Molecular Genetics of Age-related Macular Degeneration

Age-related macular degeneration (AMD; OMIM # 603075) is an eye disease of the elderly, signs of which appear after the age of 50. In the Western world it is a leading cause of permanent visual loss with a prevalence of 8.5% in persons under 54 years of age and of 37% in persons over 75 years of age. Early forms of AMD may be asymptomatic, but in the late forms usually a central scotoma in the visual field follows severely complicating daily tasks. Smoking, age, and genetic predisposition are known risk factors for AMD. Until recently no true susceptibility genes had been identified though the composition of drusen deposits, the hallmarks of AMD, has suggested that the complement system might play a role in the pathogenesis of AMD. When four groups reported in March 2005, that, on chromosome 1q32, a Y402H variant in the complement factor H (CFH) gene confers risk for AMD in independent Caucasian samples, a new period in the field of genetic research of AMD started. CFH is a key regulator of the complement system. Thus, it is logical to speculate, that it plays a role in the pathogenesis of AMD. We performed a case-control association study to analyse whether the CFH Y402H variant contain a risk for AMD in the Finnish population. Although the population of Finland represents a genetic isolate, the CFH Y402H polymorphism was associated with AMD also in our patient sample with similar risk allele frequencies as in the other Caucasian populations. We further evaluated the effects of this variant, but no association between lesion subtype (predominantly classic, minimally classic or occult lesion) or lesion size of neovascular AMD and the CFH Y402H variant was detected. Neither did the variant have an effect on the photodynamic therapy (PDT) outcome. The patients that respond to PDT carried the risk genotype as frequently as those who did not respond, and no difference was found in the number of PDT sessions needed in patients with or without the risk genotypes of CFH Y402H. Functional analyses, however, showed that the binding of C-reactive protein (CRP) to CFH was significantly reduced in patients with the risk genotype of Y402H. In the past two years, the LOC387715/ high-temperature requirement factor A1 (HTRA1) locus on 10q26 has also been repeatedly associated with AMD in several populations. The recent discovery of the LOC387715 protein on the mitochondrial outer membrane suggests that the LOC387715 gene, not HTRA1, is the true predisposing gene in this region, although its biological function is still unknown. In our Finnish patient material, patients with AMD carried the A69S risk genotype of LOC387715 more frequently than the controls. Also, for the first time, an interaction between the CFH Y402H and the LOC387715 A69S variants was found. The most recently detected susceptibilty gene of AMD, the complement component 3 (C3) gene, encodes the central component of the complement system, C3. In our Finnish sample, an additive gene effect for the C3 locus was detected, though weaker than the effects for the two main loci, CFH and LOC387715. Instead, the hemicentin-1 or the elongation of very long chain fatty acids-like 4 genes that have also been suggested as candidate genes for AMD did not carry a risk for AMD in the Finnish population. This was the first series of molecular genetic study of AMD in Finland. We showed that two common risk variants, CFH Y402H and LOC387715 A69S, represent a high risk of AMD also in the isolated Finnish population, and furthermore, that they had a statistical interaction. It was demonstrated that the CFH Y402H risk genotype affects the binding of CFH to CRP thus suggesting that complement indeed plays an important role in the pathogenesis of AMD.

The development and preliminary evaluation of an education intervention to prevent driveway run-over incidents

Objective While driveway run-over incidents continue to be a cause of serious injury and deaths among young children in Australia, few empirically evaluated educational interventions have been developed which address these incidents. Addressing this gap, this study describes the development and evaluation of a paper-based driveway safety intervention targeting caregivers of children aged 5 years or younger. Design Cross-sectional survey. Method and setting Informed by previous research, the intervention targeted key caregiver safety behaviours that address driveway risks. To assess the impact of the intervention, 137 Queensland (Australia) caregivers (95.0% women; mean age = 34.97 years) were recruited. After receiving the intervention, changes to a number of outcomes such as caregiver risk perception, safety knowledge and behavioural intentions were measured. Results Findings indicated that the intervention had increased general and specific situational risk awareness and safety knowledge among a substantial proportion of participants. Close to one-quarter of the sample strongly agreed that the intervention had increased these outcomes. In addition, 71.6% of the sample reported that they intended to make changes to their routine in and around the driveway, as a result of reading the intervention material and a further, quarter of the participants strongly agreed that the information provided would be a help both to themselves (26.5%) and other caregivers (33.8%) to keep their children safe in the driveway. Conclusion: While the educational intervention requires further validation, findings from this study suggest that intervention content and format increases driveway safety.

