Predictors of employment in young adults with psychiatric work disability

AIM: Mental disorders are the leading cause of work disability among young adults in the industrialized world. Factors predicting employment after long-term psychiatric work disability are largely unknown. METHODS: We linked personal and clinical information from the benefit applications and medical certificates of 1163 young adults (18-34 years) with a new-onset fixed-term psychiatric disability pension in 2008 with employment records between 2005 and 2013. The outcomes were starting employment during and being employed at the end of follow-up. RESULTS: Of the participants, 48% had been employed during and 22% were employed at the end of follow-up. Sustained employment history, university education (master's degree) and no recorded psychological symptoms in childhood were associated with both subsequent employment outcomes. Women and participants under 25 years were more likely to start employment. Depression and other mental disorders (vs psychotic diagnose) and having no comorbid mental disorders or substance abuse were associated with employment at the end of follow-up. CONCLUSIONS: Sustained employment history, university education and no recorded psychological symptoms during childhood predict a return to employment among young adults after a fixed-term psychiatric work disability pension. Pro-active interventions in psychological problems during childhood could enhance employment after a period of work disability

Long-term subjective results and radiologic prognosis of a distal radius fracture in working-aged patients : a prognostic cohort study of 201 patients

Objective: To investigate long-term outcomes associated with distal radius fracture (DRF) in working-aged patients. The authors hypothesized that the majority of patients experience no permanent loss of function when measured with patient-rated wrist evaluation (PRWE). Methods: This was a retrospective cohort study of patients with a DRF aged between 18 and 65 years. The primary outcome measure was PRWE score at a minimum of 4 years after DRF. Secondary outcome measures were pain catastrophizing scale (PCS) and radiographic measurements. Results: Of 201 patients included, 179 were primarily treated non-operatively with a 5-week cast treatment and 22 were primarily operated. The mean follow-up duration was 5 years. The mean PRWE score was 10.9 (95% confidence interval 8.4, 13.4) and median PRWE was 3.5 (interquartile range, 0.0–13.0). There was minor correlation between PCS and PRWE score (correlation coefficient [CC] 0.3), and between PRWE score and dorsal angulation of the fracture measured after closed reduction (CC 0.2) and in one-week follow-up radiographs (CC 0.2). Conclusions: Working-aged patients seem to gain nearly normal wrist function after DRF in longer follow-up. Pain catastrophizing appears to correlate with long-term treatment outcome.publishedVersionPeer reviewe

Association of Early Beta-amyloid Accumulation and Neuroinflammation Measured with [11C]PBR28 in Elderly Individuals Without Dementia

OBJECTIVE: To examine whether early β-amyloid (Aβ) accumulation and metabolic risk factors are associated with neuroinflammation in elderly individuals without dementia. METHODS: We examined 54 volunteers (mean age 70.0, 56% women, 51% APOE ε4 carriers) with a TSPO-tracer [11C]PBR28 to assess neuroinflammation and with [11C]Pittsburgh compound B (PiB) to assess cerebral Aβ accumulation. [11C]PBR28 and [11C]PiB standardized uptake value ratios (SUVRs) were quantified in six regions of interests by using the cerebellar cortex as a pseudo-reference/reference region, respectively. Fasting venous glucose, insulin, and high sensitivity C-reactive protein (hs-CRP) values were determined. Homeostatic model assessment of insulin resistance (HOMA-IR) was calculated. A subset of individuals (n=11) underwent CSF sampling, and Aβ40, Aβ42, total-tau, phospho-tau, soluble TREM2 and YKL-40 levels were measured. RESULTS: Among the whole study group, no significant association was found between [11C]PiB and [11C]PBR28 SUVR composite scores (slope 0.02, p=0.30). However, higher [11C]PiB binding was associated with higher [11C]PBR28 binding among amyloid negative ([11C]PiB composite score ≤1.5) (TSPO-genotype, age and sex adjusted slope 0.26, p=0.008) but not among amyloid positive participants (slope: -0.004, p=0.88). Higher CSF sTREM2 (rs 0.72, p=0.01) and YKL-40 (rs=0.63, p=0.04) concentrations were associated with a higher [11C]PBR28 composite score. Higher body mass index, HOMA-IR, and hs-CRP were associated with higher [11C]PBR28 binding in brain regions where Aβ accumulation is first detected in Alzheimer's disease (AD). CONCLUSIONS: While there was no association between amyloid and neuroinflammation in the overall study group, neuroinflammation was associated with amyloid among the subgroup at early stages of amyloid pathology

