In human intelligence, a verbal statement from a source is seldom 100% true or false, and not ver... more In human intelligence, a verbal statement from a source is seldom 100% true or false, and not very often is the source a total liar or a truth teller. From this standing point, a simple dichotomy of a liar or a truth teller might not offer an adequate diagnostic value for the purposes of human intelligence. A more diagnostic approach would be to assess which parts of the predominantly truthful verbal statement are likely to be true and which parts are assessed to be doubtful. In addition, the use of two parallel methods to detect deceit should improve the diagnostic value of the results. A pilot study in laboratory conditions (n = 8, yielding 190 assessment points) utilising an applied mock crime scenario was conducted. Correlation calculations showed that a dual-method approach slightly improved the within-statement truth accuracy, and it was achieved mainly by decreasing the number of false positives. As the truth accuracy was increased, the lie accuracy within the test group slig...
International peacekeeping operations often take place in environments in which frequent exposure... more International peacekeeping operations often take place in environments in which frequent exposure to high levels of stress is likely. Thus, implications to psychological well-being can be expected. This study examined the psychological well-being of peacekeeping veterans post-deployment and assessed possible contributing factors during deployment. A total of 2,317 Finnish veterans of peacekeeping operations took the survey within 3 months post-deployment on average; the survey covered the following categories: job strain during the operation, potentially traumatic events during deployment, and postdeployment symptoms.
This paper presents a concept for utilising falsified documents and disinformation as a security ... more This paper presents a concept for utilising falsified documents and disinformation as a security measure by diminishing the utility of the stolen information for the attacker. Classical definition of tarpitting honeypots is to create virtual servers attractive to worms and other malware that answer their connection attempts in such a way that the machine on the other end becomes stuck. A common extension to the OSI model is to refer the user as the layer 8 on top of the application layer. By generating attractive looking but falsified documents and datasets within our secured network along with the real information, we could be able to force the malicious user on the other end similarly to be 'stuck' as they need to dig through and verify all the information they have managed to steal. This in effect slows down the opponents' decision making speed, can make their activity in the network more visible and possibly even mislead them. The concept has similarities to the Cana...
Target audience analysis (TAA) is an essential part of any psychological operation. In order to c... more Target audience analysis (TAA) is an essential part of any psychological operation. In order to convey a change in behaviour, the overall population is systematically segmented into target audiences (TAs) according to their expected responsiveness to different types of influence and messages, as well as their expected ability to behave in a desired way. The cyber domain poses a challenge to traditional TAA methods. Firstly, it is vast and complex, requiring effective algorithms to filter out relevant information within a meaningful timeframe. Secondly, it is constantly changing, representing a meshwork in formation, rather than a stable collection of TAA-specific data. The third challenge is that the target audience (TA) consists not of people, but of digital representations of people, whose true identity and characteristics cannot usually be verified. To address these challenges, the authors of this article suggest that the concept of TAA has to be revised for use in the cyber doma...
Target audience analysis (TAA) is an essential part of any influence operation. To convey a chang... more Target audience analysis (TAA) is an essential part of any influence operation. To convey a change in behaviour, the overall target population is systematically segmented into target audiences (TAs) according to their expected responsiveness to different types of influence and messages, as well as their expected ability to behave in a desired way. The cyber domain poses a challenge to traditional TAA methods. Firstly, it is vast, complex and boundless, requiring effective algorithms to filter out relevant information within a meaningful timeframe. Secondly, it is constantly changing, representing a meshwork in formation, rather than a stable collection of TAA-specific data. The third challenge is that the TA consists not of people but of digital representations of individuals and groups, whose true identity, characteristics or location cannot usually be verified. To address these challenges, the authors of this chapter suggest that the concept of TAA has to be revised for use in the...
