Adverse Childhood Experiences and Risk of Binge Drinking and Drunkenness in Middle-Aged Finnish Men

Objective. The purpose of this study was to investigate associations between adverse childhood experiences and binge drinking and drunkenness in adulthood using both historical and recalled data from childhood. Methods. Data on childhood adverse experiences were collected from school health records and questionnaires completed in adulthood. Adulthood data were obtained from the baseline examinations of the male participants (n = 2682) in the Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD) in 1984–1989 from eastern Finland. School health records from the 1930s to 1950s were available for a subsample of KIHD men (n = 952). Results. According to the school health records, men who had adverse childhood experiences had a 1.51-fold (95% CI 1.05 to 2.18) age- and examination-year adjusted odds of binge drinking in adulthood. After adjustment for socioeconomic position in adulthood or behavioural factors in adulthood, the association remained unchanged. Adjustment for socioeconomic position in childhood attenuated these effects. Also the recalled data showed associations with adverse childhood experiences and binge drinking with different beverages. Conclusions. Our findings suggest that childhood adversities are associated with increased risk of binge drinking in adulthood

Pitkäaikaissairauksien hoidon itsearviointi kehittämistyön kontekstissa - ACIC-kysely Ylä-Savon terveysasemilla 2010 ja 2012

Pitkäaikaissairauksien yleistyminen on merkittävä haaste kansanterveydelle Suomessa ja koko maailmassa. Pitkäaikaissairauksien hoito kattaa huomattavan suuren osan terveydenhuollon resursseista. Ylä-Savon alueella vuosina 2010–2012 toimineessa perusterveydenhuollon kehittämiseen tähdänneessä RAMPE-hankkeessa pyrittiin vastaamaan tähän haasteeseen. Hankkeen tavoitteena oli pitkäaikaissairauksien hoidon kehittäminen perusterveydenhuollossa. Kehittämistyön viitekehyksenä käytettiin terveyshyötymallia, ja pitkäaikaissairauksien hoidon toteutusta arvioitiin hankkeessa malliin kuuluvan ACIC-kyselyn avulla. ACIC-kysely toteutettiin vuosina 2010 ja 2012 Ylä-Savon alueen neljällä terveysasemalla; Iisalmessa, Vieremällä, Kiuruvedellä ja Sonkajärvellä. Kysely toteutettiin arvioimalla erikseen viittä eri pitkäaikaissairausryhmää: Diabetes ja valtimotaudit, masennus ja päihdeongelmat, tuki- ja liikuntaelinsairaudet, keuhkosairaudet sekä muistisairaudet. Kyselyllä saatiin selville organisaatiotason itsearviointi, eli terveyskeskusten työntekijöiden näkemys, näiden pitkäaikaissairauksien hoidon toteutuksesta. ACIC-kyselyn toteutuksesta kerättiin hankkeen puitteissa kirjallista palautetta. Osana tätä tutkielmaa toteutettiin myös teemahaastatteluja ACIC-kyselyyn osallistuneille. Tutkielmassa vertaillaan ACIC-kyselyn tuloksia ja niiden kehitystä vuodesta 2010 vuoteen 2012 Ylä-Savon terveysasemien ja arvioitujen pitkäaikaissairausryhmien välillä. Lisäksi tarkastellaan kyselyllä saadun tiedon hyödynnettävyyttä kirjallisten palautteiden ja teemahaastattelujen perusteella. ACIC-kyselyaineistoa analysoitiin laskemalla tulokset kyselyn ohjeiden mukaan, eli aineistosta tuotettiin kuvaileva tilastollinen analyysi. Kirjallisen palautteen ja haastatteluaineiston analyysi toteutettiin sisällönanalyysin mukaisesti. ACIC-kyselyn tulokset ja niiden kehitys vaihteli eri sairausryhmien ja terveysasemien välillä. Kyselyn tulosten tulkinnassa tulee kuitenkin olla varovainen, sillä kysely perustuu vastaajien subjektiiviseen näkemykseen. Jotta pitkäaikaissairauksien hoidon toteutuksesta saataisiin kattava kokonaiskuva, täytyy ACIC-kyselyn rinnalla käyttää myös muita tietolähteitä. Tutkielman merkittävin tulos on se, että ACIC-kysely saattaa itsessään toimia kehittämisprosessin käynnistävänä ja sitä ylläpitävänä interventiona. Kyselyä tulee hyödyntää nimenomaan kehittämistyön työvälineenä. Se kannattaa ottaa pysyväksi ja säännölliseksi osaksi Ylä-Savon terveysasemien toimintaa, sillä työn kehittäminen on tärkeää työhyvinvoinnin, työviihtyvyyden ja työhön sitoutumisen kannalta. Asiasanat:pitkäaikaissairaudet, terveyshyötymalli, kehittämishanke, itsearvioint