Transport-related fatalities and injuries leading to hospitalisation in pre-school children

Pre-school children grow and develop rapidly with age and their changing capabilities are reflected in the ways in which they are injured. Using coded and textual descriptions of transport-related injuries in children under five years of age from the Queensland Injury Surveillance Unit (QISU) this paper profiles the modes of such injuries by single year of age. The QISU collects information on all injury presentations to emergency department in hospitals throughout Queensland using both coded information and textual description. Almost all transport-related injuries in children under one year are due to motor vehicle crashes but these become proportionately less common thereafter, while injuries while cycling become proportionately more common with age. Slow-speed vehicle runovers peak at age one year but occur at all ages in the range. Bicycle-related fatalities are rare in this age group. If bicycle-related injuries are excluded, the profiles of fatal and non-fatal injuries are broadly similar. Comparison with a Queensland hospital series suggests that these results are broadly representative.

Older male and female drivers in car-dependent settings: How much do they use other modes, and do they compensate for reduced driving to maintain mobility?

Among the societal and health challenges of population ageing is the continued transport mobility of older people who retain their driving licence, especially in highly car-dependent societies. While issues surrounding loss of a driving licence have been researched, less attention has been paid to variations in physical travel by mode among the growing proportion of older people who retain their driving licence. It is unclear how much they reduce their driving with age, the degree to which they replace driving with other modes of transport, and how this varies by age and gender. This paper reports research conducted in the state of Queensland, Australia, with a sample of 295 older drivers (>60 years). Time spent driving is considerably greater than time spent as a passenger or walking across age groups and genders. A decline in travel time as a driver with increasing age is not redressed by increases in travel as a passenger or pedestrian. The patterns differ by gender, most likely reflecting demographic and social factors. Given the expected considerable increase in the number of older women in particular, and their reported preference not to drive alone, there are implications for policies and programmes that are relevant to other car-dependent settings. There are also implications for the health of older drivers, since levels of walking are comparatively low.

The psychometric properties of the Kessler Psychological Distress Scale (K6) in a general population sample of adolescents

The 6-item Kessler Psychological Distress Scale (K6; Kessler et al., 2002) is a screener for psychological distress that has robust psychometric properties among adults. Given that a significant proportion of adolescents experience mental illness, there is a need for measures that accurately and reliably screen for mental disorders in this age group. This study examined the psychometric properties of the K6 in a large general population sample of adolescents (N = 4,434; mean age = 13.5 years; 44.6% male). Factor analyses were conducted to examine the dimensionality of the K6 in adolescents and to investigate sex-based measurement invariance. This study also evaluated the K6 as a predictor of scores on the Strengths and Difficulties Questionnaire (SDQ; Goodman, 1997). The K6 demonstrated high levels of internal consistency, with the 6 items loading primarily on 1 factor. Consistent with previous research, females reported higher mean levels of psychological distress when compared with males. The identification of sex-based measurement noninvariance in the item thresholds indicated that these mean differences most likely represented reporting bias in the K6 items rather than true differences in the underlying psychological distress construct. The K6 was a fair to good predictor of abnormal scores on the SDQ, but predictive utility was relatively low among males. Future research needs to focus on refining and augmenting the K6 scale to maximize its utility in adolescents. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

Young love: Romantic concerns and associated mental health issues among adolescent help-seekers

Over 50% of young people have dated by age 15. While romantic relationship concerns are a major reason for adolescent help-seeking from counselling services, we have a limited understanding of what types of relationship issues are most strongly related to mental health issues and suicide risk. This paper used records of 4019 counselling sessions with adolescents (10–18 years) seeking help from a national youth counselling service for a romantic relationship concern to: (i) explore what types and stage (pre, during, post) of romantic concerns adolescents seek help for; (ii) how they are associated with mental health problems, self-harm and suicide risk; and (iii) whether these associations differ by age and gender. In line with developmental-contextual theory, results suggest that concerns about the initiation of relationships are common in early adolescence, while concerns about maintaining and repairing relationships increase with age. Relationship breakups were the most common concern for both male and female adolescents and for all age groups (early, mid, late adolescence). Data relating to a range of mental health issues were available for approximately half of the sample. Post-relationship concerns (including breakups) were also more likely than pre- or during-relationship concerns to be associated with concurrent mental health issues (36.8%), self-harm (22.6%) and suicide (9.9%). Results draw on a staged developmental theory of adolescent romantic relationships to provide a comprehensive assessment of relationship stressors, highlighting post-relationship as a particularly vulnerable time for all stages of adolescence. These findings contribute to the development of targeted intervention and support programs.

