Browsing by study line "ei opintosuuntaa"

Tiivistelmä / Abstract: Religiosity has been identified as an important ideational factor in fertility studies. However, only a few studies have sought to examine how religiosity affects the realization of fertility intentions with conflicting findings. Utilizing the Theory of Planned Behavior as its framework, the present study proposes a positive association between church attendance and both fertility intentions and realized fertility. Specifically, it hypothesizes that church attendance has a positive relationship to both fertility intentions and realized fertility over a period of three years. In the study, these hypotheses are examined in a sample (N = 798) drawn from waves 9, 10, 11, and 12 of the German Family Panel study. The analysis is performed using several logistic regression models, which control for the participants age, sex, and a variety of other characteristics. The results of the study re-affirm that fertility intentions have a positive relationship to realized fertility. However, there was no statistically significant relationship between church attendance and both fertility intentions and realized fertility in this sample. In addition, the study finds no significant differences between men and women. Speculating on the surprising results, the study asks whether church attendance adequately gauges the kind of religiosity that connects to fertility behavior in the more recent age cohorts in Germany. Uskonnollisuuden on havaittu vaikuttavan lisääntymiseen – muun muassa lisääntymisideaaleihin ja -intentioihin. Vain harvat tutkimukset ovat kuitenkaan kartoittaneet, miten uskonnollisuus vaikuttaa lisääntymisintentioiden varsinaiseen toteutumiseen. Käsillä oleva tutkimus pohjautuu Theory of Planned Behaviour -teoriaan ja kysyy, onko kirkossa käyminen on yhteydessä lisääntymisintentioihin ja sitä kautta toteutuneeseen lapsilukuun. Tutkimuksessa otaksutaan, että usein kirkossa käyvillä ihmisillä on korkeammat lisääntymisintentiot, ja että he myös useammin toteuttavat intentionsa kolmen vuoden seurannassa. Näitä oletuksia tutkitaan German Family Panel -aineiston otoksessa, johon luetaan aaltojen 9, 10, 11 ja 12 vastaajat (N = 798). Oletuksia koetellaan logistisin regressiomallein, joissa vakioidaan sukupuoli ja muut taustamuuttujat. Tulokset vahvistavat, että lisääntymisintentioilla on yhteys toteutuneeseen lapsilukuun tässä otoksessa. Kirkossa käymisellä ei kuitenkaan havaita olevan yhteyttä osallistujien lisääntymisintentioihin tai toteutuneeseen lapsilukuun. Tuloksissa ei myöskään tilastollisesti merkitseviä eroja sukupuolten välillä. Näiden yllättävien tulosten pohjalta tutkimuksessa kysytään, josko kirkossa käymisen mittari kytkeytyy kyllin hyvin sellaiseen uskonnollisuuteen, joka yhdistyy lisääntymiskäyttäytymiseen myös myöhemmissä saksalaisissa ikäkohorteissa.

Objective: Both stress-related exhaustion and depression have previously been associated with a decline in cognitive performance, but there is a lack of evidence on whether these conditions have different associations with different cognitive domains and whether they have additive effects on cognitive performance. Furthermore, very little is known about the cognitive effects of chronic stress-related exhaustion. Consequently, the aims of this study were to 1) examine the associations between current stress-related exhaustion and cognitive performance, 2) investigate whether different developmental trajectories of stress-related exhaustion are differently associated with cognitive performance, 3) compare the association between stress-related exhaustion and cognitive performance to the relationship between depressive symptoms and cognitive performance, 4) examine if individuals with comorbid stress-related exhaustion and depression have lower cognitive performance than individuals with at most one of these conditions (i.e., whether clinical stress-related exhaustion and clinical depression might have additive effects on cognitive performance). Methods: The data used in the study was a Finnish population-based sample of six cohorts born between 1962 and 1977 from the Cardiovascular Risk in Young Finns Study. Stress-related exhaustion was assessed using the Maastricht Questionnaire, depressive symptoms with the Beck Depression Inventory, and cognitive performance with four subtests of the Cambridge Neuropsychological Test Automated Battery, measuring visuospatial associative learning, reaction time, sustained attention, and executive functions. Cognitive performance and depressive symptoms were assessed in 2012, and stress-related exhaustion in 2001, 2007, and 2012. Participants were 35 to 50 years old in 2012. Linear associations between stress-related exhaustion and cognitive performance (N = 905) and depressive symptoms and cognitive performance (N = 904) were examined by conducting multivariate regression analyses. Age, sex, socioeconomic status, and parents’ socioeconomic status were controlled in the regression models. Additionally, multivariate analyses of variance were performed to investigate the different developmental trajectories of stress-related exhaustion and their relation to cognitive performance (N = 541) and the associations of comorbid stress-related exhaustion and depression with cognitive performance (N = 1273). Results and conclusion: The main finding was that high stress-related exhaustion is associated with slower reaction times, but not with performance in spatial working memory, visuospatial associative learning, or executive functions. Ongoing, chronic stress-related exhaustion was more strongly associated with slower reaction times than short-term exhaustion experienced years ago. Compared to depressive symptoms, high stress-related exhaustion was associated with slower reaction times also when subclinical cases were included, whereas only clinical levels of depressive symptoms had an association with slower reaction times. There were no differences in cognitive performance between individuals with only stress-related exhaustion or depression and those with comorbid stress-related exhaustion and depression, which supports the notion that these conditions do not have additive effects on cognitive performance. These findings add to the existing evidence of the cognitive effects of stress-related exhaustion in the general population and have several practical implications. Further research is needed on the topic, preferably with longitudinal designs, more comprehensive cognitive measures, and clinical assessment of the psychiatric symptoms.

