Low schoolwork engagement and schoolwork difficulties predict smoking in adolescence?

Low academic achievement has been associated with smoking but factors behind this association are poorly known. Such factors could include schoolwork disengagement and schoolwork difficulties. To assess the extent to which they contribute to the explanation of how health inequalities emerge, we study in a longitudinal design whether these have an independent effect on smoking or whether their effect is mediated through academic achievement. Longitudinal data were collected in the Helsinki metropolitan area, Finland in 2011 and 2014. Participants were seventh-graders (12 13 years, N=9497). In the follow-up, 6534 students reported their smoking status in the ninth grade (15 16 years). Smoking, schoolwork behavioural engagement, i.e. participation in academic activities, and disengagement, schoolwork difficulties and cognitive competence were self-reported by adolescents. Academic achievement was obtained from the Finnish national application register on upper secondary education. A mediation analysis was executed with bootstrapped confidence intervals. Higher schoolwork behavioural engagement and cognitive competence in the seventh grade predicted that adolescents were more likely not to smoke in the ninth grade (all P <0.001) while higher schoolwork disengagement and schoolwork difficulties predicted adolescents smoking (all P <0.001). The effects were mediated through academic achievement. Students behavioural disengagement with schoolwork and schoolwork difficulties are risks for smoking initiation. Their effect is mediated through poor school achievement. As smoking often continues in adulthood and poor school performance typically leads to lower education, schoolwork disengagement and difficulties in adolescence constitute potential pathways to inequalities in health.Peer reviewe

Morphologic and functional correlates of synaptic pathology in the cathepsin D knockout mouse model of congenital neuronal ceroid lipofuscinosis

Mutations in the cathepsin D (CTSD) gene cause an aggressive neurodegenerative disease (congenital neuronal ceroid lipofuscinosis) that leads to early death. Recent evidence suggests that presynaptic abnormalities play a major role in the pathogenesis of CTSD deficiencies. To identify the early events that lead to synaptic alterations, we investigated synaptic ultrastructure and function in pre-symptomatic CTSD knock-out (Ctsd(−/−)) mice. Electron microscopy revealed that there were significantly greater numbers of readily releasable synaptic vesicles present in Ctsd(−/−) mice than in wild-type control mice as early as postnatal day 16. The size of this synaptic vesicle pool continued to increase with disease progression in the hippocampus and thalamus of the Ctsd(−/−) mice. Electrophysiology revealed a markedly decreased frequency of miniature excitatory postsynaptic currents (EPSCs) with no effect on pair-pulse modulation of the evoked EPSPs in the hippocampus of Ctsd(−/−) mice. The reduced miniature EPSC frequency was observed before the appearance of epilepsy or any morphological sign of synaptic degeneration. Taken together, the data indicate that CTSD is required for normal synaptic function, and that a failure in synaptic trafficking or recycling may be an early and important pathological mechanism in Ctsd(−/−) mice; these presynaptic abnormalities may initiate synaptic degeneration in advance of subsequent neuronal loss

Prognostic value of isolated tumour cells in sentinel lymph nodes in early-stage breast cancer : a prospective study

BACKGROUND: The prognostic significance of isolated tumour cells (ITCs) in the sentinel nodes (SNs) is controversial in early breast cancer, and some centres have abandoned immunohistochemistry to detect ITCs. METHODS: Patients with unilateral pT1N0 breast cancer, operated between February 2001 and August 2005 at a university hospital were included in this prospective, population-based cohort study. Survival of 936 patients with or without isolated tumour cells (ITC) in their SNs were compared with the log-rank test and Cox regression analysis. RESULTS: Eight hundred sixty one (92.0%) patients were ITC-negative (pN0i-) and 75 (8.0%) ITC-positive (pN0i+). Patients with ITC-positive cancer received more frequently adjuvant systemic therapies than those with ITC-negative cancer. The median follow-up time was 9.5 years. Ten-year distant disease-free survival was 95.3% in the pN0i-group and 88.8% in the pN0i+ group (P = 0.013). ITCs were an independent prognostic factor in a Cox regression model (HR = 2.34, 95% CI 1.09-5.04; P = 0.029), together with tumour Ki-67 proliferation index and diameter. ITCs were associated with unfavourable overall survival (P = 0.005) and breast cancer-specific survival (P = 0.001). CONCLUSIONS: We conclude that presence of ITCs in the SNs is an adverse prognostic factor in early small node-negative breast cancer, and may be considered in the decision-making for adjuvant therapy.Peer reviewe