Growing Up Vietnamese in Finland - Looking Back 12 Years Later : The Well-Being and Sociocultural Adaptation of Vietnamese as Children or Adolescents and as Young Adults

Varttuminen vietnamilaisena Suomessa: 12 vuoden seurantajakso – Vietnamilaisten hyvinvointi ja sosiokulttuurinen sopeutuminen lapsena/nuorena sekä nuorena aikuisena Tämä tutkimus oli määrällinen pitkittäistutkimus lapsena tai nuorena vuosina 1979-1991 Suomeen saapuneiden vietnamilaisten akkulturaatiosta (kulttuurin muutoksista), psyykkisestä hyvinvoinnista ja sosiokulttuurisesta sopeutumisesta. Tutkimukseen osallistui ensimmäisessä vaiheessa (vuonna 1992) 97 satunnaisesti valittua vietnamilaista peruskoululaista ympäri maata, joita verrattin suomalaisiin luokkatovereihin. Seurantavaiheeseen (vuonna 2004) osallistui 59 ensimmäisessä vaiheessa mukana ollutta vietnamilaista, nyt iältään 20 – 31 -vuotiaita. Tutkimuksen tavoitteena oli selvittää mitkä tekijät ennustivat akkulturaation lopputuloksia, samalla huomioiden iän ja ympäristön (kontekstin) vaikutukset psyykkiseen hyvinvointiin ja sosiokulttuuriseen sopeutumiseen. Yksittäiset akkulturaatiodimensiot (kieli, arvot ja identiteetti) osoittautuivat tärkeämmiksi psyykkiselle hyvinvoinnille ja sosiokulttuuriselle sopeutumiselle kuin etniset, kansalliset tai kaksikulttuuriset profiilit, joissa yhdistyivät ao. kieli, arvot ja identiteetti. Identiteettimuutosta tapahtui (etniseen) vietnamilaiseen suuntaan ajan kuluessa, kun taas arvomuutosta tapahtui (kansalliseen) suomalaiseen suuntaan. Sekä suomen että vietnamin kielen taito lisääntyivät ajan myötä, millä oli myönteisiä vaikutuksia sekä psyykkiseen hyvinvointiin että sosiokulttuuriseen sopeutumiseen. Lähtötilanteen psyykkinen hyvinvointi ennusti hyvinvointia (masennuksen puutetta ja itsetuntoa) aikuisena, mutta sosiokulttuurinen sopeutuminen (koulumenestys) lapsena tai nuorena ei ennustanut kouluttautumista aikuisena. Parempi suomen kielen taito ja vähemmän identifioitumista suomalaiseksi aikuisena sekä masentuneisuuden puute ja vähemmän koettua syrjintää lapsena tai nuorena erottelivat psyykkisesti paremmin voivat aikuiset (ei-masentuneet) heistä, jotka olivat masentuneita. Parempaa kouluttautumista aikuisena ennustivat toisaalta vähemmän koettua syrjintää lapsena tai nuorena ja toisaalta aikuisena parempi suomen kielen taito, suurempi kansallisten (suomalaisten) itsenäisyysarvojen kannattaminen, mutta kuitenkin vähemmän identifioitumista suomalaisiin. Koetun syrjinnän merkitys psyykkiselle hyvinvoinnille, erityisesti lapsena tai nuorena, sekä sen pitkäaikaisvaikutukset psyykkiselle hyvinvoinnille ja sosiokulttuuriselle sopeutumiselle aikuisena osoittavat tarpeen puuttua varhain psyykkisiin ongelmiin sekä parantaa etnisten ryhmien välisiä suhteita. Avainsanat: akkulturaatio, psyykkinen hyvinvointi, sosiokultuurinen sopeutuminen, kieli, arvot, identiteetti, vietnamilainen, Suomi, lapset, nuoret, nuoret aikuiset

Predicting crashes using traffic offences. A meta-analysis that examines potential bias between self-report and archival data

