The Possibilities and Dosimetric Limitations of MLC-Based Intensity-Modulated Radiotherapy Delivery and Optimization Techniques

The use of intensity-modulated radiotherapy (IMRT) has increased extensively in the modern radiotherapy (RT) treatments over the past two decades. Radiation dose distributions can be delivered with higher conformality with IMRT when compared to the conventional 3D-conformal radiotherapy (3D-CRT). Higher conformality and target coverage increases the probability of tumour control and decreases the normal tissue complications. The primary goal of this work is to improve and evaluate the accuracy, efficiency and delivery techniques of RT treatments by using IMRT. This study evaluated the dosimetric limitations and possibilities of IMRT in small (treatments of head-and-neck, prostate and lung cancer) and large volumes (primitive neuroectodermal tumours). The dose coverage of target volumes and the sparing of critical organs were increased with IMRT when compared to 3D-CRT. The developed split field IMRT technique was found to be safe and accurate method in craniospinal irradiations. By using IMRT in simultaneous integrated boosting of biologically defined target volumes of localized prostate cancer high doses were achievable with only small increase in the treatment complexity. Biological plan optimization increased the probability of uncomplicated control on average by 28% when compared to standard IMRT delivery. Unfortunately IMRT carries also some drawbacks. In IMRT the beam modulation is realized by splitting a large radiation field to small apertures. The smaller the beam apertures are the larger the rebuild-up and rebuild-down effects are at the tissue interfaces. The limitations to use IMRT with small apertures in the treatments of small lung tumours were investigated with dosimetric film measurements. The results confirmed that the peripheral doses of the small lung tumours were decreased as the effective field size was decreased. The studied calculation algorithms were not able to model the dose deficiency of the tumours accurately. The use of small sliding window apertures of 2 mm and 4 mm decreased the tumour peripheral dose by 6% when compared to 3D-CRT treatment plan. A direct aperture based optimization (DABO) technique was examined as a solution to decrease the treatment complexity. The DABO IMRT technique was able to achieve treatment plans equivalent with the conventional IMRT fluence based optimization techniques in the concave head-and-neck target volumes. With DABO the effective field sizes were increased and the number of MUs was reduced with a factor of two. The optimality of a treatment plan and the therapeutic ratio can be further enhanced by using dose painting based on regional radiosensitivities imaged with functional imaging methods.

Improving strategic decision-making with simulation based decision support systems

Combating climate change is one of the key tasks of humanity in the 21st century. One of the leading causes is carbon dioxide emissions due to usage of fossil fuels. Renewable energy sources should be used instead of relying on oil, gas, and coal. In Finland a significant amount of energy is produced using wood. The usage of wood chips is expected to increase in the future significantly, over 60 %. The aim of this research is to improve understanding over the costs of wood chip supply chains. This is conducted by utilizing simulation as the main research method. The simulation model utilizes both agent-based modelling and discrete event simulation to imitate the wood chip supply chain. This thesis concentrates on the usage of simulation based decision support systems in strategic decision-making. The simulation model is part of a decision support system, which connects the simulation model to databases but also provides a graphical user interface for the decisionmaker. The main analysis conducted with the decision support system concentrates on comparing a traditional supply chain to a supply chain utilizing specialized containers. According to the analysis, the container supply chain is able to have smaller costs than the traditional supply chain. Also, a container supply chain can be more easily scaled up due to faster emptying operations. Initially the container operations would only supply part of the fuel needs of a power plant and it would complement the current supply chain. The model can be expanded to include intermodal supply chains as due to increased demand in the future there is not enough wood chips located close to current and future power plants.