Neuroleptic-induced movement disorders in a naturalistic schizophrenia population: diagnostic value of actometric movement patterns

<p>Abstract</p> <p>Background</p> <p>Neuroleptic-induced movement disorders (NIMDs) have overlapping co-morbidity. Earlier studies have described typical clinical movement patterns for individual NIMDs. This study aimed to identify specific movement patterns for each individual NIMD using actometry.</p> <p>Methods</p> <p>A naturalistic population of 99 schizophrenia inpatients using conventional antipsychotics and clozapine was evaluated. Subjects with NIMDs were categorized using the criteria for NIMD found in the Diagnostic and Statistical Manual for Mental Disorders – Fourth Edition (DSM-IV).</p> <p>Two blinded raters evaluated the actometric-controlled rest activity data for activity periods, rhythmical activity, frequencies, and highest acceleration peaks. A simple subjective question was formulated to test patient-based evaluation of NIMD.</p> <p>Results</p> <p>The patterns of neuroleptic-induced akathisia (NIA) and pseudoakathisia (PsA) were identifiable in actometry with excellent inter-rater reliability. The answers to the subjective question about troubles with movements distinguished NIA patients from other patients rather well. Also actometry had rather good screening performances in distinguishing akathisia from other NIMD. Actometry was not able to reliably detect patterns of neuroleptic-induced parkinsonism and tardive dyskinesia.</p> <p>Conclusion</p> <p>The present study showed that pooled NIA and PsA patients had a different pattern in lower limb descriptive actometry than other patients in a non-selected sample. Careful questioning of patients is a useful method of diagnosing NIA in a clinical setting.</p

Effects of age, BMI and sex on the glial cell marker TSPO - a multicentre [C-11]PBR28 HRRT PET study

Purpose The purpose of this study was to investigate the effects of ageing, sex and body mass index (BMI) on translocator protein (TSPO) availability in healthy subjects using positron emission tomography (PET) and the radioligand [C-11]PBR28. Methods [C-11]PBR28 data from 140 healthy volunteers (72 males and 68 females; N = 78 with HAB and N = 62 MAB genotype; age range 19-80 years; BMI range 17.6-36.9) were acquired with High Resolution Research Tomograph at three centres: Karolinska Institutet (N = 53), Turku PET centre (N = 62) and Yale University PET Center (N = 25). The total volume of distribution (V-T) was estimated in global grey matter, frontal, temporal, occipital and parietal cortices, hippocampus and thalamus using multilinear analysis 1. The effects of age, BMI and sex on TSPO availability were investigated using linear mixed effects model, with TSPO genotype and PET centre specified as random intercepts. Results There were significant positive correlations between age and V-T in the frontal and temporal cortex. BMI showed a significant negative correlation with V-T in all regions. Additionally, significant differences between males and females were observed in all regions, with females showing higher V-T. A subgroup analysis revealed a positive correlation between V-T and age in all regions in male subjects, whereas age showed no effect on TSPO levels in female subjects. Conclusion These findings provide evidence that individual biological properties may contribute significantly to the high variation shown in TSPO binding estimates, and suggest that age, BMI and sex can be confounding factors in clinical studies

Evolution of migmatitic granulite complexes: Implications from Lapland Granulite Belt, Part II: Isotopic dating

The migmatitic metapelites of the Lapland granulite belt (LGB) in the NE part of the Fennoscandian Shield represent an arc-related greywacke basin metamorphosed in the granulite facies. Detrital zircons from migmatitic metapelites are derived from 1.94 − 2.9 Ga old acid source rocks (U-Pb SIMS ages). The clustering of detrital zircon ages between 1.97 and 2.2 Ga is problematic, because abundant felsic crust of this age is absent in the shield. The metasediments are characterized by Sm-Nd model ages of ca. 2.3 Ga. A younger, 1905 − 1880 Ma population of homogeneous zircons was formed during regional metamorphism. The peak high-grade metamorphism took place at ~1900 Ma and the latest chronological record from subsequent decompression and cooling phase is from ca. 1870 Ma. The norite-enderbite series of the LGB represents arc-magmas, which were intruded into the metasediments at ~1920 − 1905 Ma ago according to zircon U-Pb ages and were probably an important heat source for metamorphism. Older, zoned zircon grains in a quartz norite vein, initial εNd values of 0 to +1 and the continuous spectrum of LILE enrichment in the enderbite-series probably reflect assimilation of metasediments by magmas. Monazite U-Pb ages of migmatitic metasediments in the range 1906 − 1910 ± 3 Ma overlap the late stage of enderbite intrusion and growth of early metamorphic zircons. Garnet-whole rock Sm-Nd ages from leucosomes in the range 1880 − 1886 ± 7 Ma are concurrent with the growth of the youngest metamorphic zircons and probably indicate the crystallization of leucosomes or the influence of a fluid liberated from them. Isotopic and petrologic data reveal that the evolution of Lapland Granulite belt from the erosion of source rocks to the generation of a sedimentary basin, its burial, metamorphism and exhumation took place within ca. 60 Ma

