Fetal alcohol spectrum disorders in Finnish children and adolescents : diagnosis, cognition, behavior, adaptation and brain metabolic alterations

Alcohol consumption during pregnancy can potentially affect the developing fetus in devastating ways, leading to a range of physical, neurological, and behavioral alterations most accurately termed Fetal Alcohol Spectrum Disorders (FASD). Despite the fact that it is a preventable disorder, prenatal alcohol exposure today constitutes a leading cause of intellectual disability in the Western world. In Western countries where prevalence studies have been performed the rates of FASD exceed, for example, autism spectrum disorders, Down’s syndrome and cerebral palsy. In addition to the direct effects of alcohol, children and adolescents with FASD are often exposed to a double burden in life, as their neurological sequelae are accompanied by adverse living surroundings exposing them to further environmental risk. However, children with FASD today remain remarkably underdiagnosed by the health care system. This thesis forms part of a larger multinational research project, The Collaborative Initiative on Fetal Alcohol Spectrum Disorders (the CIFASD), initiated by the National Institute of Alcohol Abuse and Alcoholism (NIAAA) in the U.S.A. The general aim of the present thesis was to examine a cohort of children and adolescents growing up with fetal alcohol-related damage in Finland. The thesis consists of five studies with a broad focus on diagnosis, cognition, behavior, adaptation and brain metabolic alterations in children and adolescents with FASD. The participants consisted of four different groups: one group with histories of prenatal exposure to alcohol, the FASD group; one IQ matched contrast group mostly consisting of children with specific learning disorder (SLD); and two typically-developing control groups (CON1 and CON2). Participants were identified through medical records, random sampling from the Finnish national population registry and email alerts to students. Importantly, the participants in the present studies comprise a group of very carefully clinically characterized children with FASD as the studies were performed in close collaboration with leading experts in the field (Prof. Edward Riley and Prof. Sarah Mattson, Center for Behavioral Teratology, San Diego State University, U.S.A; Prof. Eugene Hoyme, Sanford School of Medicine, University of South Dakota, U.S.A.). In the present thesis, the revised Institute of Medicine diagnostic criteria for FASD were tested on a Finnish population and found to be a reliable tool for differentiating among the subgroups of FASD. A weighted dysmorphology scoring system proved to be a valuable additional adjunct in quantification of growth deficits and dysmorphic features in children with FASD (Study 1). The purpose of Study 2 was to clarify the relationship between alcohol-related dysmorphic features and general cognitive capacity. Results showed a significant correlation between dysmorphic features and cognitive capacity, suggesting that children with more severe growth deficiency and dysmorphic features have more cognitive limitations. This association was, however, only moderate, indicating that physical markers and cognitive capacity not always go hand in hand in individuals with FASD. Behavioral problems in the FASD group proved substantial compared to the typically developing control group. In Study 3 risk and protective factors associated with behavioral problems in the FASD group were explored further focusing on diagnostic and environmental factors. Two groups with elevated risks for behavioral problems emerged: length of time spent in residential care and a low dysmorphology score proved to be the most pervasive risk factor for behavioral problems. The results underscore the clinical importance of appropriate services and care for less visibly alcohol affected children and highlight the need to attend to children with FASD being raised in institutions. With their background of early biological and psychological impairment compounded with less opportunity for a close and continuous caregiver relationship, such children seem to run an especially great risk of adverse life outcomes. Study 4 focused on adaptive abilities such as communication, daily living skills and social skills, in other words skills that are important for gradually enabling an independent life, maintain social relationships and allow the individual to become integrated into society. The results showed that adaptive abilities of children and adolescents growing up with FASD were significantly compromised compared to both typically-developing peers and IQ-matched children with SLD. Clearly different adaptive profiles were revealed where the FASD group performed worse than the SLD group, who in turn performed worse than the CON1 group. Importantly, the SLD group outperformed the FASD group on adaptive behavior in spite of comparable cognitive levels. This is the first study to compare adaptive abilities in a group of children and adolescents with FASD relative to both a contrast group of IQ-matched children with SLD and to a group of typically-developing peers. Finally, in Study 5, through magnetic resonance spectroscopic imaging (MRS) evidence of longstanding neurochemical alterations were observed in adolescents and young adults with FASD related to alcohol exposure in utero 14-20 years earlier. Neurochemical alterations were seen in several brain areas: in frontal and parietal cortices, corpus callosum, thalamus and frontal white matter areas as well as in the cerebellar dentate nucleus. The findings are compatible with neuropsychological findings in FASD. Glial cells seemed to be more affected than neurons. In conclusion, more societal efforts and resources should be focused on recognizing and diagnosing FASD, and supporting subgroups with elevated risk of poor outcome. Without adequate intervention children and adolescents with FASD run a great risk of marginalization and social maladjustment, costly not only to society but also to the lives of the many young people with FASD.

A Framework for IT Service Management Integration

The objective of this Master’s Thesis is to find out best practices for IT service management integration. Integration in this context means process integration between an IT organization and an integration partner. For observing the objective, two different perspectives are assigned: process and technology. The thesis consists of theory, framework, implementation, and analysis parts. The first part introduces common methodology of IT service management and enterprise integration. The second part presents an integration framework for ITSM integration. The third part illustrates how the framework is used and the last part analyses the framework. The major results of this thesis were the framework architecture, the framework tools, the implementation model, the testing model, and the deployment model for ITSM integration. As a fundamental best practice, the framework contained a four-division structure between architecture, process, data, and technology. This architecture provides a baseline for ITSM integration design, implementation and testing.