Objective: Anxiety has been studied in COVID-19 patients, but there are few studies comparing the level of anxiousness in patient groups requiring different levels of treatment. The aim of this study was to investigate anxiety symptoms in COVID-19 patients six months after the acute phase of the disease. The study also compared the amount of anxiety symptoms between patients in intensive care unit, those treated in a hospital ward, those who stayed at home during the illness, and a healthy control group. Moreover, the study aimed at investigating the associations of need for support (physical, mental, practical life and obtaining disease-related information) during the recovery phase of the disease with anxiety symptoms at six months. Methods: This study was a part of the RECOVID-20 research project, which is a collaborative project between the University of Helsinki and the Hospital District of Helsinki and Uusimaa (HUS). The project investigates the physical and mental symptoms of COVID-19 patients three and six months after hospitalization. In the present study, 135 COVID-19 patients (58 in the intensive care unit, 41 in the regular hospital care, and 36 patients who stayed at home during the illness) and 50 healthy controls were included. The data were collected during the first and second wave of the pandemic in years 2020 and 2021, three and six months after the acute phase of the illness. At three months, participants were interviewed by phone. The interview included questions about their need for support, as well as questions of physical and psychological well-being. At six months, a questionnaire was sent to them including a questionnaire (GAD-7, The Generalized Anxiety Disorder Assessment) on symptoms of anxiety. The differences in anxiety between different groups and the associations between need for support and later anxiety symptoms were analyzed using general linear models (GLM). Results and conclusions: COVID-19 patients had more symptoms of anxiety six months after the acute phase when compared to the healthy control group, but the patient groups did not differ. In addition, 25 % of the COVID-19 patients and 12 % of the healthy control group had at least mild anxiety symptoms. While recovering from the COVID-19 infection, most support was needed for information about the COVID-19 disease, and the least support for practical life. Furthermore, the need for mental support associated with greater post-disease anxiety symptoms. The study provides new evidence that COVID-19 patients need more support, especially for their mental symptoms which might be associated with anxiety. Further research should focus on the need for support and its association with mental health in COVID-19 patients.

Objective: Long-term associations of the COVID-19-disease with patients’ wellbeing are not currently well known, but so far evidence of prolonging somatic and mental symptoms after the acute phase have been reported. Patients that have been treated in the ICU or normal wards have been suggested to be in elevated risk for experiencing these symptoms. How prolonging symptoms affect patient’s quality of life has not yet been thoroughly studied. The aim of this study was to investigate how the symptoms reported in three-months follow-up were associated with the quality of life at six-months follow-up of patients treated in the ICU or normal wards and those who were sick at home in six-months follow-up. COVID-19 patients were also compared with healthy controls. Associations between the length of hospital stay and quality of life in ICU and ward patients were also investigated. Methods: The data of this study were collected during the first and second waves of COVID-19 in 2020. This study is a part of the RECOVID-20 project, which is a collaboration project of Helsinki and Uusimaa Hospital District and University of Helsinki. Altogether 241 subjects (54 % women, mean age 54.5) participated in this study (54 % women, mean age 54.5), and the subjects were recruited from four groups: ICU and ward group, patients who were sick at home and healthy controls. Somatic and mental symptoms at three-months of the acute phase were assessed with a telephone survey and a questionnaire was sent to the patients’ home. In the six-months follow-up the patients’ quality of life was assessed with RAND-36 survey that was sent home. The associations of prolonging COVID-19 symptoms with quality of life were analyzed using multivariate covariance analysis (MANCOVA) and further with discriminant analysis. The relationship between the length of hospital stay and quality of life was assessed with MANCOVA. Results and conclusions: The symptoms reported in the three-months follow-up were associated with lowered quality of life in the six-months follow-up. There were no significant differences in quality of life between the patient groups. The length of hospital stay was not associated with quality of life in ICU and ward groups. These results support previous studies that have found prolonging symptoms of COVID-19 to be associated with quality of life. According to this study, all patient groups can experience clinically significant prolonging symptoms of COVID-19 alike with later association with quality of life.

