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A study investigated the prevalence of carbamazepine- or oxcarbazepine-induced hyponatraemia and leucopenia in 334 Finnish individuals with developmental disabilities. Medication with these drugs resulted in significantly lower levels of serum sodium and counts of blood leucocytes. Because of difficulties in expressing their symptoms, this population is at risk of developing serious hyponatraemia. (Author/CR)

Aim: We assessed psychosocial burdens in children who developed narcolepsy after receiving the Pandemrix H1N1 vaccine during the 2009-2010 pandemic. Parental quality of life was also assessed.Methods: This multicentre study covered four of the five Finnish University Hospital Districts, which dealt with about 90% of the paediatric narcolepsy cases after the Pandemrix vaccination. The medical records of children diagnosed from 2010 to 2014 were reviewed. The questionnaires included the Youth Self-Report (YSR), Children's Depression Inventory (CDI), the Child Behaviour Checklist (CBCL) and questions on parental resources, stress and quality of life.Results: We obtained the medical records of 94 children who were aged 5-17 years at the time of their narcolepsy diagnosis and questionnaire data for 73 of those children. Most children had strong narcolepsy symptoms, and 25% had CDI scores that suggested depression. In addition, 41% had total CBCL problem scores above the clinically significant limit and 48% were anxious, withdrawn and had somatic complaints. Sleep latency was weakly associated with the CBCL total problem score. Half of the children needed psychiatric interventions and parental stress was common.Conclusion: Depression and behavioural problems were common in children with narcolepsy after the Pandemrix vaccination and their parents frequently reported feeling stressed. [ABSTRACT FROM AUTHOR]

We study labour market outcomes by formal differentiation at upper secondary and tertiary level in Finland. Using full population register data, we take individuals born in 1976 and explore their socio-economic status and the probability of unemployment by educational qualifications and social origin in early adulthood (age 30) and at occupational maturity (age 40). We differentiate based on the level of maths, the most consequential subject choice at general upper secondary education, and show that subject-level choices divert students to stratified tertiary-level degrees and labour market positions net of prior school performance, social origin and gender. In addition, we show that educational performance and qualifications mediate the association between social origin and socio-economic status by 81-83%, leaving around one fifth to unobserved social origin differences. We also find that there are no major differences between upper secondary school tracks with respect to experiencing unemployment at age 30 or 40. Moreover, further educational degrees do not appear to provide additional protection against unemployment than having obtained an upper secondary qualification. [ABSTRACT FROM AUTHOR]

The rules of intake, which determine how educational institutions are accessed, play a significant part in generating intergenerational educational inequalities. Different rules may allow parental advantages to compensate for students' lack of advantages (such as academic performance) or to multiply and help only those students who are in a position to use such additional advantages. In this article, we study compensation and the multiplication of advantages in the context of the Finnish higher education system. Entrance exams and a dual model (universities and polytechnics) make this system stand out among many other Western countries and hence suitable for this study. Using high-quality Finnish register data, we study the associations between parental education and stratified higher education enrolment across the school performance distribution. Our results show that polytechnics provide access for poorly performing students from higher social origins (compensatory advantage). Polytechnic education also attracts well-performing students from lower social origins, which leads to a situation in which well-performing students with higher social origins have a substantially larger probability of enrolling in university compared to well-performing students with lower social origins (multiplicative advantage). [ABSTRACT FROM AUTHOR]

Re-applying after an educational rejection is a considerable but understated part of access to selective educational institutions. We study social inequalities in stopping applying to university after an educational rejection to identify the extent to which educational intentions are more constrained among students from the lower social strata. We explore applications to universities in Finland, where student selection takes place at the gates of the institutions and in which around two-thirds of the applicants are rejected on their first attempt. With full population register data and discrete-time event-history models, we show that around 40% of rejected applicants stop applying to university each year with substantial social origin differences. Previous national examination grades and various life-course changes after the rejection, such as entering the labor market and having children, account for the social origin gap in stopping applying only partially. We argue that the socially selective queue, in which all students do not have the same incentives or possibilities to stand waiting, reinforces social inequalities in university admissions. • We study the persistence of university intentions among applicants who fail to access universities. • Stopping applying after a rejection is less likely for students with parental university education compared to those without. • Prior school performance and life-course events after the rejection do not fully account for this gap. • Re-applying deepens the social origin gap in university enrolment. [ABSTRACT FROM AUTHOR]

