Browsing by Subject "toiminnanohjaus"

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  • Laakso, Hanna (Helsingin yliopisto, 2015)
    Objective: Cognitive impairment as a consequence of a stroke is common. Advanced age increases the frequency of poststroke cognitive deficits. Particularly executive dysfunction has an important role in poststroke disability. Complex by their nature, however, measuring executive function is difficult. The Hayling test, Design fluency task and Questioning task are some of the less common assessment methods of executive functions, and thus, they are not widely studied. The aim of the present study was to assess the feasibility of these tests in elderly patients three months after ischemic stroke. Performances on these tests were compared to conventional assessment methods of executive functions, and their predictive value on functional disability in follow-up was examined. Methods: 62 stroke patients and 39 control subjects, aged 55-85, underwent comprehensive neurological and neuropsychological examinations three months after the index stroke. Executive functions were studied with the Trail Making test, Stroop test, Wisconsin card sorting test, Verbal fluency task as well as with the Hayling test, Design fluency task and Questioning task. The modified Rankin Scale (mRS) and the Lawton's Instrumental activities of daily living -scale (IADL) were used to assess functional abilities at three months, and the mRS after 15 months follow-up. Results and conclusions: The Hayling test and Questioning task and the four conventional tests of executive functions differentiated stroke patients from healthy controls. Furthermore, the executive functions predicted functional dependence in the elderly stroke patients. The Hayling test was most consistently associated with functional disability as evaluated with mRS and IADL three months after the stroke, and predicted functional disability as evaluated with mRS at 15 months follow-up. Of all executive functions tests, the Hayling test proved to be the most constant predictor of functional abilities in elderly stroke patients. However, there is no golden standard for measuring executive functions, and in the future, more sensitive methods are needed. Nevertheless, the present study confirms the importance of assessing executive functions in clinical populations, when predicting functional disability even in the long-term.
  • Mikkola, Katri (Helsingfors universitet, 2016)
    Attention-deficit/hyperactivity disorder (ADHD) is a pervasive neurodevelopmental disorder of executive functions, which affects the social, occupational, educational, and personal life of the individuals concerned. The main characteristics of this disorder are age inappropriate inattention, impulsivity and hyperactivity. The research on adult ADHD is still scarce, especially concerning the neural networks of attention. Childhood ADHD has been associated with impairment in two of the attentional network subsystems alerting and executive control, leaving the third subsystem, orienting of attention, intact. Research on adult ADHD and the subsystems of attentional network is contradicting. The aim of this study was to investigate neural activation of these attentional networks during highly demanding attentional tasks in adults with ADHD. The first hypothesis was that the ADHD group have decreased activity in the frontoparietal network during orienting of attention in contrast to the control group. The second hypothesis was that the ADHD group have decreased activity in the dorsolateral prefrontal cortex, anterior cingulate gyrus, and precuneus during divided attention in contrast to the control group. Both the ADHD group and the control group included 16 participants, aged 25 – 56 across all participants, whose brain activation was measured with functional magnetic resonance imaging during the attentional tasks. The tasks included divided and selective attention. Both conditions included task-irrelevant novel distractors. The results supported both hypotheses. The ADHD group had decreased brain activity in the frontoparietal network during top-down controlled and bottom-up triggered attention. Decreased activation in the dorsolateral prefrontal cortex, anterior cingulate gyrus and precuneus was observed during divided attention in the ADHD group. Furthermore, the default-mode network was hyperactivated in the ADHD group. Activation of this network has been related to increasing task demands and failure of maintaining an alert state. Thus, adult ADHD seems to associate with abnormally functioning attention networks. Moreover, the results indicated that in addition to dysfunctional alerting and executive control, adults with ADHD have also impaired orienting of attention. These dysfunctional attentional networks may have a connection with the inattentive symptoms of adult ADHD.
  • Vakkari, Mikael (Helsingin yliopisto, 2006)
    Verkkari 2006 (1)
  • Uotila, Eino (Helsingin yliopisto, 2020)
    Executive functions refer to abilities that enable successful regulation of behaviour and other activity appropriate for the current situation. Executive functions can be assessed using different assessment methods. Usually visual fluency is examined as part of a wider assessment of executive functions. Visual fluency is often assessed using tasks of figural fluency. Figural fluency tasks are thought be a nonverbal analogue to tasks of verbal fluency as part of assessment of executive functions. However it remains unclear what executive or cognitive functions can be assessed by using figural fluency tasks. The present thesis set out to examine, how task performance in a figural fluency task is related to task performance in other tasks of cognitive and executive functions. Figural fluency task performance was hypothesized to be related to verbal fluency, visual executive and reasoning functions and motor function. Forty-five adults were assessed using tasks of figural fluency, verbal fluency, visual processing speed, working memory flexibility, visual reasoning and motor functions. Relationships between performance in the figural fluency task and the other tasks were compared. In addition the relationship between figural fluency task performance and visual reasoning task performance was compared to that of figural fluency task performance and performance in the tasks of visual processing speed and working memory flexibility. Lastly, the contribution of motor function to the relationships between performance in the different tasks was investigated through partial correlation. Figural fluency task performance was related to performance in all the tasks, except for semantic verbal fluency (r = .32, p = .123) and motor functions (r = .01, p = .952). Performance in the working memory flexibility task was more strongly related to task performance in the figural fluency task (r = -.64, p < .001), than performance in the visual reasoning task (r = .56, p < .001). Performance in the visual reasoning task was however more strongly related to figural fluency task performance, than performance in the task of visual processing speed (r = -.41, p = .008). Motor function did not contribute to the observed relationships. Results of this thesis corroborate the role of figural fluency tasks in the assessment executive functions and elaborate that figural fluency is related to other visual functions.
