Gender identities in adolescent population : Methodological issues and prevalence across age groups

Background: Increasing numbers of adolescents are seeking treatment from gender identity services, particularly natal girls. It is known from survey studies some adolescents exaggerate their belonging to minorities, thereby distorting prevalence estimates and findings on related problems. The aim of the present study was to explore the susceptibility of gender identity to mischievous responding, and prevalences of cis-gender, opposite-sex and other/non-binary gender identities as corrected for likely mischievous responding among Finnish adolescents. Method: The School Health Promotion Survey 2017 data was used, comprising data on 135,760 adolescents under 21 years (mean 15.73, ds 1.3 years), 50.6% females and 49.4% males. Sex and perceived gender were elicited and gender identities classified based thereon. Likely mischievous responding was analysed using inappropriate responses to biodata and handicaps. Results: Of the participants, 3.5% had most likely given facetious responses, boys more commonly than girls, and younger adolescents more commonly than older. This particularly concerned reporting of nonbinary gender identity. Corrected prevalence of opposite-sex identification was 0.6% and that of nonbinary identification was 3.3%. In boys, displaying non-binary gender identity increased from early to late adolescence, while among girls, opposite-sex and non-binary identifications decreased in prevalence from younger to older age groups. Conclusion: Prevalence of gender identities contrary to one's natal sex was more common than expected. (c) 2018 Elsevier Masson SAS. All rights reserved.Peer reviewe

Subsequent criminal participation among young people first admitted to psychiatric inpatient care during early and middle adolescence

Adolescents brought before court suffer excessively of mental disorders. Less is known about subsequent criminal participation of adolescent psychiatric inpatients. Our register study comprised all subjects that had between 1980 and 2010 been admitted to psychiatric inpatient care in Finland for the first time in their lives at ages 13-17 (n = 16 842), identified in the Care Register for Health Care and followed up for up to 10 years in the Register of Prosecutions, Sentences and Punishments. Incidence of register entry for any crime was 2.4/100 person-years, 4.0 in males and 1.9 in females. Incidence of violent crime was 0.9/100 person-years, 1.5 in males and 0.3 in females. Greatest risk for subsequent crime was associated with diagnoses of conduct, personality and substance use disorders (F90-92, F60-69, F10-19). Schizophrenia group diagnoses (F20-29) were associated with lowest risk. Later criminality was manifold among those who already had a crime register entry before the index treatment. Need for psychiatric inpatient care during adolescence associates with a great risk of antisocial development. Treatment needs to address this risk by systematically implementing evidence-based interventions. Health and social policies need to ensure resources and skills to these treatments.Peer reviewe

Arbete med grönstruktur i Skåne - begränsningar och förutsättningar för regional och kommunal grönstrukturplanering med Landskrona kommun som exempel

I dagens samhälle pratas det alltmer om förtätning av städer. Tätare städer ger allt mindre mellanrum mellan bebyggelsestruktur och infrastruktur. Grönstrukturen är ett begrepp som får allt mer utrymme i planeringen och ett mål är att grönstrukturplanering ska få samma självklara plats som till exempel planering av infrastruktur. Denna kandidatuppsats behandlar grönstrukturplanering på regional och kommunal nivå med Landskrona kommun som exempel. I arbetet undersöks begreppet grönstruktur och planeringen av grönstruktur. Genom två intervjuer, en med Region Skåne och en med Landskrona kommun, är tanken att ge ett utförandeperspektiv och exemplifiera kommunens och regionens nuvarande arbete. Syftet med uppsatsen är att nå en djupare insikt i hur kommun och region arbetar med grönstruktursplanering i Skåne och diskutera eventuella skillnader i hur grönstrukturplaneringen hanteras i den kommunala respektive i regionala planeringen. Utöver två stycken djupintervjuer genomförs en litteraturstudie av sakkunniga källor inom ämnet. Uppsatsen visar på att det i dagsläget finns ambitiösa visioner och planer för Skåneregionen och Landskrona kommuns grönstrukturutveckling. Det finns ett ökande intresse hos politiker och ett nytt sätt att se på grönstruktur som ett sätt att skapa attraktivitet.The ongoing discussion about expanding cities is a lot about densification. The more dense cities leave less space in between building structures and infrastructure. Green structure planning is a concept given more and more space in the debate of city planning and a goal is for green structure planning to reach the same obvious position as for example planning of infrastructure. This essay is about green structure planning at regional and municipal level and has Landskrona municipality as an example. The essay examines the concept green structure and green structure planning. By way of two interviews, one with Region Skåne and one with the municipality of Landskrona, the thought is to give a performance perspective and to give examples of regional and municipal tasks at their present situation. The main point with the essay is to reach a deeper insight about how the municipality and the region works with green structure planning in Skåne and to discuss, if any, differences about handling green structure planning in the municipality according to the planning of the region. In excess of the two interviews a literature study of sources of specialists within the subject is also performed. The essay shows ongoing ambitious visions and plans for the development of the green structure in the Skåne region and Landskrona municipality. There is an increasing interest among politicians and a new way of thinking of green structure as a way to create attractivity