International Journal of Cyber Warfare and Terrorism, 2020
The development of communications technology has enabled the internet to become a new theatre of ... more The development of communications technology has enabled the internet to become a new theatre of military operations. The influence aspects of military operations in information battlespace, however, are difficult both in theory and in practice, especially concerning international law. As a result, there is a variety of national and organizational solutions of how to divide tasks and responsibilities between authorities. This asymmetry generated by different approaches and rules of conduct provides opportunities for actors with more relaxed interpretation of international law, allowing them to use weapons of influence in order to pursue military goals. In this article the authors ask whether military influence operations, just like cyber operations, could be treated as acts of war. To help militaries address the complex issue of influence operations, a framework consisting of three categories is suggested.
This study investigated how experienced demands of the job and the social support during operatio... more This study investigated how experienced demands of the job and the social support during operations were related to psychological well-being after deployment. The data was collected from 817 Finnish peacekeepers returning home between 2012 and 2014 from altogether over 10 different operations of which the most common were ISAF (Afghanistan) and UNIFIL (Lebanon). Experiencing less social support and more job-related demands was related to higher stress and weaker sense of coherence after deployment, even though overall level of emotional difficulties after deployment was low. These results suggest that there may be health gains to achieve in improved social support and balancing job demands during operation. Given the highly hierarchical organization of the military, role of leadership is essential in both establishing social support and balancing the job demands.
Study Objectives: To evaluate the frequency of sleep problems and daytime tiredness among adolesc... more Study Objectives: To evaluate the frequency of sleep problems and daytime tiredness among adolescents with inflammatory bowel disease (IBD) in comparison with their healthy peers. Design: Parent and self-reports of sleep problems and daytime tiredness. Setting: Questionnaire-based postal survey. Intervention: N/A. Participants: One hundred sixty Finnish adolescents with IBD; 236 adolescents matched for age, sex, and place of residence; and the parents of both groups. Measurements and Results: Sleep Self-Report and sleep questions of the Child Behavior CheckList , and Youth Self-Report. The parents of adolescents with IBD reported in their index child more trouble sleeping (P < 0.01), more nightmares (P < 0.01), sleeping more than most children during the day/night (P < 0.001), and overtiredness (P < 0.001) than did the parents of control subjects. In contrast, adolescents with IBD themselves did not report more problems than their peers. However, in the group of patients with self-reported severe IBD symptoms, both the parents and the adolescents reported trouble sleeping and overtiredness more often (P values < 0.01) than in the group with mild symptoms or control subjects. Adolescents with severe IBD reported more often that their symptoms affected the quality of their sleep (P < 0.001) than did adolescents with mild disease. Conclusions: Adolescents with severe IBD symptoms have disturbed sleep and are overtired more often than are adolescents with mild IBD symptoms or control subjects. Thus, in adolescents with severe IBD symptoms, evaluating sleep is important in characterizing the disease burden. Both parent and adolescent reports are needed for comprehensive assessment of sleep in the young. Keywords: Sleep in pediatric IBD, parent and youth-self report Citation: Pirinen T; Kolho KL; Simola P; Ashorn M; Aronen ET. Parent and self-report of sleep-problems and daytime tiredness among adolescents with inflammatory bowel disease and their population-based controls.
This study compared sleep in patients with Conduct Disorder/Oppositional Defiant Disorder (CD/ODD... more This study compared sleep in patients with Conduct Disorder/Oppositional Defiant Disorder (CD/ODD) and normative children and evaluated the associations between sleep and behavioral symptoms in patients. Participants were 30 patients, aged 7 to 12 years, with diagnoses of CD/ODD and their age and gender matched controls. Patients with CD/ODD and their parents reported significantly more sleep problems than did the control children and their parents (p values < 0.01). By actigraphy, CD/ODD children with comorbid ADHD slept significantly less than did the patients with CD/ODD alone and the controls. In patients, low sleep amount and efficiency associated with increased amount of parent-reported externalizing symptoms (r = -0.72, 0.66, p values < 0.001). Results highlight the need of evaluating sleep in children with CD/ODD. Improving their sleep may ease their symptoms.