Music digitalization and its effects on the Finnish music industry stakeholders

For the past two decades the music digitalization has been considered the most significant phenomenon in the music industry as the physical sales have been decreasing rapidly. The advancement of the digital technology and the internet have facilitated the digitalization in the music industry and affected all stages of the music value chain, namely music creation, distribution and consumption. The newly created consumer culture has led to the establishment of novel business models such as music subscriptions and à-la-carte downloads websites and live streaming. The dynamic digital environment has presented the music industry stakeholders with the challenge to adapt to the requirements of the constantly changing modern consumers’ needs and demands. The purpose of this study was to identify how music digitalization can influence change in the Finnish music industry value chain; i.e. how digitalization affects the music industry stakeholders, their functions and inter-relatedness and how the stakeholders are able to react to the changes in the industry. The study was conducted as a qualitative research based entirely on primary data in the form of semi-structured interviews with experts from different units of the Finnish music industry value chain. Since the study offers assessment of diverse viewpoints on the value chain, it further provides an integrated picture of the Finnish music industry current situation and its competitive environment. The results suggest that the music industry is currently in a turbulent stage of experimentation with new business models and digital innovations. However, at this point it is impossible to determine which business model will be approved by the consumers in the longer run. Nevertheless, the study confirmed the claim that consumption of music in its digital form is to become dominant over the traditional physical copies sales in the nearest future. As a result the music industry is becoming more user-oriented; that is the focus is shifting from music production towards artist branding and management and visibility to the audience. Furthermore, the music industry is undergoing the process of integration with other industries such as media, social networks, internet services providers and mobile phone manufacturers in order to better fulfill the consumers’ needs. The previously underrated live music and merchandising are also increasing their significance for the revenues in the stagnant music markets. Therefore, the music industry is developing at present towards becoming an integrated entertainment industry deeply penetrating every point of modern people’s leisure activities.

Working capital management in the small and medium-sized enterprises Case: Project-based business environment in Flowrox Oy

This Master´s thesis illustrates how growing a business ties up the company´s working capital and what the cost of committed capital. In order to manage a company´s working capital in rapid business growth phase, the thesis suggests that by monitoring and managing the operating and cash conversion cycles of customers´ projects, a company can find ways to secure the required amount of capital. The research method of this thesis was based on literature reviews and case study research. The theoretical review presents the concepts of working capital and provides the background for understanding how to improve working capital management. The company in subject is a global small and medium-sized enterprise that manufactures pumps and valves for demanding process conditions. The company is expanding, which creates lots of challenges. This thesis concentrates to the company´s working capital management and its efficiency through the supply chain and value chain perspective. The main elements of working capital management are inventory management, accounts receivable management and accounts payable management. Prepayments also play a significant role, particularly in project-based businesses. Developing companies´ working capital management requires knowledge from different kind of key operations´ in the company, like purchasing, production, sales, logistics and financing. The perspective to develop and describe working capital management is an operational. After literature reviews the thesis present pilot projects that formed the basis of a model to monitor working capital in the case company. Based on analysis and pilot projects, the thesis introduces a rough model for monitoring capital commitments in short time period. With the model the company can more efficiently monitor and manage their customer projects.

Internet-based breast cancer patient’s pathway as an empowering patient educational tool

This three-phase study was conducted to examine the effect of the Breast Cancer Patient’s Pathway program (BCPP) on breast cancer patients’ empowering process from the viewpoint of the difference between knowledge expectations and perceptions of received knowledge, knowledge level, quality of life, anxiety and treatment-related side effects during the breast cancer treatment process. The BCPP is an Internet-based patient education tool describing a flow chart of the patient pathway during the breast treatment process, from breast cancer diagnostic tests to the follow-up after treatments. The ultimate goal of this study was to evaluate the effect of the BCPP to the breast cancer patient’s empowerment by using the patient pathway as a patient education tool. In phase I, a systematic literature review was carried out to chart the solutions and outcomes of Internet-based educational programs for breast cancer patients. In phase II, a Delphi study was conducted to evaluate the usability of web pages and adequacy of their content. In phase III, the BCPP program was piloted with 10 patients and patients were randomised to an intervention group (n=50) and control group (n=48). According to the results of this study, the Internet is an effective patient education tool for increasing knowledge, and BCPP can be used as a patient education method supporting other education methods. However, breast cancer patients’ perceptions of received knowledge were not fulfilled; their knowledge expectations exceed the perceived amount of received knowledge. Although control group patients’ knowledge expectations were met better with the knowledge they received in hospital compared to the patients in the intervention group, no statistical differences were found between the groups in terms of quality of life, anxiety and treatment-related side effects. However, anxiety decreased faster in the intervention group when looking at internal differences between the groups at different measurement times. In the intervention group the relationship between the difference between knowledge expectations and perceptions of received knowledge correlated significantly with quality of life and anxiety. Their knowledge level was also significant higher than in the control group. These results support the theory that the empowering process requires patient’s awareness of knowledge expectations and perceptions of received knowledge. There is a need to develop patient education to meet patients’ perceptions of received knowledge, including oral and written education and BCPP, to fulfil patient’s knowledge expectations and facilitate the empowering process. Further research is needed on the process of cognitive empowerment with breast cancer patients. There is a need for new patient education methods to increase breast cancer patients’ awareness of knowing.

