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(2020)Kuulojärjestelmä suorittaa jatkuvasti ääniympäristön valvontaa, joka tapahtuu valikoivan tarkkaavaisuuden suunnasta riippumatta. Oleellinen osa tätä valvontaa on rekisteröidä äänet, jotka ovat joillain tavoilla muista poikkeavia. Poikkeukset voivat olla signaali merkittävästä muutoksesta ympäristössä. Jotta tämän toiminnon suorittaminen olisi mahdollista, on kuulojärjestelmässä oltava hermostollinen mekanismi, joka tallentaa muistiin ennusteen ympäristössä esiintyvistä äänistä. Tässä tutkimuksessa tutkittiin kuulojärjestelmän rajoitteita rekisteröidä ääniä, jotka rikkovat erilaisiin abstrakteihin sääntöihin liittyviä ennusteita. Mittaukset tehtiin elektroenkefalografialla (EEG). Tulkinta tehtiin mismatch negativity (MMN) -vasteen perusteella. MMN-vastetta pidetään fysiologisesti mitattavana merkkinä siitä, että kuulojärjestelmä on onnistuneesti rekisteröinyt ennusteesta poikkeavan äänen. Ärsykkeinä käytettiin kahden siniäänen pareja. Parien äänien korkeudessa oli yhden sävelaskeleen suuruinen ero ylös- tai alaspäin. Parit oli jaettu kahteen virtaan, joita kutsuttiin matalaksi ja korkeaksi. Molempiin virtoihin kuului viisi eri korkuista paria. Koetilanteita oli yhteensä neljä. Koetilanteet suunniteltiin siten, että ne olisivat teoreettisesti kuulojärjestelmälle asteittain vaikeampia suorittaa. Koetilanteessa A korkean ja matalan virran pareja esitettiin vuorotellen. Poikkeava tapahtuma oli kahden samaan virtaan kuuluvan parin peräkkäin esiintyminen. Koetilanteessa B esitettiin nousevia pareja molemmissa virroista. Poikkeavat parit olivat laskevia. Koetilanteessa C esitettiin korkean virran nousevia pareja ja matalan virran laskevia pareja. Poikkeavat tapahtumat olivat korkeassa virrassa laskevan parin ja matalassa virrassa nousevan parin esiintyminen. Koetilanteessa D esitettiin vuorotellen nousevia ja laskevia pareja. Poikkeavissa tapahtumissa esitettiin samaan suuntaan muuttuva pari kahdesti peräkkäin. Kaikissa koetilanteissa koehenkilö katsoi äänetöntä ja tekstitettyä elokuvaa. Abstraktia sääntöä rikkovien äänien rekisteröinti onnistui koetilanteessa A, mutta ei koetilanteissa B, C ja D. Jännitevasteiden näönvarainen tulkinta tuki jossain määrin MMN-vasteen esiintymistä kaikissa koetilanteissa. Tilastollisten testien tulokset eivät kuitenkaan olleet merkitseviä lukuun ottamatta koetilanteen A tuloksia, jotka olivat erittäin lähellä tilastollisesti merkitsevää. Tuloksien tilastolliset merkitsevyydet heikkenivät sitä mukaan, kun koetilanteet vaikeutuivat. Oletus koetilanteiden vaikeusjärjestyksestä oli oikea. Tämän tutkimuksen perusteella voidaan esittää, että kuulojärjestelmä on selvästi rajoittunut kyvyltään rekisteröidä abstrakteja sääntöjä rikkovia ääniä. Tulokset ovat osittain ristiriidassa aikaisemman tutkimuksen kanssa, sillä niissä MMN-vasteita on rekisteröity osin samantapaisissa koetilanteissa.
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(2021)Objectives. Semantic verbal fluency task is a naming task in which a participant produces words from a certain semantic category during limited time frame. Currently there is only a little research where the verbal fluency performance of young children, especially with hearing impairment has been studied, and findings have not been consistent. The question whether singing is associated with verbal fluency performance has not been studied much. The aim of this thesis was to compare verbal fluency performance of children with hearing impairment and normal hearing children. In addition, the aim was to investigate the association of singing with the semantic verbal fluency performance. Methods. This study sample contained 14 children with hearing impairment and 12 children with normal hearing. Participants performed two semantic verbal fluency tasks where they produced words from categories of animals and clothes for 60 seconds. The number of produced words and accepted words and semantic strategies (number of clusters, switches, semantic subcategories, the use of semantic strategy and the number of words in clusters) were examined. Amount of singing was investigated by means of questionnaire. Statistical methods were used to investigate differences between study groups and to investigate connection of singing and verbal fluency performance. Results and conclusions. The differences between the groups of children with hearing impairment and normal hearing children were not significant. Singing was associated with verbal fluency performance only in the group of children with hearing impairment and only in the animal task. Hearing impaired children who sang daily produced more words and used more word finding strategies than hearing impaired children who sang more seldom. The findings of previous studies are partly parallel to the findings of this thesis. However more research is needed for getting more consistent findings and more comprehensive research literature of the subject.