Emmeryd 5:11

Detta arbete handlar om en gestaltning av området Emmeryd 5:11, med hänsyn till natur-, kultur- och upplevelsevärden. Syftet är att främja biologisk mångfald, den historiska läsbar-heten samt rekreationsvärdet i området. Arbetsområdet utgör större delen av fastigheten Emmeryd 5:11, vilken är belägen i en mindre by, Emmeryd, i Karlskorna kommun. Området är en del av Kvistagården, som i sin tur utgör en del av ett varierat och starkt kulturpåverkat landskap. Emmeryd 5:11 är karakteristiskt för den Blekingska mellanbygden. Området både ramas in och genomskärs av stenmurar och marken utgörs numera av igenvuxen gödslad och ogödslad åkermark, naturbetesmark och tidigare ängsmark samt skogsmark. Till stor del utgörs vegetationen av blandlövskog, snåriga buskiga områden och mindre partier av barrskog. Det finns en stor artrikedom i området samt en del öppna gräsytor och berg i dagen. I det historiska kartmaterialet, som analyseras i arbetet, går det att följa markanvändningen för Emmeryd 5:11 tillbaka till 1700-talet. På kartmaterial från 1768 är Emmeryd 5:11, som då ännu inte har fått sina nuvarande avgränsningar, ett mycket annorlunda landskap. Vid denna tid var marken trädfattig ängsmark, som till vis del betades. Under 1800- och 1900-talet har stora delar av området sedan brukats som åker och numera har de tidigare brukade åkrarna och betade markerna tillåtits att växa igen. I och med ett ägarskifte för Kvistagården, i decem-ber 2012, finns önskemål om en utvecklingsplan för området. I arbetet genomförs en analys av befintliga värden i området, med utgångspunkt i Axel Un-nerbäcks kulturhistoriska värderingsmetod (2002). Litteraturstudier som genomförs i arbetet berör gestaltningsteori, vilken tar upp hanteringen av natur-, kultur- och upplevelsevärden och hur dessa kan förstärkas eller omformas för olika syften. Övriga analysmetoder som använts för att förstå området är en mental kartanalys utformad av Kevin Lynch, Gordon Cullens serial vision samt vegetationsanalyser för krontakets öppen-/slutenhet och vegetationens skiktning. Gestaltningsförslaget, som presenteras i slutet av arbe-tet, är ett resultat av de identifierade värdena, de olika plats- och rumsanalyserna och littera-turstudierna. Utifrån inventeringar och analyser fokuserar gestaltningsförslaget på småskaligheten och det mosaikartade landskapet med de många olika småbiotoperna. Förslaget innebär en reduktion i mängden vegetation för att förstärka upplevelsen av ett varierat kulturhistoriskt odlingsland-skap, synliggöra kulturvärden samt utveckla naturvärdena på platsen. En grundläggande tanke i gestaltningen blev att utveckla olika delområdens egna karaktärer och att arbeta med en va-riation i öppen- och slutenhet. Gestaltningsförslaget har inte något att göra med ett modernt jordbruk på 2000-talet. Ut-gångspunkten är istället att ta hänsyn till befintliga natur-, kultur- och upplevelsevärden. Därmed innebär det ett brott i kontinuiteten. Även om gestaltningen tar avstamp i den histo-riska kontinuiteten på platsen så innebär den ändå ett avslut, eftersom funktionen i form av lantbruk för ekonomisk bärkraftighet helt har upphört och landskapet istället fyller en funkt-ion som bas för rekreation och fritid, även om det sker med intresse, hänsyn och vård av na-tur- och kulturaspekter.This master project is about designing the landscape Emmeryd 5:11 with consideration to natural, cultural and experiential values. The purpose is to encourage biodiversity, the historic coherence as well as recreational values in the area. The landscape in question, Emmeryd 5:11, is a part of the farm Kvistagården which is situated in the small village Emmeryd, in the municipality of Karlskrona. The area is strongly influ-enced by cultural history, in the shape of small scale farming and grazing. Emmeryd 5:11 has the characteristics for the type of landscape in Blekinge where the forests and the fields meet. Emmeryd 5:11 is both framed and crosscut by stone walls and the landscape is nowadays overgrown by varying vegetation. There are both fertilized and non-fertilized historic arable