Quasiclassical Approach to the Vortex State in Iron-based Superconductors

The quasiclassical approach was applied to the investigation of the vortex properties in the ironbased superconductors. The special attention was paid to manifestation of the nonlocal effects of the vortex core structure. The main results are as follows: (i) The effects of the pairing symmetries (s+ and s₊₊) on the cutoff parameter of field distribution, ξh, in stoichiometric (like LiFeAs) and nonstoichiometric (like doped BaFe₂As₂) iron pnictides have been investigated using Eilenberger quasiclassical equations. Magnetic field, temperature and impurity scattering dependences of ξh have been calculated. Two opposite behavior have been discovered. The ξh /ξc2 ratio is less in s+ symmetry when intraband impurity scattering (Γ₀) is much larger than one and much larger than interband impurity scattering (Γπ), i.e. in nonstoichiometric iron pnictides. Opposite, the value ξh /ξc2 is higher in s+ case and the field dependent curve is shifted upward from the "clean" case (Γ₀ = Γπ = 0) for stoichiometric iron pnictides (Γ₀ = Γπ ≪ 1). (ii) Eilenberger approach to the cutoff parameter, ξh, of the field distribution in the mixed state of high

The impact of a new partnership outsourcing arrangement: a routine-based case study in detail engineering

This thesis investigated the contemporary phenomenon of detail engineering outsourcing. The case organization had pursued a new outsourcing approach with a trusted partner. The goal of this empirical study was to examine the impact of the consequential partnership outsourcing arrangement. Particularly, the beneficence of the arrangement was evaluated based on the underlying organizational routine and the long-term economic implications of its performance outcome. The case study was needed, as the unit will likely have to rely on such distance outsourcing arrangements more and more in the future, and understanding on the impact of such operations is needed. The main findings revealed that the new outsourcing arrangement is not currently a very attractive strategic option for organizing production. The benefits which stem from the emerged, unique engineering project routine are not significant enough to make the arrangement an advantageous one, especially since increasing partnering costs are being met. This conclusion was drawn via the extended transaction cost view. Benchmarking was done in reliance to an old arrangement from which the new pursuit was a departure from. The case study then enlightened the engineering unit on the impact of its strategic maneuver by combining the routines-theory framework with contemporary methods of governance structure evaluation. Through this, it was shown that greater efforts are needed to make the new outsourcing approach a more beneficial one. However, the studied arrangement was seen to inhold potential for better results. The findings can be used to capitalize on this.

Yhdessä tuumin kohti turvallisempaa liikkumista : Loimaan seudun liikenneturvallisuussuunnitelma

