Voice onset time (VOT) är en akustisk tidsparameter som reflekterar den tidsmässiga samordningen av talmotoriken. VOT betraktas som det mest pålitliga akustiska kännetecknet på huruvida en klusil är tonlös eller tonande. Föreliggande studies syfte var att studera och jämföra VOT hos svenska barn (8, 9, 10, 11 år) och vuxna för att se hur utvecklingen sker samt för att ta fram svenska normvärden. Ljudinspelningar genomfördes på 150 barn och 36 vuxna vid uttal av de svenska klusilerna i minimala par. Akustiska analyser av materialet utfördes sedan. Resultatet visade att de tonlösa klusilerna föreföll produceras med vuxenlika VOT-värden från och med cirka nio års ålder. De tonande motsvarigheterna producerades med vuxenlik VOT omkring tio års ålder. I tioårsåldern förekom dessutom förton i helt vuxenlik utsträckning. Resultaten tyder dock på att svenska vuxna ej nödvändigtvis behöver producera tonande klusiler med förton. Inga tydliga könsskillnader erhölls. De normvärden för VOT som har tagits fram i föreliggande studie kan nyttjas som referensmaterial vid utredning av barn med talstörningar. / Voice onset time (VOT) is a temporal acoustic parameter, which reflects the timing of speech motor control. VOT is said to be the most reliable acoustic cue of whether a plosive is voiceless or voiced. The aim of the present study was to investigate and compare VOT among Swedish children (8, 9, 10, 11 years) and adults to examine the development of VOT and to obtain Swedish normative data. Audio recordings were performed on 150 children and 36 adults when pronouncing the Swedish plosives in minimal pairs. Acoustic analyses were then carried out. The results indicated that the voiceless plosives seemed to be produced with adult like VOT-values around the age of nine. The voiced plosives in turn, appeared to be produced with adult like values at approximately ten years of age. By the age of ten, also prevoicing was found in a fully adult like extent. Though, the results indicate that not all Swedish adults produce voiced plosives with prevoicing. No evident gender differences were found. The normative data for VOT that have been obtained in the present study can be used as normative data when assessing children with speech disorders.

I ABSTRACT Autor: Mgr. Helena Vomáčková Title: The Possibilities of Evaluation of the Sport Performance on the Postural Functions - CDP Normative Data for Sport Population Objective: The main aim of the dissertation is to determine the standardized values (normative data) of individual parameters of test protocols obtainable with usage of dynamic computer posturography of the NeuroCom SMART EquiTest System (hereinafter SMEQ). The partial second goal is to compare the determined normative data with the existing values used for routine evaluation of postural stability given by the SMEQ software. Another partial goal is to determine the reliability of individual test parameters in an additional pilot survey. Methods: Data for the determination of standardized values were obtained by laboratory measurements using the SMEQ system and subsequently were converted, unified and adjusted for further processing by statistical "software R". To determine the normative data, an input data-set obtained from a deliberately selected group of active athletes (n = 245) in the selected age range of 20 - 30 years with an average age of 24,04 (± 1,23 years), with an average body height of 173, 29 (± 10,04 cm), mean body weight 68,46 (± 13,10 kg) and mean BMI 22,67 (± 3,04) was used. To calculate the predicted normative data for...

