Memory disorders in acute encephalitis : a neuropsychological study

Acute encephalitis is an inflammation of the brain, mostly caused by viral infection. A variety of cognitive symptoms may persist after the acute stage, and neuropsychological assessment is crucial in evaluation of the outcome. The most commonly reported sequelae are memory deficits. The main aims of this study were to investigate the types of memory impairment in various encephalitides, the frequency of global amnesia following encephalitis, and the changes in the deficits during follow-up. Between 1 January 1985 and 31 December 1994, 77 adult patients under the age of 75 with acute encephalitis but without alcohol abuse, or coexisting or previous neurological diseases were consecutively referred for neuropsychological examination at the Department of Neurology, Helsinki University Central Hospital. The aetiology was established in 44/77 (57%) patients; 17 had Herpes simplex virus encephalitis (HSVE). Transient amnesia (TENA) at the acute stage of the disease was found in 70% of patients. Furthermore, similarly to brain trauma, TENA was found to indicate cognitive outcome. The frequency of persisting global amnesia syndrome with both anterograde and retrograde amnesia in all encephalitic patients was 6%. One patient had isolated retrograde amnesia, which is very rare. In HSVE the frequency of global amnesia was 12.5%, which is lower than expected. As a group, HSVE patients were not found to have a homogeneous pattern of amnesia, instead subgroups among all encephalitic patients were observed: some patients had impaired semantic memory, some had difficulty predominantly with executive functions and some suffered from an increased forgetting rate. Herpes zoster encephalitis was found to result in mild memory impairment only, and the qualitative features indicated a subcortical dysfunction. On the whole, the cognitive deficits were predominantly found to diminish during follow-up. Progressive deterioration was often associated with intractable epilepsy. The frequency of dementia was 12.5%. In conclusion, the neuropsychological outcome, especially in HSVE, was more favourable than has previously been reported, possibly due to early acyclovir medication. Memory disorders after encephalitis should not be considered uniform, and the need for neuropsychological rehabilitation should be considered case-by-cas

Terveyden edistäminen ravitsemuksen ja liikunnan avulla : Hyvinvointipäivä MS-tautia sairastaville

Opinnäytetyönämme järjestimme hyvinvointipäivän Päijät-Hämeen MS-yhdistyksen jäsenille. Tavoitteenamme oli MS-tautia sairastavien terveyden edistäminen ja halusimme antaa heille keinoja parantaa omaa hyvinvointiaan elintapojaan muuttamalla liikunnan ja ravitsemuksen avulla. Hyvinvointipäivässä oli 8 osallistujaa, joista yksi oli MS-yhdistyksen puheenjohtaja. Pidimme ensimmäisenä heille luennot ravitsemuksesta, sekä liikunnasta MS-taudin näkökulmasta ja tämän jälkeen pidimme heille tuolijumpan, rentoutuksen sekä lopuksi vielä taittelimme origameja. Opinnäytetyössämme määrittelemme lyhyesti mitä on terveyden edistäminen, kerromme MS-taudista sairautena ja teoriatietoa aiheista joista luennoillamme puhuimme. Kerromme myös toiminnallisen projektimme eri vaiheista, luotettavuudesta, sekä eettisyydestä. Lopuksi on raportti päivän kulusta, sekä pohdintamme koko opinnäytetyön toteutuksesta. Jokaisen osallistujan itsensä arvioitavaksi jäi, tarvitseeko tai haluaako elämäntapojaan muuttaa niillä keinoilla joista heille kerroimme. Pyrimme huomioimaan ja ennakoimaan hyvinvointipäivässämme mahdolliset eettiset ongelmat ja kokoamaan luentomme hyvin lähdekriittisesti, jotta kertomamme tieto olisi tuoreinta tutkittua tietoa ravitsemuksesta, sekä liikunnasta MS-tautiin liittyen. Opinnäytetyömme on hyvä pohja niille, jotka haluavat toteuttaa samankaltaisia toiminnallisia projekteja. Esimerkiksi Keski-Suomen MS-yhdistyksen kanssa voisi toteuttaa samankaltaisen toimintapäivän. Kehittämistarpeena koimme laajemman kirjallisuuskatsauksen tekemisen ravitsemuksen ja liikunnan vaikutuksista MS-tautiin, sillä aiheita on tutkittu hyvin vähän.As our final thesis we organized we a wellness day for the members of the Päijät-Häme MS-society. The purpose was to promote the health of people with the MS-disease and to give them ideas of how to improve their wellbeing by changing their living habits with nutrition and exercise. The wellness day had eight participants, and one of them was the chairman of the Päijät-Häme MS-society. The day started with a lecture on nutrition and exercise from the MS-disease viewpoint. After that there was an exercise session by using chairs, followed by relaxation exercises, and, finally, the participants folded origami. The thesis briefly defines health promotion and the MS-disease as well as gives theory on the topics related to the lecture held as part of the event. It also explains the different parts of the project and discusses its reliability and ethical aspects. At the end there is a report of the wellness day and a discussion on the implementation of the thesis. It was left to the participants’ own discretion whether or not they felt that they needed to change their living habits by using the means discussed during the day. We tried to pay attention to the ethical side of our project and to anticipate the potential problems that might occur. We also tried to assemble our lecture materials with a very critical point of view and give only the latest information about nutrition and exercise concerning the MS-disease. Our final thesis is a good example for those who want to implement similar kind of functional projects. As an example one could implement the same kind of a functional day with the Central Finland MS-society. One of the challenges in this project was the difficulty of producing a wider literature review, because there are so few scientific studies related to this topic

