Cognitive functions and symptoms predicting later use of psychiatric services following mild traumatic brain injury in school-age

Objective To investigate whether neuropsychological test performance or presence of some specific injury symptoms at 1-3 months following pediatric mild traumatic brain injury (mTBI) can help to identify the children at risk for developing post-traumatic psychiatric symptoms. Methods Data from 120 children and adolescents aged 7-15 years, treated at Turku University Hospital between 2010 and 2016 due to mTBI, and who had undergone neuropsychological evaluation at 1-3 months following injury, were enrolled from the hospital records. Neuropsychological test performancesand injury symptom reports were retrospectively retrieved from the patient files. Results Slow information processing speed (p = 0.044), emotion regulation deficit (p = 0.014), impulsivity (p = 0.013), verbal processing difficulties (p = 0.042) and headache (p = 0.026) were independent predictors for having later contact in psychiatric care. Conclusions Neuropsychological examination containing measure of information processing speed, injury symptom interview, and parental questionnaires on behavioural issues of the child at 1-3 months following mTBI seems to be useful in detecting children with risk for post traumatic psychiatric symptoms. Targeted support and guidance for this group of children and adolescents and their families are recommended to prevent the development of an unfavorable psychosocial outcome.Peer reviewe

Neurological and Cognitive Performance After Childhood Encephalitis

Background: Children with encephalitis have increased risk for long-term neurological sequelae. We investigated minor neurological dysfunction (MND) and cognitive performance as a measurement for long-term outcome of encephalitis in childhood.Materials and Methods: Children with encephalitis (n = 98) treated in Turku University Hospital during the years 1995–2016 were retrospectively identified. We included the patients without severe developmental delay before the encephalitis and without recorded neurological disability caused by encephalitis. MND was assessed using the Touwen examination. Age-appropriate Wechsler Intelligence Scale was used to determine the full-scale intelligence quotient (IQ). Residual symptoms in everyday life were evaluated using a questionnaire.Results: Forty-two subjects participated in the study and returned the questionnaire regarding residual symptoms. The median age was 4.3 years at the time of encephalitis, and 11.3 years at the time of the Touwen examination (n = 41) and the cognitive assessment (n = 38). The Touwen examination indicated MND in 29 of 41 participants (71%; simple MND in 16 and complex MND in 13 patients). The median full-scale IQ was lower in participants with MND compared with participants without MND (98 vs. 110, p = 0.02). Participants with IQ n = 5) had lower median age at acute encephalitis compared to participants with IQ ≥ 85 (n = 33) (1.8 vs. 5.3 years, p = 0.03). Problems in daily performance were reported in participant with MND (p = 0.2) and low full-scale IQ (p = 0.008).Conclusions: The prevalence of MND was high and it was related to lower cognitive performance after childhood encephalitis. Younger age at acute encephalitis was a risk factor for lower cognitive performance.</p

Cognitive functions and symptoms predicting later use of psychiatric services following mild traumatic brain injury in school-age

Objective: To investigate whether neuropsychological test performance or presence of some specific injury symptoms at 1-3 months following pediatric mild traumatic brain injury (mTBI) can help to identify the children at risk for developing post-traumatic psychiatric symptoms.Methods: Data from 120 children and adolescents aged 7-15 years, treated at Turku University Hospital between 2010 and 2016 due to mTBI, and who had undergone neuropsychological evaluation at 1-3 months following injury, were enrolled from the hospital records. Neuropsychological test performancesand injury symptom reports were retrospectively retrieved from the patient files.Results: Slow information processing speed (p = 0.044), emotion regulation deficit (p = 0.014), impulsivity (p = 0.013), verbal processing difficulties (p = 0.042) and headache (p = 0.026) were independent predictors for having later contact in psychiatric care.Conclusions: Neuropsychological examination containing measure of information processing speed, injury symptom interview, and parental questionnaires on behavioural issues of the child at 1-3 months following mTBI seems to be useful in detecting children with risk for post traumatic psychiatric symptoms. Targeted support and guidance for this group of children and adolescents and their families are recommended to prevent the development of an unfavorable psychosocial outcome.Keywords: Traumatic brain injury; adolescents; children; mild traumatic brain injury; pediatric; psychiatric.</p