  • Hartikka, Roosa (Helsingin yliopisto, 2019)
    Objectives. One of the key factors responsible for one’s self-regulatory skills are considered to be temperament-based effortful control (EC) and higher-order executive functions (EFs). These have been shown to share some mutual neural networks and brain regions, but little is known about the connections between them. In particular, there is a lack of longer-term follow-up studies. This study examined the association between parental-assessed EC in childhood and test performance based EFs in early adolescence. In addition, the aim was to investigate the connections between sub-features of EC and EFs, and whether gender affects the relationship between them. Methods. This study consisted of 183 children and adolescents who had participated at the age of 5,5 and 12 years in the follow-up phases of the cohort study, which began in 1998. EC was assessed by The Children’s Behavior Questionnaire (CBQ) and EFs were evaluated with subtests from Developmental Neuropsychological Assessment for Children II (NEPSY-II), Trail Making Test (TMT), Conners’ Continuous Performance Test II (CPT) and Wisconsin Card Sorting Test (WCST). Results and conclusions. Higher parental-rated EC at 5,5 years of age was associated EFs at age 12, especially in tasks measuring linguistic and non-linguistic fluency and inhibitory skills (verbal and design fluency subtests from NEPSY-II). Looking at the individual subfactors of EC, the ability to maintain attentional focus (attentional focusing), the tendency to enjoy low intensity stimuli (low intensity pleasure), and the ability to suppress inappropriate responses (inhibitory control) were found to be associated with higher EFs (better performance in verbal and design fluency subtests from NEPSY-II, less perseveration errors in WCST and lower response time in CPT). In addition, some gender specific connections were found: boys’ ability to shift attention was associated with higher stimulus resolution (higher D Prime score in CPT). The results suggest that childhood temperament could be used to identify potential challenges in EFs later in early adolescence.
  • Liesto, Sanna (Helsingfors universitet, 2014)
    Objectives. The aim of the current study was to examine whether patients with mild traumatic brain injury (MTBI) have neurocognitive deficits in acute phase and in three month follow up after injury that can be detected using a brief neuropsychological battery. Second aim of the study was also to examine if there was a subgroup of patients with more neuropsychological deficits. The aim was also to compare self-reported symptoms and objective neuropsychological deficits. MTBI is known to cause neurocognitive deficits including dysfunctions in memory, attention and executive functions in some patients. Usually neurocognitive dysfunctions resolve in three months but a minority of MTBI patients are reported to continue experience dysfunctions longer than three months. Methods. 26 patients with MTBI and 23 healthy controls participated in this study. Patients were examined with neuropsychological tests three days after the trauma. Neuropsychological tests assessed the domains of memory, attention and executive functions. Second examination was conducted three months after the first one for both groups. At the first examination patients completed SCAT2 questionnaire concerning self-reported symptoms. Results and conclusions. On a group level the neuropsychological test performance of MTBI patients did not differ from healthy controls. A minority of patients with MTBI showed significant neurocognitive deficits. Some self-reported symptoms correlated to neuropsychological performance. In the future more research is needed to explore the factors contributing to long lasting deficits after a MTBI. Also new neuropsychological tests are needed to examine the subtle deficits of MTBI.
  • Fagerlund, Hanne (Helsingfors universitet, 2016)
    Objectives. Late-preterm birth (34+0-36+6 weeks' gestation) has been associated with increased risk of adverse outcomes in executive functioning during early childhood. There is still little knowledge of long-term disadvantages associated with late-preterm birth. A majority of infants born late-preterm are also born with intrauterine growth restriction, which has been shown to increase risk of adverse outcomes in executive functioning in childhood and also in early adulthood. Although these factors have similar adverse effects in executive functions during childhood, there is little research of their possible additive effects. Previous studies have also used mainly performance-based methods to measure executive functions, which places doubts on ecological validity of previous results. The aim of this study is to examine whether late-preterm birth, intrauterine growth restriction or their additive effects are connected to self-rated executive functioning in early adulthood. Methods. The study sample comprised 2193 regionally sampled infants, who were born 1985-1986 and participated in the Arvo Ylppö Longitudinal Study (AYLS). Basic measures from peri- and neonatal periods were extracted from maternity hospital records and maternal interviews. Intrauterine growth restriction was estimated with being born small for gestational age (SGA). The participants' gestational age was reliably specified and they filled in the standardized and self-report based Behavioral Rating Inventory of Executive Functioning- Adult Version (BRIEF-A) at age of 24-26 years. The final sample comprised 634 participants, of whom 88 were born late-preterm and 37 were born SGA. The effects of late-preterm and SGA birth to self-reported executive functioning in early adulthood were analyzed using multiple-hierarchical-linear-regression, controlling for multiple confounders. The additive effects were analyzed with multiple MANOVA. Results and conclusions. Late-preterm birth and additive effects of late-preterm birth and SGA were not associated with adverse effects in self-rated executive functioning in adulthood, although negative trend was found. SGA was significantly associated with fewer adversities in self rated executive functioning. The systematic loss found in the study sample and the possibly positively skewed views of SGA adults may have affected found connections. Therefore, more research is needed from effects of late-preterm birth and SGA on executive functioning in adulthood.
