Browsing by Subject "PREDICTORS"

Sort by: Order: Results:

Now showing items 21-40 of 149
  • Airo (Toivanen), Riikka; Korja, Riikka; Saisto, Terhi; Rouhe, Hanna; Muotka, Joona; Salmela-Aro, Katariina (2018)
    The changes in emotions, subjective fear of childbirth, and personal goals were examined during a group intervention to treat fear of childbirth (FOC). The objective was to gain a more detailed understanding of the changes occurring during the group intervention of FOC. The changes in emotions, subjective FOC, and personal goals were studied in primiparous pregnant women with severe FOC participating in a group intervention (n = 105). The group intervention contained six sessions during pregnancy and one after childbirth. At every session, the participants filled in a questionnaire regarding their experiences of current positive and negative emotions and the subjective FOC. The participants also set and reported their personal goals in their preparation for childbirth and parenthood. The negative emotions decreased from the beginning of the intervention. The change became significant after the fourth session. The amount of positive emotions increased but became statistically significant only after the delivery. The subjective FOC decreased significantly from the beginning of the intervention. Personal goals shifted from being mainly self-related to being mostly related to parenthood. The group intervention decreased FOC and promoted changes in emotions and personal goals that foster emotional preparedness for childbirth. It seems that the decrease in FOC was made possible through gaining a better capacity to regulate emotions, especially negative emotions. As negative emotions and fear decreased, personal goals simultaneously changed in the direction known to be adaptive for the new life situation as a parent of a newborn.
  • Seiluri, Tina; Lahti, Jouni Markku Mikael; Rahkonen, Ossi; Lahelma, Eero; Lallukka, Tea (2011)
    BACKGROUND: Physical activity is known to have health benefits across population groups. However, less is known about changes over time in socioeconomic differences in leisure-time physical activity and the reasons for the changes. We hypothesised that class differences in leisure-time physical activity would widen over time due to declining physical activity among the lower occupational classes. We examined whether occupational class differences in leisure-time physical activity change over time in a cohort of Finnish middle-aged women and men. We also examined whether a set of selected covariates could account for the observed changes. METHODS: The data were derived from the Helsinki Health Study cohort mail surveys; the respondents were 40-60-year-old employees of the City of Helsinki at baseline in 2000-2002 (n = 8960, response rate 67%). Follow-up questionnaires were sent to the baseline respondents in 2007 (n = 7332, response rate 83%). The outcome measure was leisure-time physical activity, including commuting, converted to metabolic equivalent tasks (MET). Socioeconomic position was measured by occupational class (professionals, semi-professionals, routine non-manual employees and manual workers). The covariates included baseline age, marital status, limiting long-lasting illness, common mental disorders, job strain, physical and mental health functioning, smoking, body mass index, and employment status at follow-up. Firstly the analyses focused on changes over time in age adjusted prevalence of leisure-time physical activity. Secondly, logistic regression analysis was used to adjust for covariates of changes in occupational class differences in leisure-time physical activity. RESULTS: At baseline there were no occupational class differences in leisure-time physical activity. Over the follow-up leisure-time physical activity increased among those in the higher classes and decreased among manual workers, suggesting the emergence of occupational class differences at follow-up. Women in routine non-manual and manual classes and men in the manual class tended to be more often physically inactive in their leisure-time (<14 MET hours/week) and to be less often active (>30 MET hours/week) than those in the top two classes. Adjustment for the covariates did not substantially affect the observed occupational class differences in leisure-time physical activity at follow-up. CONCLUSIONS: Occupational class differences in leisure-time physical activity emerged over the follow-up period among both women and men. Leisure-time physical activity needs to be promoted among ageing employees, especially among manual workers.