Background Traffic offences have been considered an important predictor of crash involvement, and have often been used as a proxy safety variable for crashes. However the association between crashes and offences has never been meta-analysed and the population effect size never established. Research is yet to determine the extent to which this relationship may be spuriously inflated through systematic measurement error, with obvious implications for researchers endeavouring to accurately identify salient factors predictive of crashes. Methodology and Principal Findings Studies yielding a correlation between crashes and traffic offences were collated and a meta-analysis of 144 effects drawn from 99 road safety studies conducted. Potential impact of factors such as age, time period, crash and offence rates, crash severity and data type, sourced from either self-report surveys or archival records, were considered and discussed. After weighting for sample size, an average correlation of r = .18 was observed over the mean time period of 3.2 years. Evidence emerged suggesting the strength of this correlation is decreasing over time. Stronger correlations between crashes and offences were generally found in studies involving younger drivers. Consistent with common method variance effects, a within country analysis found stronger effect sizes in self-reported data even controlling for crash mean. Significance The effectiveness of traffic offences as a proxy for crashes may be limited. Inclusion of elements such as independently validated crash and offence histories or accurate measures of exposure to the road would facilitate a better understanding of the factors that influence crash involvement.

ACE Research Vignette 051: How and Why is Small Business Managers’ Age Related To Business Growth?

This series of research vignettes is aimed at sharing current and interesting research findings from our team of international entrepreneurship researchers. This vignette, written by Professor Hannes Zacher, Professor Michael M. Gielnik and Dr Antje Schmitt, reports findings on relationships between small business managers’ age, their focus on opportunities, and business growth (sales and number of employees) over five years.

A “business researcher” view on opportunities for psychology in entrepreneurship research

In this short essay I offer some “business researcher” advice on how to leverage a strong background in psychology when attempting to contribute to the maturing field of “entrepreneurship research”. Psychologists can benefit from within-discipline research, e.g. on emergence, small groups, fit, and expertise as well as method strengths in, e.g. experimentation, operationalisation of constructs, and multi-level modelling. However, achieving full leverage of these strengths requires a clear conceptualisation of “entrepreneurship” as well as insights into the challenges posed by the nature of this class of phenomena.

How small business managers’ age and focus on opportunities affect business growth: A mediated moderation growth model

Research on business growth has been criticized for methodological weaknesses. We present a mediated moderation growth model as a new methodological approach. We hypothesized that small business managers' age negatively affects business growth through focus on opportunities. We sampled 201 small business managers and obtained firm performance data over 5 years, resulting in 836 observations. Growth modeling showed systematic differences in firm performance trajectories. These differences could be explained by modeling focus on opportunities as a mediator of the relationship between small business managers' age and business growth. The study illustrates how mediation models can be tested using growth modeling.

Eron aika : Tyttärien kertomuksia ikääntyneen vanhemman kuolemasta

There is a relative absence of sociological and cultural research on how people deal with the death of a family member in the contemporary western societies. Research on this topic has been dominated by the experts of psychology, psychiatry and therapy, who mention the social context only in passing, if at all. This gives an impression that the white westerners bereavement experience is a purely psychological phenomenon, an inner journey, which follows a natural, universal path. Yet, as Tony Walter (1999) states, ignoring the influence of culture not only impoverishes the understanding of those work with bereaved people, but it also impoverishes sociology and cultural studies by excluding from their domain a key social phenomenon. This study explores the cultural dimension of grief through narratives told by fifteen of recently bereaved Finnish women. Focussing on one sex only, the study rests on the assumption of the gendered nature of bereavement experience. However, the aim of the study is not to pinpoint the gender differences in grief and mourning, but to shed light on women s ways of dealing with the loss of a loved one in a social context. Furthermore, the study focuses on a certain kind of loss: the death of an elderly parent. Due to the growth in the life expectancy rate, this has presumably become the most typical type of bereavement in contemporary, ageing societies. Most of population will face the death of a parent as they reach the middle years of the life course. The data of this study is gathered with interviews, in which the interviewees were invited to tell a narrative of their bereavement. Narrative constitutes a central concept in this study. It refers to a particular form of talk, which is organised around consequential events. But there are also other, deeper layers that have been added to this concept. Several scholars see narratives as the most important way in which we make sense of experience. Personal narratives provide rich material for mapping the interconnections between individual and culture. As a form of thought, narrative marries singular circumstances with shared expectations and understandings that are learned through participation in a specific culture (Garro & Mattingly 2000). This study attempts to capture the cultural dimension of narrative with the concept of script , which originates in cognitive science (Schank & Abelson 1977) and has recently been adopted to narratology (Herman 2002). Script refers to a data structure that informs how events usually unfold in certain situations. Scripts are used in interpreting events and representing them verbally to others. They are based on dominant forms of knowledge that vary according to time and place. The questions that were posed in this study are the following. What kind of experiences bereaved daughters narrate? What kind of cultural scripts they employ as they attempt to make sense of these experiences? How these scripts are used in their narratives? It became apparent that for the most of the daughters interviewed in this study the single most important part of the bereavement narrative was to form an account of how and why the parent died. They produced lengthy and detailed descriptions of the last stage of a parent s life in contrast with the rest of the interview. These stories took their start from a turn in the parent s physical condition, from which the dying process could in retrospect be seen to have started, and which often took place several years before the death. In addition, daughters also talked about their grief reactions and how they have adjusted to a life without the deceased parent. The ways in which the last stage of life was told reflect not only the characteristic features of late modernity but also processes of marginalisation and exclusion. Revivalist script and medical script, identified by Clive Seale as the dominant, competing models for dying well in the late modern societies, were not widely utilised in the narratives. They could only be applied in situations in which the parent had died from cancer and at somewhat younger age than the average. Death that took place in deep old age was told in a different way. The lack of positive models for narrating this kind of death was acknowledged in the study. This can be seen as a symptom of the societal devaluing of the deaths of older people and it affects also daughters accounts of their grief. Several daughters told about situations in which their loss, although subjectively experienced, was nonetheless denied by other people.

