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Objectives. Previous research has found associations between both cognitive ability and anxiety and school performance and anxiety. The nature of these associations is not yet clear however. On one hand, it has been speculated that the optimal development of emotion regulation requires cognitive skills and that performing well at school could protect one from anxiety e.g. through increased feelings of competence. On the other hand, anxiety may interfere with cognitive performance by directing attention to negative thoughts and impair school performance e.g. through absences from school. The objective of this study was to investigate the associations between anxiety, cognitive ability and school performance in 12- and 17-year-old youth. Of additional interest were the longitudinal changes in anxiety and cognitive ability in a 5-year follow-up. Methods. The data in this study consisted of the youth who participated in the 12- and 17-year follow-ups (N = 451) of the longitudinal study of Glycyrrhizin in Licorice (GLAKU). Anxiety was assessed using an Achenbach Child Behavior Checklist (CBCL) questionnaire completed by parents when the participants were 12. When participants were 17, they completed an Achenbach Youth Self Report (YSR) questionnaire. The cognitive ability of the participants was assessed using two subtests of verbal reasoning and two subtests of visual reasoning of Wechsler Intelligence Scale. Information about school performance was gained from parent evaluations. The associations between anxiety, cognitive ability and school performance were examined with negative binomial, logistic and linear regression models. Results and conclusions. In accordance with the diverse and partly controversial results of previous research this study also found the complexity of the associations between cognitive ability and anxiety: On one hand, lower anxiety was associated with better cognitive ability in cross-sectional designs. On the other hand, higher anxiety at the age of 12 was associated with improved performance IQ in a 5-year follow up. However, this association was found only among girls and for boys anxiety had an impairing effect on the development of performance IQ. These results suggest that early support should be targeted especially towards boys with anxiety in order to protect their cognitive development.

Tämän syventävän tutkielman tavoitteena on kirjallisuuskatsauksen ja kliinisen potilastapauksen avulla tarkastella hammaskaaren ahtauden hoitomenetelmiä vaihduntavaiheen hampaistossa. Ahtaus on yleisin oikomalla hoidettava purentavirhe ja yleisin oikomishoitoon hakeutumisen syy. Yli puolella 12-18 -vuotiaista suomalaisnuorista on ahtautta hammaskaarella. Suomessa käytössä olevan 10-portaisen purentavirheiden arviointiasteikon mukaan vain erittäin vaikea ahtaus voi täyttää kunnalliseen hoitoon pääsyn kriteerit. Kirjallisuuskatsauksessa keskitytään vaihduntavaiheen hampaiston hoitomenetelmiin ja hoidon ajoitukseen, mutta perehdytään lyhyesti myös ahtauden etiologiaan. Tutkimusaineistona käytettiin ortodontian oppikirjoja sekä tieteellisiä julkaisuja aiheesta. Julkaisuja haettiin Medline, Pubmed ja Google Scholar -tietokannoista käyttäen ensisijaisina hakutermeinä ”dental crowding” ja ”treatment of dental crowding”. Tutkielman kliininen osuus käsitteli 10-vuotiaan tytön oikomishoidon kulkua HUS Suusairauksien opetus- ja hoitoyksikössä. Hammaskaaren ahtautta voi vaihduntavaiheen hampaistossa hoitaa mahduttamalla hampaat kaarelle tai poistohoidolla. Menetelmiä hampaiden kaarelle mahduttamiselle ovat esimerkiksi maitohampaiden lähdöstä vapautuvan tilan säilyttäminen, kaarten sagittaalinen ja transversaalinen levitys sekä hampaiden selektiiviset hionnat. Hammaskaaren ahtaus esiintyy usein yhdessä jonkin toisen purentavirheen kanssa. Monissa tapauksissa pyritäänkin ensisijaisesti korjaamaan toiminnallisesti vakavampi purentavirhe, jonka kanssa ahtautta esiintyy. Potilaan purennan kokonaistilanne tulee huomioida hoidon suunnittelussa ja näin ollen on mahdotonta nimetä yksittäistä hoitomenetelmää ylitse muiden. Eniten ahtauden hoitolinjan ja -menetelmän valinnassa vaikuttavat ahtauden vaikeusaste ja potilaan ko-operaatiokyky. Ahtaus on vielä aiheena suhteellisen vähän tutkittu ja lisätutkimus aiheesta onkin suositeltavaa.