Electromagnetic signals in noninvasive brain-computer interfaces

A brain-computer interface (BCI) translates task-related brain activity into computer commands. Detecting this activity is difficult, as the measured brain signals are generated by multiple sources and also include task-irrelevant brain activity. Using conventional methods such as signal averaging is not possible, because subjects should receive online feedback of their performance. BCI users usually either learn to control some components of their brain activity with the help of feedback or are presented with some stimuli that produce detectable signals in the brain. This thesis reviews BCI research, basic principles of electroencephalography (EEG) and magnetoencephalography (MEG), the sensorimotor cortex, and then describes experimental BCI studies. The thesis comprises of five publications studying 1) sensorimotor cortical activation for BCI, 2) use of MEG for BCIs, 3) single brain signal trials during (attempted) finger movements for online BCI classification and 4) vibrotactile feedback in comparison to visual feedback. Participants were 45 healthy, 9 tetraplegic, and 3 paraplegic subjects. First our results of tetraplegic subjects show that their 10- and 20-Hz rhythmic activity is more widespread and less contralateral than that of healthy subjects, providing a poorer control signal for two-class movement classification. For separating brain signals during right and left attempted movement, we selected features from the low-frequency bands. Second, our results show that for classification, MEG is not superior to EEG for two-class BCI, despite being a more localised measurement technique. Third, brain signals during finger movements could be classified online with high accuracy after basically no training. However, results from the tetraplegic subjects are much worse than those of the healthy subjects. Fourth, we show that vibrotactile feedback can be used as an alternative feedback channel during training and is especially useful when visual attention is needed for application control. On the basis of these and earlier findings, it is concluded that accurate control of noninvasive BCI is possible but requires some training. Future important research involves more work with motor-disabled patients, especially when testing new signal processing methods. Better performance may also be achieved using different feedback modalities

EEG-Based Brain-Computer Interface for Tetraplegics

Movement-disabled persons typically require a long practice time to learn how to use a brain-computer interface (BCI). Our aim was to develop a BCI which tetraplegic subjects could control only in 30 minutes. Six such subjects (level of injury C4-C5) operated a 6-channel EEG BCI. The task was to move a circle from the centre of the computer screen to its right or left side by attempting visually triggered right- or left-hand movements. During the training periods, the classifier was adapted to the user's EEG activity after each movement attempt in a supervised manner. Feedback of the performance was given immediately after starting the BCI use. Within the time limit, three subjects learned to control the BCI. We believe that fast initial learning is an important factor that increases motivation and willingness to use BCIs. We have previously tested a similar single-trial classification approach in healthy subjects. Our new results show that methods developed and tested with healthy subjects do not necessarily work as well as with motor-disabled patients. Therefore, it is important to use motor-disabled persons as subjects in BCI development

Parental Alcohol Problems, Parental Divorce, and Type 2 Diabetes in Adulthood: A Longitudinal Prospective Cohort Study in Middle-Aged Men

Objective Type 2 diabetes is a chronic disease and a serious global public health concern increasing both mortality and morbidity. Previous studies have found evidence for an association between early psychological stress and diabetes later in life. Methods This study examined the association between parental alcohol problems and parental divorce and the incidence of type 2 diabetes in Finnish men aged 42 to 61 years (n = 754) in a prospective setting. Information on parental alcohol problems and parental divorce was derived from school records and subjective experiences of the same events from self-rated questionnaires. The average follow-up time for the participants until the first type 2 diabetes diagnosis was 23.3 years (25th-75th percentile, 21.2-27.9 years). Results Cox regression analyses revealed that parental alcohol problems (hazard ratio = 3.09, 95% confidence interval = 1.38-6.88) were associated with an increased risk of type 2 diabetes during the follow-up, even after adjustment for age, marital status, education, Human Population Laboratory Depression Scale scores, smoking, alcohol consumption, body mass index, and serum high-sensitivity C-reactive protein. In a similar model, parental divorce (hazard ratio = 1.69, 95% confidence interval = 0.40-7.05) was not associated with an increased risk of type 2 diabetes during the follow-up. Conclusions Our findings suggest that not all adverse childhood experiences contribute equally to the risk of type 2 diabetes. Parental alcohol problems, but not parental divorce, were associated with an increased risk of type 2 diabetes in men. These findings highlight the need for early interventions targeting parents with excessive alcohol consumption to reduce their offspring's risk of life-style-related disorders.</div

Registered psychiatric service use, self-harm and suicides of children and young people aged 0-24 before and during the COVID-19 pandemic : a systematic review

