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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
461

The office of coroner, 1860-1926 : resistance, reluctance and reform

Prichard, Donald January 2001 (has links)
This study explores, analyses and seeks to explain the processes by which legislative changes were achieved to overcome the problems associated with the role and duties of the office of coroner from the mid nineteenth century to the 1920s. From time to time during the period, the office was exposed to political and public scrutiny that brought calls for reform. Despite that, and the general recognition that change was necessary, the process was extremely protracted and reform limited so that when the 1926 Act reached the statute book, it was greeted with a level of subdued dissatisfaction. Throughout the period, the coroners resisted change based on an appeal to their traditional links with the people and representing the office as an ancient institution rooted in long established custom and practice. Despite that, the coroners were unable to evade the impact of changes associated with developments in local and national government which had an indirect, though significant, effect on coroners' reform. For most of the period, the policy of successive governments was to have no policy on coroners. To fill that void,various groups with conflicting interests and ambitions proposed changes to meet their needs and attempted to influence the government to implement them. A slow, complex, haphazard, fragmented and undirected process evolved that had its own dynamic. There was no strategist, no over-riding driving force, no single source. Suggestions were adopted, modified or rejected to produce a 'policy' that was eventually accepted by the Home Office. From the detailed examination of the complex events, issues and stances adopted by the various bodies, including the Home Office, an explanation for the unusual, slow and tortuous process of reform emerges. Coroners' problems were a minor issue for the government and carried little weight in the wider scheme of politics. With such a low priority rating, the government was reluctant to intervene except under the pressure of public criticism when events created a crisis or near crisis. Eventually, a minimum legislative intervention brought closure, but left important problems unresolved. The coroners still investigated unexplained deaths on behalf of the Crown and retained intact their traditional authority, independence, common law powers and discretion.
462

The ethics, aesthetics and politics of Thomas Carlyle's 'French Revolution'

Malecka, Joanna January 2017 (has links)
‘The Ethics, Aesthetics and Politics of Carlyle’s French Revolution’ examines the work of Thomas Carlyle as a crucial aesthetic intervention in the modern reception of the French Revolution in Europe. It interrogates the prevalent critical constructions of Carlyle’s work and finds them to proceed predominantly from the Whig historical agenda, structured around such key nineteenth-century concepts as utilitarianism and civilisational and moral progress. Within this critical framework, Carlyle’s largely conservative cultural stance and Christian spirituality are hardly allowed any creative potential and, ever since the famous fabrication of James Anthony Froude who depicted Carlyle as ‘a Calvinist without the theology’, they have been perceived as artistically-stunted, irrational, and out of touch with the nineteenth-century political, social and cultural realities. In examining Carlyle’s involvement with German Romanticism on the one hand, and with contemporary British periodical press on the other, this thesis proposes a more comprehensive reading of Carlyle’s politics, aesthetics and spirituality in an attempt to represent his radically open, catholic and indeed cosmopolitan artistic agenda which taps into the Scottish Enlightenment concept of rationality, Calvinist scepticism towards nineteenth-century progressivism and acute perception of evil in this world, and post-Burkean Romantic aesthetics of the sublime. We chart the aesthetic movement from Carlyle’s early dialogue with Schiller and Goethe to ‘The Diamond Necklace’, Carlyle’s first artistic rendition of the French pre-revolutionary scene, delivered as a (Gothic) moral tale and anticipating The French Revolution (a historical work that uniquely employs the Gothic genre within historical narrative, arguably unparalleled in British post-Burkean Romanticism). The critical reception of The French Revolution in Britain is examined, with special attention paid to the highly unfavourable review by Herman Merivale in The Edinburgh Review, in order to challenge the Whig line in Carlylean criticism and to expose the fundamental artistic, political and moral disagreement between Carlyle and Merivale. Carlyle’s Calvinist stance sees both Merivale’s and Thomas Babington Macaulay’s facile exorcism of the categories of good and evil from their historical agendas as irrational given the recent French terror (which, in Carlyle’s reading, released its demons precisely through such a botched ethical deal). Similarly, I highlight Carlyle’s close dialogue with John Stuart Mill both in their correspondence, and in the publications in the London and Westminster Review, while I argue that this intellectual exchange is crucial for the reading of The French Revolution as a text challenging Mill’s utilitarianism, and written within the institutional framework of the contemporary periodical press. Finally, Carlyle is seen to make capital of the concepts of Gothic and sublime, introduced by Edmund Burke and popularised by the Anti-Jacobin Review in Britain, by applying them directly to the French mob in search of a new spiritual tongue for his times (a move that even a nineteenth-century radical liberal thinker such as Mill sees as politically, if not artistically, far too subversive and revolutionary). Creative non-conclusiveness and playful deconstruction of the prevalent post-revolutionary narratives of 1789 characterise Carlyle’s deeply spiritual and artistically-sophisticated text, which, in an orthodox Christian reading, rejoices in the messy, dark and complex residue of human history, through which Christian providence acts in mysterious and unexpected ways that do not allow for any simple, de-mythologised reading.
463

