Self-rating scales in the assessment of current and childhood symptoms of attention deficit hyperactivity disorder in adults

Objective: Attention deficit hyperactivity disorder (ADHD) is a life-long condition, but because of its historical status as a self-remitting disorder of childhood, empirically validated and reliable methods for the assessment of adults are scarce. In this study, the validity and reliability of the Wender Utah Rating Scale (WURS) and the Adult Problem Questionnaire (APQ), which survey childhood and current symptoms of ADHD, respectively, were studied in a Finnish sample. Methods: The self-rating scales were administered to adults with an ADHD diagnosis (n = 38), healthy control participants (n = 41), and adults diagnosed with dyslexia (n = 37). Items of the self-rating scales were subjected to factor analyses, after which the reliability and discriminatory power of the subscales, derived from the factors, were examined. The effects of group and gender on the subscales of both rating scales were studied. Additionally, the effect of age on the subscales of the WURS was investigated. Finally, the diagnostic accuracy of the total scores was studied. Results: On the basis of the factor analyses, a four-factor structure for the WURS and five-factor structure for the APQ had the best fit to the data. All of the subscales of the APQ and three of the WURS achieved sufficient reliability. The ADHD group had the highest scores on all of the subscales of the APQ, whereas two of the subscales of the WURS did not statistically differ between the ADHD and the Dyslexia group. None of the subscales of the WURS or the APQ was associated with the participant's gender. However, one subscale of the WURS describing dysthymia was positively correlated with the participant's age. With the WURS, the probability of a correct positive classification was .59 in the current sample and .21 when the relatively low prevalence of adult ADHD was taken into account. The probabilities of correct positive classifications with the APQ were .71 and .23, respectively. Conclusions: The WURS and the APQ can provide accurate and reliable information of childhood and adult ADHD symptoms, given some important constraints. Classifications made on the basis of the total scores are reliable predictors of ADHD diagnosis only in populations with a high proportion of ADHD and a low proportion of other similar disorders. The subscale scores can provide detailed information of an individual's symptoms if the characteristics and limitations of each domain are taken into account. Improvements are suggested for two subscales of the WURS.

The Problem of Implementation and its Relation to the Philosophy of Cognitive Science

According to certain arguments, computation is observer-relative either in the sense that many physical systems implement many computations (Hilary Putnam), or in the sense that almost all physical systems implement all computations (John Searle). If sound, these arguments have a potentially devastating consequence for the computational theory of mind: if arbitrary physical systems can be seen to implement arbitrary computations, the notion of computation seems to lose all explanatory power as far as brains and minds are concerned. David Chalmers and B. Jack Copeland have attempted to counter these relativist arguments by placing certain constraints on the definition of implementation. In this thesis, I examine their proposals and find both wanting in some respects. During the course of this examination, I give a formal definition of the class of combinatorial-state automata , upon which Chalmers s account of implementation is based. I show that this definition implies two theorems (one an observation due to Curtis Brown) concerning the computational power of combinatorial-state automata, theorems which speak against founding the theory of implementation upon this formalism. Toward the end of the thesis, I sketch a definition of the implementation of Turing machines in dynamical systems, and offer this as an alternative to Chalmers s and Copeland s accounts of implementation. I demonstrate that the definition does not imply Searle s claim for the universal implementation of computations. However, the definition may support claims that are weaker than Searle s, yet still troubling to the computationalist. There remains a kernel of relativity in implementation at any rate, since the interpretation of physical systems seems itself to be an observer-relative matter, to some degree at least. This observation helps clarify the role the notion of computation can play in cognitive science. Specifically, I will argue that the notion should be conceived as an instrumental rather than as a fundamental or foundational one.

