Parents and professionals are concerned about the long-term effects of language problems on later academic, communicative and behavioral functioning of children. The purpose of this study was to examine the relationship of level of language impairment with type of class placement, reading achievement, and social emotional functioning. Subjects were 19 children, aged 4 years, 10 months through 10 years, 4 months, who had previously been enrolled in a preschool language development program. Statistical analyses were performed on data from the Kaufman Assessment Battery for Children (K-ABC), Test of Early Reading Ability (TERA), and the Achenbach Child Behavior Checklist (CBC). Results do not support a relationship between level of language impairment and academic or social/emotional functioning.

Abstract The symptom complex originating from the inner ear, known as Meniere's disease, was studied especially from the epidemiologic point of view. A total of 442 patients' charts were retrospectively analysed in several hospital districts of Finland. The period of 1992-1996 was covered. The main focus was on the epidemiological assessment of the disease in Finland. To clarify the epidemiological figures, the validity of the diagnostic assessment was examined using the latest guidelines (1995) of the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology - Head and Neck Surgery (AAO-HNS) as a gold standard. The diagnostic tools used in the different hospitals were documented and evaluated, and diagnostic accuracy at the different levels of the health care system was evaluated. The clinical picture of Meniere's disease was characterised, and the therapeutic modalities used were evaluated. The audiometric configurations were classified according to two principles. The prognosis of hearing impairment was specified by creating a multivariable model. Half of the patients (N = 221) fulfilled the AAO-HNS criteria for definite disease. The prevalence and incidence of definite cases of Meniere's disease appeared to be lower in Finland than could be expected based on previous international studies. A prevalence of at least 43 per 100,000 and an average annual incidence of 4.3 per 100,000 were obtained. The prevalence rates in the catchment areas of the university and central hospitals did not differ statistically, but a significant (p < 0.001) difference was found between the average prevalences in the northern and southern Finnish hospital districts. Fluctuation of hearing in repeated audiometric measurements appeared to be a highly sensitive (94%) diagnostic test to detect definite Meniere's disease. According to the multivariable model created in this study, the hearing impairment in Meniere's disease affects equally males and females, and the deterioration is about 1 dB per year due to the duration of the disease and 0.5 dB per year due to aging. The disease was controlled conservatively in 69% of the cases. A gently sloping high-frequency audiometric pattern was most prevalent according to the EU Work Group classification and a flat pattern according to the mid-frequency-based classification. The variability of diagnostic criteria, diagnostic tools and therapeutic modalities shows an evident need for up-to-date therapy recommendations for Meniere's disease in Finland.

