Reading the Texture of Reality : Chaos Theory, Literature and the Humanist Perspective

Tutkimuksessa analysoidaan kaaosteorian vaikutusta kaunokirjallisuudessa ja kirjallisuudentutkimuksessa ja esitetään, että kaaosteorian roolia kirjallisuuden kentällä voidaan parhaiten ymmärtää sen avaamien käsitteiden kautta. Suoran soveltamisen sijaan kaaosteorian avulla on käyty uudenlaisia keskusteluja vanhoista aiheista ja luonnontieteestä ammennetut käsitteet ovat johtaneet aiemmin tukkeutuneiden argumenttien avaamiseen uudesta näkökulmasta käsin. Väitöskirjassa keskitytään kolmeen osa-alueeseen: kaunokirjallisen teoksen rakenteen teoretisointiin, ihmisen (erityisesti tekijän) identiteetin hahmottamiseen ja kuvailemiseen sekä fiktion ja todellisuuden suhteen pohdintaan. Tutkimuksen tarkoituksena on osoittaa, kuinka kaaosteorian kautta näitä aiheita on lähestytty niin kirjallisuustieteessä kuin kaunokirjallisissa teoksissakin. Väitöskirjan keskiössä ovat romaanikirjailija John Barthin, dramatisti Tom Stoppardin ja runoilija Jorie Grahamin teosten analyysit. Nämä kirjailijat ammentavat kaaosteoriasta keinoja käsitteellistää rakenteita, jotka ovat yhtä aikaa dynaamisia prosesseja ja hahmotettavia muotoja. Kaunokirjallisina teemoina nousevat esiin myös ihmisen paradoksaalisesti tunnistettava ja aina muuttuva identiteetti sekä lopullista haltuunottoa pakeneva, mutta silti kiehtova ja tavoiteltava todellisuus. Näiden kirjailijoiden teosten analyysin sekä teoreettisen keskustelun kautta väitöskirjassa tuodaan esiin aiemmassa tutkimuksessa varjoon jäänyt, koherenssia, ymmärrettävyyttä ja realismia painottava humanistinen näkökulma kaaosteorian merkityksestä kirjallisuudessa.

Speech Rhythm in an Interlanguage Perspective : Finnish Adolescents Speaking English

Speech rhythm is an essential part of speech processing. It is the outcome of the workings of a combination of linguistic and non-linguistic parameters, many of which also have other functions in speech. This study focusses on the acoustic and auditive realization of two linguistic parameters of rhythm: (1) sentence stress, and (2) speech rate and pausing. The aim was to find out how well Finnish comprehensive school pupils realize these two parameters in English and how native speakers of English react to Finnish pupils English rhythm. The material was elicited by means of a story-telling task and questionnaires. Three female and three male pupils representing different levels of oral skills in English were selected as the experimental group. The control group consisted of two female and two male native speakers of English. The stories were analysed acoustically and auditorily with respect to interstress intervals, weak forms, fundamental frequency, pausing, and speech as well as articulation rate. In addition, 52 native speakers of English were asked to rate the intelligibility of the Finnish pupils English with respect to speech rhythm and give their attitudes on what the pupils sounded like. Results showed that Finnish pupils can produce isochronous interstress intervals in English, but that too large a proportion of these intervals contain pauses. A closer analysis of the pauses revealed that Finnish pupils pause too frequently and in inappropriate places when they speak English. Frequent pausing was also found to cause slow speech rates. The findings of the fundamental frequency (F0) measurements indicate that Finnish pupils tend to make a slightly narrower F0 difference between stressed and unstressed syllables than the native speakers of English. Furthermore, Finnish pupils appear to know how to reduce the duration and quality of unstressed sounds, but they fail to do it frequently enough. Native listeners gave lower intelligibility and attitude scores to pupils with more anomalous speech rhythm. Finnish pupils rhythm anomalies seemed to derive from various learning- or learner-related factors rather than from the differences between English and Finnish. This study demonstrates that pausing may be a more important component of English speech rhythm than sentence stress as far as Finnish adolescents are concerned and that interlanguage development is affected by various factors and characterised by jumps or periods of stasis. Other theoretical, methodological and pedagogical implications of the results are also discussed.