Toxoplasma gondii infection and common mental disorders in the Finnish general population

Objective: We investigated whether T. gondii seropositivity is associated with 12-month depressive, anxiety and alcohol use disorders and current depressive symptoms and whether inflammation, measured by C-reactive protein (CRP) level, explains these associations. Method: Health 2000 study (BRIF8901), conducted in years 2000-2001, is based on a nationally representative sample of Finns aged 30 and above, with 7112 participants and 88.6% response rate. DSM-IV depressive, anxiety and alcohol use disorders were assessed with the Composite International Diagnostic Interview and depressive symptoms with the Beck Depressive Inventory (BDI-21). We used logistic regression to investigate the association of T. gondii seropositivity with mental disorders and linear regression with BDI-21 scores. Results: T. gondii seroprevalence was significantly associated with 12-month generalized anxiety disorder but not with other anxiety, depressive or alcohol use disorders. T. gondii seropositivity was associated with higher BDI-21 scores (beta 0.56, 95% CI 0.12-1.00, P = 0.013) and with having a comorbid depressive and anxiety disorder (OR 1.86, 95% CI 1.16-2.97, P = 0.010). Higher CRP levels were associated with these outcomes and with T. gondii seropositivity, but adjusting for CRP did not change the effect of T. gondii seropositivity. Limitations: Cross-sectional study design with no information on the timing of T. gondii infection. Conclusion: T. gondii seropositivity is associated with generalized anxiety disorder, depressive symptoms and comorbid depressive and anxiety disorders, which is not mediated by inflammation.Peer reviewe

Deep brain stimulation for monogenic Parkinson's disease : a systematic review

Deep brain stimulation (DBS) is an effective treatment for Parkinson's disease (PD) patients with motor fluctuations and dyskinesias. The key DBS efficacy studies were performed in PD patients with unknown genotypes; however, given the estimated monogenic mutation prevalence of approximately 5-10%, most commonly LRRK2, PRKN, PINK1 and SNCA, and risk-increasing genetic factors such as GBA, proper characterization is becoming increasingly relevant. We performed a systematic review of 46 studies that reported DBS effects in 221 genetic PD patients. The results suggest that monogenic PD patients have variable DBS benefit depending on the mutated gene. Outcome appears excellent in patients with the most common LRRK2 mutation, p.G2019S, and good in patients with PRKN mutations but poor in patients with the more rare LRRK2 p.R1441G mutation. The overall benefit of DBS in SNCA, GBA and LRRK2 p.T2031S mutations may be compromised due to rapid progression of cognitive and neuropsychiatric symptoms. In the presence of other mutations, the motor changes in DBS-treated monogenic PD patients appear comparable to those of the general PD population.Peer reviewe

The association between toxoplasma and the psychosis continuum in a general population setting