Abstract Age-related hearing impairment is the most common type of hearing impairment among adults. Adult-onset hearing impairment is one of the leading causes of disease burden worldwide and it is associated with social isolation and depression. As the proportion of older people is increasing in Western countries, the socioeconomic importance of adult hearing impairment will increase notably. The aim of the present contribution was to study the epidemiological aspects of hearing and related factors among older adults. The prevalence of hearing impairment, defined either by audiometry or by a self-report, and the differences between these two were analyzed. Tinnitus and hyperacusis were also studied. Furthermore, the prevalence of ear diseases, otological risk factors, and noise exposure and their association with hearing thresholds were analyzed. In addition, audiogram configurations and certain subject-related factors and their relation to hearing were assessed. The subjects were randomly sampled from the population register and they responded to an extensive questionnaire. Otological status was examined and pure tone audiometry was conducted. Data on 850 subjects aged 54–66 years were analyzed. Hearing impairment was found to be a highly common condition with a prevalence of 26.7% when defined by better ear and 42.2% when defined by worse ear. Men had worse hearing than women. High-frequency sloping audiogram configurations were common. Self-reported hearing difficulty and measured hearing impairment seem to be associated at high frequencies. At least one ear disease or otological risk factor for hearing impairment was found among 18.4% of the subjects and noise exposure among 46%, more often by men. Interestingly, noise exposure did not seem to associate with hearing levels among subjects screened for ear disease or otological risk factors. The results of the present study suggest that hearing impairment is a highly common condition among older adults and this should be taken into account when future hearing healthcare is planned. Furthermore, it seems that most of the subjects reporting hearing difficulty had no measured hearing impairment according to the criteria applied for eligibility for hearing aid fitting in Finland. Based on the results of the present study, the criteria for hearing impairment entitling persons for hearing aid fitting should be reconsidered. / Tiivistelmä Ikäkuulo on yleisin aikuisten kuulovian aiheuttaja, ja aikuisiän kuulovika on merkittävä terveydellinen haittatekijä. Kehittyneiden maiden ikäjakauman painottuessa vanhempiin ikäluokkiin aikuisten kuulovioista tulee merkittävä sosioekonominen rasite yhteiskunnille. Tutkimuksen tavoitteena oli selvittää aikuisten kuulovikojen epidemiologiaa ja kuulovikoihin liittyviä tekijöitä. Myös kuulovian vallitsevuus määriteltynä kuulokäyrän tai tutkittavan oman ilmoituksen perusteella selvitettiin. Samoin tutkittiin muita kuulemiseen liittyviä ongelmia, kuten tinnitusta ja ääniyliherkkyyttä. Edelleen arvioitiin erilaisten kuuloon vaikuttavien tekijöiden, kuten korvasairauksien, muiden kuulovian riskitekijöiden ja melulle altistumisen, vallitsevuutta väestössä sekä niiden assosiaatiota kuulemiseen. Näiden lisäksi tutkittiin kuulokäyrien muotoja ja niiden yhteyttä tutkittavan ilmoittamaan kuulo-ongelmaan. Tutkittavat valittiin satunnaisesti väestörekisteristä. He täyttivät laajan kyselylomakkeen, heidän korvansa tutkittiin lääkärin vastaanotolla ja lisäksi heille tehtiin kuulotutkimukset. Tutkimukseen osallistui 850 55–66-vuotiasta henkilöä. Tutkimus osoitti, että kuulovika on tässä ikäryhmässä hyvin yleinen löydös ja miehillä yleisempi kuin naisilla. Tutkittavan ilmoittama kuulovika ennusti mitattujen kuulokynnysten heikkenemistä korkeilla taajuuksilla (4–8 kHz). Samoin korkeille taajuuksille laskeva kuulokäyrän muoto oli yleisin. Erilaisia kuulovian riskitekijöitä raportoi 18.4 % tutkittavista. Tämän lisäksi 46 % kertoi merkittävästä altistumisesta melulle, miehet naisia useammin. Yllättäen melualtistumisella ei näyttänyt olevan yhteyttä kuulokynnyksiin siinä ryhmässä tutkittavia, joilla ei ollut korvaperäisiä riskitekijöitä kuulovialle. Tutkimustulokset osoittavat, että kuulovika on hyvin yleinen löydös tämän ikäisillä aikuisilla. Vanhenevat ikäluokat ovat merkittävä haaste kuulonhuollolle, ja tämä olisi otettava huomioon päätettäessä kuulonhuollon rahoituksesta. Useat niistä aikuisista, jotka kokivat kuulo-ongelmia, eivät kuulokäyrälöydöksensä mukaan täyttäneet Suomessa käytössä olevia kriteereitä kuulokojesovitukselle. Tämän tutkimuksen perusteella näyttääkin siltä, että kuntoutustarvetta arvioitaessa kuulovian kriteereitä tulisi kansallisesti tarkistaa ottamalla huomioon myös huonomman korvan kuulokynnykset sekä kuulon alenema korkeilla taajuuksilla.

Cognitive deficit is now considered to be a core feature of schizophrenia, which significantly influences psychosocial functioning in individuals with this illness. The aim of this study is to analyze the cognitive performance during the first year after the first episode of the illness and cognition related to psychosocial functioning. A total of 28 people hospitalized after the first psychotic episode of schizophrenia F20 according to ICD-10 participated in our study and underwent measurements of cognitive functions by the international MCCB battery. They were also evaluated by the PANSS (Scale of positive and negative symptoms) and PSP (range of personal and social performance). After one year from the first measurement for re-examination, 20 patients made an appearance. In 75% of the sample (n = 28), a cognitive deficit below 1.5 standard deviations below the normative average, i.e. below 35 T-score, was detected, at least in one of the measured domains. Speed of processing was the most impaired domain (T < 35), Reasoning and problem solving was the least attenuated domain (T > 40). The resulting analysis (paired t-test) showed a significant improvement one year after first-episode schizophrenia in domains Speed of processing (p = 0,018) and Reasoning and problem solving (p = 0,023). The...