  • Manty, Minna; Kouvonen, Anne; Lallukka, Tea; Lahti, Jouni; Lahelma, Eero; Rahkonen, Ossi (2015)
    Objectives The aim this study was to examine the effect of changes in physical and psychosocial working conditions on physical health functioning among ageing municipal employees. Methods Follow-up survey data were collected from midlife employees of the City of Helsinki, Finland, at three time points: wave 1(2000-2002), wave 2(2007), and wave 3 (2012). Changes in physical and psychosocial working conditions were assessed between waves 1 and 2. Physical health functioning was measured by the physical component summary (PCS) of the Short-Form 36 questionnaire at each of the three waves. In total, 2784 respondents (83% women) who remained employed over the follow-up were available for the analyses. Linear mixed-effect models were used to assess the associations and adjust for key covariates (age, gender, obesity, chronic diseases, and health behaviors). Results Repeated and increased exposure to adverse physical working conditions was associated with greater decline in physical health functioning over time. In contrast, decrease in exposures reduced the decline Of the psychosocial working conditions, changes in job demands had no effects on physical health functioning. However, decreased job control was associated with greater decline and repeated high or increased job control reduced the decline in physical health functioning over time. Conclusions Adverse changes in physical working conditions and job control were associated with greater decline in physical health functioning over time, whereas favorable changes in these exposures reduced the decline. Preventing deterioration and promoting improvement of working conditions are likely to help maintain better physical health functioning among ageing employees.
  • Jalava-Broman, J.; Makinen, J.; Sillanmaki, L.; Vahtera, J.; Rautava, P. (2016)
    Objective: To investigate which patient characteristics are associated with the initiation of hormone replacement therapy (HRT) in a cohort of Finnish women. Study design: Responses to postal questionnaires distributed to a nationwide, randomly selected cohort of women in 1998, 2000, 2003, 2005 and 2010 were analyzed. The cohort members were aged 40-44 years at the beginning of the study. Information on hormone replacement therapy was received from the national prescription register. Women who started taking HRT between January 1, 1999 and December 31, 2011 were included and previous users were excluded from the analysis. Main outcome measures: Initiation of HRT was the main outcome measure. The following explanatory factors for predicting the use of HRT were examined: sociodemographic factors, personality, health behavior, physiological and mental symptoms, chronic diseases and use of psychopharmaceuticals. The associations between starting HRT and the explanatory factors were analyzed with single-predictor and multi-predictor logistic regression models. Results: Factors predicting that a woman would start taking HRT were: living with a partner, weak sense of coherence, BMI less than 30 kg/m(2), heavy or moderate alcohol use, symptoms of hyperactivity of the sympathetic nervous system, climacteric symptoms and use of psychopharmaceuticals. Conclusions: Women with a good sense of coherence can cope with climacteric symptoms without resorting to HRT. Clinicians need to bear in mind the burden of menopausal symptoms on a woman's personal and working life when HRT is being considered. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
  • Merikukka, Marko; Ristikari, Tiina; Tuulio-Henriksson, Annamari; Gissler, Mika; Laaksonen, Mikko (2018)
    Background: Mental disorders can affect work ability and lead to early exit from the labour market through disability pension. Aims: This study aimed to identify childhood determinants of psychiatric disability pension in early adulthood. Methods: The 1987 Finnish Birth Cohort includes a complete census of children born in a single year. The children were followed up from birth until 31 December 2012 using official registers maintained by the Finnish authorities. Risk factors for disability pension were examined in the full 1987 cohort (N = 58,739) and among children who had received mental health care (N = 9,599). Odds ratios were calculated for disability pension due to all mental disorders and separately for schizophrenia, depressive and anxiety and other mental and behavioural disorders in association with childhood determinants. Results: Altogether, 1.4% of cohort members had retired due to mental disorders in 2003-2012. In the full 1987 cohort, female sex, parental divorce and social assistance, both mother's and father's psychiatric care and mother's psychiatric disability pension increased the risk for disability pension due to mental disorders. Among children who had received mental health care, risk factors for psychiatric disability pension were father's psychiatric care and mother's psychiatric disability pension. Conclusion: Childhood determinants were related to the risk of psychiatric disability pension before the age of 25. The risk factors varied by the diagnosis of the disability pension. Using knowledge of this study's risk factors should enable the identification of adolescents and young adults in general population and especially in the mental health care population who are at greatest risk of receipt of psychiatric disability pension.