Journal of Developmental & Behavioral Pediatrics, 2009
To study emotional and behavioral problems and sleep and cognitive performance in snoring and non... more To study emotional and behavioral problems and sleep and cognitive performance in snoring and nonsnoring 3- to 6-year-old children. As part of an epidemiological study of sleep disordered breathing (SDB) in preschool-aged children, 43 snorers and 46 nonsnorers participated in a clinical study. Their parents completed the Child Behavior Checklist (CBCL). The children were assessed with Wechsler Preschool and Primary Scale of Intelligence, Revised and subtests of the Developmental Neuropsychological Assessment (NEPSY-A) representing aspects of attention, language skills, sensorimotor functions, memory, and learning. On the CBCL snoring children had significantly more parent reported internalizing symptoms (p &amp;amp;amp;amp;amp;amp;amp;amp;lt; .05) than the nonsnoring children, especially symptoms of anxious/depressed mood (p &amp;amp;amp;amp;amp;amp;amp;amp;lt; .01) and emotional reactivity (p &amp;amp;amp;amp;amp;amp;amp;amp;lt; .05). More children from the snoring group than from the nonsnoring group (22 vs 11%) scored in the subclinical or clinical range on the internalizing scale. Interestingly, no significant difference between the groups was found in the amount of externalizing symptoms. The amount of sleep problems other than snoring was higher in the snoring than in the nonsnoring group (p &amp;amp;amp;amp;amp;amp;amp;amp;lt; .01). On tests measuring auditory attention (p &amp;amp;amp;amp;amp;amp;amp;amp;lt; .01) and language skills (verbal IQ, p &amp;amp;amp;amp;amp;amp;amp;amp;lt; .05), the snoring group performed worse than the nonsnoring group. Our results support the view that SDB should be considered a possible risk factor for mood disorder symptoms and impaired cognitive performance in children.
Results: 15 patients with endoscopic and histologically proven chronic pouchitis were studied. 13... more Results: 15 patients with endoscopic and histologically proven chronic pouchitis were studied. 13 had failed to enter remission with CM, two had relapsed on maintenance C. Antibiotic coliform sensitivity testing showed: C resistance in all samples; co-amoxiclav resistance in four samples; trimethoprim resistance in 11 samples, cefixime resistance in eight samples. Four samples contained extended spectrum beta lactamase (ESBL) producing organisms. All 15 patients were treated with an antibiotic to which their faecal coliforms were sensitive. Twelve (80%) entered clinical remission with a PDAI symptom score of 0. Discussion: Targeted antibiotic therapy is effective in the majority of patients with antibiotic resistant pouchitis. Faecal coliform sensitivity testing and targeted antibiotic therapy should be used in all patients who fail to respond to empirical antibiotic treatment or relapse on long term antibiotic therapy.
Background: Motor retardation is a cardinal feature in adult depression. Limited information exis... more Background: Motor retardation is a cardinal feature in adult depression. Limited information exists about motor activity in depressed children. The present study evaluated motor activity in depressed children compared to controls and investigated whether motor activity can be linked with the severity of symptoms in depressed children. Method: Motor activity during both day-and night time was recorded by actigraphy in twentytwo depressed children and their controls. A K-SADS-PL interview of the child and his/her mother was used to diagnose depression. The depressed children filled in the Child Depression Inventory (CDI) as a self-report of the severity of depression. Parents and teachers of both depressed children and controls filled in the Child Behavior Checklist (CBCL) and the Teacher Report Form (TRF). Results: Motor activity was reduced during the daytime in depressed children compared to controls (p b 0.001). Depressed children spent more time in total immobility during the night time than their peers (p b 0.05). In depressed children motor activity was linked with the severity of self-(r = − 0.45, p b 0.05) and teacher-reported (r = − 0.52, p b 0.05) symptoms. Depressed children with suicidal ideation (n = 10) differed significantly in motor activity compared to depressed children without suicidal ideation (n = 12) and controls (n = 22). Limitations: Sample size was only moderate. Conclusions: Reduced motor activity is an important feature of childhood depression. Objectively measured motor activity can distinguish depressed children from their peers. Motor retardation can be linked with the severity of depression, especially suicidal ideation and possibly subtype depressed children into groups with different etiology, treatment needs and course of illness.