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(2023)Background and objectives. Hearing impairment can manifest as weak skills in several areas of speech and language. In previous studies, musical activities have been found to have a positive effect on the language skills of children with normal hearing (NH). The purpose of this thesis was to find out whether there is a difference between hearing-impaired (HI) and NH- children in picture naming skills or rapid serial naming, whether there is a connection between performance in different naming tests, and whether the amount of singing in the group was associated with naming performance. The thesis is part of the MULAPAPU study, which examines the effects of music intervention and singing on the speech perception and speech and language development of HI-children aged 0–7. Methods. The participants (N=37) were 1;11–6;10 aged children, of whom the HI-children (n=17) formed the research group and the NH-children (n=20) the control group. HI-children used bilateral cochlear implant (n=9), bilateral hearing aid (n=7) or combination of cochlear implant and hearing aid (n=1). Based on the amount of singing in the group, the children were divided into a group of children that sang more than once a week (n=19) and a group that sang less than once a week (n=14). Both groups included HI-children and NH-children. Naming skills were assessed with the Bo Ege test and the Rapid Automatized Naming test (colors and objects subtests). The amount of singing in the group was measured using a questionnaire that was sent to the children’s parents. The data was analyzed using statistical methods. Results and conclusions. No statistically significant difference was found between the performance of HI-children and NH-children in the Bo Ege test. In the Rapid Automatized Naming test, the NH-children performed significantly faster in the objects subtest. Regarding the errors made, no differences were found between the groups. No correlation was found between the performance in the Bo Ege test and the Rapid Automatized Naming test, which suggest that naming of individual pictures and serial naming should be evaluated separately in clinical work. Singing in the group was not related to the performance in the Bo Ege test. In the Rapid Automatized Naming test, children who sing more than once a week performed both subtests faster on average and made fewer errors in the colors subtest, while children who sing less made fewer errors on average in the objects subtest. The differences were not statistically significant. However, the results suggest, together with previous studies, that singing in a group could be beneficial for the development of children's rapid naming skills.
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(2021)Aims. In previous studies a link between nonword repetition skills and children’s language skills such as phonological knowledge and reading skills. Musical activity has been found to improve children’s cognitive development and language skills. Nonword repetition and nonword span have been widely used as a measure of phonological skills and working memory. The aim of the study was to find out whether there is a connection between singing at home and phonological skills or working memory in children with hearing impairment. The second aim of the study was to find out whether there is a correlation of performance in these two tasks and is there a decrease in parental singing as the child grows older. Methods. The study was conducted as a multiple case study. The participants were recruited from CIsumusa, a speech-music playschool for hearing-impaired children. The participants were nine Finnish-speaking hearing-impaired children aged 1–6 years who used either cochlear implants or hearing aids or both. The data was comprised of nonword repetition and nonword span tasks completed by the children. The parents of the participants filled some questionnaires about musical activity of the family which were also analyzed in the study. The children were divided into four groups for further paired analysis: 1) the children whose parents sing to them daily, 2) those whose parents sing to them less frequently than daily, 3) the children who sing daily, 4) the children who sing less frequently than daily. Nonparametric methods (such as Mann Whitney U-test) were used for statistical analysis. Results and Conclusions. No statistically significant differences were found between singing groups. A statistically significant correlation was found between performances in nonword repetition and nonword span tasks. It was found that the children over 4 years and 3 months old repeated the nonwords significantly more correctly by the number of syllables than the younger participants. It was also found that the children whose parents sing to them daily were on average 13,45 months younger than the children whose parents sing to them less frequently, even though the age difference was not statistically significant. Due to small number of subjects the results may be considered indicative, but based on them and previous research, singing should be used in speech therapy rehabilitation and home training.
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(2021)Objectives. This Master’s Thesis is part of the MULAPAPU (Miten MUsiikki-interventio ja LAulu PArantavat kuulovammaisten lasten Puhekieltä) research project and focuses on the first year pilot data. The aim of this Masters Thesis is to find out whether a music intervention of 6 or 10 weeks has an effect on how hearing-impaired children aged 2 to 6 years perform in a nonword repetition test, in repeating the number of syllables and word stresses correct as well as on their performance in the vocabulary use test. In addition, the aim is to examine whether music intervention has similar effects both on the performance in the nonword repetition test and in the vocabulary test and whether there is a correlation between them. Methods. The sample consisted of the results of 9 children using cochlear implant and/or hearing aid in the nonword repetition test and the Bo Ege vocabulary test. Four of the children participated in the music intervention in the autumn 2019 and five in the spring 2020. The effects of the intervention were analyzed by calculating percentages and averages which were presented in figures. The performance of both groups before and after the intervention was analyzed with one-sample t-test. Possible differences between the spring and autumn group on the effectiveness of the intervention were examined with the Mann-Whitney U-test. The Spearman correlation coefficient was used to examine whether music intervention has similar effects both on the performance in the nonword repetition test and in the vocabulary use test and whether there is a correlation between them. Results and conclusions. The research results show that the use of vocabulary was improved by the music intervention but no evidence was found that music intervention would improve repeating syllables or word stresses correct. No statistically significant difference was found in the performance of the autumn and spring group. When examining whether the music intervention has similar effects both on the performance in the nonword repetition test and in the vocabulary use test and whether there is a correlation between them, no significant correlation was identified. Due to the small number of the research subjects, further research is needed to draw reliable conclusions.