Abstract Aims. Family functioning plays an important role in the development, health and well-being of the child. Research literature has shown the connection between the characteristics and distress of family members and the family functioning. However, the understanding of the importance of individual strengths to family functioning is significantly more limited compared to the knowledge of connection between risk factors and family functioning. The trait of optimism is known to be associated with better social relationships, but optimism as the predictor of family functioning has not been studied yet at all. The aim of the study is to examine the relationship of mother's and child's optimism on family functioning. In addition, it is aimed to determine the stability of child’s optimism in transition from childhood to adolescence. Methods. The data consisted of mothers and children who participated in the Finnish Glycyrrhiz in Licorice (GLAKU) follow-up study. A total of 213 mother-child pairs were selected from the original GLAKU study to the sample. Of the children selected in the sample, 113 (53.1%) were girls. Mother's optimism was measured by a Life Orientation Test - Revised (LOT-R) questionnaire based on self-assessment at the child's age of 7-8 years and 11-13 years. Child's optimism at the age of 7-8 years was measured by the mother's assessment with the Parent-rated Life Orientation Test (PLOT) questionnaire. Child's optimism at 11-13 years of age was measured by the child's own assessment with the Youth Life Orientation Test (YLOT) questionnaire. The family functioning was measured according the McMaster model by the mother assessment of the Family Assessment Device (FAD) questionnaire at the child's age of 11-13. The study examined the link between optimism and McMaster model's dimensions of family functioning: general family functioning, problem-solving, communication, roles, affective responsiveness, affective involvement, and behavioral control. The connections between optimism and family functioning were studied by linear regression analysis. Results and Conclusions. The families of the more optimistic mothers were generally better functioning. Mothers' higher optimism was associated with better problem solving skills, better communication and emotional involvement. Families with higher child’s optimism at 7-8 years of age were also better functioning when the child was 11-13 years old. The child's higher optimism at the age of 7-8 was related to better problem solving skills, affective responsiveness, affective involvement and better behavior control. Child’s optimism decreased between 7-8 years and 11-13 years. The results of the connections between child's optimism and family functioning were contradictory as the child's optimism at the age of 11-13 was not connected to the dimensions of the family functioning and, on the other hand, the decrease in child's optimism was associated with better family responsiveness and emotional involvement. Because of the contradictory results, it is important to study the topic further in the future. The results provide more knowledge about the importance of optimism for social relations. Optimism seems to be a significant psychological resource especially for mothers, and it may promote the processes that support the family functioning. According to the study, the trait of optimism can be utilize as a resource when helping families with children to improve the functioning of the family and when promoting the well-being of children and parents.

Aims. Maternal perinatal depression has been shown to have multiform adverse effects on child development, such as cognitive ability. However, the prior studies are limited to early childhood cognitive ability, and the association in school-age is yet to be determined. The aim of this study was to examine the relationship between maternal perinatal depression and child cognitive ability at 7-11 years. It was hypothesized that both prenatal and postpartum depression, and also the continuity of perinatal depression from prenatal to postpartum period, would have a negative effect on child cognitive ability. Methods. The study sample, 423 mother-child-pairs, originates from Finnish PREDO-cohort. Perinatal depression was assessed with CES-D 14 times biweekly during pregnancy, beginning from gestational week 12+0, and two weeks and six months after delivery. Child cognitive ability was assessed with WISC-IV in terms of general cognitive, verbal and visual ability. The association between perinatal depression and general cognitive ability was analysed with multiple linear regression, and the association with verbal and visual ability with multivariate multiple linear regression. Results. Neither maternal prenatal nor postpartum depression was related to child general cognitive ability, verbal ability nor visual ability at 7-11 years. Continuity of depression from pregnancy to postpartum period was not related to child cognitive ability either. Conclusions. According to this study, there is no association between maternal perinatal depression and child cognitive ability at 7-11 years.