The aim was to evaluate psychosocial symptoms and competence as reported by the parents and the a... more The aim was to evaluate psychosocial symptoms and competence as reported by the parents and the adolescents themselves among patients with inflammatory bowel disease (IBD) in relation to population-based controls. Standardized Achenbach questionnaires-Child Behavior Checklist (CBCL) for the parents and Youth Self-Report (YSR) for the adolescents-were sent to Finnish families of adolescents with IBD (age 10-18 years), and their controls matched for age, gender, and place of residence. The final study group comprised 160 adolescents with IBD and 236 controls with their parents, respectively. According to parent reports, adolescents with IBD had more symptoms of anxious/depressed mood (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), withdrawn/depressed mood (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05), social problems (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05), thought problems (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), somatic complaints (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), and lower competence (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05) than population-based controls. Unexpectedly, there was no group difference in the amount of self-reported psychosocial symptoms, somatic complaints, or competence between adolescents with IBD and their peers. However, adolescents with severe IBD reported significantly more emotional problems (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) than those with mild symptoms or controls. According to parents, adolescents with IBD have more emotional problems, social problems, thought problems, and lower competence than their population-based peers. Self-perceived severity of the IBD symptoms is associated with a larger amount of parent and self-reported emotional symptoms. Complementary methods should be used while assessing the psychosocial well-being of adolescents with IBD as questionnaires alone may be insufficient.
Objective To study the prevalence of various sleep problems at school age in a Finnish community ... more Objective To study the prevalence of various sleep problems at school age in a Finnish community sample and to evaluate the persistence of the sleep problems from the preschool age to school age in a 4-year follow-up. Methods Parents completed the Sleep Disturbance Scale for Children questionnaire on their child's sleep during the preschool years (3-6 years) and again during the school years (7-11 years). At follow-up the parents also completed a questionnaire on family structure and socioeconomic status. Results The parents of 481 children completed the questionnaires during both the first study and the follow-up (girls 49%, boys 51%; mean age 9, range 7-11). At the population level, sleep problems slightly declined from preschool to school age (P < 0.05). However, sleep problems at preschool age showed a strong persistence to school age. At the follow-up, 35% of the children who were considered to have a sleep disorder at preschool age still suffered from it at school age. At the community level, this equates to 9% of the children. The children with no sleep problems at preschool age rarely developed sleep problems at school age. Conclusions This study showed that various types of sleep problems are common at school age. Sleep problems persisted from preschool to school age at the individual level. It is important to recognize all types of sleep problems, especially persistent ones. Persistent sleep problems in children may cause and exacerbate other somatic, cognitive and psychiatric problems. Therefore, more attention should be focused on sleep problems in paediatric health care with interventions aimed particularly at children with prolonged sleep problems.
The present study investigated the development of executive functions (EFs) and their association... more The present study investigated the development of executive functions (EFs) and their associations with performance and behavior at school in 8-12-year-old children. The EFs were measured by computer-based n-back, Continuous Performance and Go/Nogo tasks. School performance was evaluated by Teacher Report Form (TRF) and behavior by TRF and Child Behavior Checklist. The studied dimensions of EF were cognitive efficiency/speed, working memory/attention and inhibitory control. Strong age effects were found for these cognitive abilities (p values \0.01). Inhibitory control was associated with better adaptive functioning (learning, working hard and behaving well), academic performance and less psychiatric symptoms (p values \0.05), specially in 8-9-year-old children. In this youngest age group low inhibitory control was also associated with teacher-reported inattention (p = 0.042). Low inhibitory control was associated with teacher-and parent-reported internalizing symptoms (p \ 0.01). These results suggest that maturational factors may underlie low adaptive functioning and psychiatric symptoms during early school years. Further studies are needed to evaluate the association between inhibition and emotional symptoms.