From Minimum Viable to Maximum Lovable: Developing a User Experience Strategy Model for Software Startups

Software startups have gained attention by disrupting traditional businesses. As startups operate with scarce resources and under time pressure, efficient business value creation needs to be of the highest priority. Creating superior user experience (UX) is a means for startups to gain competitive edge that is difficult to copy. However, early product development in startups is filled with uncertainty – considering both the characteristics of the product under development and defining its target market. This is a challenge for designing UX, as both product qualities and user groups may drastically change together with the target market. However, scientific literature has not provided knowledge on ways to integrate UX creation as part of new business development (NBD) in software startups.This thesis contributes primarily to the field of human-computer interaction (HCI). Secondly, it contributes to software engineering, more specifically to human-centered software development. The goal of this doctoral research is to advance the knowledge and practices of software startups and user experience (UX) work. This is done by empirical research of the practices and needs for UX creation of the startups, and based on the gained understanding, by formulating a strategy model for including UX creation as a supporting part in establishing new software business. This compound thesis is based on six publications that result from four empirical studies with software startups. The studies were conducted over a period of two years between 2014 and 2016. The nature of the studies was qualitative and involved data collection from altogether 40 startups, mostly based in Finland but also in eight other countries.The results suggest that UX work creates value in two ways: both for users and for business development of startups. This research recognized beneficial approaches and practices for UX creation in software startups, such as light-weight UX work methods, adoption of good design solutions from successful products, and an iterative approach to product development. Studying the role of UX in early product design showed how poor UX hinders startups from gaining trustworthy feedback on their product idea, as users concentrate on deficiencies in UX. To ensure sufficient quality of UX, the Minimum Viable UX (MVUX) framework was developed to guide early design decisions in startups.The main contribution of this thesis is a UX strategy model that proposes UX strategy actions for two stages of startups lifecycle, namely validation of the product idea, and scaling for business growth. Moreover, the UX strategy model consists of UX strategy actions for UX goal setting, user involvement, and design decisions during the two phases. The UX strategy actions aim to ensure reaching minimum viable quality of UX to enable trustworthy validation of a product idea. However, for sustainable business growth and scaling, the model further aims to creating lovable UX that provides competitive advantage. The UX strategy model presents means for focusing UX creation to bringing value both to users and to the startup business

Long-term recovery from apraxia and its relation to severe apraxic-aphasic disorder in left hemisphere stroke - a systematic review

