Mikä masennus? : Tietolehtinen nuoruusiän masennuksesta nuorten monipalvelukeskus Dominon asiakkaille

Tämän opinnäytetyön tarkoituksena oli tuottaa masennusta käsittelevä tietolehtinen Lahden nuorisopalveluiden nuorten monipalvelukeskus Dominon asiakkaille. Domino tarjoaa lahtelaisille ja Lahden alueen 13–25-vuotiaille nuorille monialaisia palveluita. Opinnäytetyö toteutettiin itsenäisenä projektina yhteistyössä Dominon kanssa. Opinnäytetyö oli tuotteistamisprosessi, jonka tuotteena valmistui masennusta käsittelevä tietolehtinen. Työn tarpeellisuudesta kertoi se, että masennus on yksi yleisimmistä mielenterveyshäiriöistä nuorten keskuudessa, eikä Dominon henki-lökunnalla ollut antaa nuorille lainkaan masennusta käsittelevää kirjallista materiaalia kotona luettavaksi. Nuoren on tärkeää saada tietoa sairaudestaan, sillä tieto tukee nuorta arjessa ja auttaa löytämään selviytymiskeinoja. Työn tavoitteena oli antaa nuorille luotettavaa ja tärkeää tietoa nuoruusiän masennuksesta sekä auttaa Dominon henkilökuntaa nuorten parissa työskennellessä. Opinnäytetyöprosessissa hankittiin teoriatietoa nuoruusiästä, nuoruusiän masennuksesta, sen oireista, ilmenemisestä, esiintyvyydestä, tausta- ja riskitekijöistä sekä hoidosta. Tietolehtinen koottiin opinnäytetyöraportin teoriaosuuden pohjalta. Sitä kirjoitettaessa mietittiin tarkoin, mikä todella kiinnostaisi nuorta lukijaa, ja mitä nuori haluaisi tietää.The purpose of this thesis was to produce a leaflet about adolescent depression for the customers of the Domino youth service center which is part of Lahti city youth services. Domino offers various services to the inhabitants of Lahti, especially to young people in the city area between ages 13 and 25. The research was con-ducted as an independent project in cooperation with Domino. The research was a productization process which resulted in a leaflet about depression. The rationale behind conducting this research was the fact that even though depression is one the most common mental problems amongst young people, the employees of Domino youth service center have thus far been unable to provide struggling adolescents with any literature on depression. It is of utmost importance for young people to be able to acquire the requisite information concerning their condition, for it might help them to find the necessary coping mechanisms they need in order to gain control of their everyday lives. The objective of this thesis was to provide depressed young people with reliable information on depression and to assist the employees of the youth center in their important work with troubled adolescents. The theoretical framework of this thesis consisted of previous theories on adolescence and adolescent depression in general, and on the symptoms, hazards, treatments and various manifestations of adolescent depression in particular. The leaflet was then based on this theoretical framework. The leaflet was written with a particular emphasis on the needs and interests of the young reader