Loimaan seudun liikenneturvallisuussuunnitelma on laadittu seudun kuntien ja Varsinais-Suomen ELY-keskuksen yhteistyönä. Liikenneturvallisuussuunnitelman tavoitteena on edistää kokonaisvaltaisella tavalla nykyistä vastuullisempaa ja turvallisuushakuisempaa liikkumista seudulla. Suunnitelmassa esitetyillä toimenpiteillä pyritään merkittävästi vähentämään seudulla tapahtuvien liikennekuolemien ja liikenteessä loukkaantuneiden määrää. Tavoitteena on myös edistää nykyistä kestävämpää liikkumista, jolla terveys- ja ympäristövaikutusten ohella on myönteinen vaikutus myös liikenneturvallisuuskehitykseen. Loimaan seudulla tapahtuu vuosittain keskimäärin viisi kuolemaan ja 70 loukkaantumiseen johtanutta onnettomuutta. Asukaslukuun suhteutettuna Loimaan seudulla tapahtuu selvästi enemmän henkilövahinko-onnettomuuksia kuin maakunnassa tai koko maassa keskimäärin. Myös liikenneonnettomuuksien vakavuusaste on maakunnan ja koko maan keskitasoa korkeampi. Kulkutavoittain tarkasteltuna korostuvat erityisesti henkilöauto-onnettomuudet. Liikennekuolemista peräti kolme neljäsosaa on tapahtunut autoilijoille. Ikäryhmittäin tarkasteltuna suurin onnettomuusriski on 15–24-vuotiailla, jotka muodostavat seudun liikenteen uhreista 39 prosenttia (ikäryhmän osuus seudun väestöstä on 11 prosenttia). Liikenneonnettomuuksista aiheutuu seudun kunnille vuosittain lähes kahdeksan miljoonan euron kustannukset – yli 200 euroa asukasta kohden. Nykytilan kuvausten pohjalta ja valtakunnalliset linjaukset huomioiden seudun liikenneturvallisuustyölle on asetettu pitkän aikavälin visio, määrälliset liikenneonnettomuuksien vähentämistavoitteet sekä lähivuosien toimintaa suuntaavat kärkitehtävät. Tavoitteiden mukaan seudun liikennekuolemien määrän tulee vähentyä nykyisestä viidestä hengestä1-2 henkeen vuoteen 2020 mennessä. Loukkaantumisten määrän tulee vähentyä nykyisestä 95 henkilöstä vähintään 71 henkilöön vuoteen 2020 mennessä (-25 %). Suunnitelmassa asetettujen tavoitteiden saavuttamiseen pyritään monipuolisen ja toimien vaikuttavuuden perusteella kohdennetun toimenpidejoukon keinoin sekä kehittämällä eri toimijoiden välistä yhteistyötä ja työnjakoa toimenpiteiden edistämisessä. Suunnitelmassa on esitetty 14 kärkitehtäväkokonaisuutta, joihin toiminta tulee vaikuttavuuden perusteella ensisijaisesti kohdistaa. Suunnitelman vaikutustenarvioinnin perusteella voidaan todeta, että keinot asetettujen tavoitteiden saavuttamiseksi ovat olemassa, mutta tavoitteisiin pääseminen edellyttää erittäin suuria panostuksia kaikilla liikenneturvallisuustyön osa-alueilla, ja erityisesti liikennekäyttäytymiseen ja yhteistyöhön kohdistuvien toimenpiteiden osalta. Liikennekuolemien puolittamisen tavoite nykytasosta vuoteen 2020 on tehtyjen tarkastelujen perusteella mahdollista. Myös loukkaantumisten määrän vähentäminen on saavutettavissa esitetyin toimenpitein.

Family-based dietary intervention in the STRIP study – influences on diet and diet-related attitudes

The focus of this dissertation was to investigate the effects of family-based dietary intervention during childhood and adolescence. The participants comprised of children and parents who participated in a longitudinal, randomised atherosclerosis prevention trial (STRIP study). The intervention families (n=540) took part in a dietary intervention since the child’s age of 8- months. The control group (n=522) did not receive any tailored dietary intervention. The main focus of the intervention was to improve the quality of dietary fat. The diet of children and parents was evaluated by daily food records and dietrelated attitudes by a questionnaire. The dietary intervention influenced, favourably, the dietary fat quality in children and parents. Fat quality improved mainly by the decrease of saturated fat intake. Some minor effects of the intervention were also observed in children’s fruit and vegetable (F&V) consumption although the F&V consumption was very low. The intervention increased parental interest in healthy eating, but there was no difference in interest in natural products or in attitudes towards hedonic eating attitudes between the intervention and control parents. Parents’ interest in healthy eating associated with parents’ and children’s high fruit and vegetable consumption but not with their fat quality ratio. On the other hand, dietary fat quality improved at every level of interest in healthy eating. It seems that the main target of the intervention, the dietary fat quality of the children, was promoted effectively. In the future, more emphasis should be given on increasing unsaturated fat intake and on elevating F&V consumption in children. Children’s diet, especially F&V consumption, associated with diet-related attitudes of the parents. Therefore, co-operation with parents and family-based premises for working should be capitalized upon when promoting healthy eating in children and adolescents.