Objectives: Mental health problems as well as chronic stress and worries have been shown to have an established connection to sleep quality, but the individual effects of acute, stressful situations encountered in everyday life have received less attention. Rapid eye movement (REM) sleep has a hypothesized role in the processing of emotional memories and may therefore be affected by daytime acute stress. In experimental animal models and non-experimental human studies on healthy subjects acute stress has been associated with increases in REM sleep spectral power in the theta and beta ranges. The aim of this study was to investigate in an experimental setting utilizing virtual reality, whether an acute stress experience influences REM spectral power at these frequency ranges. Methods: Two groups of healthy young adults (N=31, 61 % female, mean age 25.5 years, SD = 3.46) underwent stress inducing or neutral virtual reality scenarios after which they spent the night at a sleep laboratory where their brain activity during sleep was measured with electroencephalography (EEG). To analyse the differences in theta and beta frequency activity during REM sleep, the EEG signal was Fourier transformed to yield power spectral density (PSD) values. Results: Statistical analysis of PSD values revealed that participants in the stress condition exhibited higher REM sleep theta power than controls when controlling for the effects of sex and age. Additionally, sex was found to have a statistically significant effect on REM sleep theta and beta power, with females exhibiting higher power. Age had a negative relationship with spectral power at the theta range, as well as with central low and high beta power. Conclusions: The finding that experimentally manipulated acute stress increases REM sleep theta power during the following night indicates the importance of REM sleep theta activity in the adaptive processing of acute stress, possibly due to the emotional processing of the stressful memory. This study also underlines the importance of sex and age in understanding the relationship between acute stress and REM sleep.

Aortic stenosis is the most important type of valvular heart disease among elderly patients, that often lead to valve replacement interventions. As the age structure shifts towards older age and life expectancy continues to rise, the prevalence of aortic stenosis is presumed to rise, resulting in more patients and additional expenses. Echocardiography is the most important tool for assessing aortic stenosis among patients. An experienced clinician can determine the severity of the disease with echocardiography alone, although the complete picture of a patient’s health must be evaluated during examination. The choice of intervention and timing thereof should be done by a heart team consisting consists of cardiologists, cardiac surgeons, radiologists, interventional radiologists and anaesthesiologists. Intervention is done by replacing the stenotic aortic valve with a functional synthetic valve either by surgical aortic valve replacement (SAVR) or by transcatheter aortic valve implant (TAVI). Echocardiography is used for evaluating prognosis and selecting type of care for each patient, based on the ECHO findings. This overview presents the use of transthoracic echocardiography as a tool for assessment of disease severity among patients with aortic stenosis, as well as advantages and limitations. The overview incudes a study of the clinical outcome of 30 patients with aortic stenosis treated with surgical aortic valve replacement and transcatheter aortic valve implant within the AS-AMYL study at the Helsinki University Hospital.

Aims of the study. It is well known that many adolescents do not get enough sleep. However, there is little research about the possible connection between adolescent sleep and family functioning. In addition, these studies vary greatly in, e.g., methodology and ages of the participants and only a few studies have used actigraphy. The aim of the present study is to examine the associations between family functioning and adolescent sleep, more specifically sleep duration, sleep quality and sleep timing. Methods. The present study was a part of SleepHelsinki!, a population-based research project based in the University of Helsinki. Sleep and family functioning of 308 adolescents (70.5% females), aged 15–18, were measured. Both subjective (PSQI) and objective (actigraphy) measures of sleep were used. Linear and logistic regressions were used to statistically analyze the associations between family functioning and sleep timing and subjective sleep quality. Results and conclusions. The association between family functioning and sleep duration was non-significant. When sex was adjusted for, the association between family functioning and sleep timing remained non- significant. However, the association between subjective sleep quality and general family functioning was statistically significant. Furthermore, problematic family functioning was related to a higher risk of poor sleep quality. Male sex was related to a higher risk of having a challenging circadian rhythm. Based on the results of the present study, family functioning is connected to subjective sleep quality and more problematic family functioning is a risk factor for lower quality sleep in adolescents.