Análisis de la preposición hacia y establecimiento de sus equivalentes en finés

Title of the Master's thesis: Análisis de la preposición hacia y establecimiento de sus equivalentes en finés (trans. Analysis of the Spanish preposition hacia and the finding of its equivalents in Finnish) Abstracts: The aim of this Master thesis is to provide a detailed analysis of the Spanish preposition hacia from a cognitive perspective and to establish its equivalents in Finnish language. In this sense, my purpose is to demonstrate the suitability of both cognitive perspectives and Contrastive Linguistics for semantic analysis. This thesis is divided into five chapters. The first chapter includes a presentation and a critical review of the monolingual lexical processing and semantic analysis of the Spanish preposition hacia in major reference works. Through this chapter it is possible to see both the inadequacies and omissions that are present in all the given definitions. In this sense, this chapter shows that these problems are not but the upper stage of an ontological (and therefore methodological) problem in the treatment of prepositions. The second chapter covers the presentation of the methodological and theoretical perspective adopted for this thesis for the monolingual analysis and definition of the Spanish preposition hacia, following mainly the guidelines established by G. Lakoff (1987) and R. Langacker (2008) in his Cognitive grammar. Taken together, and within the same paradigm, recent analytical and methodological contributions are discussed critically for the treatment of polysemy in language (cf. Tyler ja Evans 2003). In the third chapter, and in accordance with the requirements regarding the use of empirical data from corpora, is my aim to set out a monolingual original analysis of the Spanish preposition hacia in observance of the principles and the methodology spelled out in the second chapter. The main objective of this chapter is to build a full fledged semantic representation of the polysemy of this preposition in order to understand and articulate its meanings with Finnish language (and other possible languages). The fourth chapter, in accordance with the results of chapter 3, examines and describes and establishes the corresponding equivalents in Finnish for this preposition. The results obtained in this chapter are also contrasted with the current bilingual lexicographical definitions found in the most important dictionaries and grammars. Finally, in the fifth chapter of this thesis, the results of this work are discussed critically. In this way, some observations are given regarding both the ontological and theoretical assumptions as well regarding the methodological perspective adopted. I also present some notes for the construction of a general methodology for the semantic analysis of Spanish prepositions to be carried out in further investigations. El objetivo de este trabajo, que caracterizamos como una tarea de carácter comparativo-analítico, es brindar un análisis detallado de la preposición castellana hacia desde una perspectiva cognitiva en tanto y a través del establecimiento de sus equivalentes en finés. Se procura, de esta forma, demostrar la adecuación de una perspectiva cognitiva tanto para el examen como para el establecimiento y articulación de la serie de equivalentes que una partícula, en nuestro caso una preposición, encuentra en otra lengua. De esta forma, y frente a definiciones canónicas que advierten sobre la imposibilidad de una caracterización acabada del conjunto de usos de una preposición, se observa como posible, a través de la aplicación de una metodología teórica-analítica adecuada, la construcción de una definición viable tanto en un nivel jerárquico como descriptivo. La presente tesis se encuentra dividida en cinco capítulos. El primer capítulo comprende una exposición y revisión critica del tratamiento monolingüe lexicográfico y analítico que la preposición hacia ha recibido en las principales obras de referencia, donde se observa que las inadecuaciones y omisiones presentes en la totalidad de las definiciones analizadas representan tan sólo el estadio superior de una problemática de carácter ontológico y, por tanto, metodológico, en el tratamiento de las preposiciones. El capítulo segundo comprende la presentación de la perspectiva teórica metodológica adoptada en esta tesis para el análisis y definición monolingüe de la preposición hacia, teniendo por líneas directrices las propuestas realizadas por G. Lakoff , así como a los fundamentos establecidos por R. Langacker en su propuesta cognitiva para una nueva gramática. En forma conjunta y complementaria, y dentro del mismo paradigma, empleamos, discutimos críticamente y desarrollamos diferentes aportes analítico-metodológicos para el tratamiento de la polisemia en unidades lingüísticas locativas. En el capítulo tercero, y en acuerdo con las exigencias respecto a la utilización de datos empíricos obtenidos a partir de corpus textuales, se expone un análisis original monolingüe de la preposición hacia en observancia de los principios y la metodología explicitada en el capítulo segundo, teniendo por principal objetivo la construcción de una representación semántica de la polisemia de la preposición que comprenda y articule los sentidos prototípicos para ésta especificados. El capítulo cuarto, y en acuerdo con los resultados de nuestro análisis monolingual de la preposición, se examinan, describen y establecen los equivalentes correspondientes en finés para hacia; asimismo, se contrastan en este capítulo los resultados obtenidos con las definiciones lexicográficas bilingües vigentes. Se recogen en el último y quinto capítulo de esta tesis algunas observaciones tanto respecto a los postulados ontológicos y teórico-metodológicos de la perspectiva adoptada, así como algunas notas para la construcción de una metodología general para el análisis semántico preposicional.