Calling for the super citizen : contemporary naturalisation procedures in the United Kingdom and Germany

Badenhoop, Sophie Elisabeth January 2018 (has links)
Naturalisation procedures through which states symbolically and legally recognise noncitizens as citizens offer the most secure legal status for migrants and a means for them to evade global inequalities in the world system of nation-states. This study critically examines contemporary citizenship admission procedures in the UK and Germany following the introduction of citizenship tests, courses and ceremonies in the early 2000s. Based on a multi-sited state ethnography of both countries, this thesis argues that naturalisation does not simply separate citizens by discretionary application from citizens by automatic right of birth. Rather, citizenship admission procedures suggest a specific subjectivity, the Super Citizen, insofar as ‘new’ German and British citizens are expected to become a political, economic and cultural asset to the state. This study thus conceptualises naturalisation processes as a specific subject-formation regime created through particular problematisations, rationalities, authorities and techniques as institutionalised by the state. The analysis begins with a brief reconstruction of the genealogy of naturalisation in Britain and Germany, focussing on the emergence of the distinction between nationals and ‘aliens’ or ‘foreigners’, respectively, as well as on the legal mechanisms put in place to differentiate their access to full membership. Using a thematic analysis of qualitative interviews, observations and official documents, the study then tracks contemporary citizenship applications in four research locations in the two countries. It visits ceremony halls, classrooms and naturalisation offices and considers the perspective of a range of actors involved in citizenship admission procedures. This includes those who implement naturalisation on behalf of the state such as officials, legal advisers, teachers, politicians, and guest speakers, as well as the lived experience of the citizenship applicants themselves. The thesis concludes that naturalisation procedures in both the UK and in Germany produce the Super Citizen as a particular, neoliberal and neonational subjectivity that holds newly naturalized citizens responsible for developing a new nationalism.
464

A centripetal formula for Turkey : a multiculturalist proposal for the resolution of the republic's long-running Kurdish question

Kolcak, Hakan January 2018 (has links)
Like consociationalism and territorial pluralism, centripetalism is a multiculturalist way of managing ethno-cultural diversity. Many scholars have examined how a consociational or territorial pluralist formula might help Turkey to resolve its long-running Kurdish problem. To date, no one has paid enough attention to the merits of centripetalism by scrutinising whether they might contribute to the solution of the problem. There is a general neglect of centripetal solution in the academic literature on Turkey's Kurdish question. As an interdisciplinary study, this thesis seeks to fill the centripetal research gap in the literature. The thesis argues that neither consociationalism nor territorial pluralism might be the optimal multiculturalist approach that Turkey should embrace in resolving its Kurdish issue. The thesis comes up with an original centripetal formula for the resolution of the issue. The proposed formula is constructed on the following three cornerstones: 1) a parliamentary system which is built on a 560-member legislature elected via an original version of the Alternative Vote Plus electoral system; 2) asymmetric territorial autonomy for each Kurdish-populated province; and 3) cultural autonomy for individual Kurds residing in the Turkish-dominated provinces. According to the thesis, this centripetal formula might enable Turkey to satisfy or begin to satisfy all main Kurdish demands, the fulfilment of which is regarded by almost all segments of Kurdish society as the basic requirement for the solution of the Kurdish problem. The formula might also create a multiculturalist Turkey less likely to witness some problematic political scenarios that would happen should the Republic establish a consociational or territorial pluralist model for the solution of the problem.
465