In human intelligence, a verbal statement from a source is seldom 100% true or false, and not ver... more In human intelligence, a verbal statement from a source is seldom 100% true or false, and not very often is the source a total liar or a truth teller. From this standing point, a simple dichotomy of a liar or a truth teller might not offer an adequate diagnostic value for the purposes of human intelligence. A more diagnostic approach would be to assess which parts of the predominantly truthful verbal statement are likely to be true and which parts are assessed to be doubtful. In addition, the use of two parallel methods to detect deceit should improve the diagnostic value of the results. A pilot study in laboratory conditions (n = 8, yielding 190 assessment points) utilising an applied mock crime scenario was conducted. Correlation calculations showed that a dual-method approach slightly improved the within-statement truth accuracy, and it was achieved mainly by decreasing the number of false positives. As the truth accuracy was increased, the lie accuracy within the test group slig...
International peacekeeping operations often take place in environments in which frequent exposure... more International peacekeeping operations often take place in environments in which frequent exposure to high levels of stress is likely. Thus, implications to psychological well-being can be expected. This study examined the psychological well-being of peacekeeping veterans post-deployment and assessed possible contributing factors during deployment. A total of 2,317 Finnish veterans of peacekeeping operations took the survey within 3 months post-deployment on average; the survey covered the following categories: job strain during the operation, potentially traumatic events during deployment, and postdeployment symptoms.
This paper presents a concept for utilising falsified documents and disinformation as a security ... more This paper presents a concept for utilising falsified documents and disinformation as a security measure by diminishing the utility of the stolen information for the attacker. Classical definition of tarpitting honeypots is to create virtual servers attractive to worms and other malware that answer their connection attempts in such a way that the machine on the other end becomes stuck. A common extension to the OSI model is to refer the user as the layer 8 on top of the application layer. By generating attractive looking but falsified documents and datasets within our secured network along with the real information, we could be able to force the malicious user on the other end similarly to be 'stuck' as they need to dig through and verify all the information they have managed to steal. This in effect slows down the opponents' decision making speed, can make their activity in the network more visible and possibly even mislead them. The concept has similarities to the Cana...
Target audience analysis (TAA) is an essential part of any psychological operation. In order to c... more Target audience analysis (TAA) is an essential part of any psychological operation. In order to convey a change in behaviour, the overall population is systematically segmented into target audiences (TAs) according to their expected responsiveness to different types of influence and messages, as well as their expected ability to behave in a desired way. The cyber domain poses a challenge to traditional TAA methods. Firstly, it is vast and complex, requiring effective algorithms to filter out relevant information within a meaningful timeframe. Secondly, it is constantly changing, representing a meshwork in formation, rather than a stable collection of TAA-specific data. The third challenge is that the target audience (TA) consists not of people, but of digital representations of people, whose true identity and characteristics cannot usually be verified. To address these challenges, the authors of this article suggest that the concept of TAA has to be revised for use in the cyber doma...
Target audience analysis (TAA) is an essential part of any influence operation. To convey a chang... more Target audience analysis (TAA) is an essential part of any influence operation. To convey a change in behaviour, the overall target population is systematically segmented into target audiences (TAs) according to their expected responsiveness to different types of influence and messages, as well as their expected ability to behave in a desired way. The cyber domain poses a challenge to traditional TAA methods. Firstly, it is vast, complex and boundless, requiring effective algorithms to filter out relevant information within a meaningful timeframe. Secondly, it is constantly changing, representing a meshwork in formation, rather than a stable collection of TAA-specific data. The third challenge is that the TA consists not of people but of digital representations of individuals and groups, whose true identity, characteristics or location cannot usually be verified. To address these challenges, the authors of this chapter suggest that the concept of TAA has to be revised for use in the...