  • Lampinen, Anna (Helsingin yliopisto, 2019)
    Masennus on yleinen ja kansanterveydellisesti merkittävä sairaus, josta aiheutuu merkittävää haittaa ja kärsimystä yksilölle. Masennusta esiintyy vuosittain n. 8 % suomalaisväestöstä. Kognitiivisilla toiminnoilla tarkoitetaan aivojen tiedonkäsittelyprosesseja, jotka mahdollistavat sujuvan toiminnan jokapäiväisessä elämässä suunnittelusta laskutoimituksiin ja muistisuoriutumiseen. Tässä tutkimuksessa selvitettiin, millainen masennuspotilaiden kognitiivinen suoriutuminen on ja eroaako se terveiden kontrollihenkilöiden kognitiivisesta suoriutumisesta. Lisäksi tarkasteltiin, onko jokin tietty masennukseen liittyvä oire, kuten ruminaatio tai anhedonia, yhteydessä kognitiiviseen suoriutumiseen. Tutkimus koostui 38 masennuspotilaasta ja 31 perusterveestä kontrollihenkilöstä, joille tehtiin neuropsykologinen tutkimus. Toiminnanohjauksen eri komponentteja tutkittiin Trail Making -testillä (TMT-A ja -B), Reyn kuviotestillä ja Lontoon torni -testillä. Työmuistia arvioitiin Numerosarjat ja Kirjain-numerosarjat -tehtävillä ja prosessointinopeutta Merkkikokeella (WAIS-III). Masennuspotilaiden masennusoireilua kartoitettiin BDI-21 - ja PHQ-9 -kyselyillä, ruminaatiotaipumusta RSQ-kyselyllä ja anhedoniaa SHAPS-kyselyllä. Lisäksi masennuspotilaiden maniaoireilua, epävakaan persoonallisuushäiriön piireitä ja ahdistuneisuusoireilua seulottiin MDQ-, BPD- ja OASIS-kyselyillä. Masennuspotilaiden kognitiivinen suoriutuminen oli työmuistin osalta heikompaa verrattuna kontrollihenkilöihin Numerosarjoissa eteenpäin ja taaksepäin, sekä lähestyi tilastollista merkitsevyyttä Kirjain-numerosarjoissa. Muissa kognitiivisen suoriutumisen komponenteissa ei havaittu eroa masennuspotilaiden ja kontrollihenkilöiden välillä. Oirekyselyt eivät olleet masennusryhmän sisällä yhteydessä kognitiiviseen suoriutumiseen korrelatiivisesti tarkasteltuna. Masennuspotilaiden heikompi suoriutuminen työmuistitesteissä oli linjassa aiempien tutkimustulosten kanssa, kun taas toiminnanohjauksen ja prosessointinopeuden osalta tulos erosi aiemmasta tutkimustiedosta. Heikompi työmuistisuoriutuminen vaatii jatkotutkimuksia ja voi mahdollisesti olla osa-alue, joka voidaan huomioida masennuspotilaan hoidossa sekä psykoedukaation että kuntoutuksen osalta.
