Executive function subdomains are associated with post-stroke functional outcome and permanent institutionalization

Background and purposeImpairment of executive functions (EFs) is a common cognitive symptom post-stroke and affects independence in daily activities. Previous studies have often relied on brief cognitive tests not fully considering the wide spectrum of EF subdomains. A detailed assessment of EFs was used to examine which of the subdomains and tests have the strongest predictive value on post-stroke functional outcome and institutionalization in long-term follow-up. MethodsA subsample of 62 patients from the Helsinki Stroke Aging Memory Study was evaluated with a battery of seven neuropsychological EF tests 3 months post-stroke and compared to 39 healthy control subjects. Functional impairment was evaluated with the modified Rankin Scale (mRS) and Instrumental Activities of Daily Living (IADL) scale at 3 months, and with the mRS at 15 months post-stroke. Institutionalization was reviewed from the national registers of permanent hospital admissions in up to 21-year follow-up. ResultsThe stroke group performed more poorly than the control group in multiple EF tests. Tests of inhibition, set shifting, initiation, strategy formation and processing speed were associated with the mRS and IADL scale in stroke patients. EF subdomain scores of inhibition, set shifting and processing speed were associated with functional outcome. In addition, inhibition was associated with the risk for earlier institutionalization. ConclusionsExecutive function was strongly associated with post-stroke functional impairment. In follow-up, poor inhibition was related to earlier permanent institutionalization. The results suggest the prognostic value of EF subdomains after stroke.Peer reviewe

A pragmatist theory of innovation

In this chapter, I develop theoretical foundations for practice-based innovation from the embodied cognition school of thought in cognitive science and from the pragmatist line of thought in philosophy. From it, I derive the notion of cognitive distance. I use the resulting insights to discuss the well-known notions of absorptive capacity and exploitation and exploration from the innovation literature, and the way in which exploitation and exploration are connected. In the analysis I model practice in terms of the notion of a script. Cognitive difference (‘distance’) complicates but also enriches collaboration, and this positive effect is related to the notion of bridging structural holes. Among other things, the analysis yields an underpinning of the idea that application is not just a result of research but also a basis for ideas for research, in two-way traffic between theory and practice, and between research and application. The analysis also has implications for innovation policy, in particular for the currently popular principle of focus and mass