International Journal of Cyber Warfare and Terrorism, 2020
The development of communications technology has enabled the internet to become a new theatre of ... more The development of communications technology has enabled the internet to become a new theatre of military operations. The influence aspects of military operations in information battlespace, however, are difficult both in theory and in practice, especially concerning international law. As a result, there is a variety of national and organizational solutions of how to divide tasks and responsibilities between authorities. This asymmetry generated by different approaches and rules of conduct provides opportunities for actors with more relaxed interpretation of international law, allowing them to use weapons of influence in order to pursue military goals. In this article the authors ask whether military influence operations, just like cyber operations, could be treated as acts of war. To help militaries address the complex issue of influence operations, a framework consisting of three categories is suggested.
This study investigated how experienced demands of the job and the social support during operatio... more This study investigated how experienced demands of the job and the social support during operations were related to psychological well-being after deployment. The data was collected from 817 Finnish peacekeepers returning home between 2012 and 2014 from altogether over 10 different operations of which the most common were ISAF (Afghanistan) and UNIFIL (Lebanon). Experiencing less social support and more job-related demands was related to higher stress and weaker sense of coherence after deployment, even though overall level of emotional difficulties after deployment was low. These results suggest that there may be health gains to achieve in improved social support and balancing job demands during operation. Given the highly hierarchical organization of the military, role of leadership is essential in both establishing social support and balancing the job demands.
Study Objectives: To evaluate the frequency of sleep problems and daytime tiredness among adolesc... more Study Objectives: To evaluate the frequency of sleep problems and daytime tiredness among adolescents with inflammatory bowel disease (IBD) in comparison with their healthy peers. Design: Parent and self-reports of sleep problems and daytime tiredness. Setting: Questionnaire-based postal survey. Intervention: N/A. Participants: One hundred sixty Finnish adolescents with IBD; 236 adolescents matched for age, sex, and place of residence; and the parents of both groups. Measurements and Results: Sleep Self-Report and sleep questions of the Child Behavior CheckList , and Youth Self-Report. The parents of adolescents with IBD reported in their index child more trouble sleeping (P < 0.01), more nightmares (P < 0.01), sleeping more than most children during the day/night (P < 0.001), and overtiredness (P < 0.001) than did the parents of control subjects. In contrast, adolescents with IBD themselves did not report more problems than their peers. However, in the group of patients with self-reported severe IBD symptoms, both the parents and the adolescents reported trouble sleeping and overtiredness more often (P values < 0.01) than in the group with mild symptoms or control subjects. Adolescents with severe IBD reported more often that their symptoms affected the quality of their sleep (P < 0.001) than did adolescents with mild disease. Conclusions: Adolescents with severe IBD symptoms have disturbed sleep and are overtired more often than are adolescents with mild IBD symptoms or control subjects. Thus, in adolescents with severe IBD symptoms, evaluating sleep is important in characterizing the disease burden. Both parent and adolescent reports are needed for comprehensive assessment of sleep in the young. Keywords: Sleep in pediatric IBD, parent and youth-self report Citation: Pirinen T; Kolho KL; Simola P; Ashorn M; Aronen ET. Parent and self-report of sleep-problems and daytime tiredness among adolescents with inflammatory bowel disease and their population-based controls.
This study compared sleep in patients with Conduct Disorder/Oppositional Defiant Disorder (CD/ODD... more This study compared sleep in patients with Conduct Disorder/Oppositional Defiant Disorder (CD/ODD) and normative children and evaluated the associations between sleep and behavioral symptoms in patients. Participants were 30 patients, aged 7 to 12 years, with diagnoses of CD/ODD and their age and gender matched controls. Patients with CD/ODD and their parents reported significantly more sleep problems than did the control children and their parents (p values < 0.01). By actigraphy, CD/ODD children with comorbid ADHD slept significantly less than did the patients with CD/ODD alone and the controls. In patients, low sleep amount and efficiency associated with increased amount of parent-reported externalizing symptoms (r = -0.72, 0.66, p values < 0.001). Results highlight the need of evaluating sleep in children with CD/ODD. Improving their sleep may ease their symptoms.