The Effects of Service Quality, Customer Satisfaction and Customer Perceived Value on Behavioral Intentions

The intent of this research was to develop a model that describes the extent to which customer behavioral intentions are influenced by service quality, customer satisfaction and customer perceived value in the business-to-business service context. Research on customer behavioral intentions is quite fragmented and no generalized model has been presented. Thus, there was need for empirical testing. This study builds on the services marketing theory and assesses the relationships between the identified constructs. The data for the empirical analysis was collected via a quantitative online survey and a total of 226 usable responses were obtained for further analysis. The model was tested in an employment agency service setting. The measures used in this survey were first assessed by using confirmatory factor analysis (CFA) after which the hypothesized relationships were further verified using structural equation modeling (SEM) in LISREL 8.80. The analysis identified that customer satisfaction played a pivotal role in the model as it was the only direct antecedent of customer behavioral intentions, however, customer perceived value showed a strong indirect impact on buying intentions via customer satisfaction. In contrast to what was hypothesized, service quality and customer perceived value did not have a direct positive effect on behavioral intentions. Also, a contradicting finding with current literature was that sacrifice was argued to have a direct but positive impact on customer perceived value. Based on the findings in this study, managers should carefully think of their service strategies that lead to their customers’ favorable behavioral intentions.

Organisational learning and knowledge acquisition. A case study of internationalising manufacturers of wood-based prefabricated buildings

The study investigates organisational learning and knowledge acquisition of wood-based prefabricated building manufacturers. This certain group of case companies was chosen, because their management and their employees generally have a strong manufacturing and engineering background, while the housing sector is characterised by national norms, regulations, as well as local building styles. Considering this setting, it was investigated, how the case companies develop organisational learning capabilities, acquire and transfer knowledge for their internationalisation. The theoretical framework of this study constitutes the knowledge-based conceptualisation of internationalisation, which combines the traditional internationalisation process, as well as the international new venture perspective based on their commonalities in the knowledge-based view of the firm. Different theories of internationalisation, including the network-perspective, were outlined and a framework on organisational learning and knowledge acquisition was established. The empirical research followed a qualitative approach, deploying a multiple-case study with five case companies from Austria, Finland and Germany. In the study, the development of the wood-based prefabricated building industry and of the case companies are described, and the motives, facilitators and challenges for foreign expansion, as well as the companies’ internationalisation approaches are compared. Different methods of how companies facilitate the knowledge-exchange or learn about new markets are also outlined. Experience, market knowledge and personal contacts are considered essential for the internationalisation process. The major finding of the study is that it is not necessary to acquire the market knowledge internally in a slow process as proposed by the Uppsala model. In four cases companies engaged knowledge in symbiotic relations with local business partners. Thereby, the building manufacturers contribute their design and production capabilities, and in return, their local partners provide them with knowledge about the market and local regulations; while they manage the sales and construction operations. Thus, the study provides strong evidence for the propositions of network perspective. One case company developed the knowledge internally in a gradual process: it entered the market sequentially with several business lines, showing an increasing level of complexity. In both of the observed strategies, single-loop and double-loop learning processes occurred.