Non-reductive Physicalism, Irreducibility of the Mental and the Problem of Mental Causation : A study of Donald Davidson's and Georg Henrik von Wright's positions in the philosophy of mind

In this study I consider what kind of perspective on the mind body problem is taken and can be taken by a philosophical position called non-reductive physicalism. Many positions fall under this label. The form of non-reductive physicalism which I discuss is in essential respects the position taken by Donald Davidson (1917-2003) and Georg Henrik von Wright (1916-2003). I defend their positions and discuss the unrecognized similarities between their views. Non-reductive physicalism combines two theses: (a) Everything that exists is physical; (b) Mental phenomena cannot be reduced to the states of the brain. This means that according to non-reductive physicalism the mental aspect of humans (be it a soul, mind, or spirit) is an irreducible part of the human condition. Also Davidson and von Wright claim that, in some important sense, the mental aspect of a human being does not reduce to the physical aspect, that there is a gap between these aspects that cannot be closed. I claim that their arguments for this conclusion are convincing. I also argue that whereas von Wright and Davidson give interesting arguments for the irreducibility of the mental, their physicalism is unwarranted. These philosophers do not give good reasons for believing that reality is thoroughly physical. Notwithstanding the materialistic consensus in the contemporary philosophy of mind the ontology of mind is still an uncharted territory where real breakthroughs are not to be expected until a radically new ontological position is developed. The third main claim of this work is that the problem of mental causation cannot be solved from the Davidsonian - von Wrightian perspective. The problem of mental causation is the problem of how mental phenomena like beliefs can cause physical movements of the body. As I see it, the essential point of non-reductive physicalism - the irreducibility of the mental - and the problem of mental causation are closely related. If mental phenomena do not reduce to causally effective states of the brain, then what justifies the belief that mental phenomena have causal powers? If mental causes do not reduce to physical causes, then how to tell when - or whether - the mental causes in terms of which human actions are explained are actually effective? I argue that this - how to decide when mental causes really are effective - is the real problem of mental causation. The motivation to explore and defend a non-reductive position stems from the belief that reductive physicalism leads to serious ethical problems. My claim is that Davidson's and von Wright's ultimate reason to defend a non-reductive view comes back to their belief that a reductive understanding of human nature would be a narrow and possibly harmful perspective. The final conclusion of my thesis is that von Wright's and Davidson's positions provide a starting point from which the current scientistic philosophy of mind can be critically further explored in the future.