Företagsamhet i skola och utbildning : lärares tankar om förutsättningarna att nå målen i temaområdet Deltagande, demokrati och entreprenörskap

Developing students’ enterprise and proactive approaches to life have been goals of Finnish public education since its introduction. Still, education in Finland today is criticized for not reaching these goals and for overlooking the development of students’ enterprise. The role of enterprise education is ambivalent. On the one hand, enterprise education is advocated as the solution to many of the alleged problems in public education; on the other hand, the pedagogical ideas that enterprise education builds on appear to coincide with the contemporary understanding of “good education.” The thesis discusses what sets enterprise education apart from other types of education and teaching. Notably, the pedagogical foundations for enterprise education are not necessarily solid or sufficiently explored. Thus, the overall aim of the thesis is to explore the conditions for developing enterprise in education. Sloyd, as a school subject that promotes handicraft-based education, has long been attributed as having the potential to develop students’ character and person; similarly, it is also identified as being well suited for developing student enterprise. Enterprise education is not specific to sloyd, however. In fact, developing enterprise is a cross-curricular goal for basic education. In a subject-focused educational structure and culture, the development of an enterprising mindset in students is a common concern for all teachers. Thus, an understanding of the conditions for enterprise education must not be limited to one school subject; rather, the nature of the phenomenon requires a cross-curricular approach. Altogether, the conditions for enterprise education appear to be in need of further research. In addition to a subject-focused structure, other influencing factors that are mentioned in discussions on enterprise education include the need for a more enterprising working culture in school. Importantly, another key factor is the individual teacher’s pedagogical philosophy, which constitutes the frame of reference that informs how he or she understands and interprets his or her profession. Notably, the conditions for enterprise education are poor unless a teacher’s pedagogical philosophy emphasizes a focus on enterprise. The empirical research uses a hermeneutical approach and focuses on exploring teachers’ views on the conditions for reaching the national goals related to students’ enterprise. The interview study was conducted among class and subject teachers around Swedish-speaking Finland. The study shows that teachers view themselves as the most important factor for a focus on enterprise. Teachers have also identified a vast number of contextual factors that influence, support, or counteract a focus on enterprise. Structure, culture, resources, and curriculum, as well as numerous societal factors, all interact to affect the conditions for enterprise education. The prevailing culture of subject focus poses a challenge to enterprise education. At the same time, however, a focus on enterprise can be seen as a natural tendency in grades one to six. Indeed, teachers of all grade levels interpret the development of a proactive approach to life as one of education’s core values. Altogether, the thesis offers a deepened and nuanced understanding of the conditions for enterprise education. While the public education system in Finland seems to have some favourable basic conditions for enterprise education, multifaceted challenges must be faced if the national goals related to enterprise are to be reached.

Suorituskyvyn mittaaminen lasi- ja alumiinirakentamisen pk-yrityksissä

Diplomityön taustana oli oletus suorituskyvyn mittaamisen vähäisyydestä lasi- ja alumiinirakentamisen pk-yrityksissä. Tämän takia haluttiin tutkia mitataanko suorituskykyä ja jos mitataan, miten sitä tehdään sekä minkälainen järjestelmä sopisi kyseisille yrityksille. Lasi- ja alumiinirakentamisen suorituskyvyn analysoinnin tilannetta kartoitettiin haastattelututkimuksella, jossa kävi ilmi, että se tosiaan on vähäistä. Tutkimukseen osallistuneissa yrityksissä seurattiin pääasiassa liiketaloutta ja tulosta, ja näitäkin suppeasti. Laajemmalle mittaamiselle todettiin kuitenkin olevan tarvetta. Tämän jälkeen haastattelututkimuksen pohjalta suunniteltiin työssä mukana olleelle Case-yritykselle mittaristo. Suunnitteluvaiheessa valittiin yrityksen visioiden ja strategian mukaisesti neljä mitattavaa suorituskyvyn osa-aluetta ja näille mittarit. Mittariston suunnittelun jälkeen siirryttiin rakennusvaiheeseen. Järjestelmäksi valittiin SAKE, joka on helppokäyttöinen ja erityisesti pk-yritysten tarpeisiin suunniteltu työkalu. Tämän suorituskyvyn mittariston avulla lasi- ja alumiinirakentamisen yritykset voivat tehostaa toimintaansa ja ulottaa suorituskyvyn mittauksen osa-alueilla joita ei aiemmin ole huomioitu.

Building IT architecture for developing nations using TOGAF

Developing nations vary in data usage techniques with respect to developed nations because of lack of standard information technology architecture. With the concept of globalization in the modern times, there is a necessity of information sharing between different developing nations for better advancements in socio-economic and science and technology fields. A robust IT architecture is needed and has to be built between different developing nations which eases information sharing and other data usage methods. A framework like TOGAF may work in this case as a normal IT framework may not fit to meet the requirements of an enterprise architecture. The intention of the thesis is to build an enterprise architecture between different developing nations using a framework TOGAF