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(2023)Objectives. Hearing impairments (HIs) can cause delays in language skills. HIs can for example affect naming skills or the ability to perceive and produce word stress. Musical activity and singing have been shown beneficial to language skills of children with HIs. There is a lack of studies about connections between music and naming skills especially in children with HIs. The aim of this study was to examine how music intervention is linked to the production and perception of word stress in children with bilateral cochlear implants (CI) and/or hearing aids (HA). This study also examined is singing at home linked to better performance in rapid automatized naming test (RAN) or to the production and perception of word stress in nonword repetition task. This pilot study is a part of MULAPAPU research project which aims to study the effects of musical activity and singing to language skills in children with HI aged from 0 to 7 years. Methods. The participating children (n=19) with bilateral CIs and/or HAs were aged from 23 to 77 months. They were grouped based on answers given by their parents regarding the amount of singing at home (frequent singers and non-frequent singers). Production of word stress was assessed by using a non-word repetition-task invented in MULAPAPU research project and naming skills were evaluated by using the Rapid Automatized Naming -test (RAN). This study was a cross-over study in which group AB started with the intervention and group BA started with wash-up period. Both groups were tested three times. Group AB was tested before the intervention (T1), right after the intervention (T2) and after the wash-up period (T3). Group BA was tested before wash-up period (T1), right before intervention (T2) and right after the intervention (T3). Results and conclusions. Singing at home was linked to the time used and self-corrections in the RAN-test but there was no link between singing at home and the non-word repetition-task. AB groups word-stress production improved during the wash-up period. The effects of the music intervention might start to show with a delay. There were links between the children’s performances in the non-word repetition-task and RAN-test. This indicates that there might be a connection between word-stress production and naming. The results of this study are mainly in line with previous studies, and they support the evidence that music is a valuable asset in the rehabilitation of children with hearing impairment.
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(2023)Hearing impairment is a risk factor for speech and language development. Previous studies with hearing-impaired children have shown that their vocabulary development is slower than normal, and they have challenges in the use of inflectional forms. The purpose of this master's thesis is to find out if there is a difference in the proficiency of expressive vocabulary or inflections and sentences in Finnish-speaking, bilaterally hearing-impaired children compared to children with normal hearing. In addition, the effect of singing on the observed language skills is examined. The thesis is part of the MULAPAPU research project, which investigates the effects of music on the language development of hearing-impaired children aged 0-7. The study included both hearing-impaired subjects (n=23) and controls with normal hearing (n=25). The subjects were between 1 and 6 years old. Hearing-impaired subjects were bilaterally using a cochlear implant, a hearing aid, or a combination of these. The exclusion criteria for both the group of hearing impaired and controls were any severe diagnosed comorbid disorders. Expressive vocabulary proficiency was assessed with the Leinikki questionnaire completed by parents, and proficiency in the use of inflectional forms and sentences was assessed with the MCDI questionnaire. Singing was surveyed with the MULAPAPU background survey. Differences in expressive vocabulary proficiency were statistically analyzed using the Mann-Whitney U-test, and the connections between parental singing, child’s singing and singing in a group, and expressive vocabulary proficiency were analyzed using correlation analysis. Very few control subjects had answered the MCDI questionnaire's section of inflectional forms and sentences, so the skills of hearing-impaired children were analyzed on an individual level by comparing their scores to the standard values of the questionnaire. No statistically significant difference in expressive vocabulary proficiency was observed between hearing-impaired and normally hearing children. However, the hearing-impaired group had a two-peaked distribution and some subjects had poor expressive vocabulary proficiency. Hearing-impaired children's proficiency in inflections and sentences fell short of the age norms, although proportionate to hearing age, some of the subjects had a good proficiency in inflections and sentences. Only the child singing was statistically significantly correlated to expressive vocabulary proficiency. The amount of singing by parents was also statistically significantly related to the amount of singing by the child. Guiding the close environment and encouraging children to sing can be a good part of rehabilitating the language skills of hearing-impaired children.
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(2023)Tausta ja tavoitteet. Kuulovamma sekä kuulonapuvälineet saattavat vaikuttaa lapsen kykyyn havaita ja toistaa sanapainoja. Aikaisemmissa tutkimuksissa on havaittu musiikkiharrastuneisuuden ja kotona laulamisen mahdollisesti tukevan kuulovammaisten lasten sanapainojen havaitsemista ja toistoa, mikä saattaa puolestaan edesauttaa heidän kielellisten taitojen kehitystään. Aiemmin ei ole tiettävästi tutkittu molemminpuolisesti kuulovammaisten kahdella laitteella kuulevien alle kouluikäisten lasten musiikillisten taitojen yhteyksiä kotona laulamiseen eikä verrattu tätä normaalisti kuuleviin lapsiin. Tämän tutkimuksen tarkoituksena oli selvittää, toistavatko kuulovammaiset lapset normaalisti kuulevia lapsia paremmin sanapainoja ja eroavatko heidän musiikilliset taitonsa. Lisäksi selvitettiin kotona laulamisen yhteyksiä sanapainojen toistoon ja musiikillisiin taitoihin niin kuulovammaisten kuin normaalisti kuulevienkin lasten kohdalla. Tämä tutkimus on osa MULAPAPU-hanketta, jossa selvitetään musiikkitoiminnan ja laulamisen vaikutuksia 0–7-vuotiaiden lasten puheen havaitsemiseen ja tuottoon. Tutkimuksen vastuututkijana toimii Ritva Torppa. Menetelmät. Tutkittavat olivat 3–6-vuotiaita molemminpuolisesti kuulovammaisia lapsia (n=20) ja verrokkina toimivat samanikäiset normaalisti kuulevat lapset (n=21). Kuulovammaisista lapsista puolet käyttivät kahta sisäkorvaistutetta ja puolet joko kahta kuulokojetta tai yhtä sisäkorvaistutetta ja yhtä kuulokojetta. Mittausmenetelminä