land, pastureland, historic meadowland and forest. The vegetation is mostly deciduous forest, shrubberies and a smaller area of spruce forest. There are also some open grassland and stony, rocky areas. Emmeryd 5:11 contains a broad variation of plant species. According to the historic maps, which are analyzed during the project, the land use of the dif-ferent parts of Emmeryd 5:11 is traceable back to the 18th century. In the map from the year 1768, Emmeryd 5:11, which still yet has not acquired its modern boundary lines, contains a very different landscape from today. At this time most of the area is meadowland with few trees. During the 19th and 20th century major parts of the area was turned into arable land, but nowadays the former fields and pastureland has been allowed to be overgrown by brushwood. Since there was a shift in ownership for the estate in December 2012, there is a desire for a new development for the area. As part of the project, to identify existing values, an analysis, with the evaluation method of Axel Unnerbäck as starting point, is prosecuted. The literature studies during the project most-ly consider design theory concerning the experience of landscape and natural and cultural values. Other methods for analysis that has been used in the working process, to understand the area and its landscape, is the method of a visual map by Kevin Lynch, serial vision by Gordon Cul-len and analysis for the vertical structure of the vegetation and the openness of the canapé. The proposed design for Emmeryd 5:11, in the fifth chapter, is a result of the identified val-ues, the different analysis of space and place, and vegetation, and the literature studies. Pursuant to the inventories and analysis the design proposal focuses on the small scale and the mosaic shaped landscape with the many smaller different biotopes. The plan for the area im-plicates a reduction of the vegetation to enhance the impression of a diversified historic agri-cultural landscape, to make cultural values visible and to develop natural values. A fundamen-tal thought in the design became to develop a variation in characters for different sections and to work with a variety in closeness and openness. The design has nothing to do with modern farming in the 21th century. The purpose instead is to consider existing natural, cultural and experiential values, which means a break in the con-tinuity. Even if the proposal starts in the history of the area it still means an ending, because the function as an economical sustainable farm has ceased. The landscape is a place for recre-ation and leisure, even if it is with consideration and care for natural, cultural and experiential aspects

Gender dysphoria in adolescent population : A 5-year replication study

The aim of this study was to explore whether there has been an increase in prevalence and changes in sex ratio in feelings of gender dysphoria (GD) in an adolescent population in Northern Europe, and to study the impact of invalid responding on this topic. We replicated an earlier survey among junior high school students in Tampere, Finland. All first and second year students, aged 16-18, in the participating schools were invited to respond to an anonymous classroom survey on gender experience during the 2012-2013 school year and in the spring and autumn terms of 2017. Gender identity/GD was measured using the GIDYQ-A. A total of 318 male and 401 female youth participated in 2012-2013, and 326 male and 701 female youth in 2017. In the earlier survey, the GIDYQ-A scores, both among males and females, were strongly skewed toward a cis-gender experience with very narrow interquartile ranges. Of males, 2.2%, and of females, 0.5% nevertheless reported possibly clinically significant GD. The 2017 GIDYQ-A distribution was similarly skewed. The proportion of those reporting potentially clinically significant GD was 3.6% among males and 2.3% among females. Validity screening proved to have a considerable impact on conclusions. GD seems to have increased in prevalence in the adolescent population.Peer reviewe