Completeness of Pediatric Cancer Registration in the Finnish Cancer Registry

Johdanto Suomen Syöpärekisteri ylläpitää rekisteriä kaikista Suomessa todetuista syöpätapauksista. Väestöpohjainen syöpätapausten rekisteröinti tarjoaa kattavan ja luotettavan tietokannan syöpätutkimuksessa käytettäväksi. Rekisteröinnin kattavuuden ja rekisteröidyn tiedon oikeellisuuden puutteilla voi kuitenkin olla suuri vaikutus erityisesti harvinaisten sairauksien insidenssi- prevalenssi- ja elossaoloarvioihin. Tutkimuksessamme pyrimme tarkentamaan aiempaa arviota lapsuussyövän rekisteröinnin kattavuudesta Suomen Syöpärekisterissä (Leinonen ym. 2017). Materiaalit ja menetelmät Poimimme Syöpärekisteristä sekä Hoitoilmoitusrekisteristä kaikki 0–14-vuotiaiden syöpätapaukset vuosina 2009–2013. Tarkastimme jokaisen Syöpärekisteristä puuttuneen tapauksen syöpädiagnoosin oikeellisuuden joko lähettämällä potilasta hoitaneeseen sairaalaan täytettävä lomake tai tarkastamalla potilastiedot potilastietoarkistoista. Laskimme Syöpärekisterin rekisteröinnin kattavuusarviot 95 %:n luottamusvälein tauti- sekä ikäryhmittäin. Tulokset Vuosina 2009–2013 Syöpärekisteriin oli rekisteröity 741 uutta lapsisyöpätapausta. Hoitoilmoitusrekisteriin syöpätapauksia oli rekisteröity 1072. Virheellisten syöpädiagnoosien karsimisen jälkeen vahvistimme 49:n syöpätapauksen puuttuvan Syöpärekisteristä. Syöpärekisterin kattavuudeksi arvioimme 94% (95% luottamusväli 91.9¬–95.4); 92% (95% luottamusväli 89.1–94.2) kiinteiden ja 97% (95% luottamusväli 94.1–98.4) ei-kiinteiden kasvainten osalta. Retinoblastooman rekisteröinnin kattavuus oli huomattavan matala, 54% (95% luottamusväli 36.4–71.9). Myös luusto- ja keskushermostosyöpien kattavuusarviot olivat matalat. Lymfoomien ja munuaissyöpien rekisteröinnin kattavuusarvio sen sijaan oli 100%. Diskussio Suomen Syöpärekisteri tuottaa korkealaatuista tietoa lapsuusajan syövistä. Ei-kiinteiden syöpien rekisteröinti on kattavampaa kuin kiinteiden syöpien. Syöpäilmoituksia Syöpärekisterille on puuttunut erityisesti potilaista, joiden tautia ei aina varmenneta histologisesti, kuten silmä- ja keskushermostosyöpäpotilaista

Suicides and deaths linked to risky health behavior in childhood cancer patients : A Nordic population-based register study

Background Childhood cancer survivors have been reported to be vulnerable to psychiatric morbidities and risky health behavior. Suicides, substance abuse, accidents, and violence as causes of death can be regarded as an extreme manifestation of risky health behavior. In the current study, the authors studied the risk of suicide and other risky health behavior-related deaths among childhood cancer patients in Denmark, Finland, and Sweden. Methods Using linkage between national cancer, population, and cause-of-death registries, the authors investigated the causes of death in 29,285 patients diagnosed with cancer before age 20 years between 1971 and 2009 compared with a cohort of 146,282 age-matched, sex-matched, and country-matched population comparisons. Rate ratios (RRs) with 95% CIs were estimated using Poisson regression models, adjusting for demographic factors. Results The overall risk of dying of a risky health behavior was found to be increased among childhood cancer patients (RR, 1.25; 95% CI, 1.06-1.47) when compared with population comparisons. The elevated risk was statistically significant among patients with central nervous system tumors (RR, 1.49; 95% CI, 1.08-2.05) and patients diagnosed at ages 5 to 9 years and 15 to 19 years (RR, 1.50 [95% CI, 1.01-2.24] and RR, 1.31 [95% CI, 1.03-1.67], respectively). The overall risk of suicide was found to be increased (RR, 1.37; 95% CI, 1.02-1.83), and statistically significantly so when patients were diagnosed between ages 15 and 19 years (RR, 1.61; 95% CI, 1.09-2.39). Conclusions Childhood cancer patients appear to have an increased risk of risky health behavior-related causes of death compared with the general population. The results of the current study suggest the importance of integrating psychosocial support into the follow-up care of these individuals.Peer reviewe

Income disparities between adult childhood cancer survivors and their peers-A register-based cohort study from the SALiCCS research programme.