Conversion of dissolved P by ferric sulfate into a particulate form sparingly available to algae was studied in 15 ditches in Finland using stand-alone dispensers for ferric sulfate administration. Ferric sulfate typically converted 60-70 % of dissolved P into iron-associated form, a process which required 250-650 kg per kg dissolved P. Mean cost was 160 EUR per kg P converted (range 20-400 EUR kg). The costs were lowest at sites characterized by high dissolved P concentrations and small catchment area. At best, the treatment was efficient and cost-effective, but to limit the costs and the risks, ferric sulfate dispensers should only be installed in small critical source areas. [ABSTRACT FROM AUTHOR]

Long-term base cation balances (Ca, Mg and K) for forest mineral soils in Finland were calculated with mass balance methods. The aim of the study was to identify the areas in which weathering and base cation deposition do not support leaching and uptake of base cations by vegetation. The effect of stem harvesting and whole-tree harvesting on the base cation balances was studied and preliminary calculations were made about the amounts of ash needed for compensation of the potential base cation depletion. The effect of sulphur emission reduction till 2010 was also considered. The study demonstrated that there would be depletion of base cations in forest mineral soils in southern, central and northeastern Finland (40–50% of the grids) in the long term if whole-tree harvesting would be practised. Theoretical calculations showed that ash application would be most useful in those areas to compensate the base cation depletion. If stem harvesting is practised, only small areas (20%) in southwestern and southeastern Finland and northeastern Lapland would show depletion of base cations in the long term. [ABSTRACT FROM AUTHOR]

The aim of the project is to make a contribution to the semiotic theory of culture, and to study male and female cultural identities from this angle. The material for the study consists of popular Finnish cultural products (novels, films, hits and magazines concentrating on human relations). [ABSTRACT FROM AUTHOR]

Potential effects of prenatal sex hormones on later eating disorders in offspring have been investigated with two indirect methods (finger length ratio, opposite- versus same-sex twins). We utilized a direct, prospective method, examining the association between prenatal sex-hormones in maternal sera and the risk of bulimia nervosa (BN) and anorexia nervosa (AN) among daughters. Females with BN (55), AN (150), sister controls without eating disorders (one per case), and population controls (one per case) were derived from Finnish registers. Maternal gestational testosterone and estradiol levels were assayed from archived specimens stored in a national serum biobank. When females with BN were compared to their sister controls, those with higher gestational testosterone levels were at an increased risk of BN. No significant associations with BN were found when the comparison was made to population controls, and when estradiol levels and testosterone/estrogen ratio were assessed. We neither found associations between gestational sex-hormone levels and the risk of AN. Among females with familial liability for BN, higher gestational testosterone exposure may have a role in later development of BN, whereas lower testosterone exposure may have a protective effect. We found no evidence for the involvement of gestational sex-hormones in the etiology of AN., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to declare that are relevant to the content of this article., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background and Purpose: In the group of severe mental disorders, psychotic depression (PD) is essentially under-researched. Knowledge about the risk factors is scarce and this applies especially to early risk factors. Our aim was to study early childhood and adolescent risk factors of PD in a representative birth cohort sample with a follow-up of up to 50 years., Methods: The study was carried out using the Northern Finland Birth Cohort 1966 (NFBC 1966). We used non-psychotic depression (NPD) (n = 746), schizophrenia (SZ) (n = 195), psychotic bipolar disorder (PBD) (n = 27), other psychoses (PNOS) (n = 136) and healthy controls (HC) (n = 8200) as comparison groups for PD (n = 58). We analysed several potential early risk factors from time of birth until the age of 16 years., Results: The main finding was that parents' psychiatric illness [HR 3.59 (1.84-7.04)] was a risk factor and a high sports grade in school was a protective factor [HR 0.29 (0.11-0.73)] for PD also after adjusting for covariates in the multivariate Cox regression model. Parental psychotic illness was an especially strong risk factor for PD. The PD subjects had a parent with psychiatric illness significantly more often (p < 0.05) than NPD subjects. Differences between PD and other disorder groups were otherwise small., Conclusions: A low sports grade in school may be a risk factor for PD. Psychiatric illnesses, especially psychoses, are common in the parents of PD subjects. A surprisingly low number of statistically significant risk factors may have resulted from the size of the PD sample and the underlying heterogeneity of the etiology of PD.