Basic Human Values in the Workplace

Työntekijöiden henkilökohtaisia arvoja ja niiden yhteyksiä asenteisiin ei ole juuri tutkittu. Tämän tutkimuksen tavoitteena oli selvittää, onko suomalaisessa metalliteollisuuden yrityksen henkilöstön (N=1314) arvojen rakenne S. H. Schwartzin arvoteorian mukainen. Lisäksi tutkittiin arvojen yhteyksiä organisaatiomuutosta koskeviin asenteisiin ja tiedon jakamiseen työyhteisössä. Arvomittarina käytettiin uutta 40-osioista Portrait Value Questionnairea (PVQ). Mittarin validiteetti osoitettiin ver-taamalla nyt kerätyn aineiston arvorakennetta aikaisemmalla mittarilla kerättyihin arvoteorian mukaisiin yliopisto-opiskelijoiden vastauksiin. Organisaatiomuutosta koskevien asenteiden ja tiedonjakamisen mittarit luotiin laadullisissa esitutkimuksissa. Tilastolliset analyysit osoittivat, että toimihenkilöiden ja työntekijöiden arvojen rakenteet noudattivat pääosin Schwartzin teoriaa, mutta turvallisuusarvot sijaitsivat molemmissa ryhmissä universalismin ja hyväntahtoisuuden joukossa. Universalismi ja hyväntahtoisuus ennustivat myönteistä asennetta organisaatiomuutoksia kohtaan, mutta perinteiden ja mielihyvän arvostaminen liittyivät kielteisiin muutosasenteisiin. Sosiaalisia normeja kunnioittavien eli yhdenmukaisuutta arvostavien henkilöiden muut arvot vaikuttivat muutosasenteisiin vähemmän kuin niillä, joille yhdenmukaisuus ei ollut tärkeää. Lisäksi suoriutumisarvon yhteys muutosasenteisiin oli yhdenmukaisuutta arvostavilla henkilöillä positiivinen, mutta niillä, jotka eivät arvostaneet yhdenmukaisuutta, yhteys oli negatiivinen. Itseohjautuvuutta arvostavat henkilöt pitivät työyhteisönsä tiedon jakamista heikompana, kun taas hyväntahtoisuutta ja yhdenmukaisuutta arvostavat pitivät sitä muihin nähden parempana. Suoriutumisarvo oli yhteydessä tiedonjakamiseen vain silloin, kun yhdenmukaisuus oli tärkeää. Työpaikkojen (N=19) keskiarvoja vertailtaessa havaittiin, että ne työpaikat, joissa arvostettiin paljon universalismia, hyväntahtoisuutta ja yhdenmukaisuutta sekä vähän valtaa ja suoriutumista saivat henkilöstöltään parhaat arvioinnit tiedon jakamisesta. Tutkimukseen osallistuneet henkilöt jaettiin työtehtäviensä perusteella kolmeen ammatilliseen ympäristöön: konven-tionaaliseen (mm. taloushallinto), realistiseen (mm. tuotanto) ja yrittäjämäiseen (mm. myynti). Yrittäjämäisessä ammatillisessa ympäristössä toimivat arvostivat enemmän kuin konventionaalisessa ympäristössä toimivat valtaa, itseohjautuvuutta ja suoriutumista. Realistisessa ympäristössä arvostettiin enemmän perinteitä ja mielihyvää kuin yrittäjämäisessä ympäristössä. Ryhmien väliset erot arvoissa johtuivat koulutuksesta, iästä ja sukupuolijakaumasta.