My Fair Lady på skandinaviska : En studie i funktionell sångöversättning

The dissertation presents a functional model for analysis of song translation. The model is developed on the basis of an examination of theatrical songs and a comparison of three translations: the songs of the Broadway musical My Fair Lady (Lerner and Loewe, 1956), made for the premiere productions (1959–1960) in Swedish, Danish, and Norwegian. The analysis explores the three challenges of a song translator: the fitting of a text to existing music, the consideration of a prospective sung performance, and the verbal approximation of the content of the source lyric. The theoretical foundation is based on a functional approach to translation studies (Christiane Nord) and a structuralist/semiotic analysis of a theatrical message (Ivo Osolsobě, building on Roman Jakobson). Thus, three functional levels in the fitting of a text to music are explored: first, a prosodic/phonetic format; secondly, a poetic/rhetoric format; and thirdly, semantic/reflexive values (verbalizing musical expression). Similarly, three functional levels in the textual connections to a prospective performance are explored: first, a presentational goal; secondly, the theatrical potential; and thirdly, dramaturgic values (for example dramatic information and linguistic register). The functionality of Broadway musical theatre songs is analyzed, and the song score of My Fair Lady, source and target lyrics, is studied, with an in-depth analysis of seven of the songs. The three translations were all considered very well-made and are used in productions of the musical to this day. The study finds that the song translators appear to have worked from an understanding of the presentational goal, designed their target texts on the prosodic and poetic shape of the music, and pursued the theatrical functionality of the song, not by copying, but by recreating connections to relevant contexts, partly independently of the source lyrics, using the resources of the target languages. Besides metaphrases (closest possible transfer), paraphrases and additions seem normally to be expected in song translation, but song translators may also follow highly individual strategies – for example, the Norwegian translator is consistently more verbally faithful than the Danish and Swedish translators. As a conclusion, it is suggested that although linguistic and cultural difference play a significant role, a translator’s solution must nevertheless be arrived at, and assessed, in relation to the song as a multimedial piece of material. As far as a song can be considered a theatrical message – singers representing the voice, person, and situation of the song – the descriptive model presented in the study is also applicable to the translation of other types of song.

Kirkko sydämessä : Uskonnon muokkautuminen ja individuaatio inkerinsuomalaisten elämänvaiheissa 1900-luvulla

The Church in one s heart. The formation of religion and individuation in the lives of Ingrian Finns in the 20th century. Sinikka Haapaniemi University of Helsinki, Finland 302 pages The study falls within the sphere of religious views and the problematique of the life trajectory. The target group comprises those Finnish speakers (Ingrian Finns, Ingrians) living in what was historically Ingermanland and who in varying circumstances became scattered. These times were characterized by pressures for change due to societal reasons and reasons of war. In conditions of change external living conditions matters of religious conviction may assume new meaning and form. The examination focuses on sustaining personal faith in difficult life situations and on how crises affected religious views. Another level of scrutiny takes shape through the terminology of the analytic psychology of C.G. Jung. Individuation is deemed to occur as a cumulative process through the stages of life. The basic data for the study comprises interviews with twenty (20) natives of Ingria and their biographical narratives written in standard language. Many biographical accounts and memoirs serve as secondary data. The interviewees, who were largely selected at random, recounted their lives without questions formulated in advance. The study falls within the field of comparative religion and adheres to the principles of qualitative research practice and the case-study method. Effort was made to get to know each interviewee in the situation which his/her narrative presents. The aim is to pay attention to the interpretations given by the narrators of their various experiences and to understand their meanings on a personal level. The years during which the Ingrians were scattered, wandering and returning raise problems of survival. An individual s own initiative assumes individual forms and emphases. Religion was part of the narrators lives as one factor in the quality of life. Their religious thinking was influenced by both their home upbringing and the teaching of the Church. The interviewees took a serious attitude to the informative teaching of confirmation training. When there was no longer a church, it was claimed that the church travelled with them. Changed circumstances tested the validity of the teachings. The message of the Church institution persisted and helped them to preserve their traditions. A striving for unity and for the presence of a community emerged both in the form of ritual behaviour and in a predilection to sociability. Gradually, as they returned, the activity of the Church of Ingria began to revive. At the turn of the millennium the network of parishes was extensive and cultural activity flourished wherever the Ingrians settled in the postwar decades. Religion is part of the process of individuation. Examination of religion and individuation shows that religion remained an individual view, whose factual base was formed by Christianity and the tradition of the Church. Home upbringing served to orientate, but not to bind. With ageing the importance of independent thought is emphasized, for example in relation to confession, it did not pose a threat to individuality. Keywords: Life story, Religiosity, individuation, Ingrian, the Church of Ingria