The Canadian image of Finland, 1919–1948:Canadian government perceptions and foreign policy

Ratz, D. (David) 28 September 2018 (has links)
Abstract Perceptions of Finland and Finns held by Canadian government decision-makers underscore the relations between the two countries. The individuals involved had definite views of what Finland and Finns were like and these images were at times openly expressed or inferred from the archived government departmental files. Using an analysis of images, the evolving bilateral relations between Canada and Finland from the recognition of Finnish independence in 1919 until the early Cold War in 1948 can be understood from the Canadian perspective. The images are analyzed on a scale in terms of their positive or negative connotations. Positive images regarded Finland as a friendly, Northern, country, a borderland, cultured, Western, modern, progressive, liberal, and democratic. When these images were applied to Finns they were seen as honest, hardworking, reliable and the payers of debts. On the opposite end of the spectrum, Finland was an enemy and a trade competitor. The Finnish people could also be seen with negative images as dangerous and radical. These images existed before the establishment of diplomatic relations and carried over to interactions involving immigration, the League of Nations, trade, and scientific exchanges. They are also evident in relations between the two countries during the Winter War, in the decision to declare war against Finland during the Continuation War, during the armistice period, the peace process, and the during the early Cold War when normalized relations were established. The findings suggest that relations between Canada and Finland were most often impacted by events in Europe. The images of Finland and Finns did not directly impact relations as such, since the policies and actions taken were based on what decision-makers considered realistic assessments of the situation, as well as Canada’s national interests and capabilities. However, the images appear frequently as a means to narrow the range of acceptable options, rationalizations for specific polices, and justification for particular actions. / Tiivistelmä Kanadan hallituksen päätöksentekijöiden näkemykset Suomesta ja suomalaisista korostavat maiden välisiä suhteita. Hallituksen arkistot paljastavat, että päättäjillä oli selvä näkökuva Suomesta ja suomalaisista, ja siihen viitattiin joko avoimesti tai peitetysti. Kanadan ja Suomen suhteet Suomen itsenäisyyden tunnustamisesta vuonna 1919 aina kylmän sodan alkuun saakka vuonna 1948 ovat ymmärrettävissä Kanadan näkökulmasta käyttämällä näkökuva-analyysia. Näkökuvat analysoidaan joko positiivisella tai negatiivisella asteikolla. Positiiviset näkökuvat Suomesta kuvaavat sitä ystävällisenä, pohjoisena rajamaana, joka oli sivistynyt, länsimainen, nykyaikainen, edistynyt, suvaitsevainen ja demokraattinen. Suomalaiset nähtiin rehellisinä, ahkerina, luotettavina ja velkansa maksajina. Asteikon toisessa päässä Suomi nähtiin vihollisena ja kauppakilpailijana. Suomalaiset voitiin myös nähdä negatiivisesti vaarallisina ja radikaaleina. Nämä näkökuvat olivat läsnä ennen maitten välisten diplomaattisuhteiden perustamista, ja jatkuivat vuorovaikutuksissa koskien siirtolaisuutta, Kansojen liittoa, kauppaa ja tieteellistä vaihtoa. Ne ovat myös nähtävissä suhteissa talvisodan aikana, päätöksessä julistaa sota Suomea vastaan jatkosodan aikana, aserauhan aikana, rauhanteon aikana sekä paluussa normaaleihin suhteisiin kylmän sodan alussa. Euroopan tapahtumilla näytti olevan myös suuri vaikutus Suomen ja Kanadan suhteisiin. Näkökuvat Suomesta ja suomalaisista eivät suoranaisesti vaikuttaneet maitten suhteisiin, koska käytännöt ja toiminnat perustuivat päättäjien mielestä realistiseen arvioon tilanteista sekä Kanadan kansallisista eduista ja kyvyistä. Tästä huolimatta näitä näkökuvia käytettiin usein rajoittamaan hyväksyttävien vaihtoehtojen valikoimaa, järkeistämään tiettyjä käytäntöjä sekä oikeuttamaan joitakin toimintoja.
466