käytettiin MULAPAPU-hankkeessa kehitettyä epäsanatoistotehtävää sanapainojen toiston tutkimiseksi sekä musiikillisten taitojen kyselylomaketta musiikillisten taitojen tutkimiseksi. Kotona laulamisen määrää kartoitettiin taustatietokyselylomakkeen kotona laulamista koskevien kysymysten avulla. Tulokset ja pohdinta. Verrokkiryhmän lapset toistivat sanapainoja paremmin ja tarkemmin kuin kuulovammaiset lapset sekä sana- että tavutasolla tarkasteltuna. Verrokkiryhmän lapsilla oli myös paremmat musiikilliset taidot kuin kuulovammaisilla lapsilla. Erot olivat suurimmillaan melodiaa ja äänenvoimakkuuksien hallintaa kartoittavassa osiossa. Ainoa yhteys kotona laulamisen ja sanapainojen toiston tai musiikillisten taitojen välillä havaittiin kuulovammaisten lasten oman kotona laulamisen ja musiikillisten taitojen rytmiikkaa koskevan osion välillä. Tulokset kertovat paitsi alle kouluikäisten kuulovammaisten lasten haasteista havaita ja hallita melodioita ja äänenvoimakkuuksia myös lapsen oman kotona laulamisen tukevan rytmin havaitsemista ja tuottoa, mikä saattaa puolestaan auttaa sanapainojen toistossa ja kielenkehityksen tukemisessa.
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(2024)Objectives. Hearing impairment (HI) is a risk factor for speech and language development, and it can cause delay in vocabulary development and reduce the ability of word stress perception and production. HIs decrease auditory discrimination. Therefore, perceiving auditory cues of speech is limited. Previous studies suggest that musical hobbies, such as singing, may improve the language development and speech perception of HI-children. Previous studies suggest that group-based music activities may have positive impacts on language development. Age of hearing device implementation is directly linked to language skills of HI-children. Bilateral and early hearing devices improve spoken language skills and vocabulary of bilaterally HI-children. The aim of this thesis was to investigate, whether expressive vocabulary of HI-children improves during a 6,5-month follow-up, whether the amount of singing in groups or syllable and word stress repetition scores correlate to said vocabulary development and lastly, study the relationship of the age at first hearing device implementation to vocabulary development and syllable and word stress repetition scores. This thesis is a part of the MULAPAPU research project. Methods. The participants (N=17) were bilaterally hearing-impaired children aged 2 to 6 years, who used either bilateral cochlear implants (CI), bilateral hearing aids (HA) or unilateral CI and contralateral HA. They were grouped based on answers given by their parents regarding the amount of singing in groups before the follow-up (group 1: more frequent; group 2: less frequent). Their ages at first hearing device implementation were examined. The Finnish Communicative Development Inventory III (FinCDI III), a parent-report form instrument, was used to investigate expressive vocabulary development. A non-word repetition task was used to test the repetition of syllable stress and word stress. The vocabulary development was examined between first (T1) and last (T3) measuring point within 6,5 months, and syllable and word stress repetition and singing groups in T1-measuring point. Results and conclusions. A statistically significant correlation was found between age of first HA implementation and word stress repetition, where the earlier HA was implemented the better word stress repetition was. The participants’ expressive vocabulary did improve between T1 and T3. Age at T1 correlated with vocabulary development significantly. No correlation between singing groups and vocabulary development was found, but group 1 was on average found to be older in age than group 2. On average vocabulary scores of group 1 were higher in both T1 and T3, but improvement in scores was greater in group 2. No other correlations were found between study variables. The results of this thesis reinforce the idea, that early HA implementation improves word stress perception and the expressive vocabulary of CI- and HA-children under 6 years develops quickly. There is a need to study the effects of singing in groups and effects of syllable and word stress repetition to expressive vocabulary development of HI-children in future research.
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(2021)Objectives. Hearing impaired (HI) children have been found to perform more poorly in tasks measuring semantic verbal fluency compared to normal hearing peers. Music activities are known to have a positive connection to the word finding skills in HI-children. However, there has not been yet studies to find out whether organized music activities have an effect on semantic verbal fluency skills in young HI children. The purpose of this study was to determine how the number of accepted words in semantic verbal fluency task develops during a music intervention in HI-children and whether background variables (age, mother’s education and hearing device) affect development. There was also a desire to find out the effect of singing at home on the development of verbal fluency task. In addition, it was examined whether the word retrieval strategies change during the music intervention and whether they are influenced by background variables. Methods. The participants (n = 15) were HI-children aged 2–6 years. Participants were divided into non-singers and singers based how much their parents sang at home. Verbal fluency (VF) and verbal fluency strategies were measured with two semantic VF tasks (animals and clothes). Tests were performed before (T1) and after (T2) the children participated in CIsumusa music intervention, organized by LapCi ry. The results were analyzed by statistical methods. Results and conclusions. The participants developed in verbal fluency task during the music intervention in both animal and clothing categories. Higher age was strongly associated with better development in both categories. Mother’s education was related to development in the animal task. Children of non-singers developed during the music intervention, but children of singers did not. However, children of singers performed better at T1 compared to children of non-singers. In a group of all participants the number of clusters increased during the music intervention in both animal and clothing tasks and the cluster size increased in the clothing task. Higher age was associated with an increase in the number of clusters, but not in cluster size. Based on the results, the music intervention was able to improve VF of children who performed poorly before the intervention. The results suggest that if there is no singing or musical activity at home, out-of-home music activities that include singing can improve VF. Singing at home and music interventions can be recommended to children with HI.