Objectives: Fetal exposure to excess cortisol may negatively affect the mental development of a child later in life. Consumption of licorice, containing glycyrrhizin (a potent inhibitor of placental 11β- hydroxysteroid dehydrogenase type 2, the “barrier” to maternal glucocorticoids), increases the cortisol level in fetal circulation. Therefore, since 2016, the national nutritional recommendations in Finland have recommended avoiding licorice consumption during pregnancy. The aim of this study is to assess the association between glycyrrhizin consumption in different stages of pregnancy and child neurocognitive development in early childhood. In earlier research, child neurodevelopment has not been studied before school age. Methods: The sample of the study is a part of the ITU (InTraUterine sampling in early pregnancy) cohort. Mothers reported their glycyrrhizin consumption from the preceding three months three times during pregnancy. The child’s neurocognitive development was assessed with Ages and Stages Questionnaires -3 (ASQ-3) at 1–2 years (mean age = 1.55 years, standard deviation (SD) = 1.44 months, n = 516, 47.50 % girls) and with Bayley Scales of Infant and Toddler Development III (BSID-III) at 3 years (mean = 2.96 years, SD = 2.69 months, n = 476, 50.40 % girls). The association between licorice consumption and neurocognitive development was assessed using linear, logistic, and Poisson regression models. Results and conclusions: Maternal glycyrrhizin consumption and child neurocognitive development were negatively associated at 1–2 and 3 years. The results varied between areas of development and the time of pregnancy: consumption during early pregnancy was associated with slower gross motor development at 3 years, mid-pregnancy consumption with slower cognitive and language development at 3 years, and late pregnancy with slower total neurodevelopment scores at 1–2 years. Thus, avoiding licorice consumption through pregnancy and following the national guidelines that followed the previous studies on this subject is recommended.

Aims of the study. Mental disorders and their intergenerational nature are significant global health problems. Research shows that prenatal and postnatal exposure to maternal affective disorders increases the risk of mental disorders in children. A more precise understanding of the timing of maternal affective disorders in predicting the risk of child psychopathology is needed. This study examined whether maternal affective disorders before, during, and after pregnancy are associated with the risk of mental disorders in children up to the age of 7–11 years. Timing of maternal affective disorders, i.e. the sensitive periods, and additive effects of maternal affective disorders were also assessed. Methods. The study sample is a part of an ongoing prospective PREDO-study. The sample (N = 4692) comprised mother-child-pairs whose hospital records documenting mental disorders was available. The associations between maternal affective disorders and any mental disorder, disorders of psychological development, and behavioural and emotional disorders in the offspring were analyzed using Cox regression models, controlling for sociodemographic factors and maternal substance use disorders. Timing of maternal affective disorders was assessed by comparing the observed risks, i.e. hazard ratios, of the different time periods. Results and conclusions. Maternal affective disorders during every time period predicted increased risks of offspring mental disorders. Maternal affective disorders before and after pregnancy associated with the risk of any mental disorder, disorders of psychological development, and behavioural and emotional disorders. Maternal prenatal affective disorders were associated with increased risks of any mental disorders and disorders of psychological development. Timing of maternal affective disorders did not appear to be crucial, but maternal affective disorders at different timepoints had additive effects on child mental disorders. Findings suggest that maternal affective disorders predict mental disorders in young children. Preventive interventions for women planning for pregnancy, during pregnancy, and for families with young children may prevent mental disorders in both the mother and the child.