Placental abruption : Studies on incidence, risk factors and potential predictive biomarkers

Placental abruption, one of the most significant causes of perinatal mortality and maternal morbidity, occurs in 0.5-1% of pregnancies. Its etiology is unknown, but defective trophoblastic invasion of the spiral arteries and consequent poor vascularization may play a role. The aim of this study was to define the prepregnancy risk factors of placental abruption, to define the risk factors during the index pregnancy, and to describe the clinical presentation of placental abruption. We also wanted to find a biochemical marker for predicting placental abruption early in pregnancy. Among women delivering at the University Hospital of Helsinki in 1997-2001 (n=46,742), 198 women with placental abruption and 396 control women were identified. The overall incidence of placental abruption was 0.42%. The prepregnancy risk factors were smoking (OR 1.7; 95% CI 1.1, 2.7), uterine malformation (OR 8.1; 1.7, 40), previous cesarean section (OR 1.7; 1.1, 2.8), and history of placental abruption (OR 4.5; 1.1, 18). The risk factors during the index pregnancy were maternal (adjusted OR 1.8; 95% CI 1.1, 2.9) and paternal smoking (2.2; 1.3, 3.6), use of alcohol (2.2; 1.1, 4.4), placenta previa (5.7; 1.4, 23.1), preeclampsia (2.7; 1.3, 5.6) and chorioamnionitis (3.3; 1.0, 10.0). Vaginal bleeding (70%), abdominal pain (51%), bloody amniotic fluid (50%) and fetal heart rate abnormalities (69%) were the most common clinical manifestations of placental abruption. Retroplacental blood clot was seen by ultrasound in 15% of the cases. Neither bleeding nor pain was present in 19% of the cases. Overall, 59% went into preterm labor (OR 12.9; 95% CI 8.3, 19.8), and 91% were delivered by cesarean section (34.7; 20.0, 60.1). Of the newborns, 25% were growth restricted. The perinatal mortality rate was 9.2% (OR 10.1; 95% CI 3.4, 30.1). We then tested selected biochemical markers for prediction of placental abruption. The median of the maternal serum alpha-fetoprotein (MSAFP) multiples of median (MoM) (1.21) was significantly higher in the abruption group (n=57) than in the control group (n=108) (1.07) (p=0.004) at 15-16 gestational weeks. In multivariate analysis, elevated MSAFP remained as an independent risk factor for placental abruption, adjusting for parity ≥ 3, smoking, previous placental abruption, preeclampsia, bleeding in II or III trimester, and placenta previa. MSAFP ≥ 1.5 MoM had a sensitivity of 29% and a false positive rate of 10%. The levels of the maternal serum free beta human chorionic gonadotrophin MoM did not differ between the cases and the controls. None of the angiogenic factors (soluble endoglin, soluble fms-like tyrosine kinase 1, or placental growth factor) showed any difference between the cases (n=42) and the controls (n=50) in the second trimester. The levels of C-reactive protein (CRP) showed no difference between the cases (n=181) and the controls (n=261) (median 2.35 mg/l [interquartile range {IQR} 1.09-5.93] versus 2.28 mg/l [IQR 0.92-5.01], not significant) when tested in the first trimester (mean 10.4 gestational weeks). Chlamydia pneumoniae specific immunoglobulin G (IgG) and immunoglobulin A (IgA) as well as C. trachomatis specific IgG, IgA and chlamydial heat-shock protein 60 antibody rates were similar between the groups. In conclusion, although univariate analysis identified many prepregnancy risk factors for placental abruption, only smoking, uterine malformation, previous cesarean section and history of placental abruption remained significant by multivariate analysis. During the index pregnancy maternal alcohol consumption and smoking and smoking by the partner turned out to be the major independent risk factors for placental abruption. Smoking by both partners multiplied the risk. The liberal use of ultrasound examination contributed little to the management of women with placental abruption. Although second-trimester MSAFP levels were higher in women with subsequent placental abruption, clinical usefulness of this test is limited due to low sensitivity and high false positive rate. Similarly, angiogenic factors in early second trimester, or CRP levels, or chlamydial antibodies in the first trimester failed to predict placental abruption.