  • Hämäläinen, Sari (Helsingin yliopisto, 2019)
    Tässä pro gradu -tutkielmassa selvitetään musiikkiharrastuksen ja erityisesti soitonopiskelun yhteyttä 13–21-vuotiaiden nuorten tarkkaavaisuus- ja toiminnanohjaustaitoihin. Musiikkiharrastus on aiemmissa tutkimuksissa liitetty tehostuneisiin kuuloerottelukykyihin, kielellisiin kykyihin ja korkeamman asteisiin kognitiivisiin prosesseihin. Tämän laajan kognitiivisten kykyjen tehostumisen takana on ehdotettu olevan tarkkaavaisuuden säätelyn ja toiminnanohjaustaitojen kehittyminen musiikki- ja erityisesti soittoharrastuksen myötä. Tarkkaavaisuudelle ja toiminnanohjaukselle tärkeä etuotsalohko kehittyy edelleen nuoruudessa ja vielä aikuisiän saavuttamisen jälkeen, joten on kiinnostavaa selvittää musiikkiharrastuksen mahdollisia hyötyjä nuorten ja nuorten aikuisten vielä kehittyviin toiminnanohjaustaitohin ja mahdollista yhteyttä niiden taustalla oleviin aivomekanismeihin. Tutkimuksessa mitattiin aivosähkökäyrämittauksella (elektroenkefalografia, EEG) nuorten ja nuorten aikuisten (N=64, joista 35 kuului musiikkiryhmään ja loput kontrolliryhmään) inhibitiota, kognitiivista joustamista ja työmuistia edellyttävän visuaalisen vaihtamistehtävän synnyttämiä P3-tyyppisiä herätevasteita. Lisäksi nuoret ja nuoret aikuiset tekivät inhibitiokykyä ja tarkkaavaisuuden sujuvaa vaihtamista sekä työmuistia ja yleistä päättelysuoriutumista mittaavia neuropsykologisia tehtäviä. Tutkimuksessa tarkasteltiin myös näissä tehtävissä suoriutumisen yhteyttä P3-tyyppisen vasteen voimakkuuteen. Musiikki- ja kontrolliryhmän välillä ei havaittu eroa toiminnan tai taitojen tasolla koeasetelman vaihtamistehtävässä eikä neuropsykologisissa tehtävissä. Ryhmien välillä ei havaittu myöskään eroa P3-tyyppisen vasteen voimakkuudessa. Vasteen jakauma erosi kuitenkin ryhmien välillä. Musiikkiryhmällä P3-tyyppinen vaste oli voimakkaampi päälaen alueella pään keskiosaan verrattuna, kun taas kontrolliryhmällä vaste oli voimakkaampi päälaen alueella vielä taaempaan takaraivon alueeseen verrattuna. Koeasetelman vaihtamistehtävässä suoriutumisella oli yhteys P3-tyyppisen vasteen voimakkuuteen: mitä suurempi vasteen voimakkuus oli, sitä lyhyemmät olivat reaktioajat tehtävässä. Sen sijaan neuropsykologisessa inhibitio- tai vaihtamistehtävässä suoriutumisella ei havaittu olevan yhteyttä P3-tyyppisen vasteen voimakkuuteen. Työmuistisuoriutuminen oli kuitenkin positiivisesti yhteydessä P3-tyyppisen vasteen voimakkuuteen. Myös iällä havaittiin yhteys vasteen päänpinnan jakaumaan. Nuorimmilla vaste oli voimakkaampi päälaen alueella taaempaan takaraivon alueeseen verrattuna, mutta vanhimmassa ikäryhmässä vasteen amplitudi oli suurempi päälaen alueella pään keskiosaan verrattuna. Toiminnanohjaustehtävissä suoriutuminen parani iän myötä molemmilla ryhmillä. Vaikka selkeitä ryhmäeroja ei tutkimuksessa havaittukaan, tulokset viittaavat siihen, että nuorilla ja nuorilla aikuisilla musiikkiharrastus on yhteydessä erilaiseen tarkkaavaisuuden säätelyyn ja toiminnanohjaukseen liittyvään hermostolliseen toimintaan musiikkia harrastamattomiin verrattuna. Tulosten mukaan tarkkaavaisuus- ja toiminnanohjaustaidot ja niihin liittyvät hermostolliset prosessit myös kehittyvät edelleen 13–21 vuoden iässä.
  • Raappana, Maria (Helsingfors universitet, 2016)
    Objectives. Previous studies have shown that the sensitive interaction produced by adults is connected to the self-regulation and working memory of children. This is because interactions stir emotions in children. The processing of emotions is connected to the functions of the prefrontal area of the brain. These functions include self-regulation and the working memory. Children are more easily led by their emotions when compared to adults, and they need adult support in their self-regulation. Self-regulation has been shown to be a prerequisite for metacognition, and metacognition is an important component of the learning process. This study aims to find out how the interaction produced by an adult is connected to the executive functions of a student. The results of the study can be applied to interactions between adults and children in a general level, but special emphasis has been placed on immigrant children. The importance of interaction is emphasized when the child has moved from their own culture to a foreign one. Immigrant students are over-represented when looking at the decisions related to specific support, but according to various studies, the need for specific support for these children has not been demonstrated reliably. The study examines the interactive means that adults have at their disposal and tries to shed light on the interaction produced by adults. Methods. The material of the study is part of the University of Helsinki's Long Second data. The material was videotaped during the school year 2011–2012 in a preparatory class, twice a week. The approach to the study was through a socio-cultural learning theory perspective, because the socio-cultural theory focuses on the interaction between the environment, cultural tools, the individual and the community. The method of analysis applied was discussion analysis. The analysis was supported by a questionnaire on concentration, Keskittymiskysely (Klenberg, L., Jämsä, S., Häyrinen, T. & Korkman, M. 2010) which was used to analyse executive functions. One student was picked from the video material, and the changes in the student's executive functions were monitored in relation to teacher interactions. The material that was selected for analysis included four teachers. Results and conclusions. Four different types of adult interactions were discovered in the analysis phase. One of these interaction types shows genuine interest in the child. By utilizing dialogical discussion, this type of adult interaction makes students regulate their activities and speak Finnish. The more dialogical the teacher interaction was, the better were the student's own executive functions. The study also showed that rules related to the interaction improved the student's own executive functions.