Title - To what extent do firms comply with IAS 36?: A study based on firms listed on Nasdaq OMX Stockholm.Level - Master thesis in business administration.Authors - Stina Skyttner and Nora Wennertorp.Supervisors - Arne Fagerström and Saeid Homayoun.Date - 2 June 2017.Purpose - The overall aim of this paper is to build upon earlier research by examining to what extent firms listed on Nasdaq OMX Stockholm comply with disclosure requirements of IAS 36 paragraph 134. The second aim is to examine what variables affect the compliance level of these firms.Methodology - A sample of 90 firm’s annual reports and disclosure notes are surveyed from 2006 to 2016, and aggregated compliance scores are determined and analysed using quantitative statistical methods. The dependent variable is compliance with disclosure requirements of IAS 36 paragraph 134. The independent variables are size, industry, audit firm, leverage ratio, profitability ratio, learning, and the 2008 financial crisis.Findings - The results show that firm’s compliance levels with IAS 36 paragraph 134 have increased from 2006 to 2016, but they are still low compared to what the standard requires. There is not a significant increase in compliance levels during the crisis, therefore the 2008 financial crisis cannot be seen as a determinant factor of compliance with the disclosure requirements. The results show that larger firms and firms with higher leverage- and profitability ratios comply to a greater extent with the standard. Further, the type of industry in which the firm operates in affected the compliance level.Keywords - Impairment testing of Goodwill, IAS 36 paragraph 134, Compliance, Financial Reporting.

This thesis includes three empirical studies that have all aimed to increase the understanding of the interactions and connections between self-concepts, reading impairment, psychological health and Assistive Technology (AT). The use of applications in tablets as assistive technology to facilitate reading and compensate for reading impairment and its impact on the participants’ self-concepts and psychological health as well as on their reading abilities was also of interest. The first study included 67 pupils in school years 4-9. They were assessed by the Beck Youth Inventory (BYI) regarding self-image, anxiety and depression. The results showed no deviance from age-equivalent norm group scores. The second study included 35 pupils in school years 4-6. This study aimed at investigating the transfer effects on decoding and general reading ability after 20 intervention sessions where AT (applications in tablets) were used. Results showed that the decoding ability had progressed at the same rate as that of the norm group. The results also showed that using AT increased motivations to learn, as well as independence and improved family climate. The third study was a randomized control study (RCT) with 137 participants in school years 4, 8 and high school. The results showed that reading impaired children and adolescents to a great extent, but not completely unanimously, did not depict any different self-image or self-esteem than peers with an expected reading ability of the same age. Self-esteem was investigated by the Cultural Free Self Esteem Inventory (CFSEI-3). The CFSEI-3 scores showed no effect by interventions with AT. The results also showed that there were no signs of depression, assessed by BYI, in the investigated groups, but somewhat inconclusive results regarding anxiety where the school-year 4 group depicted higher levels of anxiety. The results generally showed a more positive depiction than what previous studies within the field have presented, which was interpreted as being due to the development of efficient pedagogical strategies and supportive attitudes in the school context, as well as among family members or peers.

Philosophiae Doctor - PhD / Aim: To investigate strokes, epidemiology, stroke characteristics, use of care and rehabilitation outcomes, and factors predicting these outcomes in stroke patients in Hebron city, in southern Palestine. Design: A one-year hospital-based, observational, descriptive, case-control, cohort study. Sample: One hundred and thirty nine (139) stroke patients were recruited from two main hospitals in Hebron city (Alia and Al-Ahli hospitals). Procedure: Objective assessment, patient interview, file screening and observation of the recruited cases was performed, risk factors were recorded and impairment, functional activity and participation were captured at baseline (T1), three months (T2), and six months (T3).

Procedural learning abilities have been shown to be deficient in children who meet criteria for Developmental Dyslexia (DD) and those who meet criteria for Specific Language Impairment (SLI; Lum et al., 2010; Menghini et al., 2006). Further, grammatical understanding has been linked to implicit sequence learning abilities across SLI and typically developing children (Lum, 2012). The present study examined implicit sequence learning, measured by the Serial Reaction Time Task (SRTT), in children who met criteria for DD with or without SLI. Implicit sequence learning was modeled using multi-level growth models of initial reaction time and learning slope across the repeated sequences of the SRTT. We further examined the predictive contributions of grammatical understanding, vocabulary abilities, phonological awareness, and diagnostic groups on implicit learning performance on the SRTT. Results showed language abilities and diagnostic group did not relate strongly to rates of implicit learning.