Journal of Developmental & Behavioral Pediatrics, 2009
To study emotional and behavioral problems and sleep and cognitive performance in snoring and non... more To study emotional and behavioral problems and sleep and cognitive performance in snoring and nonsnoring 3- to 6-year-old children. As part of an epidemiological study of sleep disordered breathing (SDB) in preschool-aged children, 43 snorers and 46 nonsnorers participated in a clinical study. Their parents completed the Child Behavior Checklist (CBCL). The children were assessed with Wechsler Preschool and Primary Scale of Intelligence, Revised and subtests of the Developmental Neuropsychological Assessment (NEPSY-A) representing aspects of attention, language skills, sensorimotor functions, memory, and learning. On the CBCL snoring children had significantly more parent reported internalizing symptoms (p &amp;amp;amp;amp;amp;amp;amp;amp;lt; .05) than the nonsnoring children, especially symptoms of anxious/depressed mood (p &amp;amp;amp;amp;amp;amp;amp;amp;lt; .01) and emotional reactivity (p &amp;amp;amp;amp;amp;amp;amp;amp;lt; .05). More children from the snoring group than from the nonsnoring group (22 vs 11%) scored in the subclinical or clinical range on the internalizing scale. Interestingly, no significant difference between the groups was found in the amount of externalizing symptoms. The amount of sleep problems other than snoring was higher in the snoring than in the nonsnoring group (p &amp;amp;amp;amp;amp;amp;amp;amp;lt; .01). On tests measuring auditory attention (p &amp;amp;amp;amp;amp;amp;amp;amp;lt; .01) and language skills (verbal IQ, p &amp;amp;amp;amp;amp;amp;amp;amp;lt; .05), the snoring group performed worse than the nonsnoring group. Our results support the view that SDB should be considered a possible risk factor for mood disorder symptoms and impaired cognitive performance in children.
Results: 15 patients with endoscopic and histologically proven chronic pouchitis were studied. 13... more Results: 15 patients with endoscopic and histologically proven chronic pouchitis were studied. 13 had failed to enter remission with CM, two had relapsed on maintenance C. Antibiotic coliform sensitivity testing showed: C resistance in all samples; co-amoxiclav resistance in four samples; trimethoprim resistance in 11 samples, cefixime resistance in eight samples. Four samples contained extended spectrum beta lactamase (ESBL) producing organisms. All 15 patients were treated with an antibiotic to which their faecal coliforms were sensitive. Twelve (80%) entered clinical remission with a PDAI symptom score of 0. Discussion: Targeted antibiotic therapy is effective in the majority of patients with antibiotic resistant pouchitis. Faecal coliform sensitivity testing and targeted antibiotic therapy should be used in all patients who fail to respond to empirical antibiotic treatment or relapse on long term antibiotic therapy.
Background: Motor retardation is a cardinal feature in adult depression. Limited information exis... more Background: Motor retardation is a cardinal feature in adult depression. Limited information exists about motor activity in depressed children. The present study evaluated motor activity in depressed children compared to controls and investigated whether motor activity can be linked with the severity of symptoms in depressed children. Method: Motor activity during both day-and night time was recorded by actigraphy in twentytwo depressed children and their controls. A K-SADS-PL interview of the child and his/her mother was used to diagnose depression. The depressed children filled in the Child Depression Inventory (CDI) as a self-report of the severity of depression. Parents and teachers of both depressed children and controls filled in the Child Behavior Checklist (CBCL) and the Teacher Report Form (TRF). Results: Motor activity was reduced during the daytime in depressed children compared to controls (p b 0.001). Depressed children spent more time in total immobility during the night time than their peers (p b 0.05). In depressed children motor activity was linked with the severity of self-(r = − 0.45, p b 0.05) and teacher-reported (r = − 0.52, p b 0.05) symptoms. Depressed children with suicidal ideation (n = 10) differed significantly in motor activity compared to depressed children without suicidal ideation (n = 12) and controls (n = 22). Limitations: Sample size was only moderate. Conclusions: Reduced motor activity is an important feature of childhood depression. Objectively measured motor activity can distinguish depressed children from their peers. Motor retardation can be linked with the severity of depression, especially suicidal ideation and possibly subtype depressed children into groups with different etiology, treatment needs and course of illness.