Patient doses in ct, dental cone beam ct and projection radiography in Finland, with emphasis on paediatric patients

Diagnostic radiology represents the largest man-made contribution to population radiation doses in Europe. To be able to keep the diagnostic benefit versus radiation risk ratio as high as possible, it is important to understand the quantitative relationship between the patient radiation dose and the various factors which affect the dose, such as the scan parameters, scan mode, and patient size. Paediatric patients have a higher probability for late radiation effects, since longer life expectancy is combined with the higher radiation sensitivity of the developing organs. The experience with particular paediatric examinations may be very limited and paediatric acquisition protocols may not be optimised. The purpose of this thesis was to enhance and compare different dosimetric protocols, to promote the establishment of the paediatric diagnostic reference levels (DRLs), and to provide new data on patient doses for optimisation purposes in computed tomography (with new applications for dental imaging) and in paediatric radiography. Large variations in radiation exposure in paediatric skull, sinus, chest, pelvic and abdominal radiography examinations were discovered in patient dose surveys. There were variations between different hospitals and examination rooms, between different sized patients, and between imaging techniques; emphasising the need for harmonisation of the examination protocols. For computed tomography, a correction coefficient, which takes individual patient size into account in patient dosimetry, was created. The presented patient size correction method can be used for both adult and paediatric purposes. Dental cone beam CT scanners provided adequate image quality for dentomaxillofacial examinations while delivering considerably smaller effective doses to patient compared to the multi slice CT. However, large dose differences between cone beam CT scanners were not explained by differences in image quality, which indicated the lack of optimisation. For paediatric radiography, a graphical method was created for setting the diagnostic reference levels in chest examinations, and the DRLs were given as a function of patient projection thickness. Paediatric DRLs were also given for sinus radiography. The detailed information about the patient data, exposure parameters and procedures provided tools for reducing the patient doses in paediatric radiography. The mean tissue doses presented for paediatric radiography enabled future risk assessments to be done. The calculated effective doses can be used for comparing different diagnostic procedures, as well as for comparing the use of similar technologies and procedures in different hospitals and countries.

Siperiaa sanoiksi - uralilaisuutta teoiksi : Kai Donner poliittisena organisaattorina sekä tiedemiehenä antropologian näkökulmasta

The doctoral dissertation, entitled Siperiaa sanoiksi - uralilaisuutta teoiksi. Kai Donner poliittisena organisaattorina sekä tiedemiehenä antropologian näkökulmasta clarifies the early history of anthropological fieldwork and research in Siberia. The object of research is Kai Donner (1888-1935), fieldworker, explorer and researcher of Finno-Ugric languages, who made two expeditions to Siberia during 1911-1913 and 1914. Donner studied in Cambridge in 1909 under the guidance of James Frazer, A. C. Haddon and W. H. R. Rivers - and with Bronislaw Malinowski. After finishing his expeditions, Donner organized the enlistment of Finnish university students to receive military training in Germany. He was exiled and participated in the struggle for Finnish independence. After that, he organized military offensives in Russia and participated in domestic politics and policy in cooperation with C. G. E. Mannerheim. He also wrote four ethnographic descriptions on Siberia and worked with the Scandinavian Arctic areas researchers and Polar explorers. The results of this analysis can be sum up as follows: In the history of ethnographic research in Finland, it is possible to find two types of fieldwork tradition. The first tradition started from M. A. Castrén's explorations and research and the second one from August Ahlqvist's. Donner can be included in the first group with Castrén and Sakari Pälsi, unlike other contemporary philologists, or cultural researcher colleagues, which used the method of August Ahlqvist. Donner's holistic, lively and participant-observation based way of work is articulated in his writings two years before Malinowski published his thesis about modern fieldwork. Unfortunately, Donner didn't get the change to continue his researche because of the civil war in Finland, and due to the dogmatic position of E. N. Setälä. Donner's main work - the ethnohistorical Siberia - encloses his political and anthropological visions about a common and threatened Uralic nation under the pressure of Russian. The important items of his expeditions can be found in the area of cultural ecology, nutritional anthropology and fieldwork methods. It is also possible to prove that in his short stories from Siberia, there can be found some psychological factors that correlate his early life history.