  • Lahtinen, Hanna-Mari; Laitila, Aarno; Korkman, Julia; Ellonen, Noora (2018)
    Most previous studies on disclosing child sexual abuse (CSA) have either been retrospective or focused on children who already have disclosed. The present study aimed to explore the overall CSA disclosure rate and factors associated with disclosing to adults in a large population-based sample. A representative sample of 11,364 sixth and ninth graders participated in the Finnish Child Victim Survey conceming experiences of violence, including CSA. CSA was defined as having sexual experiences with a person at least five years older at the time of the experience. Within this sample, the CSA prevalence was 2.4%. Children reporting CSA experiences also answered questions regarding disclosure, the disclosure recipient, and potential reasons for not disclosing. The results indicate that most of the children (80%) had disclosed to someone, usually a friend (48%). However, only 26% had disclosed to adults, and even fewer had reported their experiences to authorities (12%). The most common reason for non-disclosing was that the experience was not considered serious enough for reporting (41%), and half of the children having CSA experiences did not self-label their experiences as sexual abuse. Relatively few children reported lacking the courage to disclose (14%). Logistic regression analyses showed that the perpetrator's age, the age of the victim at the time of abuse, and having no experiences of emotional abuse by the mother were associated with disclosing to an adult. The results contribute to understanding the factors underlying children's disclosure patterns in a population-based sample and highlight the need for age-appropriate safety education for children and adolescents.
  • Badeau, Robert M.; Honka, Miikka-Juhani; Bucci, Marco; Iozzo, Patricia; Eriksson, Johan G.; Nuutila, Pirjo (2017)
    Background: Obesity among pregnant women is common, and their offspring are predisposed to obesity, insulin resistance, and diabetes. The circulating metabolites that are related to insulin resistance and are associated with this decreased tissue-specific uptake are unknown. Here, we assessed metabolite profiles in elderly women who were either female offspring from obese mothers (OOM) or offspring of lean mothers (OLM). Metabolic changes were tested for associations with metrics for insulin resistance. Methods: Thirty-seven elderly women were separated into elderly offspring from obese mothers (OOM; n = 17) and elderly offspring from lean/normal weight mothers (OLM; n = 20) groups. We measured plasma metabolites using proton nuclear magnetic resonance (1H-NMR) and insulin-dependent tissue-specific glucose uptake in skeletal muscle was assessed. Associations were made between metabolites and glucose uptake. Results: Compared to the OLM group, we found that the docosahexaenoic acid percentage of the total long-chain n-3 fatty acids (DHA/FA) was significantly lower in OOM (p = 0.015). DHA/FA associated significantly with skeletal muscle glucose uptake (GU) (p = 0.031) and the metabolizable glucose value derived from hyperinsulinemic-euglycemic clamp technique (M-value) in the OLM group only (p = 0.050). Conclusions: DHA/FA is associated with insulin-dependent skeletal muscle glucose uptake and this association is significantly weakened in the offspring of obese mothers.
  • ESCMID Study Grp Implant Associate (2019)
    Objectives: Debridement, antibiotics and implant retention (DAIR) is the recommended treatment for all acute prosthetic joint infections (PJI), but its efficacy in patients with late acute (LA) PJI is not well described. Methods: Patients diagnosed with LA PJI between 2005 and 2015 were retrospectively evaluated. LA PJI was defined as the development of acute symptoms (= 3 months after arthroplasty. Failure was defined as: (i) the need for implant removal, (ii) infection related death, (iii) the need for suppressive antibiotic therapy and/or (iv) relapse or reinfection during follow-up. Results: 340 patients from 27 centers were included. The overall failure rate was 45.0% (153/340). Failure was dominated by Staphylococcus aureus PJI (54.7%, 76/139). Significant independent preoperative risk factors for failure according to the multivariate analysis were: fracture as indication for the prosthesis (odds ratio (OR) 5.4), rheumatoid arthritis (OR 5.1), age above 80 years (OR 2.6), male gender (OR 2.0) and C-reactive protein > 150 mg/L (OR 2.0). Exchanging the mobile components during DAIR was the strongest predictor for treatment success (OR 0.35). Conclusion: LA PJIs have a high failure rate. Treatment strategies should be individualized according to patient's age, comorbidity, clinical presentation and microorganism causing the infection. (C) 2018 The British Infection Association. Published by Elsevier Ltd. All rights reserved.