  • Uronen, Anna (Helsingfors universitet, 2016)
    Objectives. The purpose of this study is to identify the factors that enhance or hinder meeting of the objectives, which are in this case learning in a classroom environment. In addition, we observe methods on how achieving abovementioned goals can be supported. These observations will hopefully lead to discovering a functional system for supporting students' learning. The study's theoretical section focuses on the theory of learning and executive functions. Previous studies have shown, that there is a correlation between executive functions and learning methods (e.g Gathercole, Pickering, Knight & Stegmann, 2004). Hence in this study there is an emphasis on supporting learning from an executive functions point of view. Methods. This study is a qualitative case study, with elements of action research. Action research is used through intervention, where the objective was to alter the students' actions more beneficial for learning. Data was acquired through observing and participation in the first grade primary school class. Participants consisted of 23 students and one teacher. The target of observation was the actions of these participants in the class room. Data was gathered over a span of three weeks a total of 52 hours. The material was analysed by using qualitative content analysis. Results and conclusions. The study showed that executive functions is closely tied to learning, as an enhancing and hindering factor. Guidance of the student's attention, active participating, self-direction, spontaneity, co-operation and peer support resulted in learning enhancement. The students' lack of concentration, unnecessary noise from students, inconsiderate behaviour, the lack of shifting, restlessness and students becoming passive hindered learning in the classroom. In addition, it was found that the teacher's choices of teaching methods and upbringing were important factors in promoting students' goal-oriented activity. The study shows that student executive functions, and thus learning can be influenced by the environment in which the student works in. The study's model of intervention can be applied to the teachers' practical work, either as such or, depending on the student's needs.
  • Ojamaa, Tiia (Helsingin yliopisto, 2018)
    Students who study in the Finnish basic education have a variety of different needs for education support. The three-level support model is used to respond to the individual needs. Craft subject differs from other subjects in its practical nature. It also emphasizes student's own responsibility for learning. Therefore there are different needs for education support in craft lessons than in other subjects. The aim of this study is to increase knowledge about education support needs in craft lessons in basic education and how teachers respond to those needs with support measures. This study was carried out as a case study. Four craft teachers who work within basic education were interviewed. All the teachers had students who needed general, intensified and special need in their classrooms. The transcribed data was analysed using theory-driven content analysis. Craft teachers recognized several different education support needs. The needs that kept the teachers the busiest were challenges in executive functions and behavior. These challenges linked to students' self-regulation and attention. The three-level support model was not explicit in craft lessons because the education support needs that emerge in craft lessons differ from the needs of other subjects. The teachers used a variety of support measures, the most important being differentiation which allows the teachers to individualize learning objectives, exercises and instructions according to the individual needs of the students. Also remedial teaching, co-education, special needs assistant, aids for disabled students and guidance of teacher were important support measures. The teachers found support measures helping the whole classroom, not only students with the need for education support.
  • Tommiska, Marja-Reetta (Helsingin yliopisto, 2020)
    Tavoitteet Valikoivan tarkkaavuuden ja toiminnanohjauksen kehitystä ennustavien tekijöiden tutkimus on tärkeää lapsen optimaalisen kehityksen tukemiseksi. Aivosähkökäyrässä esiintyvien tapahtumasidonnaisten jännitevasteiden avulla on mahdollista tutkia tarkkaavuuden ja tiedonkäsittelyn hermostollista perustaa. P3a-vasteet syntyvät, kun ympäristössä esiintyvä yllättävä ääni vetää tarkkaavaisuuden tahattomasti puoleensa. Tämä tutkimus selvitti, miten esikouluiässä mitattujen tapahtumasidonnaisten P3a-vasteiden amplitudit ja latenssit ennustavat ikätasoisesti kehittyneiden lasten myöhempää suoriutumista sekä vastaustyyliä valikoivaa tarkkaavuutta ja toiminnanohjausta vaativissa tehtävissä. Menetelmät Tutkimuksen koehenkilöinä oli 64 ikätasoisesti kehittynyttä lasta (50% tyttöjä), joiden perheessä tai lähisuvussa ei esiintynyt oppimisvaikeuksia tai neurologisia diagnooseja. Esikouluiässä yllättäviin ääniin syntyvää P3a-vastetta mitattiin lasten keskittyessä katsomaan elokuvaa. Ensimmäisen luokan lopussa lapset suorittivat kaksi tehtävää, joista toinen kuvasti lapsen valikoivaa tarkkaavuutta sekä inhibitiotoimintoja ja toinen näiden lisäksi toiminnanohjauksen ja työmuistin toimintaa. Vastaustyylin arvioimiseksi lapsilta laskettiin huomaamatta jääneet kohdeärsykkeet sekä viivästyneet ja väärät reaktiot ärsykkeisiin. Tulokset Yllättävät äänet synnyttivät lapsilla P3a-jännitevasteen, jonka huippu esiintyi noin 250 ms ärsykkeen esittämisen jälkeen. Yksilölliset esikouluiässä mitatut P3a-amplitudit ja -latenssit eivät kuitenkaan ennustaneet lapsen suoriutumista ensimmäisellä luokalla valikoivan tarkkaavuuden tehtävässä eivätkä tarkkaavuuden ja