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(2019)Aims. Past research has shown that hearing impaired adolescents are at a higher risk of experiencing psychosocial difficulties than their hearing peers. The research into the factors related to the psychosocial well-being of hearing-impaired adolescents has not yet come to an unambiguous conclusion. There are indications that the wellbeing of hard-of-hearing youths would be related to their communicative abilities and the functioning of their hearing among other things. This study examines self-perceived psychosocial difficulties and strengths of adolescents with hearing impairment and factors associated with these difficulties and strengths. These results also are being compared to results of psychosocial well-being obtained from Finnish adolescents. Methods. 12 11-17-year-old youths with hearing impairment filled in the Finnish version of the Strengths and Difficulties Questionnaire (SDQ-Fin) and a background questionnaire. Adolescents with other sensory deficits or disabilities were excluded from this study. Statistical analysis was performed to search for associations between psychosocial well-being and its related factors. Results and conclusions. The participants experienced more psychosocial difficulties than their Finnish peers. Emotional symptoms and peer problems were emphasized in the reports of participants. They also experienced more strengths in psychosocial well-being compared to their peers. In this study girls experienced more difficulties than boys. Participants experienced fewer difficulties in psychosocial wellbeing when their communicative abilities were good. These results can be used to improve and develop rehabilitation of hearing-impaired children and youths.
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(2022)Aim of the study: Risk-sensitive foraging theory (RSFT) is an evolutionary-biological theory of how animals should choose in uncertain foraging situations for the choice to be beneficial for survival and reproduction. When having low energy budget, a more risky choice would be beneficial, and when having high energy budget, one should avoid a risky decision. There is no one, exhaustive model for risk-sensitive behavior, RSFT being just one of them. It has earlier been established that dependence disorders have common factors causing harm, non-specific to drug, and alcohol use is associated with gambling, both through shared genetic and environmental factors, and directly, and this association might be mediated by risk taking. Also, differences in risk taking behavior are rather individual based than species related. It has even been found that heroin-dependent individuals favor more risky choices over certain ones when in need of the drug. The aim of this study was to find out whether RSFT is suitable for describing the risk taking related to gambling. Methods: The sample was from Gambling Impact and Behavior Study survey data, which was collected by random-digit dial method in USA in 1997–1999. Economical aspect of energy budget was operationalized as household income, mental aspect of energy budget as gambling problem (measured by NODS, scale 0–10), and the decision to risk as money spent on gambling. Respondents with missing values in any of the variables were excluded resulting in a final sample size of 893 individuals. It was examined if household income and gambling problem were associated with money spent on gambling. A general linear model was fitted to the sample. Results: A general liner model seemed to fit to the sample. The income variable didn’t improve the model, but gambling problem did. Moreover, income and gambling problem had a significant interaction. Only with a few exceptions, people played more money in higher income classes and with a more severe gambling problem. People played a little money in every income class even with no gambling problem at all. On the other hand, when the gambling problem was severe, it affected the amount spent on gambling more in high income classes than in lower ones. People in the lowest income classes spent nearly the same amount with severe than with no gambling problem. Conclusions: The results give mixed implications of whether RSFT describes the risk taking related to gambling, which might be due to the unprecise definition of variables and methods of analysis, and other methodological aspects specific to gambling. The twin threshold model holds more promise than the traditional model of RSFT: when both economical and mental energy budgets are low, risk is avoided in gambling (survival threshold), but when economical energy budget is high risk is favored, which however, comes short as the definition of reproductive threshold in the context of gambling. A further examination is advised before making firm conclusions. Most importantly, gambling and gambling problems might be better understood from other perspectives.
