Childhood adverseties and mental ill health: Studies on associations between reported childhood adverse and trauma experiences and adult perceived attitudes of others, mental disorders and suicidality

Several studies have indicated that childhood adversities and trauma (CAT) are not uncommon and that they are often associated with physical illnesses, mental problems and disturbed behaviour in adulthood. We have no standardised Finnish instrument for assessment of CAT, and our knowledge of the association between CAT and mental wellbeing is still sporadic. In particular, knowledge of specific associations of CAT with mental problems and gender differences is sparse. The aims of this study programme were to evaluate the feasibility of a new Finnish CAT instrument and the associations of CAT experiences with adult individuals’ perceived attitudes of other people, and the associations of CAT with suicidality and psychiatric disorders. The study samples comprise 692 adult individuals from the general population, 250 patients attending primary care, 160 patients attending psychiatric outpatient care, and 245 patients with clinical high risk (CHR) of psychosis. The three first samples were recruited from South-West Finland. The CHR sample was available from the European Prediction of Psychosis Study (EPOS). In each sample, CAT was assessed with the Trauma and Distress Scale (TADS) which was translated into Finnish. TADS and its five sub-scale domains indicated good psychometric properties in terms of internal consistency, content, inter-method reliability and concurrent validity for adults from a Finnish community sample. TADS appeared to be a useful instrument for the assessment of retrospectively reported childhood adversity and trauma in the general population and clinical samples. In the general population, nearly three fourths (72.3%) of individuals reported at least one and nearly a half (48.1%) two or more CAT experiences. In primary care, the corresponding figures were 76.9% and 57.7%, and in psychiatric outpatient care, 94.4% and 80.6%. Childhood adverse and trauma experiences in general and emotional neglect specifically associated with negative perceived attitude of others in adulthood. The effects of CAT experiences on adult perceived negative attitude of others seem to be stronger in males than in females. All CAT domains associated significantly with reported alcohol problems. In females, sexual abuse and physical abuse had a direct effect on alcohol problems, while in males the corresponding effects were mainly mediated via depressive mood. Emotional abuse and neglect and physical abuse associated most strongly with current mood and anxiety disorders. However, there were considerable inter¬correlations within the CAT domains, as well as comorbidity between clinical diagnoses. When these inter-correlations were taken into account, physical abuse and emotional neglect had the strongest specific association with adult psychiatric disorders and might transmit main effects of other CAT domains onto mental disorders. In a random clinical sample, most psychiatric disorders and CAT domains associated with suicide risk. However, when the effect of co-morbidity and overlap of CAT domains was controlled, major depression, social phobia, alcohol, drug dependency and emotional abuse seemed to increase the risk of suicide. This risk profile varied between the genders. In clinical high risk to psychosis patients, all CAT domains except physical neglect predicted suicidal ideations. The effect of CAT