Browsing by Subject "DENMARK"

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  • Vesa, Juho Antti; Kantola, Anu; Binderkrantz, Anne Skorkjaer (2018)
  • Toivonen, Anne; Eriksson, Mari; Friberg, Nathalie; Hautala, Timo; Kääriäinen, Sohvi; Leppaaho-Lakka, Jaana; Mikkola, Janne; Nieminen, Tuomas; Oksi, Jarmo; Salonen, Juha H.; Suomalainen, Pekka; Vanttinen, Markku; Jarva, Hanna; Jääskeläinen, Annemarjut J. (2021)
    Background Cryptococcosis is one of the major causes of mortality among HIV patients worldwide. Though most often associated with late stage HIV infection/AIDS, a significant number of cases occur in other immunocompromised patients such as solid organ transplant recipients and patients with hematological malignancies. Immunocompromised patients are a heterogeneous group and their number increases constantly. Since little is known about the incidence and the clinical features of cryptococcosis in Northern Europe, our aim was to investigate the clinical characteristics of cryptococcosis patients in Finland. Methods We retrospectively reviewed the laboratory confirmed cryptococcosis cases in Finland during 2004-2018. Only those who were treated for cryptococcosis were included in the study. Initial laboratory findings and medical records were also collected. Results A total of 22 patients with cryptococcosis were included in our study. The annual incidence of cryptococcosis was 0.03 cases per 100,000 population. Ten patients were HIV-positive and 12 out of 22 were HIV-negative. Hematological malignancy was the most common underlying condition among HIV-negative patients. Conclusions To our knowledge, this is the first study of the clinical presentation and incidence of cryptococcosis in Finland. We demonstrate that invasive cryptococcal infection occurs not only in HIV/AIDS patients or otherwise immunocompromised patients but also in immunocompetent individuals. Even though cryptococcosis is extremely rare in Finland, its recognition is important since the prognosis depends on rapid diagnostics and early antifungal therapy.
  • Koskinen, Anni I.; Hemminki, Otto; Försti, Asta; Hemminki, Kari (2022)
    Background Cancers of the oral cavity and pharynx encompass a heterogeneous group of cancers for which known risk factors include smoking, alcohol consumption and human papilloma virus (HPV) infection but their influence is site-specific with HPV mainly influencing oropharyngeal cancer. Their incidence and survival rates are not well known over extended periods of time. Patients/methods Data were obtained for Finnish (FI) and Swedish (SE) patients from the Nordcan database recently updated through 2019. Age-adjusted incidence trends (FI from 1953, SE from 1960) and relative survival rates for years 1970 through 2019 were calculated. Results We observed a prominent increase in oral and oropharyngeal cancers in FI and SE men and women but the trend for oral cancer was interrupted for SE men in 1985 and possibly also for FI and SE women in 2015. The trend changes in male and female oral cancer was confirmed in data for Denmark and Norway. Relative survival for these cancers has improved overall but they differed for one cluster of oral, oropharyngeal and nasopharyngeal cancers with 60-70% 5-year survival in the last period and hypopharyngeal cancer with 25% male survival. In all these cancers, survival for old patients was unfavorable. Discussion/conclusion We hypothesize that reduction in smoking prevalence helped to stop the increase in oral cancer especially in men. As the prevalence of smoking is decreasing, HPV is becoming a dominant risk factor, particularly for the increasing oropharyngeal cancer. Prevention needs to emphasize sexual hygiene and HPV vaccination.
  • Hukkinen, Janne (2020)
    Scientific knowledge is performative, as it not only represents but also constitutes reality. In politically charged fields such as ecological economics and environmental policy, science-policy interactions are often integrated into the scientific process. It is therefore important to articulate the details of the context in which knowledge performs its power. The articulation should be sensitive to the self-reflexive character of knowledge: it makes a difference whether those who engage in science-policy interaction know when knowledge is performative. I develop an account of the process of science-policy interaction that recognizes the self-reflexive nature of human knowledge. I identify analogical relationships between science-policy interactions on one hand and the workings of distributed cognition in Shakespearean theatre on the other. I illustrate the account by explaining the outcomes of science-policy interaction in European research policy and Finnish energy policy. The typology of knowledge performativity enables transdisciplinary actors at the science-policy interface to pay attention to their epistemological and ethical responsibilities.