toiminnanohjauksen tehtävässä. Pojat tekivät tyttöihin verrattuna merkitsevästi enemmän virheitä kummassakin tarkkaavuuden tehtävässä, kun taas tytöillä oli enemmän viivästyneitä reaktioita valikoivan tarkkaavuuden tehtävässä. P3a-vasteet eivät kuitenkaan ennustaneet lasten vastaustyyliä kummassakaan tehtävässä. Johtopäätökset Tämän tutkimuksen tulosten mukaan yllättäville äänille syntyvä P3a-vaste ei sovellu ääniin suuntautuvan valikoivan tarkkaavuuden ja toiminnanohjauksen kehityksen ennustamiseen ikätasoisesti kehittyneillä esikouluikäisillä lapsilla, joilla ei ole lähisuvussaan oppimisvaikeuksia tai neurologisia diagnooseja. Selvitettäväksi tulevaisuudessa jää, ennustaisiko P3a-amplitudi tai -latenssi tarkkaavuutta tai toiminnanohjausta herkemmin häiriintyvyyttä mittaavassa tarkkaavuuden tehtävässä tai näiden taitojen kehitystä tarkkaavaisuushäiriöiden riskiryhmiin kuuluvilla lapsilla.
  • Ketola, Laura (Helsingin yliopisto, 2020)
    Obesity has been identified as a risk factor for numerous chronic diseases. However, the association of Body Mass Index (BMI) and late-life cognitive functions has appeared to be complex. Obesity in mid-life has been shown to increase the risk of developing dementia later in life, whereas among older adults, being overweight has been associated with reduced risk of dementia. The recommended BMI is higher for older adults. However, obesity is probably not beneficial. Preclinical Alzheimer´s disease causes weight loss and thus confounds the associations. Few studies have investigated the association between BMI and cognitive performance among people who do not have dementia. The objective of this thesis was to evaluate whether late-life BMI is associated with cognitive performance and changes in cognitive performance during a multidomain lifestyle intervention. It also examined if changes in BMI are associated with changes in cognitive performance. The data used in this study was from The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), which aimed to prevent cognitive decline among older adults at elevated risk for dementia. The 1260 participants recruited (mean age 69 years) were randomly assigned into a two-year multidomain intervention (n=631), including dietary guidance, exercise, cognitive training and management of cardiovascular risk factors, or control (n=629), receiving general health advice. Cognitive performance was assessed with modified Neuropsychological Test Battery (NTB) at baseline, and 12 and 24 months after randomization. During the intervention weight loss occurred in both study groups. Higher BMI was associated with worse total cognitive performance, executive function and processing speed, but not memory, at baseline. Higher BMI at baseline was not associated with changes in total cognitive performance, executive function or processing speed, but it predicted less improvement in memory functioning among under-69-year-olds. Changes in BMI were not associated with changes in cognitive performance. In conclusion, being overweight and obesity may be risk factors for cognitive decline even among older adults. It is likely that weight loss during the intervention was intentional, but it was not associated with cognitive changes. Hence, maintaining a healthy BMI is recommendable also for older adults, but weight loss may not have additional benefits.
  • Enholm, Lea (Helsingin yliopisto, 2019)
    Objectives: The Boston Qualitative Scoring System (BQSS) is a tool for assessing the copying accuracy in the Rey-Osterrieth Complex Figure (ROCF) test and its qualitative features, which have been proposed to measure executive functions. The goals of this study were to examine 1) whether the qualitative properties of the ROCF copy condition predict the copying accuracy, 2) whether the copying accuracy correlate with test performance in other neuropsychological tests measuring executive functions, and 3) whether various executive tests differentiate adults who had prenatal risk factors from adults who had none. Methods: The study is part of the Finnish Longitudinal Study of Cognition, in which adults with and without prenatal risk factors born between 1971 and 1974 have been followed since their birth. In this study, of the 483 participants 390 adults were in the risk group and 93 in the control group. The average age was 42 years. The analysis of this study was done with ordinal and logistic regression analyses. Results and conclusions: All the qualitative scores of produced ROCF, namely fragmentation, planning, organization, neatness, and perseveration, correlated with the copying accuracy of the ROCF assessed by BQSS. Additionally, all the qualitative scores except for fragmentation correlated with the copying accuracy assessed by the Osterrieth scoring method. Planning, organization, neatness, and perseveration explained 1–3 % of the variance of various executive test scores. Furthermore, the copying accuracy assessed by BQSS correlated with the category fluency, Stroop task, WAIS Digit Span test, errors in TMT B, and with the BRIEF-A metacognition index. In contrast, when assessed by the Osterrieth scoring method, the copying accuracy correlated only with the letter fluency test. Fragmentation, planning, organization, and the time difference between different TMT tasks differentiated adults with prenatal risk factors from adults who had none. Finally, the increased amount of prenatal risk factors correlated with poorer performance in multiple executive tests. This study suggests that the ROCF is applicable as a part of the assessment of executive functions and that the qualitative features should be taken into account during the assessment. In addition, prenatal risks especially when accumulated, increase the probability of poorer executive functions in adulthood.