Alzheimer’s disease is a debilitating, progressive neurodegenerative disorder in the elderly, characterized by severe loss of memory and higher cognitive functions. In the hundred years since its discovery, Alzheimer’s disease (AD) has traversed from the status of a ‘rare neurological oddity’ to one of the greatest challenges faced by healthcare and medicine in this millennium. A reported 44 million people currently suffer from AD but only 1 in 4 people have been diagnosed. Although AD has been an area of intense research for almost 50 years now, most studies have focused on the end stage disease. Years of study on the pathological cause underlying AD; have conclusively shown that the accumulation of the sticky peptide, Aβ, is one of the major triggers of AD pathogenesis. However, after the initial Aβ trigger, multiple processes contribute to disease progression, so that by the time a patient is diagnosed on the basis of overt behavioral phenotypes, it is difficult to understand and differentiate between the causative mechanisms and the consequential effects of the disease. It is, perhaps, because of this, that we are still struggling to find therapies for AD which will stop or at the very least slow the course of the disease. In the 2015 report on AD, issued by the Alzheimer’s association, much emphasis has been placed on the early diagnosis of AD and the revision of the diagnostic criteria for AD. According to the new guidelines proposed in 2011, AD has been divided into three stages where the first stage occurs before the appearance of overt behavioral symptoms such as memory loss, whereas by the 1984 guidelines, cognitive disabilities must have already occurred for diagnoses of AD. This proposed preclinical stage of AD has been defined, reflecting the current belief that AD pathogenesis begins almost 20 years before the occurrence of behavioral dysfunction. However, no diagnostic criteria are currently available to establish this stage. Hence, there is a need to understand the early pathogenic mechanisms of AD, which will yield early therapeutic targets as well as early diagnostic markers of AD. One of the earliest documented events in AD pathogenesis is synaptic dysfunction, which is later manifested as loss of dendritic spines. Deficits in long term potentiation (LTP) has been demonstrated in Aβ exposed hippocampal slices as well as in mouse models of AD, much before the appearance of pathological hallmarks such as plaques and tangles as well as overt behavioral phenotypes. While these and other studies indicate clearly that elevated levels of soluble Aβ peptide leads to impairment of synaptic function, the underlying molecular mechanisms are yet to be elucidated. One of the purported mediators of Aβ induced dysfunction is oxidative stress. The Aβ peptide, especially the Aβ42, is a self aggregating peptide with a propensity to form peptidyl radicals. Interaction of the peptidyl radicals with biomolecules leads to the generation of more free radical species via cascading chain reactions. Additionally, Aβ peptide has also been demonstrated to have synaptotoxic effects via its effect on NMDA receptors and calcium influx leading to deregulated reactive oxygen species (ROS) production as well as excitotoxicity. Hence, with a view to understanding Aβ mediated early synaptic dysfunction in AD, we studied early signaling changes in the synaptosomes derived from the cortex of APP/PS1 mice model of AD at various ages. The APP/PS1 model contains a mouse/human chimeric APP gene bearing the KM670/671NL Swedish mutation and the human PS1 gene with an exon 9 deletion. These mice exhibit behavioral deficits from 7 months of age while plaque deposition and gliosis become apparent by 9 months of age. We chose to study both pre-symptomatic ages (1 and 3 months old) as well as post symptomatic (9 months old) mice. Post nuclear supernatant (PNS) as well as synaptosomes were isolated from the cortex of APP/PS1 and age matched control mice. We assayed the levels of reactive oxygen species (ROS) in the PNS and the synaptosomes of post symptomatic 9 months old APP/PS1 mice and age matched controls. In contrast to reports of enhanced oxidative stress markers in the brains of AD patients, we did not find any increase in the levels of ROS in the PNS of post symptomatic APP/PS1 mice compared to age matched controls. However, synaptosomes from the cortex of these animals exhibited a significant increase in ROS levels in APP/PS1 mice compared to controls. We further found that there was significant increase in the ROS levels in synaptosomes, but not PNS, of very young asymptomatic 1 and 3 months old APP/PS1 mice. This is a first demonstration of synapse specific increase in oxidative stress in AD mice, as young as 1 month of age, indicating that disease specific mechanisms operate at the synapse much before the appearance of any overt cellular or behavioral symptoms. The increase in synaptic ROS levels correlated with a small but significant increase in the levels of Aβ42 in the brains of APP/PS1 mice compared to controls. We also found a concurrent change in the redox status of the cytoskeletal protein, actin, at the synapse. As early as 1 month of age, there was a significant decrease in the protein level of reduced actin indicating that there is an increase in the level of oxidized actin at the synapse. This loss of reduced actin was specific to the fibrillar pool of actin while no significant change was observed in the redox status of the monomeric globular pool of actin. Oxidation of actin has been demonstrated to lead to its depolymerization. Concurrently, we found a significant loss of fibrillar actin in the synaptosomes of APP/PS1 mice. Actin is the major cytoskeletal protein at the synapse. Changes in the globular to fibrillar actin ratio at the synapse at early pre-symptomatic ages in APP/PS1 mice will likely lead to structural and consequent functional changes at the synapse. This could potentially be one of the triggers of synaptic dysfunction in AD. Furthermore, changes in the Akt-mTOR signaling pathway was also observed in the synaptosomes of 1 month old APP/PS1 mice, which is sustained at 9 months. There was a significant loss of the mTOR-pS6K-4EBP1 axis in the synaptosomes, but not PNS, of APP/PS1 mice. We found that loss of Akt signaling, as evinced by loss of Akt phosphorylation, Akt kinase activity as well as loss of phosphorylation of downstream effector GSK3β, potentially underlies the loss of mTOR signaling. Further, the loss of Akt signaling is mediated by synapse specific redox modification of Akt and consequent interaction with the protein phosphatase PP2a. Loss of the Akt-mTOR signaling at the synapse is indicative of deficits in local protein translation. Loss of this essential synaptic function, which plays critical roles in synapse maintenance as well as synaptic plasticity during learning and memory, at an early age, will have long ranging impact on synaptic function such as long term potentiation (LTP) in APP/PS1 mice. Our study is the first demonstration of oxidative stress and consequent signaling changes which occur specifically at the synapse of very young 1 month old APP/PS1 mice. These changes occur much before the appearance of overt phenotype such as plaque deposition and behavioral dysfunction but sustain till the appearance of classical pathological hallmarks. Hence, the study demonstrates that disease progression starts much before previously thought and provides us a critical time window during which therapeutic strategies designed to delay or stop these changes might change the course of AD.