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(2017)Sylkirauhaskasvaimet muodostavat esiintyvyydeltään harvinaisen mutta histologiselta kuvaltaan monimuotoisen kasvainryhmän. Ne voivat saada alkunsa kolmesta eri solutyypistä, ja näin ollen niiden kirjo on varsin laaja. Maailman terveysjärjestön (WHO:n) vuonna 2017 julkaisema epiteliaalisten sylkirauhaskasvainten jaottelu koostuu 20 pahanlaatuisesta ja 11 hyvänlaatuisesta kasvaintyypistä. Sylkirauhaskasvainten diagnostiikka on erittäin haastavaa, ja siihen tarvitaan normaalien hematoksyliini-eosiini -leikkeiden (HE-leikkeet) lisäksi lähes aina niin kutsuttuja immunohistokemiallisia värjäyksiä. Alan kirjallisuudessa kullekin sylkirauhaskasvaintyypille on määritetty tyyppi-immunoprofiili, joka voi kuitenkin vaihdella tapauskohtaisesti. Tämän tutkielman tarkoituksena oli luoda kuva-arkisto, johon on taltioituna kuvia sylkirauhaskasvaintapausten immunohistokemiallisista värjäyksistä. Arkisto tehtiin Helsingin yliopistollisen keskussairaalan patologian laitoksen käyttöön diagnostiseksi apuvälineeksi. Kuvista voidaan nähdä, mitä immunomerkkiaineita eri sylkirauhaskasvaintyypit ilmentävät ja millä voimakkuudella. Kuva-arkiston aineistoksi koottiin Helsingin yliopistollisen keskussairaalan patologiseen keskuslaboratorioon normaaliin patologiseen tutkimukseen tulleita sylkirauhaskasvainnäytteitä. Aineistoksi valittiin 12 sylkirauhaskasvaintapausta, jotka edustavat kymmentä eri epiteliaalista sylkirauhaskasvaintyyppiä. Näytteiden HE- leikkeet ja niistä tehdyt immunohistokemialliset värjäykset kuvattiin mikroskooppikameralla eri suurennoksilla. Nämä kuvat koottiin kuva-arkistoksi, johon on pääsy Patologian laitoksen kotisivujen kautta. Syventävän tutkielman osuuteen koottiin suppea otos kuva-arkiston kuvista edustamaan kunkin kuvatun sylkirauhaskasvaintapauksen immunoprofiilia. Lisäksi syventävän tutkielman osuuteen sisältyy kirjallisuuskatsaus kuvatuista sylkirauhaskasvaintyypistä. Kuva-arkiston kuvista voidaan havainnoida kuvattujen sylkirauhaskasvaintapausten histologinen kuva ja immunoprofiili. Vanhoja tapausesimerkkejä voidaan käyttää vertailukohtana diagnosoitaessa uusia sylkirauhaskasvaimia, kunhan otetaan huomioon, että arkistossa on nähtävissä vain yksittäisiä esimerkkejä siitä, miltä kunkin kasvaintyypin immunoprofiili voi näyttää.
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(2018)It is typical that memory performance decreases during normal aging. For this reason it is important to understand how to support memory functions of older adults. One proposed solution is foreign language studying and learning. Several factors affect the learning results in foreign language learning. One factor may be the presentation mode of the words being memorised. While memorising vocabulary, picture presentation is usually remembered better than textual presentation, as has been shown in studies of foreign language learning among younger students. This topic has not previously been studied in older adults, so this thesis work investigates whether foreign language learning in older adults can be intensified by using pictures and whether the learning results are long-lasting. The subjects in this study were 30 Finnish native speakers (22 women and 8 men, aged 61 to 75, mean age of 67). The subjects studied Spanish words for 15 days. The subjects were divided into two groups. For one group (the picture group), the word representation contained picture and for the other group (the text group), textual presentation. Long-lasting learning results were studied by two vocabulary tests. The first test was held immediately after the study period and the second test a week thereafter. The picture group achieved better results in both vocabulary tests compared to the results of the text group. The conclusion is that picture representation intensifies foreign language learning more than textual presentation in older adults and the learning results are long-lasting. This research result is useful for those who are planning learning materials and also for older adults interested in studying and learning foreign languages.
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(2018)Dividing attention between two tasks can be challenging due to interference between the concurrent tasks. This dual-task interference is proposed to stem from working memory load, and thus dual-task paradigm is a widely used framework in working memory research. The present thesis aimed to investigate the suitability of figural fluency task as part of a dual-task. It was hypothesized that performance would decline when figural fluency task was performed together with another task. In addition, the convergent validity of figural and action (verb) fluency and prospective time estimation were examined through their connections with other cognitive measures. It was hypothesized that the tasks would correlate moderately with these measures. The sample consisted of 29 Finnish-speaking university students who volunteered to complete a series of cognitive tasks including two dual-tasks: figural fluency with action fluency and with time estimation, separately. In addition, tasks measuring verbal fluency, processing speed, verbal working memory, attention and the fluency of executive functions were administered. As was hypothesized, dual-task interference could be observed in both dual-tasks and in each dual-task subtask. Dual-task decrement in figural fluency was largest when performed together with action fluency. In addition, dual-task decrement was found to be more pronounced in figural fluency than in action fluency when performed together. Action fluency was the only test directly associated with measures of verbal fluency, verbal working memory and processing speed. According to the results, figural fluency as a dual-task subtask can be seen as a useful method in demonstrating dual-task interference and working memory load.
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(2020)Executive functions refer to abilities that enable successful regulation of behaviour and other activity appropriate for the current situation. Executive functions can be assessed using different assessment methods. Usually visual fluency is examined as part of a wider assessment of executive functions. Visual fluency is often assessed using tasks of figural fluency. Figural fluency tasks are thought be a nonverbal analogue to tasks of verbal fluency as part of assessment of executive functions. However it remains unclear what executive or cognitive functions can be assessed by using figural fluency tasks. The present thesis set out to examine, how task performance in a figural fluency task is related to task performance in other tasks of cognitive and executive functions. Figural fluency task performance was hypothesized to be related to verbal fluency, visual executive and reasoning functions and motor function. Forty-five adults were assessed using tasks of figural fluency, verbal fluency, visual processing speed, working memory flexibility, visual reasoning and motor functions. Relationships between performance in the figural fluency task and the other tasks were compared. In addition the relationship between figural fluency task performance and visual reasoning task performance was compared to that of figural fluency task performance and performance in the tasks of visual processing speed and working memory flexibility. Lastly, the contribution of motor function to the relationships between performance in the different tasks was investigated through partial correlation. Figural fluency task performance was related to performance in all the tasks, except for semantic verbal fluency (r = .32, p = .123) and motor functions (r = .01, p = .952). Performance in the working memory flexibility task was more strongly related to task performance in the figural fluency task (r = -.64, p < .001), than performance in the visual reasoning task (r = .56, p < .001). Performance in the visual reasoning task was however more strongly related to figural fluency task performance, than performance in the task of visual processing speed (r = -.41, p = .008). Motor function did not contribute to the observed relationships. Results of this thesis corroborate the role of figural fluency tasks in the assessment executive functions and elaborate that figural fluency is related to other visual functions.