on suicidal ideation was mediated via clinical depression and concurrent depression symptoms. Gender proved to be a central moderating factor in effects of CAT experiences on mental wellbeing. Therefore, in addition to controlling for the effect of gender in the analyses, it is also important to carry out analyses for females and males separately. Emotional neglect and physical abuse proved to be associated specifically with adult psychiatric disorders and, emotional neglect also with perceived negative attitude of other people. These both CAT domains touche on child’s and adolescent’s basic needs of safety and love, and may consequently damage their psychic integrity and self¬esteem, predisposing him/her to a distrusting attitude towards other people and making him/her vulnerable to adult mental problems and disorders. The majority of childhood adverse and trauma experiences are family-centred. Parents’ mental health and their mutual interaction, i.e. family function, form a central basis for the children’s undisturbed development. Therefore, early family¬centred therapeutic and educational interventions directed to improving parents’ and children’s mental health, and to supporting parents in their parenthood can protect children from adverse and traumatic experiences. Societal measures to help families facing economic and other difficulties can contribute to the same goal. At the level of the whole society, it is a question of valuation of family life. Societal actions should be taken to support a stable and harmonious family life, and to really value children and their wellbeing. Moreover, the public media have an important role to play in these actions.Lukuisat tutkimukset ovat osoittaneet, että lapsuuden kaltoinkohtelu ja traumat (KT) eivät ole harvinaisia ja että ne usein yhdistyvät aikuisiän fyysisiin sairauksiin, mielenterveyden ongelmiin ja häiriintyneeseen käyttäytymiseen. Meillä ei ole vielä standardoitua suomenkielistä mittaria lapsuuden KT:n arviointiin ja tietomme KT:n ja psyykkisen hyvinvoinnin välisistä yhteyksistä on edelleen satunnaista. Varsinkin tietomme KT:n ja psyykkisten ongelmien välisistä spesifisistä yhteyksistä ja sukupuolieroista ovat niukkoja. Tässä tutkimuskokonaisuudessa pyrittiin arvioimaan uuden suomenkielisen lapsuuden KT-instrumentin käyttökelpoisuutta, KT:n yhteyksiä koettuun, muiden taholta tulevaan asennoitumiseen sekä KT:n yhteyksiä itsetuhoisuuteen ja psykiatrisiin häiriöihin. Tutkimusaineistot käsittävät 692 yleisväestön aikuista, 250 terveyskeskukseen ja 160 psykiatriseen avohoitoon tullutta sekä 245 psykoosiriskissä olevaa potilasta. Kolme ensiksi mainittua otosta kerättiin Lounais-Suomesta. Psykoosiriskiaineisto tuli European Prediction of Psychosis study’stä (EPOS). Kaikissa aineistoissa lapsuuden kaltoinkohtelu ja traumat arvioitiin Trauma and Distress Scale:lla (TADS), joka oli käännetty englannista suomeksi. TADS:n ja sen viiden komponentin psykometriset ominaisuudet: sisäinen konsistenssi, sisältö, menetelmällinen reliabiliteetti, samanaikaisvaliditeetti, osoit¬tautuivat hyviksi suomalaisessa väestöotoksessa. TADS osoittautui käyttökelpoi¬seksi instrumentiksi, kun takautuvasti raportoituja lapsuuden kaltoinkohtelua ja traumoja arvioidaan yleisväestössä ja kliinisissä aineistoissa. Yleisväestöstä lähes kolme neljäsosaa (72.3%) raportoi vähintään yhden ja lähes puolet (48.1) kaksi tai useamman lapsuuden KT-kokemuksen. Terveyskeskuksen potilailla vastaava osuudet olivat 76.7% ja 57.7% ja psykiatrisilla avohoitopotilailla 94.4% ja 80.6%. Lapsuuden