Background: Left hemisphere stroke often causes a severe communication disorder that is usually attributed to aphasia. While aphasia refers to linguistic problems, communication is also accomplished by voluntarily articulate and gestural movements, which may be compromised due to apraxia. Along with aphasia, apraxia is a common disorder in left hemisphere stroke, which in severe cases can limit the use of verbal and nonverbal communication methods. The discussion about apraxia from a communicative perspective is still scarce, although the disorder is regularly experienced among left hemisphere stroke patients with aphasia. The rehabilitation of the disorder in severe apraxia-aphasia is challenging and recovery is slow. Aims: The purpose of this study is to provide an overview of the research on long-term recovery from apraxia and to discuss the meaning of these findings in observing the recovery of communication abilities in a person with a severe apraxia-aphasia. The search was not restricted to any specific type of apraxia, as this review assumes that communication may be influenced by apraxia in its different manifestations. The review is based on a systematic literature search, which includes English-language studies retrieved from the databases of Ovid Medline, PsycINFO, and Scopus. Main Contribution: Seven long-term follow-up studies of apraxia were found; one case study of apraxia of speech (AOS), four group studies of ideomotor apraxia (IMA), one case study of IMA (and aphasia), and one group study of limb apraxia. Conclusions: The reviewed group studies of patients with left hemisphere stroke indicate that apraxia is a persistent disorder, but the steepest recovery occurs within the first few months post-stroke. Imitation skills and actions involving real-tool use in activities of daily functions show the best recovery. Real-tool use also continues to improve longer, while recovery of gesturing after verbal command may not show clear signs of recovery in the chronic stage post-stroke. There is some evidence that the pace of recovery from oral apraxia and limb apraxia is comparable, and recovery from apraxia and aphasia would not correlate. Some of the studies used only imitation to assess changes in gesturing, which cannot be regarded as an ecologically valid measure to compare gesturing in natural communicative situations or even gesturing after verbal command. Finally, no follow-up studies were found that would have discussed apraxia from a communicative perspective. Overall, the field is lacking research on long-term follow-up of patients with apraxic-aphasic disorder.Peer reviewe

Sairaan hauskaa! Nuorten kasvatuksellinen kapina folkloressa

Children's and young people's folklore, their own oral tradition, is an active and growing cultural area, despite the increasing urbanisation of the society. The main focus of the article is to analyse some digital folklore examples, which are not allowed for the ears of adults. This children's and youth folklore covers topics such as taboos, racism, sexual and forbidden themes. At the same time these jokes, urban legends, riddles, photo manipulations, tongue-twisters etc. offer us interesting insights into young people's way of coping with horrible happenings in the world like human suffering, wars, school shootings or catastrophes. They show us young people's own world, children's and young people's social area, without adults' custody or propriety. In some cases folklore may also be a revolt against moral norms in society and adults' way of thinking and living.Karkeiden, jopa rasististen ja moraalittomien huumorituotteiden avulla lasten ja nuorten on nähty kokeilevan rajoja ja rakentavan aikuisista erillä olevaa maailmaa. Huumori on tällöin ikään kuin osa lasten ja nuorten kasvuprosessia ja vertaisryhmäkulttuuria. Toisaalta huumoria tulkitsemalla voidaan aavistella lasten ja nuorten kulttuurista kiinnostavia ajankohtaisteemoja, pelkoja, ajattelun logiikkaa, oivalluskykyä, unelmia ja maailman tapahtumien tulkintaa, joskus myös aiemmilta sukupolvilta opittuja asenteita. Lasten ja nuorten pienfolklore tarkastelee usein niitä kasvatuksen, ohjauksen ja opetuksen malleja, joihin aikuiset pyrkivät alaikäisiä kansalaisia ohjaamaan

A software tool for customer needs driven product development in manufacturing industry