Toxoplasma gondii infection is associated with increased risk for psychosis. However, the possible association between T. gondii and psychotic-like symptoms in the general adult population is unknown. We investigated whether T. gondii is associated with psychotic-like symptoms and psychosis diagnoses using data from Health 2000, a large cross-sectional health survey of the Finnish general population aged 30 and above. Seropositivity to toxoplasma was defined as a cutoff of 50 IU/ml of IgG antibodies. Lifetime psychotic-like symptoms were identified with section G of the Composite International Diagnostic Interview, Munich version (M-CIDI). Symptoms were considered clinically relevant if they caused distress or help-seeking or there were at least three of them. Lifetime psychotic disorders were screened from the sample and were diagnosed with DSM-IV using SCID-I interview and information from medical records. All data were available for 5906 participants. We adjusted for variables related to T. gondii seropositivity (age, gender, education, region of residence, cat ownership, and C-reactive protein measuring inflammation) in regression models. We found that T. gondii seropositivity was significantly associated with clinically relevant psychotic-like symptoms (OR 1.77, p = 0.001) and with the number of psychotic-like symptoms (IRR = 1.55, p = 0.001). The association between toxoplasma and diagnosed psychotic disorders did not reach statistical significance (OR 1.45 for schizophrenia). In a large sample representing the whole Finnish adult population, we found that serological evidence of toxoplasma infection predicted psychotic-like symptoms, independent of demographic factors and levels of C-reactive protein. Toxoplasma infection may be a risk factor for manifestation of psychotic-like symptoms. (c) 2017 Elsevier B.V. All rights reserved.Peer reviewe

Association of cytomegalovirus and Epstein-Barr virus with cognitive functioning and risk of dementia in the general population : 11-year follow-up study

Background: Earlier studies have documented an association between cytomegalovirus and cognitive impairment, but results have been inconsistent. Few studies have investigated the association of cytomegalovirus and Epstein-Barr virus with cognitive decline longitudinally. Our aim was to examine whether cytomegalovirus and Epstein-Barr virus are associated with cognitive decline, in adults. Method: The study sample is from the Finnish Health 2000 Survey (BRIF8901, n = 7112), which is representative of the Finnish adult population. The sample was followed up after 11 years in the Health 2011 Survey. In addition, persons with dementia were identified from healthcare registers. Results: In the Finnish population aged 30 and over, the seroprevalence of cytomegalovirus was estimated to be 84% and the seroprevalence of Epstein-Barr virus 98%. Seropositivity of the viruses and antibody levels were mostly not associated with cognitive performance. In the middle-aged adult group, cytomegalovirus serointensity was associated with impaired performance in verbal learning. However, the association disappeared when corrected for multiple testing. No interactions between infection and time or between the two infections were significant when corrected for multiple testing. Seropositivity did not predict dementia diagnosis. Conclusions: The results suggest that adult levels of antibodies to cytomegalovirus and Epstein-Barr virus may not be associated with a significant decline in cognitive function or with dementia at population level. (C) 2018 Published by Elsevier Inc.Peer reviewe