Objective: Antisocial traits have negative short- and long-term effects on the individual and the society. Detecting early signs of antisocial traits is important in prevention of antisocial behavior. Studies have shown a strong correlation between animal cruelty in adolescence and antisocial traits in adulthood. However, the research on this correlation is insufficient. The objective of this study was to examine how animal cruelty in adolescence predicts development of antisocial traits. This was done by examining odds ratios in population-based research data. The study examines how animal cruelty by itself and combined with gender, affects the risk developing antisocial traits in young adulthood. This risk was also compared with 12 other DSM-III-R classified conduct disorder (CD) traits, and more precisely the link between theft and development of antisocial behavior. Methods: Subjects (N = 1330, of which 704 women) were from the FinnTwin-12 study, a population-based cohort study tracking the behavioral development among Finnish twins, born between 1983 and 1987. SSAGA-interviews were conducted on the same twins twice, first at the age of 14 and later at the age of 22 (mean = 22.4 years).Thirteen traits of CD (including animal cruelty), were evaluated at the age of 14 and seven traits of antisocial behavior at the age of 22. All statistical analyses were performed using multinomial logistic regression analysis. Results and conclusions: According to the study, animal cruelty in adolescence more than doubles the risk of developing two or more antisocial traits in young adulthood, compared to those who were not cruel to animals. The interaction between gender and cruelty to animals was not statistically significant. Compared to theft, animal cruelty appeared to be a weaker predictor of antisocial behavior, and was not found to have stronger or specific correlation with antisocial traits than other CD traits. The risk of developing these traits by animal cruelty alone, was reduced statistically insignificant when other CD traits were taken into account. In conclusion, animal cruelty has a strong statistical link with adulthood antisocial traits. However, effective prediction of antisocial traits requires other CD traits to be considered.

Objectives: There is little systematically analyzed register-based information regarding First Episode Psychosis (FEP). This study analyzed demographics, diagnostic distribution, substance use disorder (SUD) comorbidity and treatment in non-affective FEP (ICD-10 diagnosis codes F20-F29) in Finland. Methods: The Finnish Quality of Psychosis Care Register maintained by the Finnish Institute for Health and Welfare includes all people diagnosed with non-affective psychosis in primary or specialized care in any medical specialty. Here, all individuals of 7 to 31 years diagnosed with FEP in 2018 (n=1528) were included and followed up for one year. Logistic regression analysis was applied to study factors predicting the use of antipsychotic medication. Results: Most individuals were men (61.5%), mean age was 23. The incidence rate was highest in Eastern Finland and the Metropolitan Area and lowest on the west coast. The most common diagnose was unspecified psychosis (F29, 73.2%). For 79.6%, the treatment started in outpatient care. After one year schizophrenia increased (4.3% to 10.9%) while unspecified psychosis decreased (65.4%). One fourth had a comorbid SUD, most commonly caused by alcohol (49.6%), multiple drugs (33.2%) and cannabis (26.6%). Hospitalization rate was 4.5% within one month, 11.3% within three months, and 25.7% within 12 months. Only 49.8% were taking antipsychotic medication. Gender, age, residence area or comorbid SUD did not clearly predict medication use. Conclusions: The results underline the need for SUD expertise in the treatment of young people with FEP. The factors influencing the use of antipsychotic medication in people under 31 years old should be further studied.

Objectives: Executive function skills are essential in goal-directed behaviour. The assessment of these skills has been based on specific performance-based tasks or subjective questionnaires that measure everyday skills. The EPELI method uses gamification elements, and it has been developed to assess children’s goal-directed behaviour. The method includes both a VR and a computer version, both of which may have their individual benefits. Therefore, it is important to understand the differences between the versions. The aim of the current study was to examine irrelevant actions during EPELI and the differences in actions between the two versions as well as between two separate sessions. The hypothesis was that the number of irrelevant actions does not differ between the versions. Furthermore, the correlation between actions during EPELI and executive function skills in everyday life was examined. It was expected that a high score in BRIEF-questionnaire, which measures challenges in everyday executive functions, would be linked to worse task efficiency and more irrelevant actions. Methods: Participants of the current study were 72 typically developing 9-13 years old children. All participants played EPELI with both VR equipment and a computer. On average there were seven months between the sessions. Half of the participants began with the VR version and the other half began with the computer version. Before the meeting the participants’ guardians filled the BRIEF questionnaire. Irrelevant actions were analysed with generalized linear mixed models. The connection of everyday executive functions skills and EPELI were analysed with correlations. Results and Conclusions: As hypothesised there was no difference in the number of irrelevant actions between the EPELI versions. Instead, the session affected the number of irrelevant actions. During the second session, players had more actions on average than during the first session. The questionnaire that was filled before the first session correlated with the task efficacy and irrelevant actions during EPELI. On the contrary, the correlation was insignificant in the second session. In addition, task efficacy during the computer based EPELI correlated with the questionnaire. Regarding the irrelevant actions, VR equipment did not provide additional insight on top of the computer version. These results suggest that both EPELI versions may complement existing assessment methods. However, the change in the number of irrelevant actions between the two sessions as well as the reasons behind the change should be examined further.