  • Lallukka, Tea; Mekuria, Gashaw B.; Nummi, Tapio; Virtanen, Pekka; Virtanen, Marianna; Hammarström, Anne (2019)
    BackgroundCo-occurrence of mental and somatic symptoms is common, and recent longitudinal studies have identified single trajectories of these symptoms, but it is poorly known whether the symptom trajectories can also co-occur and change across the lifespan. We aimed to examine co-occurring symptoms and their joint trajectories from adolescence to midlife.MethodsLongitudinal data were derived from Northern Sweden, where 506 girls and 577 boys aged 16years participated at baseline in 1981 (99.7% of those initially invited), and have been followed up in four waves until the age of 43. Survey data were collected about depressive, anxiety, and somatic symptoms. Potential joint development of this three-component symptom set was examined with multiple response trajectory analysis, a method that has not been previously used to study co-occurrence of these symptoms.ResultsWe identified a five trajectory solution as the best: very low (19%), low (31%), high (22%), late sharply increasing (16%) and a very high increasing (12%). In the late sharply increasing and very high increasing groups the scores tended to increase with age, while in the other groups the levels were more stable. Overall, the results indicated that depressive, anxiety, and somatic symptoms co-exist from adolescence to midlife.ConclusionsThe multiple response trajectory analysis confirmed high stability in the co-occurrence of depressive, anxiety, and somatic symptoms from adolescence to midlife. Clinicians should consider these findings to detect symptoms in their earliest phase in order to prevent the development of co-occurring high levels of symptoms.
  • Ritvonen, Juhani; Sairanen, Tiina; Silvennoinen, Heli; Virtanen, Pekka; Salonen, Oili; Lindsberg, Perttu J.; Strbian, Daniel (2021)
    Background: Around 30-60% of patients with basilar artery occlusion (BAO) present with coma, which is often considered as a hallmark of poor prognosis. Aim: To examine factors that will help predict outcomes in patients with BAO comatose on admission. Methods: A total of 312 patients with angiography-proven BAO were analyzed. Comas were assessed as Glasgow Coma Scale (GCS) of Results: In total, 103/259 (39.8%) of BAO patients were comatose on admission. Factors associated with acute coma were higher age, coronary artery disease, convulsions, extent of early ischemia by posterior circulation Acute Stroke Prognosis Early CT Score (pc-ASPECTS) < 8, absence of patent posterior collateral vasculature, and occlusion over multiple segments of BA. A total of 21/103 (20.4%) of comatose patients had a favorable outcome (mRS 0-3), and 12/103 (11.7%) had a good outcome (mRS 0-2). Factors associated with a favorable outcome in comatose BAO patients were younger age (p = 0.010), less extensive baseline ischemia (p = 0.027), recanalization (p = 0.013), and avoiding symptomatic intracranial hemorrhage (sICH) (p = 0.038). Factors associated with the poorest outcome or death (mRS 5-6) were older age (p = 0.001), diabetes (p = 0.022), atrial fibrillation (p = 0.016), lower median GCS [4 (IQR 3.6) vs. 6 (5-8); p = 0.006], pc-ASPECTS < 8 (p = 0.003), unsuccessful recanalization (p = 0.006), and sICH (p = 0.010). Futile recanalization (mRS 4-6) was significantly more common in comatose patients (49.4 vs. 18.5%, p < 0.001). Conclusions: One in five BAO patients with acute coma had a favorable outcome. Older patients with cardiovascular comorbidities and already existing ischemic lesions before reperfusion therapies tended to have a poor prognosis, especially if no recanalization is achieved and sICH occurred.