[en] THE TENSION ALREADY AND NOT YET IN OSCAR CULLMANN: POSSIBILITIES AND IMPLICATIONS TO THE MISSION OF THE CHURCH / [pt] A TENSÃO JÁ E AINDA NÃO EM OSCAR CULLMANN: POSSIBILIDADES E IMPLICAÇÕES PARA A MISSÃO DA IGREJA

LAERTE TARDELI HELLWIG VOSS 24 July 2018 (has links)
[pt] A tensão já e ainda não em Oscar Cullmann e suas implicações e possibilidades para a missão da Igreja caracteriza-se por um trabalho de pesquisa que se desenvolve em perspectiva de diálogo entre a Escatologia e a Missiologia. O objeto principal de análise é o paradoxo temporal clássico da teologia conhecido por já e ainda não do Reino de Deus. O trabalho parte da pergunta pela natureza temporal da esperança do povo de Deus. Ele começa na Escritura, passa pela trajetória da Igreja através dos séculos e chega até os tempos atuais. Percebe-se como a expectativa pelo cumprimento das promessas de Deus alternou-se ao longo da história. Às vezes, a orientação pendia para uma ênfase futurista e celestial. Outras vezes, ela se concentrava em questões contemporâneas e terrenas. A reflexão descobre então, em Oscar Cullmann, uma proposta significativa para resolver o problema da polarização da temporalidade escatológica. Cullmann, a partir de sua exegese do Novo Testamento, vê como o Reino de Deus e suas promessas reivindicam uma dupla aplicação temporal, um aspecto já inaugurado na pessoa e obra de Jesus Cristo, já presente entre nós, e outro ainda não consumado, o qual é esperado para o futuro, para a parusia. Nascia o insight já e ainda não. Em seguida, esta dissertação vai mostrar como a tese escatológica de Cullmann foi recebida e reverberada por outros teólogos de seu tempo. E por último, esta reflexão conduz ao subtítulo deste trabalho, o qual busca explorar como a tensão já e ainda não informa a mensagem e afeta a postura missional da Igreja. / [en] The tension already and not yet in Oscar Cullmann - possibilities and implications to the mission of the Church – is a research that proposes a dialogue between the Eschatology and the Missiology, in which the main goal is to analyze the classic paradox in theology known as the already and the not yet of the Kingdom of God. The essay starts by exploring the question about the temporal nature of the hope that God s people have nurtured. It begins in the Scripture, passes through different epochs in the record of the Church up to the state of the issue in our days, perceiving how the people s expectation for the fulfillment of God s promises has alternated throughout history. Sometimes it displayed a more futuristic and celestial emphasis. In another period, it pointed to a more present-day and worldly orientation. The research discovers then, in Oscar Cullmann, a significant proposal to solve the dilemma of any eventual polarization. Cullmann, from his exegetical work in the New Testament, see how God s Kingdom and its promises have a double timing application: an aspect already inaugurated by the person and work of Jesus Christ, already present among us, and another not yet consumed, which is still awaited in the future, in the breakthrough of the parousia. Afterwards, this dissertation will show how Cullmann s thesis was received and reverberated across the thought of various theologians. And lastly, this reflection will focus in the dissertation subtitle, which seeks to address how the tension already and not yet informs the missional message and affects the missional attitude of the Church.
467

ATT PLANERA ETT SAMARBETE MELLAN FÖRSVARSMAKTER : -Förutsättningar förfinsk-svenska samarbetet ur ett logistiskt perspektiv