  • Tattari, Sirkka; Koskiaho, Jari; Kosunen, Maiju; Lepisto, Ahti; Linjama, Jarmo; Puustinen, Markku (2017)
    Long-term data from a network of intensively monitored research catchments in Finland was analysed. We studied temporal (1981-2010) and spatial variability in nitrogen (N) and phosphorus (P), from 1987 losses, both from agricultural and forestry land. Based on trend analysis, total nitrogen (TN) concentrations increased in two of the four agricultural sites and in most of the forested sites. In agricultural catchments, the total phosphorus (TP) trends were decreasing in two of the four catchments studied. Dissolved P (DRP) concentrations increased in two catchments and decreased in one. The increase in DRP concentration can be a result of reducing erosion by increased non-plough cultivation and direct sowing. In forested catchments, the TP trends in 1987-2011 were significantly decreasing in three of the six catchments, while DRP concentrations decreased significantly in all sites. At the same time, P fertilisation in Finnish forests has decreased significantly, thus contributing to these changes. The mean annual specific loss for agricultural land was on average 15.5 kg ha(-1) year(-1) for N and 1.1 kg ha(-1) year(-1) for P. In the national scale, total TN loading from agriculture varied between 34,000-37,000 t year(-1) and total P loading 2400-2700 t year(-1) These new load estimates are of the same order than those reported earlier, emphasising the need for more efforts with wide-ranging and carefully targeted implementation of water protection measures.
  • Gustafsson, Charlotta; Vuola, Pia; Leikola, Junnu; Heliövaara, Arja (2020)
    Objective: Children with Pierre Robin sequence (PRS) and cleft palate have a high rate of velopharyngeal insufficiency (VPI) following primary palatoplasty. Our purpose was to determine the long-term incidence of speech-correcting surgeries (SCSs) and fistula rates in PRS after primary palatoplasty and the influence of possible causal factors. Design: A retrospective single-center, observational chart review study. Participants: After exclusion, the study cohort comprised 78 nonsyndromic PRS children (48 females) born between 1990 and 2009 and treated at the Cleft Palate and Craniofacial Center of Helsinki University Hospital, Finland. Causal factors included gender, surgeon, age at primary palatoplasty, surgical technique, airway obstruction in infancy, and cleft severity. We analyzed the outcome at age 8 years and at data retrieval, with a median follow-up of 14 years (range: 8-27 years). Results: Thirty-four (43.6%) children received SCS by age 8 years, and of the 19 (24.4%) postoperative fistulas, 6 (7.7%) underwent closure. At data retrieval, 37 (47.4%) children had undergone SCS and 8 (10.3%) had a fistula closure. Median age at SCS was 6 years. The results showed no significant association for gender, surgeon, age at primary palatoplasty, surgical technique, cleft severity, or airway obstruction in infancy regarding incidence of SCS, fistulas, or repaired fistulas. Conclusion: Pierre Robin sequence in children is associated with a high incidence of SCS and fistula formation, which necessitates accurate clinical follow-up and observation of speech development. The development of VPI in PRS is complex and most likely involving multiple factors.
  • Haikkola, Lotta (2019)
    Activation policies form the core of employment policies in most OECD countries. They are part of 'active' welfare states and associated neoliberal forms of governance that seek to govern through freedom by producing self-governing and responsible subjectivities. Ethnographies of governmentalities have been used in the research reported in this article to examine if and how such subjectivities are put in practice in street-level encounters in local welfare delivery. Based on an ethnographic research of youth services in the Public Employment Services (PES) in Helsinki, Finland, it is shown that despite the policy focus on active citizenship the street-level practice entails not only liberal ideas of self-governing individuals but also authoritarian measures. What is governed in the meetings is not the young people's selves but their time and behaviour. In the process, the notion of active citizenship is emptied and transformed to mean participation in supervised activities offered by the PES. Such practice also reworks the temporal structures and creates insecure and eventful experience of time for PES clients. In contrast to governing through freedom, the localized interpretation of activation policies represents the authoritarian and paternalistic side of neoliberal governance.
