Women's Struggle in Finding Truth - A comparative study of the South African TRC and Rwandan Gacacas

The role of women in post-conflict countries in Africa has always been less prioritised when working for reconciliation. Our aim in this thesis is to compare how the gacacas in Rwanda and TRC´s in South Africa treated the suffering of, and justice for women and what healing processes were put in place to help them. Truth Commissions are a form of reconciliation theory which will be further analysed in this thesis in order to investigate the participation and treatment of women in these two countries. When comparing them we have found that the truth commissions are in fact gender-biased. South African and Rwandan women were less prioritised than men in the treatment during truth commissions to find justice for their suffering

Primary prevention defibrillators in clinical practice

Introduction: Guidelines for primary prevention of sudden cardiac death (SCD) advocate implantable cardioverter defibrillator (ICD) therapy in patients with reduced left ventricular ejection fraction (LVEF). Many patients are not considered for treatment and the net benefit of ICDs in real life is insufficiently studied. The aims of these studies were to investigate compliance to guidelines and to study the balance between benefits and complications of ICD therapy. Methods and Results: Paper I: In a retrospective study of the medical records of 187 patients with acute myocardial infarction (AMI), with LVEF ≤35%, we evaluated the decision process behind ICD treatment. Inadequate follow-up according to guidelines was found in 32% of the patients, while 41% showed an improvement in LVEF to such a degree that an ICD was no longer indicated. Paper II: A prospective study of 100 patients with AMI and reduced LVEF (≤40%). The incidence and time span of improvement of LVEF were studied. At one month of follow-up, 55% of the patients had an LVEF of >35%. The mean difference in LVEF between one and three months was small (1.9 percentage units). A high risk of life-threatening arrhythmias (9%) was found in the first few weeks after AMI. Paper III: Using register data, 865 patients with reduced LVEF treated with ICDs for primary prevention of SCD were identified. The medical records were scrutinized. We found that annually 6% of the patients had correctly treated arrhythmias, 2.4% had inappropriate shocks and 4.4% had complications requiring reoperation. Men were twice as likely to receive correct ICD treatment compared with women. Paper IV: We analyzed intracardiac electrograms from 125 explanted ICDs from deceased patients. During the last 24 h of life, 31% of the patients had received shock treatment. Although 52% of the patients had a do-not-resuscitate order, 65% of them still had ICD shock therapies activated. Conclusions: Follow-up after AMI is insufficient. Most patients show improved LVEF after AMI and in the majority the improvement can be confirmed after one month, implying that further delay of ICD implantation may not be motivated. Patients (especially men) with heart failure benefit from ICD treatment, but complications are common and it is crucial to inactivate shock treatment towards the end of life

MAJOR LEGISLATION & TREATIES: 3. Labor Law/Social Security Law

Syftet med den här studien är att undersöka fem nyutexaminerade lärares upplevelser av föräldrakontakt i skolan. Studien baseras på intervjuer med fem nyutexaminerade lärare som arbetar på olika skolor inom samma kommun. Vi har enbart undersökt hur dessa fem lärare upplever föräldrakontakten, skolorna som lärarna arbetar på är inte av intresse för den här studien. Vi inleder uppsatsen med att ge en historisk tillbakablick på hur synen på föräldrakontakt mellan skolan och hemmet har utvecklats och förändrats genom tiderna. I litteraturgenomgången tar vi upp synen på samverkan mellan föräldrar och lärare ur olika perspektiv. Vi behandlar bland annat betydelsen av attityder, hos föräldrar och lärare, för barnens skolgång samt kommunikationen mellan föräldrar och lärare genom olika kontaktformer. Analysen av intervjuerna med de fem nyutexaminerade lärarna visar att samtliga informanter är av uppfattningen att föräldrakontakt är en viktig del i läraryrket. Det framgår även att flera informanter saknade förberedelser för detta under sin utbildning samt att flera informanter upplevde sig vara osäkra i kontakten med föräldrar i början av sin yrkestid. Utifrån denna studie kan vi dra slutsatsen att föräldrakontakt skulle behövts ha fått ett större utrymme i våra informanters utbildning, eftersom det framgår att det är en viktig och tidskrävande del av lärarprofessionen. Vi kommer även fram till att både lärarnas och föräldrarnas attityder påverkar barnens skolgång samt att läraren utifrån sin yrkesroll bör vara professionell i mötet med föräldrar. En svårighet som tydliggörs i uppsatsen av några informanter är att klara av att sätta gränser mellan yrkesroll och privatliv. Utifrån detta har vi, i likhet med några av informanterna, kommit fram till att det är viktigt att markera en tydlig gräns mellan yrkesrollen och privatlivet