Lyckfjäll, Magnus, Rönnlund, Peter January 2018 (has links)
Det militära samarbetet, FISE mellan Sverige och Finland påbörjades efter politiskt beslut 2014. Samarbetet har succesivt växt fram, dels genom politiska beslut och dels genom förslag från respektive lands försvarsmakter. Vi har i denna uppsats undersökt vad det är som påverkar den gemensamma planeringen av samarbetet på operativ nivå ur ett logistiskt perspektiv. Undersökningen har genomförts med induktiv ansats inspirerad av grounded theory i huvudsak genom intervjuer av deltagare som är delaktiga i planeringen av samarbetet. De faktorer som påverkar och har betydelse för hur den gemensamma planeringen av samarbetet ska fungera är organiseringen av det svenska högkvarteret, de tilldelade resurserna och att deltagarnas upplevelse av att målet för samarbetet är oklart. Författarna kan således konstatera att det, förvånande nog, inte är skillnader i materiel och system som har störst påverkan. Nyckelord: Finskt-svenskt samarbete, FISE, logistik, interoperabilitet, organisation. / The military cooperation, FISE between Sweden and Finland, commenced following the political decision in 2014. The cooperation has been progressively developed, partly through political decisions and partly by proposals from the respective national defense forces. In this paper we have investigated what is affecting the joint planning of the collaboration at the operational level from a logistical perspective. The survey has been conducted with an inductive approach inspired by grounded theory mainly through interviews of participants who are involved in the planning of the collaboration. The factors that influence and affect the way in which the joint planning of the cooperation will work is the organization of the Swedish headquarter, the allocated resources and the participants' experience that the goal of the cooperation is unclear. The authors can thus find that surprisingly, there are not differences in materials and systems that have the greatest impact. Key words: Finnish-Swedish cooperation, FISE, logistics, interoperability, organization. / Suomen ja Ruotsin sotilaallinen FISE-yhteistyö alkoi poliittisella päätöksellä vuonna 2014. Poliittiset päätökset ja puolustusvoimien omat aloitteet ovat laajentaneet yhteistyötä vaiheittain. Olemme tutkielmassamme käsitelleet tekijöitä, jotka vaikuttavat operatiivisen logistiikka yhteistyön suunnitteluun. Tutkielman lähestymistapa on ollut induktiivinen ja siinä on otettu vaikutteita ”grounded theory”-mallista. Tutkielma on toteutettu pääosin haastattelemalla henkilöitä, jotka osallistuvat yhteistyön suunnitteluun. Tekijät, jotka vaikuttavat merkittävästi yhteistyön suunnittelun onnistumiseen, ovat Ruotsin esikunnan organisointi, käytettävissä olevat resurssit sekä osallistujien kokemukset siitä, että yhteistyön päämäärä on epäselvä. Tutkielman päätelmä on, että materiaalien ja järjestelmien erilaisuus ei koeta tärkeämmäksi tekijäksi yhteistyössä. Avainsanat: Suomen ja Ruotsin puolustusyhteistyö, FISE, puolustuslogistiikka, yhteentoimivuus, organisaatio
468

