Specific adolescent prodromal symptoms associated with onset of psychosis in the Northern Finland Birth Cohort 1986

Background: Several psychological symptoms in adolescence associate with later development of psychosis. However, it is unclear which symptoms specifically predict psychotic disorders rather than psychiatric disorders in general. We conducted a prospective study comparing how specific adolescent psychotic-like symptoms, predicted psychotic and non-psychotic hospital-treated psychiatric disorders in the population-based Northern Finland Birth Cohort 1986 (NFBC1986). Methods: At age 15-16 years, 6632 members of the NFBC1986 completed the PROD-screen questionnaire. New hospital-treated mental disorders of the NFBC1986 participants were detected between age 17 and 30 years from the Finnish Care Register for Health Care. Multiple covariates were used in the analysis. Results: During the follow-up, 1.1% of the participants developed a psychotic and 3.2% a non-psychotic psychiatric disorder. Three symptoms were specifically associated with onset of psychosis compared to non-psychotic psychiatric disorders: 'Difficulty in controlling one's speech, behaviour or facial expression while communicating' (adjusted OR 4.00; 95% CI 1.66-9.92), 'Difficulties in understanding written text or heard speech' (OR 2.25; 1.12-4.51), and 'Difficulty or uncertainty in making contact with other people' (OR 2.20; 1.03-4.67). Of these, the first one remained statistically significant after Bonferroni correction for multiple comparisons. Conclusion: To our knowledge, this is the first general-population-based prospective study exploring psychiatric symptoms predicting the onset of hospital-treated first-episode psychosis in comparison to non-psychotic disorders. We found three symptoms related with difficulties in social interaction which predicted onset of psychosis. This is a novel finding and should be replicated.</p

Endokrinologinen potilas kilpirauhasen ja lisäkilpirauhasen isotooppitutkimuksissa ja radiojodihoidossa