INTRODUÇÃO: A Addenbrookes Cognitive Examination Revised (ACE-R) avalia cinco domínios cognitivos em conjunto e também oferece notas parciais para cada um deles, a saber: Atenção e Orientação, Memória, Fluência, Linguagem e Habilidades VisuaisEspaciais. Essa bateria tem se mostrado útil na diferenciação entre a doença de Alzheimer (DA) e a demência frontotemporal (DFT) em outros países. O instrumento foi submetido à adaptação para o português e sua versão brasileira foi previamente publicada pelos autores. OBJETIVO: Investigar o desempenho de indivíduos idosos cognitivamente saudáveis e de outros com DA provável leve na versão brasileira da ACE-R. MÉTODOS: O teste foi administrado a um grupo de 31 pacientes com DA provável leve e a 114 idosos cognitivamente saudáveis. Destes, 62 foram equiparados aos pacientes por idade e escolaridade. Todos os participantes incluídos tinham idade 60 anos e 4 anos de escolaridade. Não apresentavam sintomatologia depressiva associada, definida como pontuação > 7 na Escala Cornell para Depressão em Demência. O comprometimento cognitivo dos pacientes foi evidenciado por pontuação < 123 na Escala Mattis de Avaliação de Demência (DRS). Os controles apresentaram escore total na DRS 123. Dados normativos foram extraídos da amostra total de indivíduos sadios. Foi analisada a correlação entre a ACE-R e o Teste de Memória de Figuras (BCB-Edu), os de Fluência Verbal (Frutas e F.A.S.) e a Bateria de Avaliação Frontal. Os grupos/variáveis foram analisados pelos testes Qui-quadrado, Teste t de Student e Teste de Mann-Whitney. Analisou-se a influência da idade/escolaridade pelo ANOVA e Bonferroni (dados com distribuição normal) e pelo Teste de Kruskal- Wallis e Método Diferença Mínima Significativa (dados sem distribuição normal). Os índices de correlação de Pearson e Spearman foram utilizados para aferir a relação entre o desempenho na ACE-R e nos demais testes cognitivos. A acurácia da bateria foi investigada pela análise das áreas das curvas ROC. RESULTADOS: As médias (DP) de idade e escolaridade dos 62 controles foram de 77,82 (6,58) e 10,05 (4,98), e dos pacientes, 78,03 (6,74) e 9,97 (5,19), respectivamente. A amostra sadia foi subdividida em três faixas etárias (60-69, 70-79 e 80) e em três grupos de escolaridade (4-7, 8-11 e 12). As subescalas da ACE-R se correlacionaram significativamente com os demais testes. Os escores gerais da bateria e da DRS mostraram forte correlação A escolaridade influenciou em todos os escores da ACER. Já a idade interferiu nas subescalas Memória, Fluência e na pontuação total. A nota de corte < 78 na ACE-R demonstrou sensibilidade de 100% e especificidade de 82,26% para o diagnóstico de DA leve (ASC = 0,947). A nota de corte para DA determinada pela razão VLOM foi de > 3,22 (ASC = 0,836; sens. 67,74%; espec. 96,77% e VPP 91,73%). CONCLUSÕES: A versão brasileira da ACE-R provou ser um instrumento de boa acurácia e de propriedades diagnósticas satisfatórias para a avaliação cognitiva em nosso meio, tendo sido capaz de discriminar pacientes com DA leve de indivíduos controles, além de avaliar com eficiência vários domínios cognitivos comumente afetados em estágios iniciais da doença. Os dados normativos apresentados representam parâmetros úteis de normalidade em idosos brasileiros. / INTRODUCTION: The Addenbrooke\'s Cognitive Examination Revised (ACE-R) allows evaluation of five cognitive domains, namely: Attention and Orientation, Memory, Fluency, Language and Visuospatial. It is particularly useful in differentiating Alzheimer\'s disease (AD) from frontotemporal dementia (FTD). The instrument was adapted to the Brazilian population and this version has already been published by the authors. OBJECTIVES: To investigate the performance of healthy individuals and patients with mild probable AD in the ACE-R Brazilian version. METHODS: The test was administered to 31 AD patients and to 114 cognitively preserved elderly. Sixty two subjects of this healthy group were adequately matched to the patients for age and education. The participants included were aged 60 years, had 4 years of schooling and did not show depressive symptoms, defined by a score > 7 in the Cornell Scale for Depression in Dementia. Cognitive impairment was defined by a score < 123 in the Mattis Dementia Rating Scale (DRS), while control scores were 123 in the DRS. Normative data were extracted from the whole sample of healthy subjects. We correlated scores in the ACE-R with those in Memory tests from the BCB-Edu, with Verbal Fluency Tests (Fruits and F.A.S.) and with the Frontal Assessment Battery. Data were analyzed with Chi-square test, Students t test and Mann-Whitney