Robots and the Future of Welfare Services – A Finnish Roadmap

kirjoittajat: Kyrki, Ville; Aaltonen, Iina; Ainasoja, Antti; Heikkilä, Päivi; Heikkinen, Sari; Hennala, Lea; Koistinen, Pertti; Kämäräinen, Joni-Kristian; Laakso, Kalle; Laitinen, Arto; Lammi, Hanna; Lanne, Marinka; Lappalainen, Inka; Lehtinen, Hannu; Lehto, Paula; Leppälahti, Teppo; Lundell, Jens; Melkas, Helinä; Niemelä, Marketta; Parjanen, Satu; Parviainen, Jaana; Pekkarinen, Satu; Pirhonen, Jari; Porokuokka, Jaakko; Rantanen, Teemu; Ruohomäki, Ismo; Saurio, Riika; Sahlgren, Otto; Särkikoski, Tuomo; Talja, Heli; Tammela, Antti; Tuisku, Outi; Turja, Tuuli; Van Aerschot, Lina; Verdoja, Francesco; Välimäki, KariThis roadmap summarises a six-year multidisciplinary research project called Robots and the Future of Welfare Services (ROSE), funded by the Strategic Research Council (SRC) established within the Academy of Finland. The objective of the project was to study the current and expected technical opportunities and applications of robotics in welfare services, particularly in care services for older people. The research was carried out at three levels: individual, organisational and societal. The roadmap provides highlights of the various research activities of ROSE. We have studied the perspectives of older adults and care professionals as users of robots, how care organisations are able to adopt and utilise robots in their services, how technology companies find robots as business opportunity, and how the care robotics innovation ecosystem is evolving. Based on these and other studies, we evaluate the development and use of robots in care for older adults in terms of social, ethical-philosophical and political impacts as well as the public discussion on care robots. It appears that there are many single- or limited-purpose robot applications already commercially available in care services for older adults. To be widely adopted, robots should still increase maturity to be able to meet the requirements of care environments, such as in terms of their ability to move in smaller crowded spaces, easy and natural user interaction, and task flexibility. The roadmap provides visions of what could be technically expected in five and ten years. However, at the same time, organisations’ capabilities of adopting new technology and integrating it into services should be supported for them to be able to realise the potential of robots for the benefits of care workers and older persons, as well as the whole society. This roadmap also provides insight into the wider impacts and risks of robotization in society and how to steer it in a responsible way, presented as eight policy recommendations. We also discuss the ROSE project research as a multidisciplinary activity and present lessons learnt.Tämä tiekartta tiivistää kuusi vuotta kestäneen strategisen tutkimuksen neuvoston rahoittaman monitieteisen tutkimushankkeen Robotit ja hyvinvointipalvelujen tulevaisuus, jonka keskeisenä tavoitteena oli arvioida robotiikan tarjoamia teknisiä mahdollisuuksia ja niiden soveltamista ikäihmisille tarkoitettujen palvelujen tuotannossa sekä samalla arvioida alan kehittymistä lähitulevaisuudessa. Tutkimusta on tehty kolmella tasolla: yksilön, organisaation ja yhteiskunnan. Tiekartassa keskitymme erityisesti ikäihmisten hoito- ja hoivapalveluihin ja tarkastelemme ikäihmisiä ja vanhuspalveluiden ammattilaisia robottien käyttäjinä sekä hoito- ja hoivaorganisaatioita teknologian hyödyntäjinä. Analysoimme teknologiayritysten liiketoimintamahdollisuuksia ja luomme kuvan alan kehittyvästä innovaatioekosysteemistä ja robotiikan roolista sen osana. Olemassa olevan tutkimustiedon ja projektin yhteydessä tehtyjen omien tutkimusten ja kokeilujen varassa arvioimme palvelurobottien hyödyntämiseen ja kehittämiseen liittyviä sosiaalisia, eettis-filosofisia ja poliittisia vaikutuksia ja sekä robotteihin liittyvää julkista keskustelua. On osoittautunut, että robotiikka teknologiana on edelleen monelta osin epäkypsää ikäihmisten palveluissa sovellettavaksi. Tämän hetken toimivat sovellukset ovat hyvin rajattuja käyttötarkoitukseltaan. Visioimme sitä, mikä on todennäköisesti teknisesti mahdollista viiden ja kymmenen vuoden kuluttua. Jotta robotiikan hyödyt realisoituvat, samaan aikaan tulee tukea organisaatioiden kykyä ottaa uutta teknologiaa käyttöön ja kytkeä se osaksi palvelutuotantoa. Tarkastelemme laajemmin robotisaation vaikutuksia ja riskejä yhteiskunnassa ja miten sitä tulisi luotsata vastuullisesti. Esitämme politiikkasuosituksia ja uusia tutkimussuuntia kohti kestävää robotisaatiota. Lopuksi pohdimme hankkeen monitieteistä luonnetta

Facilitating design and innovation workshops using the Value Design Canvas

Design and innovation workshops are common practices to match diverse stakeholders to initiate collaboration for innovation. Due to the complex and multi-faceted processes in such a collaboration workshop, not only the toolkits but also the facilitation of the process needs to be taken into account. This paper discusses the use of the Value Design Canvas, a paper-based tool that is designed to support multi-stakeholder co-design process in a design and innovation workshop. We evaluated the current version of the tool in a multi-stakeholder design and innovation workshop session with a special focus on the quality of the facilitation process. The findings are described by relating facilitator activities with implications for tool (re-)design