Kansallinen identiteetti ja suomalaiseksi samastuminen

National identity is a general, more or less shared meaning structure. Those who share it, identify with a nation according to their beliefs of what national identity consists of. The present study examined the Finnish national identity in relation to other spatial identities, such as local or European identity. Data were drawn from a sample of 179 respondents who represented the adult population in the year 1993. The focus was on the representation of the Finnish national identity, the limits and components of this identity, and on the position of national identification among all human identifications. Categorization, the basic process in the construction of national identity, consists of inclusion and exclusion. Different forms of identification could be distinguished along with different contents. Discrimination and derogation of outgroups were associated with identification that emphasized inter-nation comparison and framed identity in an essentialistic and thus exclusionary way. The contents of national identity were examined using a quantitative word-assessment method, and related to different forms of identification. With regard to Finnish identification, few differences between age, educational or SES groups were found. Despite the lack of differences in the strength of Finnish identification, those with more education to a greater extent relativized their Finnishness. Those who held positive attitudes to immigrants associated Finnishness with both positive and negative traits. Pro-immigrant attitude was related to an emphasis on cultural Finnishness and a de-emphasis on comparative and status-oriented Finnishness. Among the respondents with lower level of education, the emphasis on cultural Finnishness clearly predicted pro-immigrant attitudes. Those who did not produce any spontaneous response to a request to define Finnishness were more likely to be anti-immigrant. Thus, reflexive self-understanding implies openness towards other nationalities. Changes in the representation of Finnishness are suggested by differential weights given by respondents to different aspects of the national identity. Older respondents regarded the moral-anthropomorphic aspects of identity as more important. The younger respondents felt relatively more Finnish in the company of foreigners than did the older generations, to whom being with friends and in other close relationships stood out as contexts of national identification. The aspect of identity which is based on categorization and comparison could be called identity for others. The other aspect of the national identity is identity for ourselves, which emphasizes self and cultural self-understanding. A modern marketing oriented “image-of-Finland” identity represents identity for others.

Sikiöaikana päihteille altistuneiden lasten kasvuympäristö ja kehitys

Life of children exposed to alcohol or drugs in utero This study focused on the growth environment, physical development and socio-emotional development of children, aged 16 and under, who had been exposed to alcohol (n=78) or drugs (n=15) in utero. The aim of the study was to obtain a comprehensive picture of the living conditions of these children and to examine the role of the growth environment in their development. The study was carried out using questionnaires, written life stories and interviews. Attachment theory was used as a background theory in the study. Over half of the children exposed to alcohol were diagnosed with foetal alcohol syndrome (FAS), one quarter was diagnosed with foetal alcohol effects (FAE), and one fifth had no diagnosis. Most of the children exposed to drugs had been exposed to either amphetamines or cannabis, and a smaller number to heroin. Some of the children exposed to alcohol were mentally handicapped or intellectually impaired. The children exposed to drugs did not exhibit any serious learning difficulties but a considerable number of them had socio-emotional development problems. Language and speech problems and attention, concentration and social interaction problems were typical among both the children exposed to alcohol and those exposed to drugs. Only one child had been placed into long-term foster care in a family immediately after leaving the maternity hospital. In biological families there had been neglect, violence, mental health problems, crime and unemployment, and many parents were already dead. Two of the children had been sexually abused and four were suspected of having been abused. From the point of view of the children's development, the three most critical issues were 1) the range of illnesses and handicaps that had impaired their functional capacity as a result of their prenatal exposure to alcohol, 2) child's age at the time of placement on a long-term basis, and 3) the number of their traumatic experiences. The relationship with their biological parents after placement also played a role. Children with symptoms were found in all diagnosis categories and types of exposure. Children with the smallest number of symptoms were found among those who had never lived with their biological parents. Almost all children were exhibiting strong symptoms at the time of placement in foster care. In most cases, they were behaving in a disorderly manner towards others, but some children were withdrawn. The most conspicuous feature among those with the most severe symptoms was their disorganized behaviour. Placement in a foster family enhanced the children's development, but did not solve the problems. The foster parents who brought these children up did not receive as much therapy for the children and support for the upbringing as they appear to have needed. In Finland, transfer to long-term custody is based on strict criteria. The rights of children prescribed in the child protection law are not fulfilled in practice. Key words: FASD, FAS, FAE, alcohol exposure, drugs exposure, illegal drugs, early interaction, child development, attachment