Kilpirauhanen on kaulalla sijaitseva umpirauhanen, joka erittää kasvuun, kehitykseen ja aineenvaihduntaan vaikuttavia kilpirauhashormoneja. Kilpirauhasen takaosassa sijaitsevat lisäkilpirauhaset erittävät parathormonia, joka osallistuu elimistön kalsiumaineenvaihdunnan säätelyyn. Kilpirauhasen ja lisäkilpirauhasen liikakasvuun ja hormonitoiminnan häiriöihin liittyviä endokrinologisia sairauksia voidaan tutkia isotooppitutkimuksilla. Kilpirauhasen gammakuvauksella voidaan selvittää rauhasen koko, muoto ja toiminnallinen tila. Kaksoisisotooppimenetelmää hyödyntävällä gamma- ja SPET-TT-kuvauksella voidaan havaita ja paikantaa suurentunut patologinen lisäkilpirauhaskudos. Isotooppiyksikössä annettava radiojodihoito on yksi kilpirauhasen liikatoiminnan hoitomuodoista. Projektin tuotteena valmistuneessa tietopaketissa esitellään kilpirauhasen ja lisäkilpirauhasen anatomiaa, fysiologia ja yleisimpiä patologisia muutoksia. Tuotteessa käsitellään endokrinologisen kilpirauhas- ja lisäkilpirauhaspotilaan hoitopolkua, sekä isotooppilääketieteellisiä tutkimuksia ja hoitoa. Aloite projektiin on tullut Oulun yliopistollisen sairaalan isotooppiosastolta keväällä 2018. Toimeksiantaja tavoittelee tietopaketin käyttöönotolla isotooppihoitajien asiantuntemuksen vahvistamista ja sen myötä parempaa tutkimusten ja hoitojen laatua sekä kattavampaa potilasohjausta. Tuotteen kohderyhmäksi valikoitui isotooppiosastolla työskentelevät röntgenhoitajat ja bioanalyytikot sekä opiskeluharjoittelua suorittavat opiskelijat. Projekti on toteutettu osana toiminnallista opinnäytetyötä, jonka kehittämistehtävä oli valmistaa toimeksiantajan vaatimusten mukainen tuote projektityön menetelmää käyttäen. Tuotteen tietoperusta on kirjoitettu syksyllä 2018 ja tammi-helmikuussa 2019. Lähdemateriaalina on käytetty alan kirjallisuutta, kansainvälisiä tutkimusartikkeleita, Oulun yliopistollisen sairaalan menetelmäohjeita sekä asiantuntijahaastatteluja. Havainnollistamisen tukena on käytetty kuvitusta, kaavioita ja taulukoita. Tuotteelle asetettiin laatutavoitteita, joiden onnistumista arvioitiin isotooppiosaston henkilökunnalta kerätyn palautteen avulla. Palautetta kerättiin kyselylomakkeella, johon vastasi neljä henkilöä. Tietopaketin sisältöä muokattiin saadun palautteen perusteella ja valmis tuote palautettiin isotooppiosastolle huhtikuussa 2019. Tuotetta voidaan hyödyntää isotooppiosaston henkilökunnan perehdyttämisessä ja ammatillisen osaamisen syventämisessä sekä opiskelijoiden ohjauksessa. Tietopakettia voisi jatkossa laajentaa koskemaan myös onkologisten potilaiden isotooppitutkimuksia ja radiojodihoitoa.Thyroid is an endocrine gland that secretes hormones which influence the metabolic rate, growth and development. Parathyroid glands produce parathyroid hormone which influences calcium metabolism regulation. Endocrine disorders affecting thyroid and parathyroid function can be examined with nuclear medicine imaging procedures. Thyroid scintigraphy can be used to assess the size, shape and function of the gland. Pathological hypertrophy of the parathyroid glands can be detected with scintigraphy and SPET-CT imaging using dual-isotope method. Hyperthyroidism is treated with radioactive iodine therapy in the nuclear medicine unit. The anatomy, physiology and common pathologies of the thyroid and parathyroid glands are reviewed in the informational booklet that was implemented as a product of a project. The booklet includes introduction of the clinical pathway and nuclear medicine examinations and treatment of a patient with endocrine thyroid and parathyroid disorders. The project was initiated by the nuclear medicine unit of Oulu University Hospital in the spring 2018. The client’s objective for the product is to use it as a tool for improving the know-how of the radiographers and biomedical laboratory scientists working in the unit. More profound expertise is expected to result in better patient guidance and quality of treatment. The target group of the project comprises the radiographers, biomedical laboratory scientists and students in the nuclear medicine unit of Oulu University Hospital. The booklet was produced as a part of functional thesis. The information presented in the booklet was compiled in the fall 2018 and in January and February 2019. Literature of the field of medicine and nuclear medicine, multinational research publications, working instructions of the nuclear medicine unit and specialist interviews were used as source material. Images and charts were used to visually demonstrate the subject. Several quality requirements were established for the product and the result was assessed analyzing the feedback that was obtained from the target group. The feedback was collected using a questionnaire in which four persons responded. The contents of the booklet were modified based on the feedback and the final product was delivered to the nuclear medicine unit in April 2019. The booklet can be used as a tool in orientation and professional development of the nuclear medicine unit staff and students. The booklet was delivered in electronic format so the contents can be updated and modified by the staff. Further development of the booklet could be to include information on oncological nuclear medicine examinations and radioiodine treatment of the thyroid

Severe mood disorders and schizophrenia in the adult offspring of antenatally depressed mothers in the Northern Finland 1966 Birth Cohort: Relationship to parental severe mental disorder.