Evolution of migmatitic granulite complexes: Implications from Lapland Granulite Belt, Part I: Metamorphic geology

The Palaeoproterozoic Lapland granulite belt was juxtaposed between Archaean and Proterozoic terrains in the NE part of the Fennoscandian Shield concurrently with the accretion of Svecofennian arc complexes at ~1.9 Ga. The belt consists mainly of aluminous migmatitic metagreywackes. Abundant noritic to enderbitic magmas were intruded concordantly into the metasediments and were probably an important heat source for metamorphism, which took place during the crystallization of the magmas. This is supported by structural and contact relations of metasediments and igneous rocks, and by the lack progressive metamorphic reaction textures in the igneous rock series. The peak of metamorphism took place above the dehydration melting temperature of the biotite-sillimanite-plagioclase-quartz assemblage at 750 − 850 °C and 5 − 8.5 kbar which lead to formation of a restitic palaeosome and peraluminous granitic melt in metapelites. Subsequently, the rocks were decompressed and cooled below the wet melting temperature of pelitic rocks (650 °C) under the stability field of andalusite coexisting with potassium feldspar (2 − 3 kbar). Cooling was accompanied by the crystallization of the neosomes, often carrying aluminium-rich phases. Postmetamorphic duplexing of the LGB is clearly seen in the distribution of calculated PT conditions

Server-Based Computing Solution Based on Open Source Software

Server-Based Computing (SBC), i.e., replacing workstations with thin clients, is an effective solution to many IT problems, while free open source software is a cost-efficient alternative to proprietary software. We studied synergies of these two approaches. The results indicated that the open source SBC solution offered at least the same quality of service as the proprietary implementation but lowered the total cost of ownership around 50% compared to previous desktop PC solutions

Geology and crystallization conditions of the Särkiniemi intrusion and related nickel-copper ore, central Finland:implications for depth of emplacement of 1.88 Ga nickel-bearing intrusions

Abstract Several Ni-Cu deposits occur within the Kotalahti area, central Finland, in proximity to an Archaean gneiss dome surrounded by a Palaeoproterozoic craton-margin supracrustal sequence comprising quartzites, limestones, calc-silicate rocks, black schists and banded diopside amphibolites. The geology of the area and age of the Ni-bearing intrusions (1.88 Ga) are similar to the Thompson Ni belt in the Canadian Trans-Hudson Orogen. The small mafic-ultramafic and Ni-Cu -bearing Särkiniemi intrusion, closely associated with the Archaean basement core of the Kotalahti Dome, is composed of a western peridotite and eastern gabbro body, both of which are mineralized. The eastern gabbro has a contact aureole several meters thick, consisting of orthopyroxene +/- cordierite bearing hornfels between the intrusion and the migmatites. Geochemically, the Särkiniemi intrusion shares many features in common with other Svecofennian mafic-ultramafic intrusions, including crustal contamination and nickel depletion. The related Ni-Cu deposit has a low Ni/Co value (15) and low nickel content in the sulphide fraction (2.8 wt.%), together with a low estimated magma/sulphide ratio of around 170. Svecofennian 1.88 Ga mafic-ultramafic intrusions occur in terrains of variable metamorphic grade (from low-amphibolite to granulite facies) and are likely to represent emplacement at different crustal depths. Multi-equilibrium thermobarometry indicates that the contact aureole at Särkiniemi reached equilibrium at pressures of 4.5–6 kbar (15–20 km depth) and temperatures of 600–670 °C. Combined with the results of earlier research on the Svecofennian intrusions, this study indicates that a depth of 15–20 km crustal level was favourable, along with other critical factors, for nickel sulfide deposition at 1.88 Ga