Captured by conventions : On objectivity and factuality in international news agency discourse

The thesis explores the discourse of two global news agencies, the Associated Press (AP) and Reuters, which together with the French AFP are generally regarded as the world s leading news distributors. A glance at the guidelines given by AP and Reuters to their journalists shows that these two news agencies make a lot of effort to strive for objectivity the well-known journalistic ideal, which, however, is an almost indefinable concept. In journalism textbooks definitions of objectivity often contain various components: detachment, nonpartisanship, facticity, balance, etc. AP and Reuters, too, in their guidelines, present several other ideals besides objectivity , viz., reliability, accuracy, balance, freedom from bias, precise sourcing, reporting the truth, and so on. Other central concepts connected to objectivity are neutrality and impartiality. However, objectivity is, undoubtedly, the term that is most often mentioned when the ethics of journalism is discussed, acting as a kind of umbrella term for several related journalistic ideals. It can even encompass the other concept that is relevant for this study, that of factuality. These two intertwined concepts are extremely complex; paradoxically, it is easier to show evidence of the lack of objectivity or factuality than of their existence. I argue that when journalists conform to the deep-rooted conventions of objective news reporting, facts may be blurred, and the language becomes vague and ambiguous. As global distributors of news, AP and Reuters have had an influential role in creating and reinforcing conventions of (at least English-language) news writing. These conventions can be seen to work at various levels of news reporting: the ideological (e.g., defining what is regarded as newsworthy, or who is responsible), structural (e.g., the well-known inverted pyramid model), and stylistic (e.g., presupposing that in hard news reports, the journalist s voice should be backgrounded). On the basis of my case studies, I have found four central conventions to be worthy of closer examination: the conventional structure of news reports, the importance of newsworthiness, the tactics of impersonalisation which tends to blur news actors responsibility, and the routines of presenting emotions. My linguistic analyses draw mainly on M.A.K. Halliday s Systemic Functional Grammar, on notions of transitivity, ergativity, nominalisation and grammatical metaphor. The Appraisal framework, too, has provided useful tools for my analyses. The thesis includes six case studies dealing with the following topics: metaphors in political reporting, terrorism discourse, terrorism fears, emotions more generally, unnamed sources as rhetorical constructs, and responsibility in the convention of attribution.

Iäkkäiden lääkehoitoihin liittyvien riskien kartoittaminen – Arviointityökalun kehittäminen Delfoi-menetelmällä