kaltoinkohtelu ja traumakokemukset yleisesti ja emotionaalinen laiminlyönti spesifisesti yhdistyivät aikuisiässä koettuun, toisten ihmisten nega¬tiiviseen asenteeseen. KT-kokemusten vaikutukset aikuisiässä koettuun, toisten ihmisten negatiiviseen asenteeseen näyttivät olevan miehillä voimakkaampia kuin naisilla. Kaikki KT:n komponentit yhdistyivät merkitsevästi raportoituihin alkoholiongelmiin. Naisilla seksuaalinen hyväksikäyttö ja fyysinen kaltoinkohtelu yhdistyivät suoraan alkoholiongelmien esiintymiseen; miehillä vastaavat yhteydet välittyivät pääasiassa masentuneen mielialan kautta. Emotionaalinen kaltoinkohtelu ja laiminlyönti sekä fyysinen kaltoinkohtelu yhdistyivät vahvimmin ajankohtaisiin mieliala-ja ahdistuneisuushäiriöihin. KT:n komponentit kuitenkin korreloivat huomattavasti keskenään, samoin kliinisten diagnoosien kesken ilmeni samanaikaisesiintymistä. Kun nämä samanaikais¬korrelaatiot otettiin huomioon, fyysinen kaltoinkohtelu ja emotionaalinen laiminlyönti yhdistyivät spesifisesti aikuisiän psykiatrisiin häiriöihin ja saattoivat siten välittää KT:n muiden komponenttien pääasialliset vaikutukset mielenterveyden häiriöihin. Satunnaisessa kliinisessä aineistossa useimmat psykiatriset häiriöt ja lapsuuden KT:n komponentit yhdistyivät itsemurhariskiin. Kuitenkin kun oheissairaudet ja KT:n komponenttien päällekkäisyys oli kontrolloitu, masennustila, sosiaalinen fobia, alkoholi-ja huumeriippuvuus sekä emotionaalinen kaltoinkohtelu näyttivät lisänneen itsemurhariskiä. Tämä riskiprofiili vaihteli sukupuolten välillä. Psykoosi¬riskipotilailla kaikki KT:n komponentit paitsi fysikaalinen laiminlyönti ennustivat seuranta-aikaisia itsetuhoisia ajatuksia. KT:n vaikutus itsetuhoisiin ajatuksiin välittyi perusvaiheen kliinisen masennushäiriön ja samanaikaisen masentuneisuuden kautta. Sukupuoli osoittautui keskeiseksi muovaavaksi tekijäksi, kun tarkasteltiin lapsuuden KT:n vaikutusta psyykkiseen hyvinvointiin. Niinpä sen lisäksi, että sukupuolen vaikutus analyyseissä kontrolloidaan, on tärkeää myöskin suorittaa analyysit naisilla ja miehille erikseen. Emotionaalinen laiminlyönti ja fyysinen kaltoinkohtelu osoittautuivat yhdis¬tyvän spesifisti psykiatrisiin häiriöihin ja emotionaalinen laiminlyönti myös negatiiviseksi koettuun toisten ihmisten asenteeseen. Nämä molemmat KT:n muodot koskettavat lapsen ja nuoren perustavaa laatua olevia turvallisuuden ja rakastettuna olemisen tarpeita ja voivat siten vahingoittaa hänen psyykkistä eheyttään ja itsetuntoaan altistaen hänet aikuisiässä epäluottamuksen sävyttämälle asenteelle toisia ihmisiä kohtaan sekä mielenterveyden ongelmille ja häiriöille. Enemmistö lapsuuden kaltoinkohtelusta ja traumakokemuksista liittyy perheisiin. Vanhempien mielenterveys ja heidän keskinäinen vuorovaikutuksensa, ts. perhefunktio, muodostaa keskeisen pohjan lasten häiriöttömälle kehitykselle. Tämän vuoksi varhaiset vanhempien ja lasten mielenterveyttä tukevat perhekes¬keiset terapeuttiset ja neuvontatoimenpiteet sekä vanhempien tukeminen heidän vanhemmuuden tehtävässään voivat suojata lapsia ja nuoria kaltoinkohtelulta ja traumakokemuksilta. Sosiaalipoliittiset toimenpiteet, jotka suunnataan perheisin niiden kohdatessa taloudellisia ja muita vaikeuksia, voivat vaikuttaa samaan tavoitteeseen. Koko yhteiskunnan taholla kyse on perhe-elämän arvostamisesta. Yhteiskunnan tuleekin ryhtyä toimenpiteisiin stabiilin ja tasapainoisen perhe-elämän tukemiseksi sekä suhtautua todella arvostavasti lapsiin ja heidän hyvinvointiinsa. Myös julkisella medialla on tärkeä rooli näissä toimenpiteissä