Ennakoimattomissa olevat riskit yritysten toiminnassa : case Covid-19

Toimivalla ja ajantasaisella riskienhallinnalla on tärkeä rooli yritysten arjessa. Riskienhallintaprosessin keskiössä on riskien tunnistaminen, analysointi ja niihin reagointi (mm. Shin & Park, 2017). Tämän tutkimuksen empiirisessä osiossa on paneuduttu pääasiassa näistä viimeisimpään, eli siihen, kuinka yritykset reagoivat riskeihin ja kuinka ne siten pitävät omat riskienhallintaprosessinsa ajantasaisina. Kaikkiin olemassa oleviin riskeihin ei kuitenkaan ole mahdollista varautua kaikkein erinomaisimmillakaan riskienhallintaprosesseilla. Tällaisia riskejä kutsutaankin nimensä mukaisesti ennakoimattomissa oleviksi riskeiksi. Tyypillisimpiä esimerkkejä ennakoimattomissa olevista riskeistä ovat onnettomuudet ja luonnonkatastrofit. Yksi viime aikojen laajimmille levinneistä ja vaikuttaneista globaaleista ennakoimattomista riskeistä on ollut maaliskuussa 2020 maailmanlaajuiseksi pandemiaksi asti levinnyt Covid-19 –virus, joka onkin valikoitunut tämän tutkielman tapausnäkökulmaksi. Tässä pro gradu -tutkielmassa tutkitaan sitä, kuinka Covid-19 –pandemian kaltainen ennakoimattomissa oleva riski realisoituessaan vaikuttaa eri toimialalla operoivien yritysten toimintaan, ja mitä toimenpiteitä yritykset joutuvat toteuttamaan pitääkseen riskienhallintansa tasapainossa ja turvatakseen oman liiketoimintansa. Tutkimus toteutettiin kvalitatiivisena tutkimuksena, ja tutkimusmenetelmäksi valikoitui teorialähtöinen sisällönanalyysi. Riskienhallinnan näkökulmana käytettiin muun muassa CAS ERM -viitekehyksen mukaista jaottelua taloudellisiin, strategisiin, operatiivisiin ja vahinkoriskeihin. Tutkimusaineistona käytettiin neljän eri toimialalla toimivan suuren pörssiyhtiön tilinpäätösaineistoa vuodelta 2020. Tutkimuksessa havaittiin, että valtionhallinnon asettamilla rajoitus- ja sulkutoimilla oli merkittävä rooli siinä, miten eri yritykset pystyivät jatkamaan liiketoimintaansa pandemian jyllätessä pahimmillaan. Toimiala näytteli merkittävää roolia, siinä missä myös yritysten innovatiivisuus ja nopea reagointikyky olivat keskeisessä asemassa toimenpiteiden tehokkuuden ja toisaalta myös niiden vakavuuden kannalta. Samat tekijät näyttelivät suurta roolia myös sen suhteen, voiko yrityksen luokitella pandemian voittajiin ja häviäjiin. Tutkimus on kuitenkin rajoitettu koskemaan vain vuotta 2020, joten tarkastelun kohteeksi jää vain yhden hetken tilanne, eikä toimenpiteiden pitkäaikaiset vaikutukset ole tiedossa

Neurological and Cognitive Performance After Childhood Encephalitis

Background: Children with encephalitis have increased risk for long-term neurological sequelae. We investigated minor neurological dysfunction (MND) and cognitive performance as a measurement for long-term outcome of encephalitis in childhood. Materials and Methods: Children with encephalitis (n = 98) treated in Turku University Hospital during the years 1995-2016 were retrospectively identified. We included the patients without severe developmental delay before the encephalitis and without recorded neurological disability caused by encephalitis. MND was assessed using the Touwen examination. Age-appropriate Wechsler Intelligence Scale was used to determine the full-scale intelligence quotient (IQ). Residual symptoms in everyday life were evaluated using a questionnaire. Results: Forty-two subjects participated in the study and returned the questionnaire regarding residual symptoms. The median age was 4.3 years at the time of encephalitis, and 11.3 years at the time of the Touwen examination (n = 41) and the cognitive assessment (n = 38). The Touwen examination indicated MND in 29 of 41 participants (71%; simple MND in 16 and complex MND in 13 patients). The median full-scale IQ was lower in participants with MND compared with participants without MND (98 vs. 110, p = 0.02). Participants with IQ &lt; 85 (n = 5) had lower median age at acute encephalitis compared to participants with IQ &gt;= 85 (n = 33) (1.8 vs. 5.3 years, p = 0.03). Problems in daily performance were reported in participant with MND (p = 0.2) and low full-scale IQ (p = 0.008). Conclusions: The prevalence of MND was high and it was related to lower cognitive performance after childhood encephalitis. Younger age at acute encephalitis was a risk factor for lower cognitive performance