  • Leppänen, Veera (Helsingin yliopisto, 2021)
    Tiivistelmä Tiedekunta: Valtiotieteellinen tiedekunta Koulutusohjelma: Sosiaalitieteiden maisteriohjelma Opintosuunta: Sosiaalityö Tekijä: Veera Leppänen Työn nimi: Sosiaalityö ja Apotti – Havaintoja asiakastieto- ja toiminnanohjausjärjestelmän käytännöstä Työn laji: Maisterintutkielma Kuukausi ja vuosi: Toukokuu 2021 Sivumäärä: 64 + liitteet Avainsanat: sosiaalihuolto, tietohallinto, asiakastietojärjestelmä, Apotti, toiminnanohjaus, tietojärjestelmien kehittäminen Ohjaaja tai ohjaajat: Aino Kääriäinen Säilytyspaikka: Helsingin yliopiston kirjasto Tämä maisterintutkielma on katsaus suomalaiseen sosiaalihuollon ja sosiaalityön tietohallinnon sekä tietojärjestelmien kehityskulkuun ja tämän kehityskulun tuloksena rakennettuun Apotti-asiakastieto- ja toiminnanohjausjärjestelmään. Kiinnitän huomioni Apotti-asiakastietojärjestelmän ja käytännön sosiaalityön näkökulmiin. Analysoin näiden tekijöiden pohjalta sitä, miten asiakastieto- ja toiminnanohjausjärjestelmä toimii käytännössä ja millaisia toiminnanohjauksen haasteita ja onnistumisia sosiaalityöntekijät tunnistavat järjestelmässä. Tutkimusaineistoni koostuu 10:sta sähköisellä kyselylomakkeella kerätystä vastauksesta, joissa lapsiperhepalveluiden sosiaalityöntekijät kuvaavat asiakastietojärjestelmän toimivuutta ja soveltuvuutta käytännön sosiaalityöhön sekä toiminnanohjausrakenteen vaikutuksia päivittäistyön tekemiseen. Aineisto on analysoitu aineistolähtöisen sisällönanalyysin keinoin. Tutkimustulokset olen jäsennellyt tutkielmalle keskeisten käsitteiden sekä aiemman tutkimuksen kautta sekä niihin verraten. Apotti asiakastieto- ja toiminnanohjausjärjestelmän rakentamisessa ja käyttöön viemisessä on haasteita ja järjestelmä koetaan käytettävyydeltään hankalaksi sekä monivaiheiseksi. Sosiaalityön päivittäistyön tekemisen näkökulmaa ei ole huomioitu tarpeeksi järjestelmän suunnittelu- ja rakennusvaiheessa. Kyseessä on nykyaikainen järjestelmä, joka on tarjonnut suorastaan ”digiloikan” aiempaan asiakastietojärjestelmään verrattuna, mutta järjestelmän suunniteltuja ja toivottuja hyötyjä ei tässä hetkessä ole mahdollista saada täysimääräisinä irti. Toimintaa ohjaava rakenne on tunnistettavissa järjestelmässä, mutta sen hyödyt päivittäistyön tekemiselle riippuvat työntekijän omasta osaamisesta sekä taidoista, kuten myös perehdytyksen ja koulutuksen määrästä sekä laadusta. Toiminnanohjaus onnistui vähentämällä työntekijän muistitaakkaa, keräämällä dataa sekä mahdollistamalla tiedolla johtamisen. Haasteina taas näyttäytyy muistitaakan lisääntyminen, kuten erilaisten klikkailupolkujen osaaminen sekä toiminnanohjausjärjestelmän mukanaan tuoma aikataakka. Tutkimuksen suuntaaminen sosiaalityön kentälle mahdollistaa ymmärryksen lisäämisen järjestelmän taustalla vaikuttavista ohjeistuksista ja lainsäädännöstä. Asiakastietojärjestelmien ja käyttäjien välistä näkökulmaa on tarpeen tutkia jatkossakin, jotta järjestelmiä on mahdollista kehittää vastaisuudessakin. Järjestelmän mahdollistaman datankeruun osalta kiinnostaviksi tutkimusaiheiksi nousevat tulevaisuudessa ne näkymät, joita datankeruu suhteessa työn tekemiseen ja sosiaalityöhön mahdollistaa.