Background The COVID-19 pandemic has impacted on psychiatric symptoms of children and young people, but many psychiatric services have been disrupted. It is unclear how service use, self-harm and suicide has changed since the pandemic started. To gain timely information, this systematic review focused on studies based on administrative data that compared psychiatric service use, self-harm and suicide before and during the pandemic among children and young people. Methods and finding A systematic review of studies published in English from 1 January 2020 to 22 March 2021 was conducted, using the Web of Science, PubMed, Embase and PsycINFO databases. Increases or reductions in service use were calculated and compared using percentages. Of the 2,676 papers retrieved, 18 were eligible for the review and they provided data from 19 countries and regions. Most studies assessed changes during the early phase of the COVID-19 pandemic, from March to July 2020, and three assessed the changes until October 2020. Fifteen studies reported a total of 21 service use outcomes that were quantitively examined. More than three-quarters of the 21 outcomes (81%) fell by 5-80% (mean reduction = 27.9%, SD = 35%). Ten of the 20 outcomes for psychiatric emergency department (ED) services reduced by 5% to 80% (mean = 40.1%, SD = 34.9%) during the pandemic. Reductions in service use were also recorded for ED visits due to suicide ideation and self-harm, referrals to secondary mental health services, psychiatric inpatient unit admissions and patients receiving treatment for eating disorders. However, there were also some increases. Suicide rate and the number of ED visits due to suicide attempts have increased, and there was an increase in the number of treatment sessions in a service that provided telemedicine. Conclusion Most of the studies showed reductions in the use of psychiatric services by children and young people during the early phase of the pandemic and this highlighted potential delays or unmet needs. Suicide rate has increased during the second wave of the pandemic. Further studies are needed to assess the pattern of service use in the later phases of the COVID-19 pandemic.Peer reviewe

Vibrotactile Feedback for Brain-Computer Interface Operation

To be correctly mastered, brain-computer interfaces (BCIs) need an uninterrupted flow of feedback to the user. This feedback is usually delivered through the visual channel. Our aim was to explore the benefits of vibrotactile feedback during users' training and control of EEG-based BCI applications. A protocol for delivering vibrotactile feedback, including specific hardware and software arrangements, was specified. In three studies with 33 subjects (including 3 with spinal cord injury), we compared vibrotactile and visual feedback, addressing: (I) the feasibility of subjects' training to master their EEG rhythms using tactile feedback; (II) the compatibility of this form of feedback in presence of a visual distracter; (III) the performance in presence of a complex visual task on the same (visual) or different (tactile) sensory channel. The stimulation protocol we developed supports a general usage of the tactors; preliminary experimentations. All studies indicated that the vibrotactile channel can function as a valuable feedback modality with reliability comparable to the classical visual feedback. Advantages of using a vibrotactile feedback emerged when the visual channel was highly loaded by a complex task. In all experiments, vibrotactile feedback felt, after some training, more natural for both controls and SCI users

Associations of subjective and objective cognitive functioning after COVID-19 : A six-month follow-up of ICU, ward, and home-isolated patients

Publisher Copyright: © 2023 The AuthorsBackground: Subjective and objective cognitive dysfunction are reported after COVID-19 but with limited data on their congruence and associations with the severity of the acute disease. The aim of this cohort study is to describe the prevalence of subjective and objective cognitive dysfunction at three and six months after COVID-19 and the associations of subjective cognitive symptoms and psychological and disease-related factors. Methods: We assessed a cohort of 184 patients at three and six months after COVID-19: 82 patients admitted to the Intensive Care Unit (ICU), 53 admitted to regular hospital wards, and 49 isolated at home. A non-COVID control group of 53 individuals was included. Demographic and clinical data were collected. Subjective cognitive symptoms, objective cognitive impairment, and depressive and post-traumatic stress disorder (PTSD) symptoms were assessed. Results: At six months, subjective cognitive impairment was reported by 32.3% of ICU-treated, 37.3% of ward-treated, and 33.3% of home-isolated patients and objective cognitive impairment was observed in 36.1% of ICU-treated, 34.7% of ward-treated, and 8.9% of home-isolated patients. Subjective cognitive symptoms were associated with depressive and PTSD symptoms and female sex, but not with objective cognitive assessment or hospital metrics. Conclusions: One-third of COVID-19 patients, regardless of the acute disease severity, reported high levels of subjective cognitive dysfunction which was not associated with results from objective cognitive screening but with psychological and demographic factors. Our study stresses the importance of thorough assessment of patients reporting long-term subjective symptoms, screening for underlying mental health related factors such as PTSD or depression.Peer reviewe

hiPSC-derived hepatocytes closely mimic the lipid profile of primary hepatocytes: A future personalised cell model for studying the lipid metabolism of the liver

Peer reviewe