BACKGROUND Childhood cancer survivors face various adverse consequences. This Nordic register-based cohort study aimed to assess whether survivors of childhood cancer are more likely to have low income than their peers. METHODS We identified 17,392 childhood cancer survivors diagnosed at ages 0 to 19 between 1971 and 2009 with 83,221 age-, sex-, and country-matched population comparisons. Annual disposable income at ages 20 to 50 years was retrieved from statistical offices (for 1990-2017) and categorized into low income and middle/high income. The number of transitions between income categories were assessed using binomial regression analyses. RESULTS The prevalence of annual low income among childhood cancer survivors was 18.1% and 15.6% among population comparisons (risk ratio [RR] 1.17; 95% confidence interval [CI] 1.16-1.18). Compared to population comparisons, childhood cancer survivors were 10% (95% CI 8%-11%) less likely to transition from low to middle/high income and 12% (10%-15%) more likely to transition from middle/high to low income during follow-up. Among those initially in the low income category, survivors were 7% (95% CI 3%-11%) more likely to remain in the low income category. If the initial category was middle/high income, childhood cancer survivors were 10% (95% CI 8%-11%) less likely to remain in the middle/high income and 45% (37%-53%) more likely to transition to the low income category permanently. CONCLUSIONS Childhood cancer survivors are at higher risk for low income in adulthood than their peers. These disparities might be reduced by continued career counseling along with support in managing within the social security system

MASTL promotes cell contractility and motility through kinase-independent signaling

Microtubule-associated serine/threonine-protein kinase-like (MASTL) is a mitosis-accelerating kinase with emerging roles in cancer progression. However, possible cell cycle-independent mechanisms behind its oncogenicity remain ambiguous. Here, we identify MASTL as an activator of cell contractility and MRTF-A/SRF (myocardin-related transcription factor A/serum response factor) signaling. Depletion of MASTL increased cell spreading while reducing contractile actin stress fibers in normal and breast cancer cells and strongly impairing breast cancer cell motility and invasion. Transcriptome and proteome profiling revealed MASTL-regulated genes implicated in cell movement and actomyosin contraction, including Rho guanine nucleotide exchange factor 2 (GEF-H1, ARHGEF2) and MRTF-A target genes tropomyosin 4.2 (TPM4), vinculin (VCL), and nonmuscle myosin IIB (NM-2B, MYH10). Mechanistically, MASTL associated with MRTF-A and increased its nuclear retention and transcriptional activity. Importantly, MASTL kinase activity was not required for regulation of cell spreading or MRTF-A/SRF transcriptional activity. Taken together, we present a previously unknown kinase-independent role for MASTL as a regulator of cell adhesion, contractility, and MRTF-A/SRF activity

MASTL promotes cell contractility and motility through kinase-independent signaling

Microtubule-associated serine/threonine-protein kinase-like (MASTL) is a mitosis-accelerating kinase with emerging roles in cancer progression. However, possible cell cycle-independent mechanisms behind its oncogenicity remain ambiguous. Here, we identify MASTL as an activator of cell contractility and MRTF-A/SRF (myocardin-related transcription factor A/serum response factor) signaling. Depletion of MASTL increased cell spreading while reducing contractile actin stress fibers in normal and breast cancer cells and strongly impairing breast cancer cell motility and invasion. Transcriptome and proteome profiling revealed MASTL-regulated genes implicated in cell movement and actomyosin contraction, including Rho guanine nucleotide exchange factor 2 (GEF-H1, ARHGEF2) and MRTF-A target genes tropomyosin 4.2 (TPM4), vinculin (VCL), and nonmuscle myosin IIB (NM-2B, MYH10). Mechanistically, MASTL associated with MRTF-A and increased its nuclear retention and transcriptional activity. Importantly, MASTL kinase activity was not required for regulation of cell spreading or MRTF-A/SRF transcriptional activity. Taken together, we present a previously unknown kinase-independent role for MASTL as a regulator of cell adhesion, contractility, and MRTF-A/SRF activity. [Abstract copyright: © 2020 Taskinen et al.

New insights into the genetic etiology of Alzheimer's disease and related dementias

Characterization of the genetic landscape of Alzheimer's disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/'proxy' AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele

Proteomic Changes of Alveolar Lining Fluid in Illnesses Associated with Exposure to Inhaled Non-Infectious Microbial Particles

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