Background: Fetal exposure to maternal smoking during pregnancy is associated with the development of noncommunicable diseases in the offspring. Maternal smoking may induce such long-term effects through persistent changes in the DNA methylome, which therefore hold the potential to be used as a biomarker of this early life exposure. With declining costs for measuring DNA methylation, we aimed to develop a DNA methylation score that can be used on adolescent DNA methylation data and thereby generate a score for in utero cigarette smoke exposure., Methods: We used machine learning methods to create a score reflecting exposure to maternal smoking during pregnancy. This score is based on peripheral blood measurements of DNA methylation (Illumina's Infinium HumanMethylation450K BeadChip). The score was developed and tested in the Raine Study with data from 995 white 17-y-old participants using 10-fold cross-validation. The score was further tested and validated in independent data from the Northern Finland Birth Cohort 1986 (NFBC1986) (16-y-olds) and 1966 (NFBC1966) (31-y-olds). Further, three previously proposed DNA methylation scores were applied for comparison. The final score was developed with 204 CpGs using elastic net regression., Results: Sensitivity and specificity values for the best performing previously developed classifier ("Reese Score") were 88% and 72% for Raine, 87% and 61% for NFBC1986 and 72% and 70% for NFBC1966, respectively; corresponding figures using the elastic net regression approach were 91% and 76% (Raine), 87% and 75% (NFBC1986), and 72% and 78% for NFBC1966., Conclusion: We have developed a DNA methylation score for exposure to maternal smoking during pregnancy, outperforming the three previously developed scores. One possible application of the current score could be for model adjustment purposes or to assess its association with distal health outcomes where part of the effect can be attributed to maternal smoking. Further, it may provide a biomarker for fetal exposure to maternal smoking. https://doi.org/10.1289/EHP6076.

Background: The study aimed to explore the association between early life and life-course exposure to social disadvantage and later life body mass index (BMI) accounting for genetic predisposition and maternal BMI., Methods: We studied participants of Helsinki Birth Cohort Study born in 1934-1944 (HBCS1934-1944, n = 1277) and Northern Finland Birth Cohorts born in 1966 and 1986 (NFBC1966, n = 5807, NFBC1986, n = 6717). Factor analysis produced scores of social disadvantage based on social and economic elements in early life and adulthood/over the life course, and was categorized as high, intermediate and low. BMI was measured at 62 years in HBCS1934-1944, at 46 years in NFBC1966 and at 16 years in NFBC1986. Multivariable linear regression analysis was used to explore associations between social disadvantages and BMI after adjustments for polygenic risk score for BMI (PRS BMI), maternal BMI and sex., Results: The association between exposure to high early social disadvantage and increased later life BMI persisted after adjustments (β = 0.79, 95% CI, 0.33, 1.25, p < 0.001) in NFBC1966. In NFBC1986 this association was attenuated by PRS BMI (p = 0.181), and in HBCS1934-1944 there was no association between high early social disadvantage and increased later life BMI (β 0.22, 95% CI -0.91,1.35, p = 0.700). In HBCS1934-1944 and NFBC1966, participants who had reduced their exposure to social disadvantage during the life-course had lower later life BMI than those who had increased their exposure (β - 1.34, [- 2.37,-0.31], p = 0.011; β - 0.46, [- 0.89,-0.03], p = 0.038, respectively)., Conclusions: High social disadvantage in early life appears to be associated with higher BMI in later life. Reducing exposure to social disadvantage during the life-course may be a potential pathway for obesity reduction.