Novel histological scoring for predicting disease outcome in primary sclerosing cholangitis

Background Primary sclerosing cholangitis (PSC) is a progressive cholestatic liver disease that may lead to liver cirrhosis or cholangiocarcinoma. Liver histology and fibrosis stage are predictive markers of disease progression, and histological cirrhosis is defined as a significant endpoint. PSC-specific histological scoring methods are lacking at present. We aimed to develop a tailored classification system for PSC, the PSC histoscore, based on histological features associated with disease progression. Methods In total, 300 PSC patients diagnosed between 1988 and 2018 were enrolled; their data were collected from the PSC registry (Helsinki University Hospital), and liver specimens were obtained from the Biobank of Helsinki. Five histological features included in the adapted Nakanuma scoring system and three additional parameters typical for PSC histology were evaluated and compared with the clinical and laboratory data. A compound endpoint consisting of liver transplantation, development of cholangiocarcinoma, or death was used as outcome measurement. Results Stage (fibrosis, bile duct loss, ductular reaction, and chronic cholestasis) and grade (portal inflammation, portal edema, hepatitis activity, and cholangitis activity) parameters were found to be independent predictive risk factors for the compound endpoint (P < 0.001). High disease grade (2-6) and stage (2-4) better correlated with clinical endpoints when evaluated with the PSC histoscore system compared to the adapted Nakanuma classification. The risk for disease progression in sequential endoscopic retrograde cholangiography (ERC) examinations was increased with elevated total PSC histoscores. Conclusion The PSC histoscore is a novel histological classification system for PSC. Our findings support the applicability of liver histology as a marker for disease progression.Peer reviewe

Automated image analysis of keratin 7 staining can predict disease outcome in primary sclerosing cholangitis

Background and AimsPrimary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease that obstructs the bile ducts and causes liver cirrhosis and cholangiocarcinoma. Efficient surrogate markers are required to measure disease progression. The cytokeratin 7 (K7) load in a liver specimen is an independent prognostic indicator that can be measured from digitalized slides using artificial intelligence (AI)-based models. MethodsA K7-AI model 2.0 was built to measure the hepatocellular K7 load area of the parenchyma, portal tracts, and biliary epithelium. K7-stained PSC liver biopsy specimens (n = 295) were analyzed. A compound endpoint (liver transplantation, liver-related death, and cholangiocarcinoma) was applied in Kaplan-Meier survival analysis to measure AUC values and positive likelihood ratios for each histological variable detected by the model. ResultsThe K7-AI model 2.0 was a better prognostic tool than plasma alkaline phosphatase, the fibrosis stage evaluated by Nakanuma classification, or K7 score evaluated by a pathologist based on the AUC values of measured variables. A combination of parameters, such as portal tract volume and area of K7-positive hepatocytes analyzed by the model, produced an AUC of 0.81 for predicting the compound endpoint. Portal tract volume measured by the model correlated with the histological fibrosis stage. ConclusionsThe K7 staining of histological liver specimens in PSC provides significant information on disease outcomes through objective and reproducible data, including variables that cannot be measured by a human pathologist. The K7-AI model 2.0 could serve as a prognostic tool for clinical endpoints and as a surrogate marker in drug trials.Peer reviewe

Chronic cholestasis detection by a novel tool : automated analysis of cytokeratin 7-stained liver specimens