  • Norsker, Filippa Nyboe; Rechnitzer, Catherine; Cederkvist, Luise; Holmqvist, Anna Sällfors; Tryggvadottir, Laufey; Madanat-Harjuoja, Laura-Maria; Ora, Ingrid; Thorarinsdottir, Halldora K.; Vettenranta, Kim; Bautz, Andrea; Schroder, Henrik; Hasle, Henrik; Winther, Jeanette Falck (2018)
    Because of the rarity of neuroblastoma and poor survival until the 1990s, information on late effects in neuroblastoma survivors is sparse. We comprehensively reviewed the long-term risk for somatic disease in neuroblastoma survivors. We identified 721 5-year survivors of neuroblastoma in Nordic population-based cancer registries and identified late effects in national hospital registries covering the period 1977-2012. Detailed treatment information was available for 46% of the survivors. The disease-specific rates of hospitalization of survivors and of 152,231 randomly selected population comparisons were used to calculate standardized hospitalization rate ratios (SHRRs) and absolute excess risks (AERs). During 5,500 person-years of follow-up, 501 5-year survivors had a first hospital contact yielding a SHRR of 2.3 (95% CI 2.1-2.6) and a corresponding AER of 52 (95% CI 44-60) per 1,000 person-years. The highest relative risks were for diseases of blood and blood-forming organs (SHRR 3.8; 95% CI 2.7-5.4), endocrine diseases (3.6 [3.1-4.2]), circulatory system diseases (3.1 [2.5-3.8]), and diseases of the nervous system (3.0 [2.6-3.3]). Approximately 60% of the excess new hospitalizations of survivors were for diseases of the nervous system, urinary system, endocrine system, and bone and soft tissue. The relative risks and AERs were highest for the survivors most intensively treated. Survivors of neuroblastoma have a highly increased long-term risk for somatic late effects in all the main disease groups as compared to background levels. Our results are useful for counseling survivors and should contribute to improving health care planning in post-therapy clinics.
  • Moseholm, Ellen; Aho, Inka; Mellgren, Asa; Johansen, Isik S.; Storgaard, Merete; Pedersen, Gitte; Scofield, Ditte; Katzenstein, Terese L.; Weis, Nina (2022)
    Objective: The success of antiretroviral therapy has resulted in the normalization of pregnancy among women living with HIV and a very low risk of perinatal transmission of HIV. Despite these advances, women living with HIV still face complex medical and psychosocial issues during pregnancy. The purpose of this study is to describe experiences of pregnancy and the relevance of social support among women living with HIV in Nordic countries. Methods: This qualitative study examined data from pregnant women living with HIV from sites in Denmark, Sweden and Finland from 2019 to 2020. Data were collected in the third trimester via individual interviews using a hybrid, narrative/semistructured format. The transcribed interviews were analyzed using narrative thematic analysis. Results: In total, 31 women living with HIV were enrolled, of whom 61% originated from an African country and 29% from a Nordic country. The analysis generated four primary narrative themes: just a normal pregnancy, unique considerations and concerns, interactions with healthcare, and social support. Women living with HIV have a strong desire to have normal pregnancies and to be treated like any other pregnant woman. However, this normality is fragile, and being pregnant and living with HIV does come with unique considerations and concerns, such as fear of transmission, antiretroviral therapy, and the need for specialized care, which are fundamental to the women's experiences. Interactions with healthcare providers and social support influence their experiences in both positive and negative ways. Conclusion: The findings emphasize a sense of normality in pregnancy among women living with HIV. However, pregnancy does come with unique considerations and concerns, which highly influence the women's experience of pregnancy. Healthcare providers should focus on person-centered care, ensuring continuity and that women living with HIV do not feel discriminated against throughout their pregnancy.