test. The influence of age/educational level in ACE-R scores was investigated by ANOVA and Bonferroni Multiple test (normal distribution data) as well as by Kruskal-Wallis test and the Minimum Significant Difference test (non-normal distribution data). Pearsons and Spearmans correlation indexes were used to assess the relationship between performance in the ACE-R and other cognitive tests. The accuracy of the battery was investigated by ROC curve analysis. RESULTS: Mean (SD) age / schooling found in the groups were 77.82 (6.58) / 10.05 (4.98) for the 62 controls and 78.03 (6.74) / 9.97 (5.19) for the patients, respectively. The healthy sample of 114 subjects was divided into three age groups (60-69, 70-79 and 80 years) and into three groups according to education (4-7, 8-11 and 12 years). The performance in the ACE-R subscales significantly correlated with that in the other cognitive instruments. The total scores from both ACE-R and DRS were strongly correlated between themselves. The educational status influenced the ACE-R sub-scores. Age interfered in the Memory, Fluency and in the ACE-R composite score. The cut-off point < 78 of ACE-R demonstrated 100% of sensitivity and 82.26% of specificity for the diagnosis of mild AD (AUC = 0,947). The VLOM cut-off point to determinate AD was > 3.22 (AUC = 0.836; sens. 67.74%; spec. 96.77% and PPV 91.73%). CONCLUSIONS: The Brazilian version of the ACE-R displayed high accuracy and great diagnostic properties for cognitive assessment in our milieu; also it was able to discriminate patients with mild AD from cognitively healthy individuals. In addition, the ACE-R efficiently assesses multiple cognitive domains that are commonly affected in the early stages of dementia. Normative data presented here represent useful parameters for the clinical use of the ACE-R in Brazilian elderly.

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<p>The oral sensory ability in children can be assessed through test of intraoral stereognosis and two-point discrimination. Currently, these two tests are not frequently used in clinical settings, and normative data are not always available. The aim of this study was to establish normative data for these two tests in children aged 5;6 to 7;0 years. Further, intention was to compare the results with respect to age and gender. In total 103 children participated, 49 boys and 54 girls. The participants were divided into three age-groups. The results regarding intraoral stereognosis showed significant differences between genders, where boys performed poorer than girls. Differences between two of the three age-groups could also be established. The results show that an improvement can be expected in children six years and older.</p><p>Regarding two-point discrimination 73 of the 103 children performed perfectly. The remaining children’s scores were also consistently high. No differences between gender and age were found.</p><p>There was no correlation between the test results of intraoral stereognosis and two-point discrimination. Therefore it would be necessary to perform both these tests in assessment, since they probably examine two separate aspects of the oral sensory ability.</p><p> </p> / <p>Oral sensorisk förmåga hos barn kan bland annat utredas genom test av intraoral stereognosi och tvåpunktsdiskrimination. Dessa två test är i nuläget inte särskilt kliniskt utbredda, och normvärden saknas ofta. Föreliggande studie syftade till att fastställa normvärden för dessa två test hos barn mellan 5;6 och 7;0 år. Vidare jämfördes även testresultaten med avseende på åldersgrupp och kön. 103 barn deltog i studien, varav 49 var pojkar och 54 var flickor. Deltagarna delades in i tre åldersgrupper. Resultatet visade signifikanta könsskillnader på test av intraoral stereognosi, där pojkarnas resultat var något sämre än flickornas. Även skillnader mellan två av åldersgrupperna konstaterades gällande intraoral stereognosi. Resultatet visar att en förbättring på testet kan förväntas då barnen har fyllt sex år.</p><p>Angående test av tvåpunktsdiskrimination klarade 73 av de 103 barnen testet felfritt, och överlag presterade barnen mycket bra på testet. Inga skillnader mellan kön eller åldersgrupper noterades beträffande test av tvåpunktsdiskrimination.</p><p>Testresultaten av intraoral stereognosi och tvåpunktsdiskrimination korrelerade inte. Därför är det sannolikt nödvändigt att i utredning utföra båda testen, eftersom det kan röra sig om två olika aspekter av intraoral sensorik.</p><p> </p>