Tutkimuksen taustalla on väestön ikääntyminen ja iäkkäiden lisääntynyt lääkkeiden käyttö. Ikääntyminen aiheuttaa elimistössä useita muutoksia, jotka voivat muuttaa lääkevastetta ja altistaa potilaan haittavaikutuksille. Iäkkäillä riski joutua sairaalaan lääkkeen haittavaikutuksen vuoksi on arvioitu olevan neljä kertaa suurempi kuin nuoremmilla. Monet lääkkeiden yhteis- ja haittavaikutukset olisivat ehkäistävissä välttämällä iäkkäillä tiettyjä lääkeaineita. Iäkkäiden lääkehoitojen seurantaa ja arviointia varten on kehitetty erilaisia suosituksia sekä Suomessa että kansainvälisesti. Tutkimuksen tavoitteena oli luoda Suomen oloihin soveltuva, hoitajien koulutettuina käytettävissä oleva, avohoidon yli 65-vuotiaiden iäkkäiden lääkitykseen liittyviä riskejä arvioiva työkalu. Työkalun avulla voitaisiin löytää ne potilaat, joiden lääkitykseen liittyy paljon riskejä. Tutkimuksen aineistona olivat laaja kansainvälinen kirjallisuuskatsaus iäkkäiden lääkehoitoihin liittyvistä tekijöistä sekä asiantuntijakommentoinnit, joiden perusteella luotiin alustava arviointityökalu. Alustava arviointityökalu validoitiin kolmikierroksisella Delfoi-menetelmällä. Delfoi-menetelmä on laadullinen konsensusmenetelmä, joka perustuu asiantuntijoiden arvioihin tutkittavasta asiasta. Kaksi ensimmäistä Delfoi-kierrosta mittasivat alustavan arviointityökalun kohtien soveltuvuutta ja kolmas kierros kohtien tärkeyttä arvioitaessa iäkkään lääkityksiin liittyviä riskejä. Tutkimuksen Delfoi-kierroksien vastaajiksi pyydettiin 33 geriatrian asiantuntijaa, joista vastaajiksi lupautui 11 lääkäriä, 3 proviisoria ja 4 sairaanhoitajaa. Delfoi-kierrosten tuloksia analysoitiin sekä kvantitatiivisesti että kvalitatiivisesti. Tutkimuksen tuloksena saatu arviointityökalu käsittää 19 iäkkäiden lääkehoitoa arvioivaa kohtaa. Asiantuntijapaneelin mukaan kaikki arviointityökalun lääkitykseen liittyviä riskejä mittaavat kohdat ovat tärkeitä tai jokseenkin tärkeitä, joten työkalun voidaan olettaa olevan validi mitattaessa lääkitykseen liittyviä riskejä. Jatkotutkimuksissa työkalun käytettävyyttä sekä riskien mittaamiskykyä tulee testata sekä arviointityökalun käyttäjien että potilaiden keskuudessa. Kehitettyä työkalua voidaan jatkossa hyödyntää esimerkiksi koulutustarkoituksissa sen varsinaisen käyttötarkoituksen lisäksi. Työkalun avulla iäkkäiden lääkehoitoa voidaan tulevaisuudessa toteuttaa entistä turvallisemmin ja tarkoituksenmukaisemmin.

"Musiikki merkitsee minulle paljon" : Asennetutkimus musiikin opiskelun merkityksellisyydestä peruskoulun 9. luokkalaisille

The main purpose of the Master Thesis was to find out what kind of attitudes the pupils in the 9th grade of Finnish comprehensive school have towards music as a school subject and compare it to the attitudes of the principals at a school level. The theoretical context of the research is based on the former studies of the significance of music education in the comprehensive school, the connection between learning and attitudes and the motivational factors towards the study motivation of music. In addition to this, I have analysed the role of the evaluation and the assessment from the point of view of developing the educational system and what is the role of management and leadership in relation to the pupils` behaviour and attitudes. The data of the research is the Finnish National Board of Education`s collected data of the assessment of the learning outcomes of arts education and it is nationally representative (N=5056 I phase and n=1570 II phase), both the Finnish-language and the Swedish-language pupil data. I have especially concentrated on the items of measuring the attitudes, the certain background variables and the questionnaire of the principals. The numerical data was analyzed using the multivariate statistical methods. The results of the research prove that in general the pupils and the principals think that music is quite significant as a school subject. The girls valued music on average more than the boys when comparing all the dimensions. The differences were systematic but the effect sizes were under 10 %. There were not statistically significant differences between the Finnish-language and the Swedish-language pupils. Comparing the grades of music in the 7th grade, the differences were growing linearly and the effect size was 15.7 %. There was a positive statistically significant correlation between the Significance of music and music as a hobby (Active interest in music, Informal interest in music, Taking part of music activities in the school) during free time. The strongest correlation were with the Active interest in music variable (r= 0.53, p= .000). Also the principals thought that music is important as a school subject considering the development of the pupil and the function of the school. The answers of the pupils were not clustering at a school level and there were no strong correlations between the attitudes of the pupils and the principals. A statistically nearly significant and a slight correlation (r= 0.21, p= .011) was found between the principals valuing the Significance of the music for school function and the pupils valuing the Benefits and hobbyism. The role of a well-motivated and active music teacher can be important from this point of view. The most important conclusion of the research was that the significance of music is a very personal individual level phenomenon. The results highlight also that in the pupils` opinion the most important thing about music lessons is to musical activity and learning as an experience.