Looking for pyromania: Characteristics of a consecutive sample of Finnish male criminals with histories of recidivist fire-setting between 1973 and 1993

BACKGROUND: As pyromania is a rare diagnosis with questionable validity, we aimed to describe a forensic psychiatric population of arson recidivists. METHODS: The medical records as well as the forensic psychiatric examination statements of 90 arson recidivists referred for pretrial psychiatric assessment in Helsinki University Hospital Department of Forensic Psychiatry between 1973 and 1993 were reviewed. RESULTS: The most important diagnostic categories of arson recidivists were personality disorders, psychosis and mental retardation, often with comorbid alcoholism. In all, 68% of arsonists were under alcohol intoxication during the index crime. Psychotic as well as mentally retarded persons with repeated fire-setting behaviour were mostly "pure arsonists"- persons guilty only of arsons during their criminal careers. Arson recidivists with personality disorder, in contrast, often exhibited various types of criminal behaviour and arson appeared to be only one expression of a wide range of criminal activity. Comorbid alcoholism was apparently a more rarely observed phenomenon among pure arsonists than in "nonpure arsonists". We found only three subjects fulfilling the present diagnostic criteria for pyromania. CONCLUSION: Using the criteria of the DSM-IV-TR, pyromania must be regarded as an extremely rare phenomenon. Especially the question of substance intoxication as an exclusion criterion for pyromania should be reconsidered

Mortality of young offenders : a national register-based follow-up study of 15-to 19-year-old Finnish delinquents referred for forensic psychiatric examination between 1980 and 2010

Background: The mortality rate of young offenders is high. Furthermore, mortality in young offenders is associated with psychiatric and substance use disorders. The primary aim of this national register-based follow-up study was to investigate the mortality rate of Finnish delinquents who underwent a forensic psychiatric examination between 1980 and 2010. As delinquency is not a solid entity, we further aimed to compare the risk of premature death among different subgroups of the delinquents; violent versus non-violent offenders, offenders with alcohol use disorders versus those with no such diagnoses, offenders with schizophrenia spectrum disorders versus conduct-and personality-disordered offenders, under-aged versus young adult offenders, and, finally, boys versus girls. Methods: We collected the forensic psychiatric examination reports of all 15- to 19-year-old offenders who were born in Finland and had undergone the examination between 1.1.1980 and 31.12.2010 (n = 606) from the archives of the National Institute of Health and Welfare and retrospectively reviewed them. For each delinquent, four age-, gender- and place of birth-matched controls were randomly selected from the Central Population Register (n = 2424). The delinquents and their controls were followed until the end of 2015. The median follow-up time was 23.9 years (interquartile range 15.3-29.5). We obtained the mortality data from the causes of death register. Deaths attributable to a disease or an occupational disease were considered natural, and those attributable to an accident, suicide or homicide were considered unnatural. Results: By the end of the follow-up period, 22.1% (n = 134) of the delinquents and 3.4% (n = 82) of their controls had died (OR 8.11, 95% CI 6.05-10.86, p <0.001). Among boys, 22.0% (n = 121) of the delinquents and 3.7% (n = 81) of the controls had died (OR 7.38, 95% CI 5.46-9.95, p <0.001). Male delinquents' risk of unnatural death was almost 11-fold, of natural death more than twofold, and of unclear death more than fourfold compared to that of their controls. No girls had natural or unclear deaths, but 23.6% (n = 13) of the delinquents and 0.5% (n = 1) of the controls had died due to unnatural causes (OR 67.79, 95% CI 8.63-532.00, p <0.001). The violent delinquents' risk of premature death was twice that of the non-violent delinquents. The other comparisons demonstrated no statistically significant differences between subgroups. Conclusions: Even though the Finnish correction system prefers psychiatric treatment and rehabilitation over criminal sanctions, and the national health care system offers developmental-phase-specific psychiatric care, the mortality rate of delinquents, especially of those with a history of violent offences, is high. The excess mortality of offenders can be regarded as a specific public-health inequity that calls for more effective intervention procedures than those used thus far.Peer reviewe