Tuotekehitys ja uusien tuotteiden tuominen markkinoille on kriittinen osa valmistavan teollisuuden yritysten liiketoimintaa. Tuotekehityksen on pystyttävä vastaamaan muuttuviin asiakastarpeisiin ja markkinoiden kysyntään yhä nopeammin ja tehokkaammin. Samaan aikaan yritysten toiminta on yhä hajautetumpaa ympäri maailman. Tiedonhallinnan haasteet hajautetuissa tiimeissä ja arvoketjuissa tuovat tarpeen uusille järjestelmille, jotka auttavat hallitsemaan niin tietoa kuin prosessejakin luotettavasti ja nopeasti. Asiakastarpeiden ymmärtäminen ja tämän tiedon siirtäminen kaikille tuotekehitykseen osallistuville auttaa tuomaan parempia tuotteita markkinoille ja luomaan yritykselle kilpailuetua. Tässä työssä tutkittiin valmistavan teollisuuden tuotekehityksen prosesseja ja työkaluja, sekä erityisesti asiakastiedon hyödyntämistä tuotekehityksessä. Käyttäjien kokemia hyviä ja huonoja ominaisuuksia sekä käytettävyyttä nykyisissä työkaluissa kartoitettiin. Tehdyn tutkimuksen perusteella suunniteltiin työkalu asiakastarvevetoiseen tuotekehitykseen. Käyttäjäkeskeiseen suunnitteluprosessiin kuului useita käyttäjätutkimuksia yhteensä kahdeksassa eri yrityksessä sekä lisäksi käyttäjätestejä eri käyttöliittymäkuvilla. Viimeisen käyttäjätutkimuksen perusteella suunniteltu työkalu ja sen käyttöliittymä on käyttäjälle selkeä ja tukee priorisoitujen asiakastarpeiden hyödyntämistä tuotekehityksessä. Asiakastieto kulkee usein monen portaan kautta, ennen kuin se saapuu tuotekehitykselle. Tieto voi matkalla muuttua tai sitä ei aina ole tarpeeksi. Tässä työssä suunnitellun työkalun avulla asiakastietoa voidaan jakaa yrityksessä suoraan asiakasrajapinnasta kaikille tuotekehitykseen osallistuville. Tämän lisäksi työkalun avulla voidaan asiakasarvon muodostuminen tuotteesta nähdä systemaattisen asiakastarveanalyysin perusteella. Tuotekehitys joutuu kehittymään koko ajan markkinoiden muuttuessa enenevässä määrin globaaleiksi ja asiakassuhteiden muuttuessa. Myös muutokset palvelutoiminnan lisääntymisessä on otettava jatkossa huomioon, kun tuotteeseen kuuluvat sekä fyysinen tuote, että palvelutuote. Yritysten ikärakenteen aiheuttama sukupolvenvaihdos aiheuttaa tarvetta erilaisille toimintatavoille sekä dokumentoinnille

A Prospective 30-Year Follow-Up of ADHD Associated With Perinatal Risks

OBJECTIVE: Longitudinal follow-up of ADHD suggests a poorer outcome in those affected. Studies extending to 30 years however are rare. We investigated the adult outcome of ADHD associated with perinatal risks (PRs), treated non-pharmacologically. METHOD: A study group of 122 participants (86 men, 36 women) with PR-associated ADHD was followed-up from birth and compared with a control group also prospectively studied. RESULTS: The study group showed more cognitive, motor perception, and learning impairments as well as psychiatric problems at ages 5, 9, and 16. At age 30, the study group reported less education, more involuntary job dismissals and more alcohol abuse. Self-reported ADHD symptoms were still prevalent in adulthood. CONCLUSION: ADHD symptoms persist and impair the long-term educational, occupational, and psychiatric outcome. ADHD in participants with PR appears to follow a course seen in studies of unselected ADHD.Peer reviewe

63 windows: Generating Relationality Through Poetic and Metaphorical Engagement

In this paper, an artist-researcher and scholars from the fields of cultural studies, theology, and educational and social sciences reflect on their artistic experiences to think about what kinds of affects, meanings, and responses emerge when engaging with the sound artwork 63 windows. The experiences are discussed particularly in relation to the metaphor of the window and weaved together with the perspectives of collective biography and memory work, the ethics of care, and the narrative and interpretation theories. On this basis, the paper suggests that relational ethics of care emerges in the continuous and puzzling process of attentive engagement with art: first (1) with imagination, then (2) experiencing belonging and distance, and finally (3) arriving at the understanding of mutual connectedness of life

Teacher Ratings of Executive Function Difficulties in Finnish Children with Combined and Predominantly Inattentive Symptoms of ADHD

School-age children with difficulties in executive functions (EFs) are at risk for substantial academic impairment and poorer developmental outcome. Although Attention Deficit Hyperactivity Disorder (ADHD) is generally associated with weaknesses in EFs, a relatively minimal amount is known about school-related EF difficulties and differences between ADHD subtypes. The present study examined teacher ratings of EF behaviors in 7- to 15-year-old Finnish children with combined symptoms of ADHD (ADHD-C; n =189), predominantly inattentive symptoms (ADHD-I; n = 25), and no ADHD (n = 691). The teacher ratings showed that both ADHD groups had more EF difficulties than controls. Ratings also indicated specific EF profiles for the ADHD subtypes, students with ADHD-I having more wide-ranging EF difficulties in attention as well as initiation, planning, and execution of actions than children with ADHD-C. According to the present findings, the school-related EF difficulties of children with ADHD-I need to be specifically acknowledged. Teacher ratings seem to be sensitive indicators of EF difficulties and distinguish between different kinds of EF profiles. In clinical practice, rating scales with reliable psychometric properties and normative data relevant to the specific cultural environment should be employed.Peer reviewe