  • Hiilamo, Aapo; Shiri, Rahman; Kouvonen, Anne; Manty, Minna; Butterworth, Peter; Pietilainen, Olli; Lahelma, Eero; Rahkonen, Ossi; Lallukka, Tea (2019)
    Objective: We examined trajectories of work disability, indicated by sickness absence and disability retirement, among midlife public sector employees with and without common mental disorders (CMD) at baseline. We also examined adverse childhood events, occupational class, long-standing illness and health behaviour as determinants of the trajectories. Methods: A sample from the Helsinki Health Study was extracted comprising 2350 employees. Baseline characteristics were obtained from mail surveys conducted in 2000-2 and 2007. CMD were measured by the General Health Questionnaire. Participants were followed between the ages of 50-59. Work disability trajectories were modelled by the annual number of work disability months in group-based trajectory analysis. Multinomial regression was used to predict trajectory group memberships. Results: Three trajectories were identified: no work disability (consisting 59% of the all employees), stable/low (31%) and high/increasing disability (10%). Employees with CMD were more likely to belong to the stable/low (odds ratio 1.73 [95% confidence interval 1.37-2.18]), and the high/increasing (2.55 [1.81-3.59]) trajectories. Stratified models showed that the determinants of the trajectories were largely similar for those with CMD compared to those without CMD except that obesity was a somewhat stronger predictor of the high/increasing trajectory among employees with CMD. Limitations: The focus on midlife public sector employees limits the generalisability to other employment sectors and younger employees. Conclusions: CMD were strongly associated with a trajectory leading to early exit from employment and a stable/ low work disability trajectory. These findings have implications for interventions promoting work ability of employees with mental ill-health.
  • Marttila, E.; Thoren, H.; Törnwall, J.; Viitikko, A.; Wilkman, T. (2018)
    The aim of this retrospective study was to analyse the incidence of complications and loss of flaps after primary reconstructions for oral cancer in 191 patients at our hospital over the five years 2005-2010. The patients' clinical and personal details, characteristics of the tumours, types of microvascular flap, complications, and outcomes were recorded. The soft tissue flaps used most often were the fasciocutaneous radial forearm free flap (RFFF) (n = 86, 45%) and the anterolateral thigh free flap (ALTFF) (n = 48, 25%) while the most commonly used osseous flap was the deep circumflex iliac artery flap (DCIA) (n = 25, 13%). There were postoperative complications that required intervention in a quarter of the patients, most often in the age group 41-50 years (p = 0.018). Older age was not associated with the development of complications. The overall survival of all free flaps was 181/191 (95%), and the only significant individual predictor of loss of a flap was reconstruction with a DCIA (p = 0.016), five of the 25 of which were lost. We conclude therefore that DCIA free flaps are associated with an increased risk of failure; the method of osseous reconstruction for maxillofacial reconstruction should be selected carefully; and carefully chosen older patients do not seem to be at increased risk of morbidity. (C) 2018 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
  • Taponen, Saara; Lehtimaki, Lauri; Karvala, Kirsi; Luukkonen, Ritva; Uitti, Jukka (2017)
    Background: This study aims to elucidate factors that among adults with asthma are associated with working full-time. Methods: This cross-sectional survey of 2613 working-age adults with asthma included questions on asthma history, symptoms and use of asthma medication, socioeconomic factors and health behavior. Full-time workers were compared to groups according to employment status: unemployed, work disability and retired due to age. Results: Adults with asthma working full time were younger and more often nonmanual workers, experienced less asthma symptoms, used less asthma medication and smoked less than subjects with work disability. After adjusting for age, gender, smoking and professional status, having frequent symptoms of asthma during last month was associated with an increase in the risk of unemployment (OR 2.3, 95% CI 1.3-4.2) and with an increase in the risk of work disability (OR 4.4, 95% CI 2.3-8.2). Conclusions: Among adults with asthma, full-time work was associated with younger age, less symptomatic asthma despite of less medication, nonmanual work and less smoking. Having more severe symptoms of asthma was associated with undesirable employment status such as unemployment or work disability. Possibilities to change from manual to nonmanual work may be important in preventing work disability and early exit from work.
