Incidence trends of childhood central nervous system tumors in Finland 1990-2017

Introduction Central nervous system (CNS) tumors are a leading cause of cancer-related morbidity and mortality in children. Our aim is to characterize incidence trends of pediatric CNS tumors in Finland over the last three decades. Methods Data on all benign and malignant incident CNS tumors diagnosed in children aged 0-14 years in 1990-2017 were extracted from the Finnish Cancer Registry and classified according to the 2016 WHO classification of CNS tumors. We analyzed age-standardized incidence rates (ASR) for pediatric CNS tumors overall and by sex, age, tumor histology, grade, and location using Poisson regression. We used joinpoint regression to evaluate changes in trends. Results Overall, 1117 pediatric CNS tumor cases were registered in Finland with a 1.2:1 male to female ratio. The average annual ASR was 4.3 per 100,000 person-years (95% CI 4.26, 4.34). The most common tumor type was pilocytic astrocytoma (30% of tumors), followed by medulloblastoma (10%) with incidence rates of 1.30 and 0.45 per 100,000 person-years, respectively. The overall incidence of pediatric CNS tumors increased by an annual percentage change (APC) of 0.8% (95% CI 0.2, 1.4). We observed no major changes in incidence trends of tumor histology groups or tumor location groups. The ASR of benign tumors increased by an APC of 1.0 (95% CI 0.1, 2.0). Conclusions Utilizing the high-quality and completeness of data in the Finnish Cancer registry, we found that the incidence of pediatric CNS tumors in Finland has increased slightly from 1990 until 2017. Although variations in diagnostic and registration practices over time might have affected the rates, the trend may also reflect a true increase in incidence.Peer reviewe

The baby box : Enhancing the wellbeing of babies and mothers around the world

The baby box is a Finnish social innovation that has captivated interest around the globe. This book highlights the journey of the baby box in over 60 countries, offering a comprehensive overview of the Finnish baby box and its many international adaptations. The story of the baby box begins in post-war Finland, where it evolved from a community-based resource to a nationally-funded and internationally recognized social benefit. The global mapping of the baby box presented in this book expands on this history by exploring the influence of the baby box concept internationally, from refugee camps and high-income countries to remote islands and prisons. Written by an international, multi-disciplinary team of researchers, this book explores the baby box concept from various angles. The diverse and expansive nature of this study makes it an excellent resource for parents, researchers, and anyone generally interested in the baby box concept. Also showcased are the many creative solutions that baby box programme organisers have devised to address context-specific challenges, making it additionally useful as a handbook for policy-makers or professionals developing their own programme.The baby box is a social innovation: a maternity package with baby clothes and other items for expectant mothers to promote the wellbeing of baby and family. In Finland, the baby box (officially called the maternity package) has been a universal benefit since 1949 and is given to all expectant mothers provided they attend antenatal care (ANC). The baby box is still considered to be a valuable social benefit in Finland today, with 95% of first-time mothers choosing the box instead of a cash grant. Although it is known that the baby box concept has been adapted across the world, there is little information available about how these adaptations have been made and for what purpose the boxes are given out. In order to map these programmes, we conducted a research project on baby boxes globally. Based on our findings, this report introduces the baby box concept, its various adaptations, and its possible uses to improve maternal and child health and wellbeing globally. The contents of this report are based on a mapping of 91 baby box programmes and an in-depth study of 29 programmes across different world regions in high-, middle- and low-income countries. These programmes were initiated by governmental bodies, non-profit organisations, United Nations (UN) agencies, hospitals, and academic institutions. Although we use the term baby “box” throughout the report, many programmes used a different container, such as a basket or bag, to package the items. The programmes ranged in scale from small to nationwide and targeted various groups, from specific vulnerable communities to all pregnant women in a country. Programmes set various goals, including reducing infant or maternal mortality, promoting the wellbeing of babies and mothers, easing financial and parenting burden, encouraging the uptake of health and community support services, and strengthening communities and reducing inequalities. They intended to achieve their goals through the practical support provided by the box and items, as well as the conditions attached to claiming the box (e.g. attendance at services) and additional education (e.g. booklets or arranged groups) included in the programme. The impact of the baby box is of timely concern, as governments are increasingly interested in the concept. However, it is difficult to provide an unequivocal answer to the question of whether the baby box “works,” as this depends on the desired outcomes of the programme. In addition, due to resource constraints, few programmes measure the impact of their intervention systematically. In response to this question and these restraints, we outline the potential current contributions of the baby box to the wellbeing of mothers and babies and provide a commentary on its possible future impact. For example, there is emerging evidence globally that baby box programmes can increase the rates of attending ANC or giving birth at a health facility, which may save lives in contexts where these rates are traditionally low. Baby box programmes may also provide psychosocial support for the mother during the vulnerable time of childbirth. Beyond their potential to support families in their everyday lives, baby box programmes may also be valuable in contexts where families have been forced to flee their homes, such as natural disasters or refugee camps. In addition to our findings, we also discuss high-interest topics surrounding the baby box, including safety issues. Ultimately, we intend for our report to serve as an overview of baby box programmes and a foundation for further research, as well as a reference for those interested in the topic or aiming to implement or evaluate a baby box programme themselves. The baby box is not a one-size-fits-all solution to intricate health challenges. However, it offers significant health and social gains, especially for those who are commonly the most vulnerable in communities: mothers and babies.31,00 euroanonPeerReviewedVertaisarvioimato

Trends of computed tomography use among children in Finland

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