Microstructural and environmental effects on the mechanical properties of porous particle-polymer composites

Papper kan anses vara ett av de mest använda materialen i det dagliga livet. Tidskrifter, tidningar, böcker och diverse förpackningar är några exempel på pappersbaserade produkter. Papperets egenskaper måste anpassas till användningsändamålet. En tidskrift kräver t.ex. hög ljushet, opacitet och en slät yta hos papperet, medan dessa egenskaper är mindre viktiga för en dagstidning. Allt tryckpapper behöver vissa mekaniska egenskaper för att tåla vidarebearbetning såsom kalandrering, tryckning och vikning. Man kan bestryka papper för att förbättra dess optiska egenskaper och tryckbarhetsegenskaper. Vid bestrykning appliceras en dispersion av mineralpigment och polymerbindemedel som ett tunt lager på papperets yta. Bestrykningsskiktet kan ses som ett komplext, poröst kompositmaterial som även bidrar till papperets mekaniska egenskaper och dess processerbarhet i diverse konverteringsoperationer. Kravet på framställning av förmånligt papper med tillräckliga styrkeegenskaper ställer allt högre krav på optimeringen av pappersbestrykningsskiktets egenskaper och produktionskostnader. Målet med detta arbete var att förstå sambandet mellan pigmentbestrykningsskiktets mikrostruktur och dess makroskopiska, mekaniska egenskaper. Resultaten visar att adhesionen i gränsytan mellan pigment och bindemedel är kritisk för bestrykningsskiktets förmåga att bära mekanisk belastning. Polära vätskor är vanliga i tryckfärger och kan, eftersom de påverkar syra/bas-interaktionerna mellan pigment och latexbindemedel, försvaga denna adhesion. Resultaten tyder på att ytstyrkan hos bestruket papper kan höjas genom användning av bifunktionella dispergeringsmedel för mineralpigment. Detta medför inbesparingar i pappersproduktionen eftersom mängden bindemedel, den dyraste komponenten i bestrykningsskiktet, kan minskas.

The Effects of Estradiol, Androgens and the Selective Estrogen Modulators: Ospemifene, Raloxifene and Tamoxifen on Explant Cultures of Human Breast Tissue

The impact of menopausal hormone therapy (MHT) on increasing the risk for breast cancer (BC) remains controversial. To understand MHT-elicited cellular breast effects and the potential risks, included with using this therapy, a further investigation into this controversy is the subject of this thesis. In this thesis, to study the effects of estrogen, progestin, androgens and selective estrogen receptor modulators (SERMs), a modified tissue explant culture system was used. The different types of human breast tissues (HBTs) used in this study were normal HBTs, obtained from reduction mammoplasties of premenopausal women (prem-HBTs) or postmenopausal (postm-HBTs) women and peritumoral HBTs (peritum-HBTs) which were obtained from surgeries on postmenopausal BC patients. The explants were cultured up to three weeks in the presence or absence of estradiol (E2), medroxyprogesterone acetate (MPA), testosterone (T), dihydrotestosterone (DHT) and SERMs - ospemifene (OSP), raloxifene (RAL) and tamoxifen (TAM). The cultured HBTs maintained morphological integrity and responded to hormonal treatment in vitro. E2, MPA or E2/MPA increased proliferative activity and was associated with increased cyclin-D1 and caused changes in the cell cycle inhibitors p21 and p27, whereas the androgens T and DHT inhibited proliferation and increased apoptosis in HBT epithelia and opposed E2-stimulated proliferation and cell survival. The postm-HBTs were more sensitive to E2 than prem-HBTs. The effects of OSP, RAL and TAM on HBT epithelium were antiproliferative. E2, androgens and SERMs were associated with marked changes in the proportions of epithelial cells expressing steroid hormone receptors: E2 increased ERα expressing cells and decreased androgen receptor (AR) positive cells, whereas T and DHT had opposite effects. The OSP, RAL and TAM, also decreased a proportion of ERα positive cells in HBT epithelium. At 100 nM, these compounds maintained the relative number of AR positive cells, present at control level, which may partly explain proliferative inhibition. In conclusion, the proliferative activity of E2, in the epithelium of postm-HBTs, is opposed by T and DHT, which suggests that the inclusion of androgens in MHT may decrease the risk for developing BC.