  • Halonen, Jaana; Pulakka, Anna; Pentti, Jaana; Kallio, Minna; Koskela, Sofia; Kivimäki, Mika; Kawachi, Ichiro; Vahtera, Jussi; Stenholm, Sari (2020)
    Objective Neighbourhood characteristics may affect the level of physical activity (PA) of the residents. Few studies have examined the combined effects of distinctive neighbourhood characteristics on PA using objective data or differentiated between activity during working or non-working days. We examined the associations of socioeconomic disadvantage and greenness with accelerometer-measured leisure-time PA during working and non-working days. Design Cross-sectional study. Setting Finnish Retirement and Aging (FIREA) study. Participants 708 workers (604 women, mean age 62.4 ranging from 58 to 64 years,) participating in the FIREA study who provided PA measurement data for at least 1 working and non-working day. Primary and secondary outcomes PA was measured with wrist-worn accelerometer on average of 4 working and 2 non-working days. Outcomes were total PA, light PA (LPA) and moderate-to-vigorous PA (MVPA). These measurements were linked to data on neighbourhood socioeconomic disadvantage and greenness within the home neighbourhood (750x750 m). Generalised linear models were adjusted for possible confounders. Results On non-working days, higher neighbourhood disadvantage associated with lower levels of total PA (p value=0.07) and higher level of neighbourhood greenness associated with higher level of total PA (p value=0.04). Neighbourhood disadvantage and greenness had an interaction (p value=0.02); in areas of low disadvantage higher greenness did not associate with the level of total PA. However, in areas of high disadvantage, 2 SD higher greenness associated with 46 min/day (95% CI 8.4 to 85) higher total PA. Slightly stronger interaction was observed for LPA (p=0.03) than for the MVPA (p=0.09). During working days, there were no associations between neighbourhood characteristics and leisure-time total PA. Conclusions Of the disadvantaged neighbourhoods, those characterised by high levels of greenness seem to associate with higher levels of leisure-time PA during non-working days. These findings suggest that efforts to add greenness to socioeconomically disadvantaged neighbourhoods might reduce inequalities in PA.
  • Vandenbroucke, Loren; Verschueren, Karine; Desoete, Annemie; Aunio, Pirjo; Ghesquiere, Pol; Baeyens, Dieter (2018)
    Working memory is important for a variety of life domains,. including for children's school functioning. As such, it is crucial to understand its development, antecedents and consequences. The current study investigates the development of different working memory components (phonological loop, visuospatial sketchpad, central executive), the influence of different aspects of the teacher-student relationship (closeness, conflict, dependency) and its predictive value for academic achievement (reading, spelling, mathematics) across the transition from kindergarten to first grade. The sample consisted of 107 kindergarten children. Working memory tasks were administered at the end of kindergarten and first grade. Teachers reported on teacher-student relationship quality in the middle of first grade. Standardized tests were used to assess academic achievement at the end of first grade. Results indicate moderate to large increases in the phonological loop and visuospatial sketchpad and large gains in the central executive. Dependency of the student towards the teacher significantly predicted visuospatial sketchpad performance at the end of first grade. Reading was significantly predicted by the visuospatial sketchpad and phonological loop in kindergarten, while for spelling the visuospatial sketchpad was important. Finally, mathematics was predicted by performance on the phonological loop and the visuospatial sketchpad. The current study indicates the importance of the affective quality of the teacher-student relationship for working memory performance, which in turn is important for academic achievement. It is therefore critical to attend to the early detection and prevention or intervention of working memory problems in the classroom in order to prevent future academic problems. Additionally, maintaining a positive relationship with students and encouraging their independent exploration may be important when preventing such problems, complementary to cognitive or other types of training and intervention.