  • Nordic Twin Study Canc NorTwinCan; Harris, Jennifer R.; Hjelmborg, Jacob; Adami, Hans-Olov; Czene, Kamila; Mucci, Lorelei; Kaprio, Jaakko (2019)
    Nordic twin studies have played a critical role in understanding cancer etiology and elucidating the nature of familial effects on site-specific cancers. The NorTwinCan consortium is a collaborative effort that capitalizes on unique research advantages made possible through the Nordic system of registries. It was constructed by linking the population-based twin registries of Denmark, Finland, Norway and Sweden to their country-specific national cancer and cause-of-death registries. These linkages enable the twins to be followed many decades for cancer incidence and mortality. To date, two major linkages have been conducted: NorTwinCan I in 2011-2012 and NorTwinCan II in 2018. Overall, there are 315,413 eligible twins, 57,236 incident cancer cases and 58 years of follow-up, on average. In the initial phases of our work, NorTwinCan established the world's most comprehensive twin database for studying cancer, developed novel analytical approaches tailored to address specific research considerations within the context of the Nordic data and leveraged these models and data in research publications that provide the most accurate estimates of heritability and familial risk of cancers reported in the literature to date. Our findings indicate an excess familial risk for nearly all cancers and demonstrate that the incidence of cancer among twins mirrors the rate in the general population. They also revealed that twin concordance for cancer most often manifests across, rather than within, cancer sites, and we are currently focusing on the analysis of these cross-cancer associations.
  • Knickel, Karlheinz; Almeida, Alexandra; Bauchinger, Lisa; Casini, Maria Pia; Gassler, Bernd; Hausegger-Nestelberger, Kerstin; Heley, Jesse; Henke, Reinhard; Knickel, Marina; Oostindie, Henk; Ovaska, Ulla; Pina, Carlos; Rovai, Massimo; Vulto, Hans; Wiskerke, Johannes S. C. (2021)
    Decision-makers, planners and administrators involved in different policy domains at different governance levels face the important challenge of fostering more balanced, sustainable and territorially integrated development. Well-designed, multi-level, multi-sector and multi-actor governance arrangements can play a key role in this process through orchestrating the interplay between different spheres, activities, actors and interests. In this paper, we examine the role of spatial planning in improving the relations between rural, peri-urban and urban areas. We analyse the strengths and limitations of spatial planning and explore the connections with territorial development. The methodology used for this analysis combines regional case studies in seven European locations-Ede, Frankfurt/Rhein-Main, Styria/Graz, Helsinki, Lisbon, Lucca and Mid Wales, with rapid appraisals, the analysis of published data, expert judgement and triangulation. We ask under which conditions spatial planning can induce more balanced, sustainable territorial relations, and look at the contribution planning can make to achieving sustainable development goals. The problem of ineffective (or toothless) plan implementation provides the entry point into the analysis and discussion. We illustrate why mutually beneficial relations between urban, peri-urban and rural communities (and territories) cannot simply be planned. Instead, these relationships need to be supported by strategies, policy instruments and governance arrangements that foster synergies between different actors and activities. The planning process itself needs to become more transparent and participatory. We conclude that the questions addressed in this article in an exploratory fashion merit further research especially as a more sustainable and territorially integrated development is becoming increasingly important in European policy making.
  • Lundberg, Frida E.; Andersson, Therese M. -L.; Lambe, Mats; Engholm, Gerda; Morch, Lina Steinrud; Johannesen, Tom Borge; Virtanen, Anni; Pettersson, David; Olafsdottir, Elinborg J.; Birgisson, Helgi; Johansson, Anna L. V.; Lambert, Paul C. (2020)
    Background Differences in cancer survival between the Nordic countries have previously been reported. The aim of this study was to examine whether these differences in outcome remain, based on updated information from five national cancer registers. Materials and methods The data used for the analysis was from the NORDCAN database focusing on nine common cancers diagnosed 1990-2016 in Denmark, Finland, Iceland, Norway and Sweden with maximum follow-up through 2017. Relative survival (RS) was estimated at 1 and 5 years using flexible parametric RS models, and percentage point differences between the earliest and latest years available were calculated. Results A consistent improvement in both 1- and 5-year RS was found for most studied sites across all countries. Previously observed differences between the countries have been attenuated. The improvements were particularly pronounced in Denmark that now has cancer survival similar to the other Nordic countries. Conclusion The reasons for the observed improvements in cancer survival are likely multifactorial, including earlier diagnosis, improved treatment options, implementation of national cancer plans, uniform national cancer care guidelines and standardized patient pathways. The previous survival disadvantage in Denmark is no longer present for most sites. Continuous monitoring of cancer survival is of importance to assess the impact of changes in policies and the effectiveness of health care systems.