Background The objective was to build a novel method for automated image analysis to locate and quantify the number of cytokeratin 7 (K7)-positive hepatocytes reflecting cholestasis by applying deep learning neural networks (AI model) in a cohort of 210 liver specimens. We aimed to study the correlation between the AI model's results and disease progression. The cohort of liver biopsies which served as a model of chronic cholestatic liver disease comprised of patients diagnosed with primary sclerosing cholangitis (PSC). Methods In a cohort of patients with PSC identified from the PSC registry of the University Hospital of Helsinki, their K7-stained liver biopsy specimens were scored by a pathologist (human K7 score) and then digitally analyzed for K7-positive hepatocytes (K7%area). The digital analysis was by a K7-AI model created in an Aiforia Technologies cloud platform. For validation, values were human K7 score, stage of disease (Metavir and Nakunuma fibrosis score), and plasma liver enzymes indicating clinical cholestasis, all subjected to correlation analysis. Results The K7-AI model results (K7%area) correlated with the human K7 score (0.896; p < 2.2e(- 16)). In addition, K7%area correlated with stage of PSC (Metavir 0.446; p < 1.849e(- 10) and Nakanuma 0.424; p < 4.23e(- 10)) and with plasma alkaline phosphatase (P-ALP) levels (0.369, p < 5.749e(- 5)). Conclusions The accuracy of the AI-based analysis was comparable to that of the human K7 score. Automated quantitative image analysis correlated with stage of PSC and with P-ALP. Based on the results of the K7-AI model, we recommend K7 staining in the assessment of cholestasis by means of automated methods that provide fast (9.75 s/specimen) quantitative analysis.Peer reviewe

Vammaisten henkilöiden henkilökohtaisen budjetoinnin kokeiluhankkeen tuloksia : Esitys Suomen malliksi

Vammaisten henkilöiden henkilökohtaisen budjetoinnin kokeiluhankkeen tuloksia -julkaisu on tulos Terveyden ja hyvinvoinnin laitoksen tekemästä työstä vammaisten henkilöiden henkilökohtaisen budjetoinnin kokeiluhankkeessa (HB-hanke) 2020 2021. HB-hankkeen tavoitteiden mukaisesti julkaisu noudattaa soveltuvin osin hallituksen esityksen muotoa. Julkaisu sisältää henkilökohtaisen budjetoinnin mallin, jolla tarkoitetaan ehdotusta henkilökohtaista budjetointia koskevaksi lainsäädännöksi. HB-hankkeen lähtökohtana oli vahvistaa vammaisen henkilön itsemääräämisoikeutta, osallisuutta ja valinnanmahdollisuuksia palveluiden suunnittelu- ja toteuttamisprosessissa. Henkilökohtaista budjetointia arvioitiin suhteessa siihen, mahdollistaisiko se avun ja tuen saamisen nykyistä joustavammin elämän eri tilanteissa ja edistäisikö se yksilöllisiin tarpeisiin vastaamista nykyistä paremmin. Hankkeessa pyrittiin ratkaisemaan, millaista apua ja tukea henkilökohtaisella budjetoinnilla voidaan järjestää, miten budjetin arvo määritellään ja miten budjetin käyttöä seurataan sekä millaista tukea budjetin käyttöön annetaan. Hankkeessa arvioitiin myös henkilökohtaisen budjetoinnin vahvuuksia, heikkouksia, mahdollisuuksia ja haasteita verrattuna muihin palvelujen järjestämistapoihin sekä luotiin yhteisesti hyväksytty henkilökohtaisen budjetoinnin määritelmä. Hankkeen lopuksi tehtiin esitys henkilökohtaisen budjetoinnin Suomen mallista. Julkaisu on THL:n esitys siitä, mitä tulee ottaa huomioon, jos henkilökohtainen budjetointi otettaisiin maassamme käyttöön yhtenä vammaisten henkilöiden sosiaalipalveluiden järjestämistapana

Genome-wide linkage scan for colorectal cancer susceptibility genes supports linkage to chromosome 3q