Effects of Socioeconomic Status and Sociodemographic Features on Cardiovascular Disease. Mortality and Morbidity in Finland

Despite declining trends in morbidity and mortality, cardiovascular diseases have a considerable impact on Finnish public health. A goal in Finnish health policy is to reduce inequalities in health and mortality among population groups. The aim of this study was to assess inequalities in cardiovascular diseases according to socioeconomic status (SES), language groups and other sociodemographic characteristics. The main data source was generated from events in 35-99 year-old men and women registered in the population-based FINMONICA and FINAMI myocardial infarction registers during the years ranging from 1988-2002. Information on population group characteristics was obtained from Statistics Finland. Additional data were derived from the FINMONICA and FINSTROKE stroke registers and the FINRISK Study. SES, measured by income level, was a major determinant of acute coronary syndrome (ACS) mortality. Among middle-aged men, the 28-day mortality rate of the lowest group of six income groups was 5.2 times and incidence 2.7 times as high when compared to the highest income group. Among women, the differences were even larger. Among the unmarried, the incidence of ACS was approximately 1.6 times as high and their prognosis was significantly worse than among married persons - both in men and women and independent of age. Higher age-standardized attack rates of ACS and stroke were found among Finnish-speaking compared to Swedish-speaking men in Turku and these differences could not be completely explained by SES. In these language groups, modest differences were found in traditional risk factor levels possibly explaining part of the found morbidity and mortality inequality. In conclusion, there are considerable differences in the morbidity and mortality of ACS and stroke between socioeconomic and sociodemographic groups, in Finland. Focusing measures to reduce the excess morbidity and mortality, in groups at high risk, could decrease the economic burden of cardiovascular diseases and thus be an important public health goal in Finland.

Training executive functions in the laboratory and in real life : cognitive consequences of computer-based exercises and bilingualism

The question of the trainability of executive functions and the impact of such training on related cognitive skills has stirred considerable research interest. Despite a number of studies investigating this, the question has not yet been solved. The general aim of this thesis was to investigate two very different types of training of executive functions: laboratory-based computerized training (Studies I-III) and realworld training through bilingualism (Studies IV-V). Bilingualism as a kind of training of executive functions is based on the idea that managing two languages requires executive resources, and previous studies have suggested a bilingual advantage in executive functions. Three executive functions were studied in the present thesis: updating of working memory (WM) contents, inhibition of irrelevant information, and shifting between tasks and mental sets. Studies I-III investigated the effects of computer-based training of WM updating (Study I), inhibition (Study II), and set shifting (Study III) in healthy young adults. All studies showed increased performance on the trained task. More importantly, improvement on an untrained task tapping the trained executive function (near transfer) was seen in Study I and II. None of the three studies showed improvement on untrained tasks tapping some other cognitive function (far transfer) as a result of training. Study I also used PET to investigate the effects of WM updating training on a neurotransmitter closely linked to WM, namely dopamine. The PET results revealed increased striatal dopamine release during WM updating performance as a result of training. Study IV investigated the ability to inhibit task-irrelevant stimuli in bilinguals and monolinguals by using a dichotic listening task. The results showed that the bilinguals exceeded the monolinguals in inhibiting task-irrelevant information. Study V introduced a new, complementary research approach to study the bilingual executive advantage and its underlying mechanisms. To circumvent the methodological problems related to natural groups design, this approach focuses only on bilinguals and examines whether individual differences in bilingual behavior correlate with executive task performances. Using measures that tap the three above-entioned executive functions, the results suggested that more frequent language switching was associated with better set shifting skills, and earlier acquisition of the second language was related to better inhibition skills. In conclusion, the present behavioral results showed that computer-based training of executive functions can improve performance on the trained task and on closely related tasks, but does not yield a more general improvement of cognitive skills. Moreover, the functional neuroimaging results reveal that WM training modulates striatal dopaminergic function, speaking for training-induced neural plasticity in this important neurotransmitter system. With regard to bilingualism, the results provide further support to the idea that bilingualism can enhance executive functions. In addition, the new complementary research approach proposed here provides some clues as to which aspects of everyday bilingual behavior may be related to the advantage in executive functions in bilingual individuals.