Luokanopettajien haastattelututkimus kouluruokailusta ja ruokakasvatuksesta

Tiivistelmä. Maksuton kouluruokailu on merkittävä voimavara ja oppimisen tuki oppilaille ja opettajille, jota on tarjottu jo usean vuosikymmenen ajan Suomessa. Kouluruokailulla on kasvatuksellisia, sosiaalisia ja fyysisiä tavoitteita. Kouluruokailun haasteita nykypäivänä ovat suosion väheneminen ja ruokakulttuurin muutokset. Tämän tutkimuksen taustalla on huoli siitä, onko luokanopettajilla riittäviä keinoja ohjata ja edistää kouluruokailun toteutumista tavoitteiden mukaisesti. Kouluruokailun pedagogiseen ulottuvuuteen kuuluu ruokakasvatus, jonka avulla voidaan edistää syömisen taitoja ja sitä kautta kouluruokailun suosion lisäämistä. Tällä hetkellä ruokakasvatuksella ei ole merkittävää roolia suomalaisessa koulujärjestelmässä. Tässä tutkimuksessa on käytetty laadullista menetelmää, jonka lähestymistapa on fenomenologinen. Tutkimusintressinä oli selvittää luokanopettajien kokemuksia kouluruokailusta sekä käsityksiä ja keinoja toteuttaa ravitsemuskasvatusta. Tämä tutkimus toi esiin uuden näkökulman asiaan, koska luokanopettajien kokemuksia ja näkemyksiä ei ole tutkittu kouluruokailun osalta aikaisemmin. Työn teoreettinen viitekehys pohjautuu osittain Kyllösen (2021) kandidaatin työn päälle. Tutkimusmetodina oli käytössä puolistrukturoitu teemahaastattelu, jossa haastateltavina oli kahdeksan luokanopettajaa eri puolelta Suomea. Haastattelut toteutettiin etäyhteyksin joulu-tammikuun aikana 2021–2022. Aineiston analyysimenetelmänä on käytetty teoriaohjaavaa sisällönanalyysia. Tutkimustulokset osoittivat, että luokanopettajat pitivät kouluruokailua positiivisena ja oppimista tukevana keinona koulun arjessa. Kouluruokailu oli myös opettajille itselleen tärkeä tauko ja mahdollisuus oppilaiden kohtaamiseen. Haastattelujen perusteella luokanopettajat pitivät sekä kouluruokailun fysiologista että sosiaalista ja kasvatuksellista puolta tärkeinä. Ruokailutilanteessa sosiaalinen ulottuvuus nähtiin merkittävänä kulttuurin ja tapakasvatuksen osalta. Luokanopettajat painottivat kouluruokailun fysiologista välttämättömyyttä. Kasvatuksellisesta ulottuvuudesta korostui etenkin sääntöjen merkitys ruokailutilanteessa. Lisäksi haastatellut korostivat oppiaineiden sisältöjä ruokailun tavoitteiden saavuttamiseksi. Haasteena luokanopettajat näkivät omat keinonsa ohjata ja tukea ruokailun ongelmakohtia, kuten heikosti syöviä oppilaita. Johtopäätöksissä todetaan, että luokanopettajilla on paljon syömisen taitoa tukevia menetelmiä, mutta tavoitteiden saavuttamiseksi tarvittaisiin yhtenäinen toimintalinja valtakunnallisesti. Kotien kanssa tehtävä yhteistyö kouluruokailun tukemiseksi näyttäytyi osittain haasteena ja osittain merkittävänä voimavarana. Tämän tutkimuksen tulokset voivat tukea kouluja niiden suunnitellessa kouluruokailun ja ravitsemuskasvatuksen toteuttamista.Interview study on preschool teachers about school dining and nutrition education. Abstract. Free school dining is a significant resource and learning support for students and teachers that has been offered in Finland for several decades. School dining has educational, social, and physical objectives. The challenges of school lunch today are its declining popularity and changes in food culture. Underlying in this study is a concern as to whether classroom teachers have the appropriate means to guide and implement school meals in accordance with the learning objectives. The pedagogical dimension of school meals also includes nutrition education, which can be used to practice eating skills and thereby increase the popularity of school meals. At present, nutrition education does not play a significant role in the Finnish school system. This study is qualitative in nature with a phenomenological approach. The aim of the research was to find out how class teachers experience school dining as well as gather their perceptions and ways of implementing nutrition education. This study brought a new perspective to the topic, as the experiences and views of classroom teachers regarding school lunches have not been studied before. The theoretical framework of the thesis is partly based on Kyllönen’s (2021) bachelor’s thesis. The research method used was a semi-structured thematic interview, in which eight classroom teachers from different parts of Finland were interviewed. The interviews were conducted remotely during December and January of 2021–2022. Theory-guided content analysis was used as the method of data analysis. The results of the survey showed that preschool teachers considered school dining to be a positive and supportive learning situation in everyday school life. School lunches were also an important break for teachers and provided an opportunity to meet students. Based on the interviews, the preschool teachers considered both the physiological and social, but also educational aspects of school dining, important. In the eating situation, the social dimension was seen as important both in terms of culture and teaching manners. The preschool teachers also emphasized the physiological necessity of school dining. The educational dimension highlighted the importance of rules in the dining situation. In addition, the interviewees emphasized the contents of the school subjects in order to achieve the goals of the eating situation. When asked about challenges, the classroom teachers brought up difficulties regarding their own ways to guide and address the problem areas of the eating situations, such as students who have problems with eating. The findings of the study show that preschool teachers have many different methods to support the students’ eating skills, but that a unified policy would be needed nationwide to achieve the goals. Working together with homes to support school meals turned out to be both a challenge as well as a significant resource. The results of this study may help schools in planning the implementation of school meals and nutrition education