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(2022)Background and aims. Aphasia and apraxia are neurological disorders most commonly caused by stroke. Aphasia manifests as varying degrees of difficulties in linguistic functions and apraxia as varying degrees of difficulties in producing voluntary body movements, such as speech movements and head nodding and shaking. Aphasia and apraxia often occur simultaneously. A severe apraxic-aphasic disorders manifests as diffi-culties in linguistic functions and the production of speech and head gestures, which can make communicating very challenging. In this case, answering yes/no questions can be a significant means of communication. There is only limited longitudinal follow-up research on recovery from apraxic-aphasic disorder. The aim of this thesis is to examine how the ability to respond intelligibly and correctly to yes/no questions changes in participants with a severe apraxic-aphasic disorder during a three-year follow-up period, beginning on the onset of the disorder. In addition, the aim is to examine whether the means used to respond intelligibly and correctly to yes/no questions change during the follow-up period, and how the changes in the amount and means of giving intelligible and correct yes/no responses compare across participants. Methods. The study included seven adults with a severe apraxic-aphasic disorder resulting from left hemisphere stroke. Participants were examined on five separate occasions during the three-year follow-up, apart from one participant, who was examined on four occasions. The examination sessions typically occurred within the first three months after the onset of the disorder, then six months, one year, two years and finally three years after the onset of the disorder. During the sessions participants were instructed to respond “yes” or “no” to 50 yes/no questions, composed by Sanna Lemmetyinen. The research data consisted of participants' responses to the questions, raw data consisted of video recordings of the sessions. The data was analyzed both qualitatively and quantitatively. Qualitative analysis consisted of evaluating the clarity and correctness of the participants’ responses, and of examining the means used to respond. Quantitative analysis consisted of scoring the responses based on their clarity and correctness. Results and conclusions. Participants' ability to respond intelligibly and correctly to yes/no questions during the three-year follow-up period varied. One participant’s ability clearly improved after the initial three months following disorder acquisition. Four participants’ performance profile was ascending during the follow-up period, two participant’s performance profile was descending, and one participant’s performance was the same after three years as it was in the first examination session. Some changes occurred in the means used to respond intelligibly and correctly. The amount of speech responses clearly increased in two participants. Apart from one, all participants appeared to have some characteristic means of responding. Participants were able to produce intelligible and correct yes/no responses using and combining several different means of responding.
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(2017)Aims and Objectives. Devices for treating stuttering have become more common in the last decades. One of these is an anti-stuttering device based on Altered Auditory Feedback (AAF). The auditory feedback of speech can be altered so that the speaker hears their voice either with a delay (DAF, Delayed Auditory Feedback) from a different frequence (FAF, Frequency Altered Feedback) or utilizing both of these settings simultaneously. The Hospital Districts of Helsinki and Uusimaa (HUS) Foniatrics Unit launched an anti-stuttering device trial in 2008. The aim of this study is to provide information on that anti-stuttering device trial, the use of the device and the effects it has on speech. The aim is to discover the occasions when the device can be useful, on what occasions it cannot be used, and what kind of issues the use has caused. There is no former Finnish study on the use of anti-stuttering devices, but internationally the topic has been widely researched. Methods. The research method in this thesis was a survey sent by post. The survey was sent to patients who had participated in the anti-stuttering device trial, and it included two different forms, A and B. Form A was for patients who were still using the device and form B for those who had either returned the device or were not using it. The forms comprise of both open and closed questions. The responses to the open questions were analysed qualitatively by categorizing and sorting into themes, and then coding them to the same data along with the closed question responses. The quantitative analysis of the final data was made with an SPSS-program by calculating frequencies and relative frequencies and by cross-tabulating the dependencies between the variables. Results and conclusions. The results showed that the experiences of the trial participants varied greatly. A majority of the respondents had returned the device, yet almost half of all those who answered the survey had found the device useful. The most common finding was that the anti-stuttering device cannot be utilized in background noise. There had also been technical difficulties with the devices, concerning the settings and battery life. Those who answered form A, i.e. device-users, found it useful on singular occasions, e.g. while speaking on the phone or face to face with another person, or in all communication situations in general. Majority of the respondents had received positive feedback on their speech while using the anti-stuttering device. The most frequent feedback was that the speech of the stutterer was slower and clearer. All those who had received positive feedback would have recommended the anti-stuttering device to stutterers. Opinions on the use of the device are mixed, but based on individual positive experiences testing the device can be recommended when deciding on rehabilitation and therapy methods.