Alternative Investigation and Sanctioning Systems for Corporate and Corporate-Related Crime in Finland

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Development of a Method to Compensate for Signal Quality Variations in Repeated Auditory Event-Related Potential Recordings

Reliable measurements are mandatory in clinically relevant auditory event-related potential (AERP)-based tools and applications. The comparability of the results gets worse as a result of variations in the remaining measurement error. A potential method is studied that allows optimization of the length of the recording session according to the concurrent quality of the recorded data. In this way, the sufficiency of the trials can be better guaranteed, which enables control of the remaining measurement error. The suggested method is based on monitoring the signal-to-noise ratio (SNR) and remaining measurement error which are compared to predefined threshold values. The SNR test is well defined, but the criterion for the measurement error test still requires further empirical testing in practice. According to the results, the reproducibility of average AERPs in repeated experiments is improved in comparison to a case where the number of recorded trials is constant. The test-retest reliability is not significantly changed on average but the between-subject variation in the value is reduced by 33–35%. The optimization of the number of trials also prevents excessive recordings which might be of practical interest especially in the clinical context. The efficiency of the method may be further increased by implementing online tools that improve data consistency

Rat subthalamic stimulation : Evaluating stimulation-induced dyskinesias, choosing stimulation currents and evaluating the anti-akinetic effect in the cylinder test

In experimental deep brain stimulation of the subthalamic nucleus (STN HFS), stimulation currents just below the appearance threshold of stimulation-induced dyskinesias has often been used. The behavioral effect of STN HFS can be measured by the reversal of forelimb use asymmetry produced by hemiparkinsonism can be measured with the cylinder test among other tests. We used 18 Wistar rats with 6-hydroxydopamine induced hemiparkinsonism to test a customized scale to rate the severity of stimulation-induced dyskinesia; we then used these ratings to choose low and high stimulation currents. Subsequent cylinder tests showed that stimulation at the higher current, inducing mild and short-lived dyskinesias, was required for robust improvement in forelimb use, contradicting the use of currents below stimulation-induced dyskinesia threshold. It was also beneficial to separately count both all touches and first touches with the cylinder wall; this provided additional sensitivity and robustness to our results. Scoring stimulation-induced dyskinesias can be used as a quantitative measure of dyskinesias and to choose stimulation currents. Cylinder test scoring separately for both first and all touches can improve both sensitivity and reliability. STN HFS at a current producing short-lived dyskinesias was required for robust improvement in forelimb use asymmetry. (C) 2019 The Authors. Published by Elsevier B.V.Peer reviewe

Combined threats of climate change and land use to boreal protected areas with red-listed forest species in Finland

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Käsimüügiravimid eneseraviks – kas mõistame võimalikke riske?

Käsimüügiravimid sisaldavad samu toimeaineid nagu retsepti alusel väljastatavad ravimid. Enamikul juhtudel on käsimüügiravimite annus ja pakendite suurus väiksemad kui sama toimeainega retseptiravimitel, kuid patsient võib osta neid mitu pakki ja seega võib lühiaegseks kasutamiseks mõeldud ravimi tarvitamine pikeneda ja kokku kasutatud annused suureneda. Võib-olla olulisem risk tekib, kui kasutataval käsimüügiravimil on negatiivne koostoime samal ajal kasutamisel olevate retseptiravimitega. Näiteks võib mittesteroidsetel põletikuvastastel valuvaigistitel olla neerutoksiline koostoime reniin-angiotensiinsüsteemi blokaatoridega. Paratsetamool suurtes annustes on hepatotoksiline ja võimendab antikoagulantide toimet. Atsetüülsalitsüülhappe ja varfariini samaaegne kasutamine on vastunäidustatud. Ravimiamet hindab käsimüügiravimite ohutust ja nende ravimite õige kasutamine on üsna ohutu

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Predicting valuable forest habitats using an indicator species for biodiversity