<p>The goals of this thesis are to evaluate quality of life (QoL) in adult patients with growth hormone deficiency (GHD) in relation to population normative data, to construct a preference-weighted index (utility) from a disease-specific QoL measure and to assess it in a clinical context.</p><p>The study included samples from the general population and patients with GHD from four European populations: England & Wales, the Netherlands, Spain and Sweden. The country-specific patient cohorts were retrieved from KIMS (Pfizer International Metabolic Database). </p><p>A questionnaire was developed that contained items from existing QoL questionnaires including, among others, Quality of Life Assessment in Growth Hormone Deficiency in Adults (QoL-AGHDA) and the EQ-5D. The QoL-AGHDA is a disease-specific measure for use in adults with GHD. The EQ-5D is a generic instrument which describes health states for which country-specific preference-based weights are available. Thus, it was possible to generate preference-weighted indices (utilities) based on data generated by both instruments. </p><p>This thesis reports QoL-AGHDA normative values for the populations of England & Wales, the Netherlands, Spain and Sweden, and confirms the extent of QoL impairment in patients with GHD in comparison with the general population. Long-term GH replacement resulted in sustained improvements in overall QoL towards normative country-specific values, as well in most of the dimensions that were impaired before treatment. </p><p>For use in health economic evaluations, models for generating utilities (QoL-AGHDA_utility) from QoL-AGHDA were developed. It is believed that these models may facilitate medical decision making, given that they provide a tool for obtaining utilities in the absence of directly collected preference-weighted indices.</p><p>QoL-AGHDA_utility effectively monitored treatment effects in patients with GHD. Moreover, this study confirmed a QoL-AGHDA_utility deficit before treatment and a gain after starting GH replacement. </p><p>The novel aspect of the present approach was to apply preference-weighted indices derived from a disease-specific measure to assess QoL in the clinical context, together with patient demographic and clinical characteristics. The robustness of this analysis is reinforced by the fact that utilities in both general and patient populations were generated using the same methodology. </p>

The goals of this thesis are to evaluate quality of life (QoL) in adult patients with growth hormone deficiency (GHD) in relation to population normative data, to construct a preference-weighted index (utility) from a disease-specific QoL measure and to assess it in a clinical context. The study included samples from the general population and patients with GHD from four European populations: England &amp; Wales, the Netherlands, Spain and Sweden. The country-specific patient cohorts were retrieved from KIMS (Pfizer International Metabolic Database). A questionnaire was developed that contained items from existing QoL questionnaires including, among others, Quality of Life Assessment in Growth Hormone Deficiency in Adults (QoL-AGHDA) and the EQ-5D. The QoL-AGHDA is a disease-specific measure for use in adults with GHD. The EQ-5D is a generic instrument which describes health states for which country-specific preference-based weights are available. Thus, it was possible to generate preference-weighted indices (utilities) based on data generated by both instruments. This thesis reports QoL-AGHDA normative values for the populations of England &amp; Wales, the Netherlands, Spain and Sweden, and confirms the extent of QoL impairment in patients with GHD in comparison with the general population. Long-term GH replacement resulted in sustained improvements in overall QoL towards normative country-specific values, as well in most of the dimensions that were impaired before treatment. For use in health economic evaluations, models for generating utilities (QoL-AGHDAutility) from QoL-AGHDA were developed. It is believed that these models may facilitate medical decision making, given that they provide a tool for obtaining utilities in the absence of directly collected preference-weighted indices. QoL-AGHDAutility effectively monitored treatment effects in patients with GHD. Moreover, this study confirmed a QoL-AGHDAutility deficit before treatment and a gain after starting GH replacement. The novel aspect of the present approach was to apply preference-weighted indices derived from a disease-specific measure to assess QoL in the clinical context, together with patient demographic and clinical characteristics. The robustness of this analysis is reinforced by the fact that utilities in both general and patient populations were generated using the same methodology.