The aim was to evaluate psychosocial symptoms and competence as reported by the parents and the a... more The aim was to evaluate psychosocial symptoms and competence as reported by the parents and the adolescents themselves among patients with inflammatory bowel disease (IBD) in relation to population-based controls. Standardized Achenbach questionnaires-Child Behavior Checklist (CBCL) for the parents and Youth Self-Report (YSR) for the adolescents-were sent to Finnish families of adolescents with IBD (age 10-18 years), and their controls matched for age, gender, and place of residence. The final study group comprised 160 adolescents with IBD and 236 controls with their parents, respectively. According to parent reports, adolescents with IBD had more symptoms of anxious/depressed mood (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), withdrawn/depressed mood (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05), social problems (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05), thought problems (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), somatic complaints (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), and lower competence (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05) than population-based controls. Unexpectedly, there was no group difference in the amount of self-reported psychosocial symptoms, somatic complaints, or competence between adolescents with IBD and their peers. However, adolescents with severe IBD reported significantly more emotional problems (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) than those with mild symptoms or controls. According to parents, adolescents with IBD have more emotional problems, social problems, thought problems, and lower competence than their population-based peers. Self-perceived severity of the IBD symptoms is associated with a larger amount of parent and self-reported emotional symptoms. Complementary methods should be used while assessing the psychosocial well-being of adolescents with IBD as questionnaires alone may be insufficient.
Objective To study the prevalence of various sleep problems at school age in a Finnish community ... more Objective To study the prevalence of various sleep problems at school age in a Finnish community sample and to evaluate the persistence of the sleep problems from the preschool age to school age in a 4-year follow-up. Methods Parents completed the Sleep Disturbance Scale for Children questionnaire on their child's sleep during the preschool years (3-6 years) and again during the school years (7-11 years). At follow-up the parents also completed a questionnaire on family structure and socioeconomic status. Results The parents of 481 children completed the questionnaires during both the first study and the follow-up (girls 49%, boys 51%; mean age 9, range 7-11). At the population level, sleep problems slightly declined from preschool to school age (P < 0.05). However, sleep problems at preschool age showed a strong persistence to school age. At the follow-up, 35% of the children who were considered to have a sleep disorder at preschool age still suffered from it at school age. At the community level, this equates to 9% of the children. The children with no sleep problems at preschool age rarely developed sleep problems at school age. Conclusions This study showed that various types of sleep problems are common at school age. Sleep problems persisted from preschool to school age at the individual level. It is important to recognize all types of sleep problems, especially persistent ones. Persistent sleep problems in children may cause and exacerbate other somatic, cognitive and psychiatric problems. Therefore, more attention should be focused on sleep problems in paediatric health care with interventions aimed particularly at children with prolonged sleep problems.
The present study investigated the development of executive functions (EFs) and their association... more The present study investigated the development of executive functions (EFs) and their associations with performance and behavior at school in 8-12-year-old children. The EFs were measured by computer-based n-back, Continuous Performance and Go/Nogo tasks. School performance was evaluated by Teacher Report Form (TRF) and behavior by TRF and Child Behavior Checklist. The studied dimensions of EF were cognitive efficiency/speed, working memory/attention and inhibitory control. Strong age effects were found for these cognitive abilities (p values \0.01). Inhibitory control was associated with better adaptive functioning (learning, working hard and behaving well), academic performance and less psychiatric symptoms (p values \0.05), specially in 8-9-year-old children. In this youngest age group low inhibitory control was also associated with teacher-reported inattention (p = 0.042). Low inhibitory control was associated with teacher-and parent-reported internalizing symptoms (p \ 0.01). These results suggest that maturational factors may underlie low adaptive functioning and psychiatric symptoms during early school years. Further studies are needed to evaluate the association between inhibition and emotional symptoms.
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