The aim of the study: In research literature depressive symptoms in mothers have been associated with lower parental sense of competence. The developmental mechanisms responsible for this relation are poorly understood and there is a need for longitudinal study especially. The study of this master’s thesis explores the association of both postnatal and later depressive symptoms with parental sense of competence when the child is 1–5 years. It also explores whether demographic factors have an impact to the relation and does later depressive symptomology in mothers mediate the relation between postnatal depressive symptomology and later parental competence. Method: Data is part of the Finnish cohort of The Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction (PREDO) research. The sample includes 2255 mothers who gave birth between years 2006-2010. Mothers evaluated their depressive symptoms 2 weeks / 6 months after birth (Center for Epidemiologic Studies Depression Scale ) and at the follow-up when the child was between 1–5 years old (Beck´s Depression Inventory). Mothers also evaluated their parental sense of competence (Parenting Sense of Competence Scale) at the follow-up. Data was analysed using linear regression and mediation analysis. Results and Conclusion: Both postnatal and later depressive symptoms were associated to lower parental sense of competence when the child was 1–5 years and demographic background did not have any impact to the relations. A significant mediation model was found where later depressive symptomology in mothers partly mediated the relation between postnatal depressive symptomology and later parental competence. Therefore effective screening and early treatment of postnatal depressive symptoms are important. Evaluating parental competence could potentially be a valuable part of screening and treatment of depressive symptomology in mothers.

Background: Parenting stress, romantic relationship satisfaction and their associations have been studied extensively, mostly with cross-sectional studies and in different clinical groups. However, parents of young children in non-clinical groups are less studied, especially with longitudinal settings. The aim of this master’s thesis is to investigate the change in maternal parenting stress over time, associations with romantic relationship satisfaction and if romantic relationship satisfaction modifies the change in parenting stress. Methods: Our sample (n = 361) is drawn from the prospective cohort study “The InTraUterine sampling in early pregnancy” (ITU). Participating mothers took part in two follow-up assessments: first at the child’s age of 1–2-years and second at 3 years. Parenting stress was assessed at the first and second follow-ups with the “Parenting Stress Index-Short Form” (PSI-SF) questionnaire with three subscales: parental distress, parent-child dysfunctional interaction and difficult child. Romantic relationship satisfaction was assessed at the first follow-up with the satisfaction subscale form the “Dyadic Adjustment Scale” (DAS) questionnaire. Data were analyzed using linear regression models and mixed models. Child’s age, sex, daycare, and siblings, as well as mother’s education and mental health disorders were controlled for in the analyses. Results: Higher parenting stress at the first follow-up was associated with higher parenting stress at the second follow-up. Higher romantic relationship satisfaction was associated with lower parenting stress at the first follow-up in all the subscales, and at the second follow-up in parental distress and difficult child subscales. Parenting stress related to difficult child’s subscale appeared to increase over time in the entire sample, but in the closer examination the changes in parenting stress were partly different in the groups of high and low romantic relationship satisfaction. Controlling for background variables did not affect the results. Conclusions: The results of this thesis fill the previous gaps in longitudinal settings and studies carried out with mothers of young children in non-clinical groups. It seems that romantic relationship satisfaction may be connected to parenting stress and its change in the early childhood. A broader understanding of these phenomena in the family context may be beneficial for applications, for example in health care, in preventing problems and promoting wellbeing of families with children.