Answers to Polarity Questions : A Typological Study

Moser, Elena Vera January 2018 (has links)
Polarity questions, i.e. questions that demand as an answer either an affirmation or a denial (e.g. yes or no), are considered to be an universal language feature. Different strategies to answer polarity questions have been observed across languages. Sadock & Zwicky (1985) identified three systems of answer strategies: yes/no systems, agree/disagree systems and echosystems. Other studies have attested languages exhibiting a mix of these types (i.a. Floydet al. 2016, Holmberg 2016). Sadock & Zwicky (1985) do not offer any statements about the frequency distribution of the language systems, nor do they explain what kind of sample was used for their analysis. The aim of this study is to fill this gap. Specifically, the goals are to investigate the validity of the typology offered in Sadock & Zwicky (1985) and to establish some estimates about the cross-linguistic frequency of the types identified during this investigation. The data are collected through consultation of reference grammars and elicitation by means of a questionnaire. / Polaritetsfrågor, frågor där det förväntade svaret är ja eller nej, anses vara ett universellt språk drag. Olika strategier för att svara på polaritetsfrågor har observerats i världens språk. Sadock & Zwicky (1985) identifierade tre svarssystem: polaritetsystem (yes/no system), sanningssystem (agree/disagree system) och ekosystem (echo system). Andra studier har funnit att språk också kan blanda dessa system (i.a. Floyd et al. 2016, Holmberg 2016). Sadock & Zwicky (1985) varken redogör för vilken distribution dessa svarssystem har eller vilket urval resultaten baseras på. Syftet med denna studie är att fylla den luckan. Målet är att undersöka validiteten i Sadock & Zwickys (1985) typologi samt att fastställa den tvärspråkliga frekvensen för de svarssystem som undersöks. Datainsamlingen sker genom grammatikor och elicitering genom en enkät.
469

Alopecia; its prevalence and association with cardiovascular diseases, risk factors and quality of life—cross-sectional population-based studies

Hirsso, P. (Päivi) 07 August 2007 (has links)
Abstract Alopecia has been suggested to be associated with coronary artery diseases (CAD). However, the mechanism underlying this association has remained unclear. The purpose of the present study was to examine the relationships between metabolic syndrome-related risk factors, cardiovascular diseases (CVD) and alopecia among Finnish population. In addition, health-related quality of life (HRQOL) was studied in respect of alopecia among both genders. The data come from the national Finrisk survey alopecia sub-study (4 066 men aged 25–74 years old) and two community samples of men and women (aged 55 and 63 years) living in the city of Oulu in 2001 and 1998, respectively. The degree of alopecia was assessed using the Norwood-Hamilton classification scale for men and the Ludwig scale for women. This study showed a high prevalence of alopecia in the general male Finnish population varying from 17% to 73% among men aged 25–74 years, and its association with CVD particularly in age-groups older than 55 years. In addition, insulin resistance, as a metabolic syndrome-related risk factor, was associated with alopecia in middle-aged men. Among men younger than 35 years, low-grade inflammation was associated with alopecia, especially combined with central obesity. Further, in middle-aged general Finnish population, obesity associated most closely with low-grade inflammation, which