Musiikki ahdistuksen taitona : Filosofinen tutkimus musiikin eksistentiaalis-ontologisesta merkityksestä

Music as the Art of Anxiety: A Philosophical Approach to the Existential-Ontological Meaning of Music. The present research studies music as an art of anxiety from the points of view of both Martin Heidegger s thought and phenomenological philosophy in general. In the Heideggerian perspective, anxiety is understood as a fundamental mode of being (Grundbefindlichkeit) in human existence. Taken as an existential-ontological concept, anxiety is conceived philosophically and not psychologically. The central research questions are: what is the relationship between music and existential-ontological anxiety? In what way can music be considered as an art of anxiety? In thinking of music as a channel and manifestation of anxiety, what makes it a special case? What are the possible applications of phenomenology and Heideggerian thought in musicology? The main aim of the research is to develop a theory of music as an art of existential-ontological anxiety and to apply this theory to musicologically relevant phenomena. Furthermore, the research will contribute to contemporary musicological debates and research as it aims to outline the phenomenological study of music as a field of its own; the development of a specific methodology is implicit in these aims. The main subject of the study, a theory of music as an art of anxiety, integrates Heideggerian and phenomenological philosophies with critical and cultural theories concerning violence, social sacrifice, and mimetic desire (René Girard), music, noise and society (Jacques Attali), and the affect-based charme of music (Vladimir Jankélévitch). Thus, in addition to the subjective mood (Stimmung) of emptiness and meaninglessness, the philosophical concept of anxiety also refers to a state of disorder and chaos in general; for instance, to noise in the realm of sound and total (social) violence at the level of society. In this study, music is approached as conveying the existentially crucial human compulsion for signifying i.e., organizing chaos. In music, this happens primarily at the immediate level of experience, i.e. in affectivity, and also in relation to all of the aforementioned dimensions (sound, society, consciousness, and so on). Thus, music s existential-ontological meaning in human existence, Dasein, is in its ability to reveal different orders of existence as such. Indeed, this makes music the art of anxiety: more precisely, music can be existentially significant at the level of moods. The study proceeds from outlining the relevance of phenomenology and Heidegger s philosophy in musicology to the philosophical development of a theory of music as the art of anxiety. The theory is developed further through the study of three selected specific musical phenomena: the concept of a musical work, guitar smashing in the performance tradition of rock music, and Erik Bergman s orchestral work Colori ed improvvisazioni. The first example illustrates the level of individual human-subject in music as the art of anxiety, as a means of signifying chaos, while the second example focuses on the collective need to socio-culturally channel violence. The third example, being music-analytical, studies contemporary music s ability to mirror the structures of anxiety at the level of a specific musical text. The selected examples illustrate that, in addition to the philosophical orientation, the research also contributes to music analysis, popular music studies, and the cultural-critical study of music. Key words: music, anxiety, phenomenology, Martin Heidegger, ontology, guitar smashing, Erik Bergman, musical work, affectivity, Stimmung, René Girard

Scheffleriläinen rationaalisuus ja kasvatustodellisuuden monikerroksisuus : Jännitteitä ja ratkaisuja Israel Schefflerin kasvatusfilosofiassa

The study is a philosophical analysis of Israel Scheffler’s philosophy of education, focusing on three crucial conceptions in his philosophy: the conception of rationality, the conception of human nature, and the conception of reality. The interrelations of these three concepts as well as their relations to educational theorizing are analysed and elaborated. A conceptual problem concerning Scheffler’s ideal of rationality derives from Scheffler’s supposition of the strong analogy between science education and moral education in terms of the ideal of rationality. This analogy is argued to be conceptually problematic, since the interconnections of rationality, objectivity, and truth, appear to differ from each other in the realms of ethics and science, given the presuppositions of ontological realism and ethical naturalism, to which Scheffler explicitly subscribes. This study considers two philosophical alternatives for solving this problem. The first alternative relates the analogy to the normative concept of personhood deriving from the teleological understanding of human nature. Nevertheless, this position turns out to be problematic for Scheffler, since he rejects all teleological thinking in his philosophy. The problem can be solved, as it is argued, by limiting Scheffler’s rejection of teleology – in light of his philosophical outlook on the whole – in a manner that allows a modest version of a teleological conception of human nature. The second alternative, based especially on Scheffler’s later contributions, is to suggest that reality is actually more complex and manifold than it appears to be in light of a contemporary naturalist worldview. This idea of plurealism – Scheffler’s synthesis of pluralism and realism – is represented especially in Scheffler’s contributions related to his debate with Nelson Goodman dealing with both constructivism and realism. The idea of plurealism is not only related to the ethics-science-distinction, but is more widely related to the relationship between ontological realism and the incommensurable systems of description in diverse realms of human understanding. The Scheffler-Goodman debate is also analysed in relation to the contemporary constructivism-realism debate in educational philosophy. In terms of educational questions, Scheffler’s plurealism is argued as offering a fruitful perspective. Scheffler’s philosophy of education can be interpreted as searching for solutions to the problems deriving from the tension between the tradition of analytical philosophy and the complexity and multiplicity of educational reality. The complexity of reality combined with the supposition of the limitedness of human knowledge does not lead Scheffler to relativism or particularism, but, in contrast, Schefflerian formulations of rationality and objectivity preserve the possibility for critical inquiry in all realms of educational reality. In light of this study, Scheffler’s philosophy of education provides an exceptional example of combining ontological realism, epistemological fallibilism, and the defence of the ideal of rationality, combined with a wide-ranging understanding of educational reality.