Intensive management of boreal forests impairs forest biodiversity and species of old-growth forest. Effective measures to support biodiversity require detection of locations valuable for conservation. We applied species distribution models (SDMs) to a species of mature forest, the northern goshawk (Accipiter gentilis, goshawk), that is often associated with hotspots of forest biodiversity. We located optimal sites for the goshawk on a landscape scale, assessed their state under intensified logging operations and identified characteristics of goshawks' nesting sites in boreal forests. Optimal sites for the goshawk covered only 3.4% of the boreal landscape and were mostly located outside protected areas, which highlights the importance of conservation actions in privately-owned forests. Furthermore, optimal sites for the goshawk and associated biodiversity were under threat. Half of them were logged to some extent and 10% were already lost or notably deteriorated due to logging shortly after 2015 for which our models were calibrated. Habitat suitability for the goshawk increased with increasing volume of Norway spruce (Picea abies) peaking at 220 m(3) ha(-1), and with small quantities of birches (Betula spp.) and other broad-leaved trees. Threats to biodiversity of mature spruce forests are likely to accelerate in the future with increasing logging pressures and shorter rotation periods. Logging should be directed less to forests with high biodiversity. Continuous supply of mature spruce forests in the landscape should be secured with a denser network of protected areas and measures that aid in sparing large entities of mature forest on privately-owned land.peerReviewe

Anticancer activity of the protein kinase C modulator HMI-1a3 in 2D and 3D cell culture models of androgen-responsive and androgen-unresponsive prostate cancer

Prostate cancer is one of the most common cancers in men. Although it has a relatively high 5-year survival rate, development of resistance to standard androgen-deprivation therapy is a significant clinical problem. Therefore, novel therapeutic strategies are urgently needed. The protein kinase C (PKC) family is a putative prostate cancer drug target, but so far no PKC-targeting drugs are available for clinical use. By contrast to the standard approach of developing PKC inhibitors, we have developed isophthalate derivatives as PKC agonists. In this study, we have characterized the effects of the most potent isophthalate, 5-(hydroxymethyl) isophthalate 1a3 (HMI-1a3), on three prostate cancer cell lines (LNCaP, DU145, and PC3) using both 2D and 3D cell culture models. In 2D cell culture, HMI-1a3 reduced cell viability or proliferation in all cell lines as determined by the metabolic activity of the cells (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide assay) and thymidine incorporation. However, the mechanism of action in LNCaP cells was different to that in DU145 or PC3 cells. In LNCaP cells, HMI-1a3 induced a PKC-dependent activation of caspase 3/7, indicating an apoptotic response, whereas in DU145 and PC3 cells, it induced senescence, which was independent of PKC. This was observed as typical senescent morphology, increased beta-galactosidase activity, and upregulation of the senescence marker p21 and downregulation of E2F transcription factor 1. Using a multicellular spheroid model, we further showed that HMI-1a3 affects the growth of LNCaP and DU145 cells in a 3D culture, emphasizing its potential as a lead compound for cancer drug development.Peer reviewe

Can Topographic Variation in Climate Buffer against Climate Change-Induced Population Declines in Northern Forest Birds?

Increased attention is being paid to the ecological drivers and conservation measures which could mitigate climate change-induced pressures for species survival, potentially helping populations to remain in their present-day locations longer. One important buffering mechanism against climate change may be provided by the heterogeneity in topography and consequent local climate conditions. However, the buffering capacity of this topoclimate has so far been insufficiently studied based on empirical survey data across multiple sites and species. Here, we studied whether the fine-grained air temperature variation of protected areas (PAs) affects the population changes of declining northern forest bird species. Importantly to our study, in PAs harmful land use, such as logging, is not allowed, enabling the detection of the effects of temperature buffering, even at relatively moderate levels of topographic variation. Our survey data from 129 PAs located in the boreal zone in Finland show that the density of northern forest species was higher in topographically heterogeneous PAs than in topographically more homogeneous PAs. Moreover, local temperature variation had a significant effect on the density change of northern forest birds from 1981–1999 to 2000–2017, indicating that change in bird density was generally smaller in PAs with higher topographic variation. Thus, we found a clear buffering effect stemming from the local temperature variation of PAs in the population trends of northern forest birds