is in line with the findings among young men with alopecia. Compared to subjects with no alopecia, HRQOL dimension scores (RAND-36) were significantly lower in physical functioning, role limitations due to physical health and general health among women with alopecia, and in physical functioning and social functioning among men with alopecia. Regression analyses of HRQOL-related factors revealed that alopecia was associated with role limitations due to physical health in women but not in men. An association between alopecia and CVD was strengthened in this study. In addition, low-grade inflammation and insulin resistance were associated with alopecia, especially with early onset alopecia. In elderly women, alopecia seemed to be associated with morbidity in vascular diseases. In the future, recognition of the risk factors for cardiovascular disease among subjects with alopecia is a challenge for primary health care that may prevent the development of arterial diseases. / Tiivistelmä Hiustenlähdön yhteys sydän- ja verisuonisairauksiin on ollut tiedossa jo pitkään, mutta yhteyden taustalla olevat patofysiologiset mekanismit ovat edelleenkin epäselviä. Tässä väitöskirjatyössä tutkittiin hiustenlähdön yhteyksiä metaboliseen oireyhtymään ja siihen liittyviin riskitekijöihin suomalaisessa väestössä yleisesti. Lisäksi tutkittiin elämänlaadun yhteyttä hiustenlähtöön 63-vuotiailla miehillä ja naisilla. Tutkimukseen käytettiin kolmea aineistoa; kansallisen Finrisk 2002 tutkimuksen alopecia (hiustenlähtö) alaotos (4066 iältään 25–74-vuotiasta miestä) ja kaksi aineistoa Oulun kaupungista (Oulussa asuneet 55- ja 63-vuotiaat miehet ja naiset vuonna 2001 ja 1998). Hiustenlähdön laajuus määriteltiin miehillä Norwood-Hamiltonin ja naisilla Ludwigin luokitteluasteikon mukaan. Hiustenlähdön esiintyvyys suomalaisessa miesväestössä vaihteli 17 %:sta (25–34-vuotiaat) 73 %:iin (65–74-vuotiaat) ja se näytti liittyvän sydän- ja verisuonisairauksiin 55-vuotiailla ja sitä vanhemmilla miehillä. Lisäksi alentunut insuliiniherkkyys metabolisen oireyhtymän merkkinä oli yhteydessä hiustenlähtöön keski-ikäisillä miehillä. Varhain alkanut hiustenlähtö (alle 35-vuotiaat) liittyi matala-asteiseen tulehdukseen erityisesti keskivartalolihavilla kaljuuntuvilla nuorilla miehillä. Samansuuntainen tulos tuli esille myös väestötutkimuksessa 55-vuotiailla oululaisilla miehillä ja naisilla, jonka mukaan matala-asteinen tulehdus oli yhteydessä erityisesti yleiseen lihavuuteen eikä pelkästään vyötärölihavuuteen. Terveyteen liittyvän elämänlaadun osa-alueiden pisteet (RAND-36) 63-vuotialla hiustenlähdöstä kärsivillä naisilla olivat merkittävästi matalampia kolmella osa-alueella; fyysiset toiminnot, fyysisen terveydentilan aiheuttamat muutokset roolitoiminnoissa ja yleinen terveys. Samanikäisillä kaljuuntuvilla miehillä merkittävästi matalammat terveyteen liittyvät elämänlaadun osakomponentit olivat fyysisten ja sosiaalisten toimintojen alueella. Tilastollisessa regressioanalyysissä ilmeni, että hiustenlähtö selitti fyysisen terveydentilan aiheuttamia rajoituksia roolitoimintoihin erityisesti kaljuuntuvilla naisilla, mutta ei miehillä. Hiustenlähdön yhteys eri sydän- ja verisuonisairauksiin vahvistui tässä tutkimuksessa. Varhainen hiustenlähtö on ilmeisesti merkki sekä matala-asteisesta tulehduksesta että alentuneesta insuliiniherkkyydestä. Myös naisilla hiustenlähtö näyttäisi liittyvän suurempaan sairastavuuteen. Terveydenhuollon tulisi jatkossa tarkemmin paneutua sydän- ja verisuonisairauksien riskin kartoittamiseen hiustenlähdöstä kärsivien potilaiden kohdalla.
470