Psychological consequences of cancer from the salutogenic and dyadic perspective

Previous empirical research has shown that positive, i.e. salutogenic, psychological resources and social support, have health-promoting effects in stressful life situations. In the present study the associations between sense of coherence (SOC), dispositional optimism, partner support, psychological distress, and quality of life among cancer patients and their partners were examined. The data was collected from Helsinki University Central Hospital in 1997 2000 by self-report questionnaires approximately 2, 8, and 14 months post diagnosis. Participants in studies I-IV were 155, 123, 153, and 147 cancer patients and their partners, respectively. The sample of the present study consisted of physically relatively well-functioning patients, whose overall psychological wellbeing was generally good as compared to the healthy population. Partners in this study, however, reacted more strongly to their partners illness and treatment. The partners displayed e.g. higher levels of anxiety and depression than the patients. The results of this study indicated that cancer patients and their partners with strong SOC and who are optimistic report fewer symptoms of distress. Moreover, patients who display an optimistic attitude to life, who receive support from their partner, and who control how they express anger have a better quality of life. The findings also confirmed that the role of the partner is significant in coping with cancer. The symptoms of depression and anxiety in patients and partners were associated, and the partner s optimism seemed to protect also the patient from elevated levels of anxiety. The role of the partner was also highlighted in the couples anger-expression styles. The patients and partners tendency to inhibit anger was associated with decreased partner support and worse patient quality of life. Finally, in the present study we found substantial gender differences. For the patients, partner support was more significant for the women than for the men. Furthermore, for the female patients, the husband s tendency to openly express anger (anger-out) had a negative impact on their psychological quality of life, whereas the wives high anger-out seemed to predict good psychological quality of life in the men. Also, in this study the female partners reported higher levels of anxiety and depression as compared to the male partners. The results of the present study extend the previous literature on positive psychological resources and psychological wellbeing among cancer couples. Furthermore, these findings support the theory on SOC and optimism as health-promoting factors. However, the construct of SOC seems to include other important elements besides optimism. The findings of this study are applicable in designing new rehabilitation programmes for cancer patients and their partners.

Evidence-based perspective on CP rehabilitation : Reviews on physiotherapy, physiotherapy-related motor-based interventions and orthotic devices