L’objectif de cette thèse est de déterminer si le déficit auditif des enfants dysphasiques est spécifique au domaine verbal et d’étudier les liens qu’entretiennent les habiletés verbales et musicales chez ces enfants. Nous avons testé 18 dysphasiques et des enfants au développement du langage typique (DLT) âgés de 7 à 12 ans. Dans la première étude, nous avons étudié leurs capacités de détection des syllabes dans des phrases chantées et parlées. Nos résultats ont confirmé les déficits de détection des syllabes chez les dysphasiques. Nous n’avons toutefois pas observé d’effet facilitateur du chant sur la détection des syllabes. Dans une seconde étude, nous avons exploré leur perception musicale à l’aide de la MBEMA (Peretz et al., 2013). Une part importante de ces enfants a montré des troubles de perception mélodique et rythmique. Une corrélation positive a été retrouvée entre les scores aux tests de perception rythmique et de conscience phonologique, étayant les liens entre le traitement temporel et la perception verbale chez les dysphasiques. Dans la troisième étude, nous avons exploré leurs capacités de chant avec une épreuve de reproduction de notes et de mélodies. Les dysphasiques montraient des troubles importants dans ces deux conditions. Des troubles de production et de perception musicale ont été mis en évidence chez la plupart des dysphasiques et les capacités de conscience phonologique semblaient liées au traitement temporel en musique. Ces résultats en faveur d’un déficit auditif plus global chez la plupart des dysphasiques suggèrent l’importance d’évaluer les capacités auditives non verbales dans la prise en charge diagnostique et thérapeutique de ces enfants. / The aim of this thesis is to determine whether the auditory deficit of children with Specific Language Impairment (SLI) is specific to verbal stimuli, and to examine the relation between language and musical abilities in these children. We tested 18 children with SLI and groups of children with Typical Language Development (TLD) aged from 7 to 12 years. In the first study, we examined syllable detection in sung and spoken sentences. Results confirmed the detection syllable deficit in children with SLI. However, we did not observe a facilitation effect of sung over spoken stimuli. In the second study, we explored musical perception abilities in the same children with the MBEMA (Peretz et al. 2013). Our results showed that a large proportion of the children with SLI present deficits in melodic and rhythmic perception. A positive correlation was found between scores in Rhythm and phonological awareness tasks, documenting a link between language and temporal processing in children with SLI. In the third study, we assessed singing abilities in children with SLI: we created a singing reproduction task and tested the pitch matching condition and the melodic reproduction condition. The SLI showed deficits for both conditions. These results suggested deficits in music perception and production in children with SLI for most of them and that development of phonological awareness abilities seems related to the auditory temporal processing in music. The findings seem to support the existence a more general auditory dysfunction in a majority of children with SLI emphasizing the relevance of systematically assessing nonverbal abilities for the diagnostic and rehabilitation of SLI.