BACKGROUND: Maternal antenatal depression may alter offspring neurodevelopment, but long follow-up studies are lacking. We studied the risks for mood disorders and schizophrenia in adult offspring of antenatally depressed mothers, taking account parental severe mental disorders. METHODS: In the general population-based Northern Finland 1966 Birth Cohort with 12,058 children, 13.9% of the mothers reported themselves depressed at mid-gestation. The offspring were followed 43 years. Severe mood disorders and schizophrenia in the offspring and severe mental disorders in the parents were detected using the Care Register for Healthcare. Maternal smoking during pregnancy, perinatal complications, fathers´ social class, family type at birth, and grand multiparity were considered as confounding variables. RESULTS: The offspring of antenatally depressed mothers had an elevated risk for depression (adjusted OR 1.5; 95% CI 1.03-2.2), compared to cohort members without maternal antenatal depressed mood. The offspring with maternal antenatal depressed mood and parental severe mental disorder had markedly elevated risks for depression (3.3; 1.8-6.2), and schizophrenia (3.9; 2.0-7.5), compared to the offspring without one or both of these risk factors. LIMITATIONS: Maternal antenatal depressed mood was determined by one question and did not necessarily signify a clinical condition. Data on maternal postnatal mood was not available. CONCLUSION: The offspring with maternal antenatal depressed mood and parental severe mental disorder had high risk for depression and schizophrenia. Early interventions in parental severe mental disorder might present an opportunity for decreasing the risk for mood disorders and schizophrenia in the offspring

Switching perspectives:from a language teacher to a designer of language learning with new technologies

Abstract Despite abundant research on educational technology and strategic input in the field, various surveys have shown that (language) teachers do not seem to embrace in their teaching the full potential of information and communication technology available in our everyday life. Language students soon entering the professional field could accelerate the process, which highlights the role of teacher education in contributing to the change. The students should see how technology development may change the affordances for language learning, at the same time transforming the teachers’ professional roles and practices. However, taking an active role in designing a new kind of language pedagogy seems to be challenging for students. This study explores an attempt to facilitate the students’ perspective switch from the teacher role to the designer position through participatory design. This effort was to lead the students to envision new practices for language learning and teaching with new technologies. However, initial analyses of the research materials indicated that, despite the support, the students were not fully able to see their role as designers for the future. Cultural--historical activity theory was used to examine the problem more closely. The analysis suggests that in order to position themselves as designers of the future language learning activity, language students need to understand their role as designers, conduct real-life experiments on the evolving visions with their learners, and involve learners as participants in the design activity by sharing visions and collaborative reflection on the experiments. The findings of the study provide tools for language teacher educators to make these activity systems visible and, thus, target for change

Antisocial and borderline personality disorders in the offspring of antenatally depressed mothers:a follow-up until mid-adulthood in the Northern Finland 1966 birth cohort

Abstract Background: Maternal depression is common during pregnancy, affecting 10–15% of mothers. In previous reports, the offspring of antenatally depressed mothers have had an elevated risk for antisocial, criminal and violent behaviour in adolescence, and for borderline personality features in childhood, but long-term outcomes are unknown. Aims: To study whether the adult offspring of antenatally depressed mothers have an elevated risk for antisocial (ASPD) or borderline personality disorder (BPD) when followed until mid-adulthood. Methods: In the general population-based Northern Finland 1966 Birth Cohort, mothers of 12,058 children were asked during mid-gestation if they felt depressed. Of the mothers, 14% reported being depressed. The offspring were followed for 49 years. The diagnoses of in- and outpatient-treated ASPD and BPD in the offspring were detected using the Finnish Care Register for Healthcare. Maternal antenatal smoking, newborn´s low birthweight or short gestational age, father’s social class, and family type at birth were considered as confounding variables. Logistic regression analyses on the potential confounders were performed. Maternal postnatal depression and paternal ASPD information was not available. Results: In the male offspring of antenatally depressed mothers, the risk for ASPD was elevated (adjusted odds ratio 5.6; 95% confidence interval 1.8–17.8), but not in female offspring. The risk for BPD was not elevated in the offspring of antenatally depressed mothers in this study. Conclusions: The sons of antenatally depressed mothers had an increased risk for ASPD. Prevention and treatment of antenatal depression might present an opportunity to decrease the risk of antisocial personality in the offspring

Specific adolescent prodromal symptoms associated with onset of psychosis in the Northern Finland Birth Cohort 1986.