Background: Colorectal cancer is one of the most common causes of cancer-related mortality. The disease is clinically and genetically heterogeneous though a strong hereditary component has been identified. However, only a small proportion of the inherited susceptibility can be ascribed to dominant syndromes, such as Hereditary Non-Polyposis Colorectal Cancer (HNPCC) or Familial Adenomatous Polyposis (FAP). In an attempt to identify novel colorectal cancer predisposing genes, we have performed a genome-wide linkage analysis in 30 Swedish non-FAP/non-HNPCC families with a strong family history of colorectal cancer.Methods: Statistical analysis was performed using multipoint parametric and nonparametric linkage.Results: Parametric analysis under the assumption of locus homogeneity excluded any common susceptibility regions harbouring a predisposing gene for colorectal cancer. However, several loci on chromosomes 2q, 3q, 6q, and 7q with suggestive linkage were detected in the parametric analysis under the assumption of locus heterogeneity as well as in the nonparametric analysis. Among these loci, the locus on chromosome 3q21.1- q26.2 was the most consistent finding providing positive results in both parametric and nonparametric analyses Heterogeneity LOD score (HLOD) = 1.90, alpha = 0.45, Non-Parametric LOD score (NPL) = 2.1).Conclusion: The strongest evidence of linkage was seen for the region on chromosome 3. Interestingly, the same region has recently been reported as the most significant finding in a genome-wide analysis performed with SNP arrays; thus our results independently support the finding on chromosome 3q

Tiedonlouhintaprosessien soveltuvuus tietoliikenne-elementtien vikatiedostojen analysoimiseen

Tässä opinnäytetyössä tutkitaan tiedonlouhintamenetelmien soveltuvuutta laajojen vikatiedostojen analysointiin ja erityisesti työssä on keskitytty elementteihin, joista ei löydy testeissä vikaa. Opinnäytetyö on osa projektia, jossa on tutkittu syitä tietoliikenne-elementtien vikaantumiseen. Näistä yksiköistä aiheutuu turhia huolto- ja kuljetuskustannuksia. Työn tutkimuskysymys on ”miten tiedonlouhintaprosesseja sovelletaan tietoliikenne-elementtien vikatiedostojen analysoimiseen?” Tiedonlouhinta tarkoittaa suurten tietojoukkojen kuten tietokantojen, dokumenttien tai mittaustulosten analyysia sekä mallien muodostamista. Työssä käsitellään tiedonlouhintaan liittyviä prosesseja ja keskitytään datan esikäsittelyvaiheisiin. Knowledge Discovery in Databases, KDD viitataan koko prosessiin, jossa etsitään hyödyllistä tietoa datasta ja tiedonlouhinta on oma prosessi KDD-prosessissa. KDD-prosessi voidaan jakaa viiteen päävaiheeseen, jotka ovat tietämyksen vaatimukset, datan valinta, tiedonlouhinta, tulosten analysointi ja tietämyksen sisällyttäminen tietämyskantaan. Tiedonlouhinta voidaan erikseen jakaa myös viiteen osaan, jotka ovat datan pelkistäminen, menetelmän valinta, datan esikäsittely, datan valmistelu ja metodien käyttö. Esikäsittelyvaiheen tavoite on mahdollistaa analyysimenetelmät, joilla erotetaan oikeat ja asiaankuuluvat tiedot datasta. Työssä käytetään tiedonlouhinnan esikäsittelytekniikoita. Reaalimaailman data vaatii yleensä puhdistamista, koska siinä on häiriöitä ja epätarkkuuksia. Tutkimuksen aluksi selvitetään ongelman yleisyyttä muussa teollisuudessa ja määritellään keskeisistä käsitteistä. Tavoitteena oli tutkia teollisuudessa käytettyjä tiedonlouhintaprosesseja ja niissä saatuja testaustuloksia. Tietoliikenne-elementtien vika-analyysit ja tietoliikenneympäristö oli tuttua aikaisemmasta projektista. Tutkimuksen viitekehyksenä tutkittiin Hevnerin (2007) tietojärjestelmätutkimuksen kolmea sykliä. Suunnittelututkimus valittiin tutkimusmetodologiaksi, koska se soveltuu ongelman ratkaisemiseen ja sen arvioimiseen. Tutkimuksen päätavoitteena oli tietämyksen lisääminen kentällä vikaantuneista tietoliikenne-elementeistä, joista ei löydetä vikaa huollon testeissä. Tiedonlouhintaprosessit sopivat huollosta saatujen vikatiedostojen analysointiin, koska niiden avulla datasta pystytään selvittämään mitä tietoja on saatavilla ja myös datan puutteet tulevat selville. Tietojen esikäsittelytekniikoilla voidaan parantaa datan laatua, mikä osaltaan parantaa tarkkuutta ja tehokkuutta myöhemmissä louhintaprosesseissa.The purpose of this thesis was to determine the feasibility of data mining methods to analyze large fault file. In particular I concentrate on the no fault found elements. The thesis is a part of the project, in which has been studied the causes of failure of the telecommunication network elements. No fault found units cause unnecessary maintenance and transportation costs. The research question of the thesis is "how can data mining processes be applied to analyze the fault file of the telecommunication elements?" Data mining refers to large data sets such as databases, documents, and measurement analysis, as well as the formation of models. The processes of data mining are covered and the pre-processing techniques are presented in more detail. Knowledge Discovery in Databases, KDD refers to the entire process of searching for useful information from the data. Data mining is own process which belong to the KDD process. KDD process can be divided into five main phases which are the knowledge requirements, data selection, data mining, result analysis and the knowledge incorporation. Data mining can be separately divided into the five parts which are data reduction, data mining method selection, data pre-processing, data preparation and use of data mining methods. The main target of the pre-processing phase is to ensure that during the analysis stage, the required and relevant information are extracted from data. The data mining pre-processing techniques are used. Real-world data usually requires cleaning, as it is noisy and contains inaccuracies. The research started with a literature review in order to get an understanding of the frequency of the no fault found problem in other industry areas and to get a knowledge of the essential concepts related to malfunction. The aim was to learn about former data mining processes which were used in industries, and test results that can be obtained from processes. Fault analysis of the telecommunications elements, and the environment of the telecommunication was familiar from the earlier project. Hevner (2007) "A Three Cycle View of Design Science Research" was used as the subtext of the thesis. The research methodology chosen was design science research because it is suitable for solving the problem and evaluating. The main objective of this thesis was to increase knowledge about the no fault found elements of the telecommunication network. Data mining processes can be applied to analyze the fault file of the maintenance, because the data mining processes help to find out problem related information from the data and also the lack of the information of the data. Data pre-processing techniques can improve data quality, which improve the accuracy and efficiency of the following mining process