Genetic and life course determinants of cardiovascular risk factors:structural equation modelling of complex relations

Kaakinen, M. (Marika) 08 January 2013 (has links)
Abstract Cardiovascular disease is currently the leading cause of mortality worldwide. Several factors contribute to its development, including increased body mass index, high blood pressure and smoking. Many genetic and behavioural determinants of these risk factors have been identified, but the interplay between them along the life course is still poorly understood. Life course epidemiology and statistical methods developed for life course studies are required to enhance understanding of the aetiologies of these risk factors for more effective prevention and treatment of cardiovascular disease. In this thesis, structural equation modelling was applied 1) to estimate the effect of variation in the fat mass and obesity-associated gene, FTO, on body mass index over the life course, 2) to identify sensitive periods of growth in influencing adult blood pressure and 3) to identify developmental changes in the effects of two confirmed genetic loci, TTC12-ANKK1-DRD2 and CHRNA5-CHRNA3-CHRNB4, affecting smoking behaviour. Additionally, pleiotropic effects of the variation in CHRNA5-CHRNA3-CHRNB4 on smoking, body mass index and blood pressure were studied. The study population was based on the Northern Finland Birth Cohort 1966 with data available from early gestation until the age of 31 years (N≈6000). The first study indicated that the effect of the FTO variant on body mass index changes over time, with strengthening of the effect by age. The results from the second study demonstrated the important role of both prenatal and postnatal growth in determining adult blood pressure. In the third study, TTC12-ANKK1-DRD2 was shown to influence the initiation of smoking, while CHRNA5-CHRNA3-CHRNB4 was associated with smoking persistence. Finally, some evidence was found for pleiotropic effects of the CHRNA5-CHRNA3-CHRNB4 gene cluster on the three traits of interest. Results from all the studies emphasised the importance of environmental and behavioural factors in determining adult metabolic profile, in addition to genetic predisposition. This study demonstrated the usefulness of life course studies in detecting age-varying genetic effects, and provided new insights into the already identified factors associated with cardiovascular disease risk. The findings also emphasise the importance of early interventions and life style guidance for long-term benefits in health. / Tiivistelmä Sydän- ja verisuonitaudit ovat maailman yleisin kuolemansyy. Useat tekijät vaikuttavat näiden tautien kehittymiseen, mukaan lukien ylipaino ja lihavuus, kohonnut verenpaine sekä tupakointi. Useita geneettisiä ja ei-geneettisiä tekijöitä on yhdistetty näihin riskitekijöihin, mutta niiden yhteisvaikutukset elämänkaaren varrella ovat vielä huonosti tunnettuja. Elämänkaariepidemiologiaa ja sitä varten kehitettyjä tilastollisia menetelmiä tarvitaan, jotta saataisiin uutta tietoa riskitekijöiden etiologioista ja voitaisiin tehokkaammin ennaltaehkäistä ja hoitaa sydän- ja verisuonitauteja. Tässä väitöskirjatyössä käytettiin rakenneyhtälömallitusta 1) estimoimaan FTO-geenin yhteyttä painoindeksiin (BMI) elämänkaaren varrella, 2) tunnistamaan kehityksellisesti tärkeitä ajanjaksoja suhteessa aikuisiän verenpaineeseen ja 3) tutkimaan kahden jo ennestään tunnistetun geneettisen lokuksen, TTC12-ANKK1-DRD2:n ja CHRNA5-CHRNA3-CHRNB4:n, vaikutusta tupakointiin eri elämänvaiheissa. Lisäksi tutkittiin CHRNA5-CHRNA3-CHRNB4:n mahdollisia pleiotrooppisia vaikutuksia tupakointiin, painoindeksiin ja verenpaineeseen. Tutkimusväestönä käytettiin Pohjois-Suomen syntymäkohorttia vuodelta 1966, joka sisältää tutkimusaineistoa varhaisraskaudesta aikuisuuteen 31 vuoden ikään saakka (N≈6000). Ensimmäinen osatyö osoitti, että FTO-geenin vaikutus painoindeksiin voimistuu iän kasvaessa. Toisen osatyön tulokset antoivat näyttöä siitä, että raskaudenaikainen ja syntymän jälkeinen kasvu ovat yhteydessä aikuisiän verenpaineeseen. Kolmannessa osatyössä osoitettiin, kuinka TTC12-ANKK1-DRD2 on yhteydessä tupakoinnin aloittamiseen, kun taas CHRNA5-CHRNA3-CHRNB4 vaikuttaa tupakointikäyttäytymisen pysyvyyteen. Viimeinen osatyö antoi näyttöä CHRNA5-CHRNA3-CHRNB4-geeniklusterin pleiotrooppisista vaikutuksista kolmeen tutkittuun fenotyyppiin. Kaikkien osatöiden tuloksissa korostui, geneettisten tekijöiden lisäksi, ei-geneettisten tekijöiden tärkeys aikuisiän metabolisen profiilin kehityksessä. Tämä työ on osoittanut elämänkaarimallituksen hyödyllisyyden, kun pyritään havaitsemaan iän mukaan vaihtelevia geneettisiä efektejä. Se on myös tuonut uutta tietoa liittyen jo aiemmin todettuihin sydän- ja verisuonitautien riskitekijöihin. Lisäksi tulokset korostavat riittävän varhaisten ehkäisytoimien ja elämäntapaohjauksen tärkeyttä pyrittäessä saavuttamaan pitkäaikaisia terveyshyötyjä.

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