The thesis describes cognitive abilities and attention of children and adolescents with ADHD. It deals with therapeutic and intervention strategies that can be used to reduce symptomes of the disease and to improve cognitive performance of people with the diagnosis. The theoretical part of the thesis summarizes findings about attention and the structure of cognitive abilities of people with ADHD. A separate chapter lists intervention approaches used in the context of the diagnosis, such as pharmacotherapy, psychotherapy, and also different kinds of alternative approaches (relaxation, exercises, food complements, compensatory tools etc.). In the empirical part we examine a specific intervention, use of earplugs to eliminate the background noise, can improve the cognitive performance of children with ADHD. The research involved fourteen children with the diagnosis of ADHD. The CAS 2 assessment battery was used to measure their cognitive skills. The statistical analysis confirmed the difference between the cognitive profile of children with ADHD and normal population in executive functioning without working memory. When using the earplugs children with ADHD had better results in the overall score and on the planning scale and successive processes scale. Keywords: Attention, ADHD, therapy of ADHD, earplugs.

Det är väl belagt att patienter postoperativt och inom intensivvården drabbas av en funktionell sömnbrist i form av störd dygnsrytm, stort antal uppvaknanden och rubbad sömncykel med underskott av djupsömn och REM-sömn. En delförklaring till sömnbristen är de generellt höga ljudnivåerna på intensivvårdsavdelningar. Syftet med föreliggande pilotstudie var att undersöka huruvida öronproppar kunde förbättra den upplevda sömnkvalitén för patienter inom intensivvård och postoperativt. Tjugotvå patienter från två intensivvårdsavdelningar, en hjärtintensivvårdsavdelning och en postoperativ avdelning deltog i studien. I interventions-gruppen sov elva patienter en natt med öronproppar och elva patienter som sov utan öronproppar utgjorde kontrollgrupp. Sömnkvalitén självskattades med hjälp av Richards-Campbells Sleep Questionnaire (RCSQ). Resultatet visade att de patienter som sovit med öronproppar skattade sin sömn som bättre (median RCSQ sömnindex = 81) än kontrollgruppen (median RCSQ sömnindex = 58), men också att andelen patienter på intensivvårds- och postoperativa avdelningar som kan tillgodogöra sig de eventuellt positiva effekterna av öronproppar är begränsad. / It is a well established fact that patients postoperatively and in intensive care frequently suffer from a functional sleep deprivation in the form of disturbed circadian rhythm, large number of awakenings and disturbed sleep cycle with a deficit of slow wave sleep and REM sleep. A partial explanation for the lack of sleep has been shown to be the high noise levels in intensive care and recovery rooms. The purpose of this pilot study was to examine whether earplugs could improve intensive care and post-operative patients' perceived sleep quality. Twenty-two patients from two intensive care units, a cardiac intensive care unit and a post-surgical department participated in the study. In the intervention group eleven patients spent one night with earplugs, and eleven patients that slept without earplugs formed control group. The patients self-estimated their sleep by using the Richards-Campbell Sleep Questionnaire (RCSQ). The results showed that patients who slept with earplugs rated their sleep as better (median RCSQ sleep index = 81) than the control group (median RCSQ sleep index = 58), but also that the proportion of patients in intensive and post-operative care that can benefit from the potentially positive effects of earplugs is limited.

Patients admitted to an adult intensive care unit (ICU) are at risk of developing an acute condition known as ICU delirium, which can impact patients’ length of hospital stay and increase short term and 6-month mortality. The cause of ICU delirium is multifactorial, and lack of quality sleep is a known risk factor. Patients’ sleep in the ICU is frequently interrupted by clinicians involved in their care and equipment alarms. Sleep hygiene interventions to minimize these interruptions for the patient are one strategy to reduce the risk of ICU delirium. Examples of sleep hygiene interventions include eye masks, earplugs, and grouping patient care to minimize nighttime interruptions. The primary purpose of this thesis was to review the available evidence on non-pharmacological sleeping interventions and how they can prevent the development of ICU delirium in adults hospitalized with a critical illness. A secondary aim of this thesis was to study the impact of non-pharmacological interventions on sleep quality. Seven studies conducted in critical care units were included in this scoping review, which examined how non-pharmacological sleep hygiene interventions impacted both the prevention of ICU delirium, and sleep quality. Study results were analyzed to determine their effectiveness in relation to the two outcome measures. Although this review identified many benefits of non-pharmacological sleep interventions, the results on which are most effective in preventing delirium and improving sleep quality are inconclusive. Future research needs to be done to evaluate which sleep-promoting intervention(s) will benefit critical care patients most in preventing or lowering their risk of delirium. The feasibility of both health care staff consistently and effectively executing the intervention(s) outside of research conditions, and patient compliance to the interventions needs to be further studied. Additionally, there is a need for future studies measuring sleep quality as a result of sleep promoting interventions to be measured by PSG rather than subjective written/oral reports in order to obtain objective, reliable results.

Sleep is an essential component of optimal physiological and psychological functioning in humans. However, numerous studies have identified sleep deficits in patients within the critical care setting. Sleep deprivation has been shown to cause adverse effects including cardiovascular, respiratory, and endocrine variations, and altered psychological functioning such as cognitive dysfunction, decreased concentration, mood variability, and delirium. The critical care environment often contains stimuli that may be a causative factor in sleep alterations such as sleep deprivation, fragmentation or alterations in sleeping patterns. These environmental stimuli include noise, light, pain, discomfort, nursing care activities, medications, psychological stressors and underlying disease and have the capability to severely impact the quantity and quality of sleep in critically ill patients. The integrated research review identifies correlations between environmental stressors and sleep alterations in critically ill patients. Outcomes of interventions including earplugs and eye masks, behavior modification, complementary and alternative medicine and pharmacological considerations are examined. Additionally, implications for nursing education, research and practice are addressed. A current integrated research review incorporating nursing implications and alternative interventions could be significant to the provision of nursing care for the critically ill patient.

Attention is a complex ability, which significantly contributes to the process of intentional learning. On the theoretical level, this thesis focuses on the types and theories of attention related to the effective management of school demands. More specifically, it focuses on the development period of older school age and adolescence, i. e. secondary school pupils. The paper analyzes the results of scientific studies that have been focused on the research of attention and its properties (e.g. stability, concentration or selectivity). The work is focused on examining whether a low-cost compensation aid - here earplugs - can improve concentration and stability of attention during learning. Furthermore, the work briefly mentions the physiological basis of the functioning of this cognitive process. The conclusion of the theoretical part of the paper maps the current possibilities of diagnostics of attention, especially in children and adolescents. There are also sporadic mentions of selected attention disorders (e.g. ADD, ADHD), which are closely related (not only) to learning. In the empirical part of the thesis, a quantitative research is described, using several different tests of attention. The research question is whether and how the attention (concentrating) and, where appropriate, the...