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(2018)Tausta Tutkimuksen tarkoituksena on selvittää Helsingin kaupungilla ikääntyneitä potilaita laitosolosuhteissa hoitavan henkilökunnan koulutusta, resursseja sekä asenteita potilaidensa suunterveydenhoitoon liittyvissä kysymyksissä. Vastaavia tutkimuksia on tehty aiemmin muualla, ja näiden konsensus on ollut, että hoitava henkilökunta saa koulutusta suuterveyteen liittyvissä asioissa vaihtelevasti ja että henkilökunnan kouluttamisella myös heidän hoidossa olevien henkilöiden suuterveys paranee. Menetelmät Tutkimus suoritettiin syksyllä 2013 jakamalla yhteensä 300 kyselylomaketta kolmen eri Helsingissä sijaitsevan geriatrisen hoitolaitoksen henkilökunnan edustajille. Kysely jaettiin kaikille henkilökunnan jäsenille ja palautettiin hoitoloittain anonyyminä. Kaavakkeessa kysyttiin asioita vastaajan taustoista, ja siinä oli 20 monivalintakysymystä liittyen potilaiden suunterveydenhoitoon. Tulokset Vastauksia palautettiin 180 kappaletta (60 %) hoitoloihin, josta ne toimitettiin yliopistolle. Tässä tutkielmassa käsiteltäväksi valittiin henkilökunnan koulutukseen, työpaikkojen resursseihin ja käytäntöihin sekä henkilökunnan asenteisiin liittyviä kysymyksiä. 66,3 % vastanneista kertoi saaneensa koulutusta asiakkaiden suun terveyden hoidossa, ja vastaava osuus, 66,1 %, toivoi aiheesta vielä lisäkoulutusta. Mielestään riittävät välineet oli käytettävissä 65,9 %:lla vastanneista. 63,3 % vastanneista piti suun terveyttä tärkeänä yleisterveyden ja hyvinvoinnin kannalta. Vain 2,9 % vastanneista potilaan suun puhdistaminen kuului päivittäisiin työtehtäviin. Pohdinta Hoitava henkilökunta pääasiassa mieltää suun terveyden tärkeäksi osaksi yleisterveyttä ja hyvinvointia. Koulutusta aiheesta on saatu, mutta yhtälailla sitä toivotaan saatavan lisää. Täydentävä koulutus olisi tarkoituksenmukaista järjestää kyseisissä hoitolaitoksissa, jossa resurssit ja olosuhteet ovat samat kuin hoitotyön arjessa.
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(2024)Tämä tutkielma on osa hanketta, jonka tarkoituksena on selvittää kyynärhermopinteen riskitekijöitä systemaattisen katsauksen ja meta-analyysin keinoin. Tämän tutkielman laajuuteen sisältyy hankkeen ensimmäinen vaihe, jonka tarkoituksena oli löytää hankkeen seuraavassa vaiheessa tehtäviin systemaattisiin katsauksiin ja meta-analyyseihin käytettävät kyynärhermopinteen riskitekijöitä käsittelevät tutkimukset. Tutkimusten haku suoritettiin PubMed- ja Scopus-tietokannoista huhtikuussa 2022. Hakutekijöiden perusteella tietokannoista löytyi 6090 tietuetta, joista 1331 tietuetta olivat päällekkäisiä tietokantojen välillä. Tutkimusten valinnan ensimmäisessä vaiheessa kävin läpi kaikkien artikkelien otsikot ja tiivistelmät, ja läpikäynnin perusteella hylkäsin 4696 artikkelia. Seuraavassa vaiheessa kävin läpi jäljellä olevat 63 artikkelia kokonaisuudessaan, tässä vaiheessa hylätyiksi tuli vielä 42 artikkelia. Hyväksytyille 21 artikkelille tein tutkimusten laadun arvioinnin, jossa arvioitiin viiden eri harhan lähteen riskiä kolmiportaisella asteikolla kunkin artikkelin kohdalla. Tutkimuspopulaatioon liittyvän harhan riski oli useimmissa tutkimuksissa keskisuuri, ja vain viidessä tutkimuksessa pieni. Riskitekijän tunnistamiseen liittyvän harhan riski arvioitiin viiden eri riskitekijän suhteen, ja se oli tutkimuksissa pieni tai keskisuuri. Päätetapahtuman tunnistamiseen liittyvän harhan riski oli useimmissa tutkimuksissa pieni, mutta kuudessa tutkimuksessa riski oli keskisuuri. Sekoittavat tekijät oli huomioitu laadukkaasti vain viidessä tutkimuksessa, seitsemässä tutkimuksissa harhan riski oli suuri ja lopuissa tutkimuksissa keskisuuri. Suurin osa tutkimuksista oli poikkileikkaustutkimuksia, minkä vuoksi tutkimuspopulaation pysyvyyteen liittyvä riski oli useimmissa tutkimuksissa pieni. Tutkimusten valinta ja laadun arviointi tehtiin tehtiin myös toisen, riippumattoman arvioitsijan toimesta samanaikaisesti. Molempien arvioitsijoiden valitsemat artikkelit sekä laadun arviointi olivat hyvin pitkälle samankaltaiset, mikä lisää uskoa työn luotettavuuteen. Hankkeen seuraavassa vaiheessa tehtävissä meta-analyyseissä tutkittaviksi riskitekijöiksi tulevat kyseeseen erityisesti tupakointi ja ylipaino, joita käsitteleviä tutkimuksia oli useita, ja tutkimuksissa kyseiset altisteet oli kuvattu varsin yhteismitallisesti.
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