.V. on behalf of European Association of Urology.Peer reviewe

A Prospective Comparison of 18F-prostate-specific Membrane Antigen-1007 Positron Emission Tomography Computed Tomography, Whole-body 1.5 T Magnetic Resonance Imaging with Diffusion-weighted Imaging, and Single-photon Emission Computed Tomography/Computed Tomography with Traditional Imaging in Primary Distant Metastasis Staging of Prostate Cancer (PROSTAGE)

Background: Computed tomography (CT) and bone scintigraphy (BS) are the imaging modalities currently used for distant metastasis staging of prostate cancer (PCa).Objective: To compare standard staging modalities with newer and potentially more accurate imaging modalities.Design, setting, and participants: This prospective, single-centre trial (NCT03537391) enrolled 80 patients with newly diagnosed high-risk PCa (International Society of Urological Pathology grade group ≥3 and/or prostate-specific antigen [PSA] ≥20 and/or cT ≥ T3; March 2018-June 2019) to undergo primary metastasis staging with two standard and three advanced imaging modalities.Outcome measurements and statistical analysis: The participants underwent the following five imaging examinations within 2 wk of enrolment and without a prespecified sequence: BS, CT, 99mTc-hydroxymethylene diphosphonate (99mTc-HMDP) single-photon emission computed tomography (SPECT)-CT, 1.5 T whole-body magnetic resonance imaging (WBMRI) using diffusion-weighted imaging, and 18F-prostate-specific membrane antigen-1007 (18F-PSMA-1007) positron emission tomography(PET)-CT. Each modality was reviewed by two independent experts blinded to the results of the prior studies, who classified lesions as benign, equivocal, or malignant. Pessimistic and optimistic analyses were performed to resolve each equivocal diagnosis. The reference standard diagnosis was defined using all available information accrued during at least 12 mo of clinical follow-up. Patients with equivocal reference standard diagnoses underwent MRI and/or CT to search for the development of anatomical correspondence. PSMA PET-avid lesions without histopathological verification were rated to be malignant only if there was a corresponding anatomical finding suspicious for malignancy at the primary or follow-up imaging.Results and limitations: Seventy-nine men underwent all imaging modalities except for one case of interrupted MRI. The median interval per patient between the first and the last imaging study was 8 d (interquartile range [IQR]: 6-9). The mean age was 70 yr (standard deviation: 7) and median PSA 12 ng/mL (IQR:7-23). The median follow-up was 435 d (IQR: 378-557). Metastatic disease was detected in 20 (25%) patients. The imaging modality 18F-PSMA-1007 PET-CT had superior sensitivity and highest inter-reader agreement. The area under the receiver-operating characteristic curve (AUC) values for bone metastasis detection with PSMA PET-CT were 0.90 (95% confidence interval [CI]: 0.85-0.95) and 0.91 (95% CI: 0.87-0.96) for readers 1 and 2, respectively, while the AUC values for BS, CT, SPECT-CT, and WBMRI were 0.71 (95% CI: 0.58-0.84) and 0.8 (95% CI: 0.67-0.92), 0.53 (95% CI: 0.39-0.67) and 0.66 (95% CI: 0.54-0.77), 0.77 (95% CI: 0.65-0.89) and 0.75 (95% CI: 0.62-0.88), and 0.85 (95% CI: 0.74-0.96) and 0.67 (95% CI: 0.54-0.80), respectively, for the other four pairs of readers. The imaging method 18F-PSMA-1007 PET-CT detected metastatic disease in 11/20 patients in whom standard imaging was negative and influenced clinical decision making in 14/79 (18%) patients. In 12/79 cases, false positive bone disease was reported only by PSMA PET-CT. Limitations included a nonrandomised study setting and few histopathologically validated suspicious lesions.Conclusions: Despite the risk of false positive bone lesions, 18F-PSMA-1007 PET-CT outperformed all other imaging methods studied for the detection of primary distant metastasis in high-risk PCa.Patient summary: In this report, we compared the diagnostic performance of conventional and advanced imaging. It was found that 18F-prostate-specific membrane antigen-1007 positron emission tomography/computed tomography (18F-PSMA-1007 PET-CT) was superior to the other imaging modalities studied for the detection of distant metastasis at the time of initial diagnosis of high-risk prostate cancer. PSMA PET-CT also appears to detect some nonmetastatic bone lesions.</p

Comprehensive evaluation of botulinum toxin treatment outcomes of a patient with persistent myofascial orofacial pain

The outcome evaluation method presented in this case study, including Axes I and II findings combined with the results of quantitative bite force and EMG measurements, provides a good tool for proper evaluation of the effect of BoNT-A on patients with myofascial orofacial pain and changes in jaw muscle function.Peer reviewe

Focal atrophy of the unilateral masticatory muscles caused by pure trigeminal motor neuropathy : case report

Key Clinical Message Patients with unknown clinical or radiological asymmetry in the face structures combined with atrophy and weakness of the masticatory muscles should be comprehensively examined clinically and with MRI, neurophysiological measurements, and serologically. Malignant lesions or benign idiopathic unilateral trigeminal motor neuropathy should be considered as an etiological explanation for the asymmetry.Peer reviewe