Hydrokefalus eli aivo-selkäydinnestekierron häiriö on neurokirurgisesti hoidettava sairausryhmä, jonka hoitona potilaalle voidaan asentaa suntti. Hydrokefalus voi aiheutua useasta eri syystä ja ilmetä eri ikäisillä. Sunttileikkausiin liittyy komplikaatioita ja ventrikuloatriaalisuntteihin on aiemmin ajateltu liittyvän suurentunut komplikaatioiden riski. Tämän tutkimuksen tavoitteena oli tarkastella Helsingin ja Uudenmaan sairaanhoitopiirissä vuosien 2015-2016 aikana sunttileikkauksella hoidettuja aikuisia hydrokefaluspotilaita ja kartoittaa näiden hydrokefaluspotilaiden taustatekijät, hydrokefaluksen etiologiat, käytetyt sunttityypit, leikkauskomplikaatioiden kirjo sekä kuolleisuus. Tutkimus toteutettiin retrospektiivisesti keräämällä aineisto potilaskertomuksista. Tutkimuksessa osoitettiin, että revisiomäärät ja kuolleisuus olivat HUSissa samanlaiset kuin kirjallisuudessa. Tutkimuksessa havaittiin eroja pitkäaikaiskuolleisuudessa hydrokefaluksen eri taustasyiden välillä.

Nykyaikainen karieksen hoito pyrkii ensisijaisesti reikiintymisen ennaltaehkäisyyn ja pysäytyshoitoon. Paikkaushoidot kuluttavat kuitenkin suuren osan hammaslääkärin työajasta, ja aiemman kirjallisuuden perusteella ennaltaehkäisevä suun terveydenhoito aikuisille on harvinaista. Tutkielman tavoitteena oli selvittää ikäryhmittäin paikkaus- ja ennaltaehkäisytoimenpiteiden määrä, niissä tapahtuneet muutokset kahden tutkimusvuoden välillä ja toimenpiteiden sisältö. Tutkielma suoritettiin retrospektiivisena rekisteritutkimuksena. Tutkimusaineisto koostuu vuosina 2012 ja 2017 Helsingin kaupungin hammashoitoloissa hoidetuista 20–60-vuotiaista potilaista ja heille suoritetuista toimenpiteistä. Tulokset tilastoitiin ja analysoitiin 10-vuotisikäryhmissä, nuorimman ikäryhmän ollessa 20–29-vuotiaat ja vanhimman 50–60-vuotiaat. Tulokset ilmoitettiin prosenttiosuuksina ja tunnuslukuina. Tutkimusvuosien välillä ikäryhmien populaatio kasvoi 6,2 %, hoidettujen potilaiden ja suoritettujen toimenpiteiden määrät kasvoivat noin 20 %. Paikkauspotilaiksi luokiteltiin koko aineistosta 48 % ja paikkaustoimenpiteet kattoivat 11 % koko aineiston toimenpiteistä. Vastaavasti ennaltaehkäisypotilaiksi luokiteltiin koko aineistosta 3 % ja ennaltaehkäisytoimenpiteet kattoivat 0.3 % koko aineiston toimenpiteistä. Paikkauspotilaiden- ja toimenpiteiden suhteelliset osuudet laskivat kaikissa ikäryhmissä tutkimusvuosien välillä. Paikkaustoimenpiteiden suhteelliset osuudet ikäryhmien sisällä erosivat ikäryhmien kesken; laajemmat paikkaustoimenpiteet olivat suhteellisesti yleisempiä vanhemmissa ikäryhmissä. Viiden vuoden aikana havaittiin pienempien paikkaustoimenpiteiden määrän kasvua ja laajempien vähentymistä. Ennaltaehkäisyksi luokiteltujen potilaiden ja toimenpiteiden suhteelliset osuudet laskivat kaikissa ikäryhmissä tutkimusvuosien välillä. Ennaltaehkäisevät suun terveydenhoidon toimenpiteet olivat yleisempiä nuoremmilla ikäryhmillä. Paikkaushoitojen vähentyminen voi johtua työikäisten parantuneesta suunterveydestä, sekä muuttuneista hoitokäytännöistä. Ennaltaehkäisevä suun terveydenhoito ei ollut tutkielmassa yleistä ja huolestuttava muutos oli toimenpiteiden huomattava väheneminen tutkimusvuosien välillä. Syiden selvittäminen vaatisi jatkotutkimuksia, jotka olisivat ajankohtaisia ottaen huomioon tulevan sosiaali- ja terveysalojen uudistuksen.