Objective: To test whether maternal hemoglobin during pregnancy associates with offspring perinatal outcomes in a developed country. Changes in maternal hemoglobin concentration during pregnancy are partly physiological phenomena reflecting alterations of maternal blood volume. Especially hemoglobin measures outside the physiological range may influence maternal health and fetal growth with long-lasting consequences., Study Design: We studied an unselected sample drawn from two regional birth cohorts born 20 years apart: The Northern Finland Birth Cohorts 1966 and 1986. These are two mother-and-child population-based birth cohorts together comprising 21,710 mothers and their children. After exclusions, the sample size of the current study was 20,554. Concentrations of maternal hemoglobin at first and last antenatal visits were categorized as low (lowest 10%), medium (reference) or high (highest 10%). Multinomial logistic regression analyses for categories of maternal hemoglobin and perinatal outcomes such as preterm delivery and full-term small and large for gestational age were conducted with adjustments for maternal cofactors., Results: Low maternal hemoglobin at early pregnancy associated with decreased risk of full-term small for gestational age (adjusted OR 0.73, 95% CI [0.58, 0.93], p = 0.010). At late pregnancy, low maternal hemoglobin associated with increased risk of preterm delivery (adjusted OR 1.60, 95% CI [1.26, 2.02], p < 0.0005) whereas high maternal hemoglobin associated with increased risk of full-term small for gestational age (adjusted OR 1.29, 95% CI [1.07, 1.56], p = 0.009). Maternal hemoglobin did not show constant association with risk of large for gestational age., Conclusion: The results from this study support evidence that both low and high maternal hemoglobin associate with adverse perinatal outcomes. Low maternal hemoglobin associated with preterm delivery and high with full-term small for gestational age. Association was mainly present when maternal hemoglobin was measured during the third trimester. These results indicate that it is important to monitor both extremes of maternal hemoglobin throughout the pregnancy., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background: Psychotic depression (PD) is heavily understudied despite high mortality and the severe course of illness. A majority of the studies conducted so far are also largely based on selected clinical samples. The aim of this study was to examine the clinical characteristics of PD in a representative prospective birth cohort sample., Methods: The Northern Finland Birth Cohort 1966 is a well-known prospective population-based cohort including 12 058 people followed since mid-pregnancy. We identified 55 individuals with PD, analysed their characteristics and compared them with schizophrenia (SZ), non-psychotic depression (NPD), psychotic bipolar disorder (PBD) and other psychoses (PNOS)., Results: The life-time prevalence of stable (no conversion to schizophrenia, bipolar disorder or schizoaffective disorder) PD was 0.5%. PD subjects were older than SZ and PNOS subjects during the first psychotic episode and compared to SZ, more often female. PD required hospitalization and transition to disability pension more often than NPD, but less often than SZ. Comorbid alcohol abuse disorder (44%) and personality disorder (40%) were highly common in PD. PNOS had a similar occupational outcome than PD but hospitalization rate was lower in the PNOS group. PBD and PD had mostly comparable outcomes., Conclusions: Our findings in a naturalistic cohort support the notion that the course of illness in PD is mostly similar to that of PBD, it is less severe than in schizophrenia, but worse than in non-psychotic depression. PD seems to have high psychiatric comorbidity., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Objective: Daily smoking has been associated with a greater risk of psychosis. However, we are still lacking studies to adjust for baseline psychotic experiences and other substance use. We examined associations between daily smoking and psychosis risk in a 15-year follow-up while accounting for these covariates in a prospective sample (N = 6081) from the Northern Finland Birth Cohort 1986., Methods: Self-report questionnaires on psychotic experiences (PROD-screen), tobacco smoking and other substance use were completed when the cohort members were 15-16 years old. Tobacco smoking was categorized into three groups (non-smokers, 1-9 cigarettes and ≥10 cigarettes/day). Psychosis diagnoses were obtained from national registers until the age of 30 years., Results: Subjects in heaviest smoking category were at increased risk of subsequent psychosis (unadjusted HR = 3.15; 95% CI 1.94-5.13). When adjusted for baseline psychotic experiences the association persisted (HR = 2.87; 1.76-4.68) and remained significant even after adjustments for multiple known risk factors such as cannabis use, frequent alcohol use, other illicit substance use, parental substance abuse, and psychosis. Furthermore, number of smoked cigarettes increased psychosis risk in a dose-response manner (adjusted OR = 1.05; 1.01-1.08)., Conclusion: Heavy tobacco smoking in adolescence was associated with a greater risk for psychosis even after adjustment for confounders., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)