BACKGROUND: Several psychological symptoms in adolescence associate with later development of psychosis. However, it is unclear which symptoms specifically predict psychotic disorders rather than psychiatric disorders in general. We conducted a prospective study comparing how specific adolescent psychotic-like symptoms, predicted psychotic and non-psychotic hospital-treated psychiatric disorders in the population-based Northern Finland Birth Cohort 1986 (NFBC1986). METHODS: At age 15-16 years, 6632 members of the NFBC1986 completed the PROD-screen questionnaire. New hospital-treated mental disorders of the NFBC1986 participants were detected between age 17 and 30 years from the Finnish Care Register for Health Care. Multiple covariates were used in the analysis. RESULTS: During the follow-up, 1.1% of the participants developed a psychotic and 3.2% a non-psychotic psychiatric disorder. Three symptoms were specifically associated with onset of psychosis compared to non-psychotic psychiatric disorders: 'Difficulty in controlling one's speech, behaviour or facial expression while communicating' (adjusted OR 4.00; 95% CI 1.66-9.92), 'Difficulties in understanding written text or heard speech' (OR 2.25; 1.12-4.51), and 'Difficulty or uncertainty in making contact with other people' (OR 2.20; 1.03-4.67). Of these, the first one remained statistically significant after Bonferroni correction for multiple comparisons. CONCLUSION: To our knowledge, this is the first general-population-based prospective study exploring psychiatric symptoms predicting the onset of hospital-treated first-episode psychosis in comparison to non-psychotic disorders. We found three symptoms related with difficulties in social interaction which predicted onset of psychosis. This is a novel finding and should be replicated

DataSheet_1_State of perinatal mental health care in the WHO region of Europe: a scoping review.docx

BackgroundAlthough perinatal mental disorders are the most common health complication among women in the perinatal period, there is a huge gap in the implementation of related research findings in the health care system. We mapped the state of perinatal mental health (PMH) care in the WHO Europe region with aim to identify leading countries, which can serve as models for countries with less developed perinatal mental health care.MethodsGuidelines, policies, and documents related to screening and treatment services for PMH were searched as grey literature. Results were analysed to assess the status of PMH care in the WHO European countries and to identify gaps (absence of relevant service or documents). The state of perinatal mental health care was scored on a 0-5 scale.ResultsThe grey literature search resulted in a total of 361 websites. Seven countries (Belgium, Finland, Ireland, Netherlands, Sweden, UK, Malta) received full points for the presence of relevant PMH services or documents, while five countries received zero points. Most WHO European countries (48/53) have general mental health policies, but only 25 countries have policies specifically on perinatal mental health. Ten countries offer PMH screening, and 11 countries offer PMH service (of any type). Any PMH guidelines were provided in 23/53 countries.ConclusionsPerinatal mental health care is in its infancy in most WHO European countries. Leading countries (Belgium, Finland, Ireland, Netherlands, Sweden, UK, Malta) in PMH care can serve as conceptual models for those less developed and geopolitically close.</p

Table_1_State of perinatal mental health care in the WHO region of Europe: a scoping review.docx

BackgroundAlthough perinatal mental disorders are the most common health complication among women in the perinatal period, there is a huge gap in the implementation of related research findings in the health care system. We mapped the state of perinatal mental health (PMH) care in the WHO Europe region with aim to identify leading countries, which can serve as models for countries with less developed perinatal mental health care.MethodsGuidelines, policies, and documents related to screening and treatment services for PMH were searched as grey literature. Results were analysed to assess the status of PMH care in the WHO European countries and to identify gaps (absence of relevant service or documents). The state of perinatal mental health care was scored on a 0-5 scale.ResultsThe grey literature search resulted in a total of 361 websites. Seven countries (Belgium, Finland, Ireland, Netherlands, Sweden, UK, Malta) received full points for the presence of relevant PMH services or documents, while five countries received zero points. Most WHO European countries (48/53) have general mental health policies, but only 25 countries have policies specifically on perinatal mental health. Ten countries offer PMH screening, and 11 countries offer PMH service (of any type). Any PMH guidelines were provided in 23/53 countries.ConclusionsPerinatal mental health care is in its infancy in most WHO European countries. Leading countries (Belgium, Finland, Ireland, Netherlands, Sweden, UK, Malta) in PMH care can serve as conceptual models for those less developed and geopolitically close.</p