  • Kropsu, Hannu (Helsingin yliopisto, 2019)
    Objectives Perinatal risk factors, e.g. low birth weight (< 2000g), can cause neuropsychological or cognitive deficits which are observable into adulthood. This pro gradu thesis examines the association of low birth weight with executive function deficits in adulthood (research question 1). Low birth weight can also cause problems in social life and life management manifesting as alcohol over consumption or dependency on: therefore alcohol use was investigated (research question 2). Alcohol consumption and executive functions can be related; an increace in alcohol use could impair executive functions, and vice versa (research question 3). Methods The age of the subjects ranged from 39 to 45 years. 86 of the subjects (61 women, 25 men) were born at a low weight. Other perinatal risk factors (low Apgar score, respiratory distress, neurological symptoms, hypoglycaemia, hyperbilirubinemia, meningitis, sepsis, or maternal diabetes) – group consisted of 328 subjects (148 women, 180 men) and 83 subjects in the control group (46 women, 37 men). Executive function was assessed using the Behavior Rating Inventory of Executive Function – Adult Version (BRIEF-A) (n = 497). Alcohol consumption was assessed by the Alcohol Use Disorders Identification Test (AUDIT) (n = 460). The subjects completed the BRIEF-A questionnare at the end of the neuropsychological examinations and the AUDIT via the Internet or in paper form. Results and conclusions The groups differed from each other in the level of executive functions, with the low birth weigth -group being the weakest. Statistically significant differences were shown in overall executive function, in the regulation of behavior and emotions, in shifting, in planning/organization and in working memory. The observed deficits in executive functions may be due to developmental defects or deficiencies in the brain structures sometimes associated with low birth weight. In terms of alcohol use, the groups did not differ from each other. There was however, an association between the level of alcohol use and the level of executive functions: as executive functions weaken, alcohol consumption increases, and vice versa.
  • Wilska, Karoliina (Helsingfors universitet, 2017)
    Objectives. Childhood ADHD has been linked to dysfunctions in executive functioning, lower level of education and poorer occupational functioning in young adulthood but long-term developmental course of ADHD beyond 30 years age is still poorly understood. The present study examines executive functioning, level of education, current employment and subjective working capacity at the age of 40 in adults who have had perinatal risks related ADHD in childhood. Associations between executive function tests and occupational functioning are also examined. Methods. The present study is part of a larger longitudinal birth cohort research project examining long-term effects of perinatal risk factors. The cohort has been followed since 1970's. The present sample includes individuals with perinatal risks associated childhood ADHD (n = 31), individuals with perinatal risk factors without childhood ADHD (n = 145) and control individuals without perinatal risks or childhood ADHD (n = 36). Executive functioning was examined by using traditional neuropsychological tests as well as computerized assessment methods. Results and conclusions. Adults with perinatal risks related childhood ADHD had poorer functioning in some of the executive function tests. Poorer performance was detected especially in the area of cognitive flexibility. Adults with perinatal risks but without childhood ADHD did not differ from controls in executive functioning which suggests that perinatal risks alone without ADHD symptoms do not affect executive functioning in adulthood. The group with perinatal risks related childhood ADHD also had lower education level compared to controls. No significant associations were found between executive function tests and occupational functioning. It appears that childhood ADHD with perinatal risk factors can have mild long-term effects to executive functioning extending to 40 years age. This emphasizes the significance of early support directed to risk groups.
  • Sinikara, Kaisa (Helsingin yliopisto, 2007)
    Verkkari 2007 (5)
  • Haaman, Tuija (Helsingfors universitet, 2016)
    Aims. The aim of this study was to examine the effects of Nele and Noa in Rainforest intervention on executive functions (EF) of children with intensive special education needs in the school context. The field of research of executive functions is wide and there is no generally accepted definition of executive functions. Previous studies indicate that executive functions play an important role in children's learning and academic performance processes. It is also possible to influence the skills of executive functions with different kinds of interventions. According to previous research, Nele and Noa in Rainforest intervention has demonstrated positive effects on generally supported children's executive functions, but its effectiveness has not been studied on children with intensive special education needs. Children with intensive special education needs have been found to have various challenges in EFs. Interventions aiming to improve EF skills are therefore being called for. Methods. The study involved a total of 57 pupils, aged 5-13years, with intensive special education needs from seven different classes of extended compulsory education. The children were split in two groups. The experimental group (n = 31) performed individual tasks and played the pair and small group games of Nele and Noa in Rainforest intervention while the control group (n = 26) attended school normally and participated in the intervention only after the research data was collected. Intervention continued for six weeks and the experimental group participated in the intervention exercises three times a week. Children's executive function skills were assessed using ATTEX, Attention and executive function rating inventory. Analyses were done with non-parametric analyses, like Mann-Witney U-test and Wilcoxon signed rank test. Results and conclusions. There was a slight positive development of executive function skills in the experimental group in all areas of ATTEX during the intervention, but the results were statistically significant only in the skills of motor hyperactivity and EF – evaluation. The effect sizes of the intervention were medium-sized on total score, shifting of attention and EF -evaluation. The results suggest that it is possible to develope EFs on children with intensive special education needs with the intervention. However, based on this study, it is not possible to draw general conclusions on the effectiveness of the intervention for the EF skills and it calls for future research to investigate the effectiveness of intervention, for example, with a variety of indicators.