This thesis utilises an evidence-based approach to critically evaluate and summarize effectiveness research on physiotherapy, physiotherapy-related motor-based interventions and orthotic devices in children and adolescents with cerebral palsy (CP). It aims to assess the methodological challenges of the systematic reviews and trials, to evaluate the effectiveness of interventions in current use, and to make suggestions for future trials Methods: Systematic reviews were searched from computerized bibliographic databases up to August 2007 for physiotherapy and physiotherapy-related interventions, and up to May 2003 for orthotic devices. Two reviewers independently identified, selected, and assessed the quality of the reviews using the Overview Quality Assessment Questionnaire complemented with decision rules. From a sample of 14 randomized controlled trials (RCT) published between January 1990 and June 2003 we analysed the methods of sampling, recruitment, and comparability of groups; defined the components of a complex intervention; identified outcome measures based on the International Classification of Functioning, Disability and Health (ICF); analysed the clinical interpretation of score changes; and analysed trial reporting using a modified 33-item CONSORT (Consolidated Standards of Reporting Trials) checklist. The effectiveness of physiotherapy and physiotherapy-related interventions in children with diagnosed CP was evaluated in a systematic review of randomised controlled trials that were searched from computerized databases from January 1990 up to February 2007. Two reviewers independently assessed the methodological quality, extracted the data, classified the outcomes using the ICF, and considered the level of evidence according to van Tulder et al. (2003). Results: We identified 21 reviews on physiotherapy and physiotherapy-related interventions and five on orthotic devices. These reviews summarized 23 or 5 randomised controlled trials and 104 or 27 observational studies, respectively. Only six reviews were of high quality. These found some evidence supporting strength training, constraint-induced movement therapy or hippotherapy, and insufficient evidence on comprehensive interventions. Based on the original studies included in the reviews on orthotic devices we found some short-term effects of lower limb casting on passive range of movement, and of ankle-foot orthoses on equinus walk. Long term effects of lower limb orthoses have not been studied. Evidence of upper limb casting or orthoses is conflicting. In the sample of 14 RCTs, most trials used simple randomisation, complemented with matching or stratification, but only three specified the concealed allocation. Numerous studies provided sufficient details on the components of a complex intervention, but the overlap of outcome measures across studies was poor and the clinical interpretation of observed score changes was mostly missing. Almost half (48%) of the applicable CONSORT-based items (range 28 32) were reported adequately. Most reporting inadequacies were in outcome measures, sample size determination, details of the sequence generation, allocation concealment and implementation of the randomization, success of assessor blinding, recruitment and follow-up dates, intention-to-treat analysis, precision of the effect size, co-interventions, and adverse events. The systematic review identified 22 trials on eight intervention categories. Four trials were of high quality. Moderate evidence of effectiveness was established for upper extremity treatments on attained goals, active supination and developmental status, and of constraint-induced therapy on the amount and quality of hand use and new emerging behaviours. Moderate evidence of ineffectiveness was found for strength training's effect on walking speed and stride length. Conflicting evidence was found for strength training's effect on gross motor function. For the other intervention categories the evidence was limited due to the low methodological quality and the statistically insignificant results of the studies. Conclusions: The high-quality reviews provide both supportive and insufficient evidence on some physiotherapy interventions. The poor quality of most reviews calls for caution, although most reviews drew no conclusions on effectiveness due to the poor quality of the primary studies. A considerable number of RCTs of good to fair methodological and reporting quality indicate that informative and well-reported RCTs on complex interventions in children and adolescents with CP are feasible. Nevertheless, methodological improvement is needed in certain areas of the trial design and performance, and the trial authors are encouraged to follow the CONSORT criteria. Based on RCTs we established moderate evidence for some effectiveness of upper extremity training. Due to limitations in methodological quality and variations in population, interventions and outcomes, mostly limited evidence on the effectiveness of most physiotherapy interventions is available to guide clinical practice. Well-designed trials are needed, especially for focused physiotherapy interventions.

Balancing Social Citizenship and New Paternalism : Finnish activation policy and street-level practice in a comparative perspective