The oral sensory ability in children can be assessed through test of intraoral stereognosis and two-point discrimination. Currently, these two tests are not frequently used in clinical settings, and normative data are not always available. The aim of this study was to establish normative data for these two tests in children aged 5;6 to 7;0 years. Further, intention was to compare the results with respect to age and gender. In total 103 children participated, 49 boys and 54 girls. The participants were divided into three age-groups. The results regarding intraoral stereognosis showed significant differences between genders, where boys performed poorer than girls. Differences between two of the three age-groups could also be established. The results show that an improvement can be expected in children six years and older. Regarding two-point discrimination 73 of the 103 children performed perfectly. The remaining children’s scores were also consistently high. No differences between gender and age were found. There was no correlation between the test results of intraoral stereognosis and two-point discrimination. Therefore it would be necessary to perform both these tests in assessment, since they probably examine two separate aspects of the oral sensory ability. / Oral sensorisk förmåga hos barn kan bland annat utredas genom test av intraoral stereognosi och tvåpunktsdiskrimination. Dessa två test är i nuläget inte särskilt kliniskt utbredda, och normvärden saknas ofta. Föreliggande studie syftade till att fastställa normvärden för dessa två test hos barn mellan 5;6 och 7;0 år. Vidare jämfördes även testresultaten med avseende på åldersgrupp och kön. 103 barn deltog i studien, varav 49 var pojkar och 54 var flickor. Deltagarna delades in i tre åldersgrupper. Resultatet visade signifikanta könsskillnader på test av intraoral stereognosi, där pojkarnas resultat var något sämre än flickornas. Även skillnader mellan två av åldersgrupperna konstaterades gällande intraoral stereognosi. Resultatet visar att en förbättring på testet kan förväntas då barnen har fyllt sex år. Angående test av tvåpunktsdiskrimination klarade 73 av de 103 barnen testet felfritt, och överlag presterade barnen mycket bra på testet. Inga skillnader mellan kön eller åldersgrupper noterades beträffande test av tvåpunktsdiskrimination. Testresultaten av intraoral stereognosi och tvåpunktsdiskrimination korrelerade inte. Därför är det sannolikt nödvändigt att i utredning utföra båda testen, eftersom det kan röra sig om två olika aspekter av intraoral sensorik.

Benämningsförmågan av verb och substantiv kan påverkas på skilda sätt vid neurologisk skada eller sjukdom och idag finns inget normerat verbbenämningstest på svenska. Syftet med föreliggande studie var att översätta och ta fram normvärden för friska vuxna personer på Action Naming Test (ANT), samt att undersöka huruvida ålder, kön, utbildnings- och kognitionsnivå påverkar resultaten. Målorden i ANT översattes från engelska till svenska genom omvänd översättning och 120 personer i åldrarna 20-83 år testades med detta. För möjlighet att undersöka inverkande faktorer på resultaten samlades information om utbildningsnivå in och deltagarna testades även med Irregularly Spelled Words (ISW) och Wechsler Intelligence Scale for Children-III (WISC-III) Blockmönster. Resultaten visade att ålder, utbildning och kognition hade en inverkan på hur friska vuxna personer presterade på ANT. Yngre deltagare presterade signifikant bättre, liksom deltagare med hög utbildnings- och kognitionsnivå. Hänsyn bör tas till att anpassningar till svenska språket inte är fullständigt utförda, men då resultaten har ett stort underlag kan de ändå användas som normvärden vid testning av verbbenämningsförmåga hos personer med neurologisk skada eller sjukdom. / In case of brain damage the naming ability of verbs and nouns can be differently affected. Since there is no test of verb naming available in Swedish, the aim of this study was to translate and establish normative data for Action Naming Test (ANT). Further, the intention was to compare the results with respect to age, gender, educational and cognitive level. The words in ANT were translated from English to Swedish through back translation and 120 healthy participants, aged 20-83 years, were tested. To be able to study factors possible influence on the results, information about education was also collected and the participants were tested with Irregularly Spelled Words (ISW) and Wechsler Intelligence Scale for Children-III (WISC-III) Block Design. The result showed that age, education and cognition had a significant influence on the ANT results. Young participants performed better, as well as participants with high educational and cognitive level. Considerations should be taken that the adaptations to the Swedish language are incompletely, but since the result is based on a large sample it can be used to test verb naming in patients with brain damage.