Cytolytic replication of echoviruses in colon cancer cell lines

<p>Abstract</p> <p>Background</p> <p>Colorectal cancer is one of the most common cancers in the world, killing nearly 50% of patients afflicted. Though progress is being made within surgery and other complementary treatments, there is still need for new and more effective treatments. Oncolytic virotherapy, meaning that a cancer is cured by viral infection, is a promising field for finding new and improved treatments. We have investigated the oncolytic potential of several low-pathogenic echoviruses with rare clinical occurrence. Echoviruses are members of the enterovirus genus within the family <it>Picornaviridae</it>.</p> <p>Methods</p> <p>Six colon cancer cell lines (CaCo-2, HT29, LoVo, SW480, SW620 and T84) were infected by the human enterovirus B species echovirus 12, 15, 17, 26 and 29, and cytopathic effects as well as viral replication efficacy were investigated. Infectivity was also tested in spheroids grown from HT29 cells.</p> <p>Results</p> <p>Echovirus 12, 17, 26 and 29 replicated efficiently in almost all cell lines and were considered highly cytolytic. The infectivity of these four viruses was further evaluated in artificial tumors (spheroids), where it was found that echovirus 12, 17 and 26 easily infected the spheroids.</p> <p>Conclusions</p> <p>We have found that echovirus 12, 17 and 26 have potential as oncolytic agents against colon cancer, by comparing the cytolytic capacity of five low-pathogenic echoviruses in six colon cancer cell lines and in artificial tumors.</p

A rapid and efficient method for studies of virus interaction at the host cell surface using enteroviruses and real-time PCR

<p>Abstract</p> <p>Background</p> <p>Measuring virus attachment to host cells is of great importance when trying to identify novel receptors. The presence of a usable receptor is a major determinant of viral host range and cell tropism. Furthermore, identification of appropriate receptors is central for the understanding of viral pathogenesis and gives possibilities to develop antiviral drugs. Attachment is presently measured using radiolabeled and subsequently gradient purified viruses. Traditional methods are expensive and time-consuming and not all viruses are stable during a purification procedure; hence there is room for improvement. Real-time PCR (RT-PCR) has become the standard method to detect and quantify virus infections, including enteroviruses, in clinical samples. For instance, primers directed to the highly conserved 5' untranslated region (5'UTR) of the enterovirus genome enable detection of a wide spectrum of enteroviruses. Here, we evaluate the capacity of the RT-PCR technology to study enterovirus host cell interactions at the cell surface and compare this novel implementation with an established assay using radiolabeled viruses.</p> <p>Results</p> <p>Both purified and crude viral extracts of CVB5 generated comparable results in attachment studies when analyzed with RT-PCR. In addition, receptor binding studies regarding viruses with coxsackie- and adenovirus receptor (CAR) and/or decay accelerating factor (DAF) affinity, further demonstrated the possibility to use RT-PCR to measure virus attachment to host cells. Furthermore, the RT-PCR technology and crude viral extracts was used to study attachment with low multiplicity of infection (0.05 × 10^-4TCID₅₀/cell) and low cell numbers (250), which implies the range of potential implementations of the presented technique.</p> <p>Conclusion</p> <p>We have implemented the well-established RT-PCR technique to measure viral attachment to host cells with high accuracy and reproducibility, at low cost and with less effort than traditional methods. Furthermore, replacing traditional methods with RT-PCR offers the opportunity to use crude virus containing extracts to investigate attachment, which could be considered as a step towards viral attachment studies in a more natural state.</p