The study examines the origin and development of the Finnish activation policy since the mid-1990s by using the 2001 activation reform as a benchmark. The notion behind activation is to link work obligations to welfare benefits for the unemployed. The focus of the thesis is policy learning and the impact of ideas on the reform of the welfare state. The broader research interests of the thesis are summarized by two groups of questions. First, how was the Finnish activation policy developed and what specific form did it receive in the 2001 activation reform? Second, how does the Finnish activation policy compare to the welfare reforms in the EU and in the US? What kinds of ideas and instruments informed the Finnish policy? To what extent can we talk about a restructuring or transformation of the Nordic welfare policy? Theoretically, the thesis is embedded in the comparative welfare state research and the concepts used in the contemporary welfare state discourse. Activation policy is analysed against the backdrop of the theories about the welfare state, welfare state governance and citizenship. Activation policies are also analysed in the context of the overall modernization and individualization of lifestyles and its implications for the individual citizen. Further, the different perspectives of the policy analysis are applied to determine the role of implementation and street-level practice within the whole. Empirically, the policy design, its implementation and the experiences of the welfare staff and recipients in Finland are examined. The policy development, goals and instruments of the activation policies have followed astonishingly similar paths in the different welfare states and regimes over the last two decades. In Finland, the policy change has been manifested through several successive reforms that have been introduced since the mid-1990s. The 2001 activation reform the Act on Rehabilitative Work Experience illustrates the broader trend towards stricter work requirements and draws its inspiration from the ideas of new paternalism. The ideas, goals and instruments of the international activation trend are clearly visible in the reform. Similarly, the reform has implications for the traditional Nordic social policies, which incorporate institutionalised social rights and the provision of services.

Depression and Cognition in Type 2 Diabetes from a Life Course Perspective

Background: Type 2 diabetes is linked to several complications which add to both physical and mental distress. Depression is a common co-morbidity of diabetes which can occur both as a cause and a consequence of type 2 diabetes. Depression has been shown to correlate with glucose regulation and treating depression might prove beneficial for glucose regulation as well as for mental well being. Another complication which might affect diabetes management is cognitive decline. Several risk factors and complications of diabetes might modify the risk for developing cognitive impairment, which is increased 1.5 times among subjects with type 2 diabetes. Type 2 diabetes, depression and impaired cognitive performance have all been linked to low birth weight. This thesis aimed to explore the effects and interactions of birth weight, depression and cognitive ability in relation to type 2 diabetes from a life course perspective. Subjects and methods: Studies I, II and V were part of the Helsinki Birth Cohort Study. 2003 subjects participated in an extensive clinical examination at an average age of 61 years. A standard glucose tolerance test (OGTT) was performed and depressive symptoms were assessed using the Beck Depression Inventory (BDI). In addition data was obtained from child welfare clinics and national registers. A subset of the cohort (n=1247) also performed a test on cognitive performance (CogState ®) at the average age of 64. Studies III and IV were randomised clinical trials where mildly depressed diabetic subjects were treated with paroxetine or placebo and the effect on metabolic parameters and quality of life was assessed. The first trial included 14 women and lasted 10 weeks, while the second trial included 43 subjects, both men and women, and lasted 6 months. Results: Type 2 diabetes was positively associated with the occurrence of depressive symptoms. Among diabetic subjects 23.6% had depressive symptoms, compared to 16.7% of subjects with normal glucose tolerance (OR = 1.77, p<0.001). Formal mediation analysis revealed that cardiovascular disease (CVD) is likely to act as a mediator in the association. Furthermore, low birth weight was found to modify the association between type 2 diabetes, CVD and depression. The association between BDI score and having type 2 diabetes or CVD was twice as strong in the subgroup with low birth weight (≤ 2500g) compared with the group with birth weight > 2500g (p for interaction 0.058). In the six months long randomised clinical trial (study IV) paroxetine had a transient beneficial effect on glycosylated haemoglobin A1c (GHbA1c) and quality of life when compared to placebo after three months of treatment. In study V we found that subjects with known diabetes had a consistently poorer level of cognitive performance than subjects with normal glucose tolerance in most of the tested cognitive domains. This effect was further amplified among those born with a small birth weight (p for interaction 0.002). Conclusions: Type 2 diabetes is associated with a higher occurrence of depressive symptoms compared to subjects with normal glucose tolerance. This association is especially strong among subjects with CVD and those born with a low birth weight. Treating depressed diabetic subjects with paroxetine has no long term effect on glucose regulation. Physicians should be aware of depression as an important co-morbidity of type 2 diabetes. Both depression and the cognitive decline often seen among diabetic subjects are increased if the subject is born with a low birth weight. Physicians should recognise low birth weight as an additional risk factor and modifier of diabetic complications.