MEDIEBILDEN AV VÄSTRA GÖTALANDSREGIONEN En kvantitativ innehållsanalys av svenska nyhetsartiklar

Denna uppsats syfte är att undersöka mediebilden av Västra Götalandsregionen (VGR). Media har makten att influera allmänhetens bild av regionen, och därför är det viktigt för VGR att veta vilka ämnen som media skriver om och vilka attityder mot VGR som uttrycks i texterna. Genom att undersöka artiklar publicerade av svensk nyhetsmedia går det att dra vissa slutsatser om den bild som media förmedlar till allmänheten. Denna uppsats utgår från teorier om medielogik och medialiseringen av offentliga organisationer. Fokus läggs på mediers nyhetsurval och de ideologier och mål som avgör vad som blir nyheter. Kvantitativ innehållsanalys och attitydanalys av svenska tryckta nyhetsartiklar från perioden 2016-06-01 t.o.m. 2016-12-31, samt en kvantitativ analys av pressutskick från VGR:s olika verksamhetsområden. Den kvantitativa innehållsanalysen visade att de vanligaste ämnen medier skrev om under den undersökta perioden var sådant som berör VGR:s verksamhetsområde Folkhälsa, kultur och evenemang, artiklar om regionindelning m.fl. Attitydanalysen visade att de vanligaste attityder som uttrycktes emot VGR var neutrala d.v.s. icke-värderande. Resultatet av den kvantitativa analysen av pressutskick visade att meddelandena fångas upp av media, men i ett relativt litet omfång. Sällan genererade pressutskicken fler än fem artiklar i media, och vanligast var att meddelandena inte resulterade i några artiklar alls