  • Konev, Alexey A.; Kharitonov, Alexey; Rozov, Fedor N.; Altshuler, Evgeny P.; Serebryanaya, Daria; Lassus, Johan; Harjola, Veli-Pekka; Katrukha, Alexey G.; Postnikov, Alexander B. (2020)
    Aims Insulin-like growth factor binding protein-4 (IGFBP-4) fragments have been shown to predict the risk of major adverse cardiovascular events, including segment-elevation myocardial infarction, in patients with acute coronary syndrome. We evaluated the prognostic value of the carboxy-terminal fragment of IGFBP-4 (CT-IGFBP-4) for all-cause mortality in emergency room patients with acute heart failure (AHF). Methods and results CT-IGFBP-4, N-terminal pro brain natriuretic peptide (NT-proBNP), and C-reactive protein (CRP) were measured at admission from the lithium-heparin plasma of 156 patients with AHF. All-cause mortality was recorded for 1 year. Receiver operator characteristic (ROC) curves, Kaplan-Meier, and Cox proportional hazard ratio analyses were performed to evaluate the prognostic value of the various clinical variables, CT-IGFBP-4, NT-proBNP, CRP, and their combinations. During 1 year of follow-up, 52 (33.3%) patients died. CT-IGFBP-4 only weakly correlated with NT-proBNP (Pearson correlation coefficient r = 0.16, P = 0.044) and did not correlate with CRP (r = 0.08, P = 0.35), emphasizing the different nature of these biomarkers. The receiver operator characteristic area under the curve (ROC AUC) of CT-IGFBP-4 for the prediction of all-cause mortality (0.727) was significantly higher than that of NT-proBNP (0.680, P = 0.045) and CRP (0.669, P = 0.016). The combination of CT-IGFBP-4, NT-proBNP, and CRP predicted mortality significantly better (ROC AUC = 0.788) than any of the biomarkers alone (P <0.01 for all). The addition of CT-IGFBP-4 to a clinical prediction model that included age, gender, systolic blood pressure, creatinine, and sodium levels, as well as the history of previous heart failure, coronary artery disease, and hypertension significantly improved the mortality risk prediction (ROC AUC 0.774 vs. 0.699, P = 0.025). Cox hazard analysis indicated that elevated CT-IGFBP-4 was independently associated with 1 year mortality (hazard ratio 3.26, P = 0.0008) after adjustment for age, gender, history of previous heart failure, coronary artery disease, hypertension, chronic kidney failure, history of diabetes, heart rate, haemoglobin, plasma sodium, NT-proBNP, CRP, cystatin C, and elevated cardiac troponin I or T. Patients with increased levels of either two or three of the biomarkers CT-IGFBP-4, NT-proBNP, and CRP had significantly higher mortality risk (adjusted hazard ratio 10.04, P <0.0001) than patients with increased levels of one or none of the biomarkers. Conclusions CT-IGFBP-4 was independently associated with all-cause mortality in patients with AHF. Compared with single biomarkers, the combination of CT-IGFBP-4, NT-proBNP, and CRP improved the prediction of all-cause mortality in patients with AHF.
  • Hansen, Sylvia; Huttunen-Lenz, Maija; Sluik, Diewertje; Brand-Miller, Jennie; Drummen, Mathijs; Fogelholm, Mikael; Handjieva-Darlenska, Teodora; Macdonald, Ian; Martinez, Alfredo J.; Larsen, Thomas Meinert; Poppitt, Sally; Raben, Anne; Schlicht, Wolfgang (2018)
    PurposeWeight loss has been demonstrated to be a successful strategy in diabetes prevention. Although weight loss is greatly influenced by dietary behaviors, social-cognitive factors play an important role in behavioral determination. This study aimed to identify demographic and social-cognitive factors (intention, self-efficacy, outcome expectancies, social support, and motivation with regard to dietary behavior and goal adjustment) associated with weight loss in overweight and obese participants from the PREVIEW study who had pre-diabetes.MethodProspective correlational data from 1973 adult participants were analyzed. The participants completed psychological questionnaires that assessed social-cognitive variables with regard to dietary behavior. Stepwise multiple regression analyses were performed to identify baseline demographic and social-cognitive factors associated with weight loss.ResultsOverall, being male, having a higher baseline BMI, having a higher income, perceiving fewer disadvantages of a healthy diet (outcome expectancies), experiencing less discouragement for healthy eating by family and friends (social support), and lower education were independently linked to greater weight loss. When evaluating females and males separately, education was no longer associated with weight loss.ConclusionThe results indicate that a supportive environment in which family members and friends avoid discouraging healthy eating, with the application of a strategy that uses specific behavior change techniques to emphasize the benefits of outcomes, i.e., the benefits of a healthy diet, may support weight loss efforts. Weight loss programs should therefore always address the social environment of persons who try to lose body weight because family members and friends can be important supporters in reaching a weight loss goal.
  • Asikainen, Henna; Katajavuori, Nina (2021)
    Background: The decline in the well-being among university students well as increasing dropouts has become a serious issue in universities around the world. Thus, effective ways to support students' well-being and their ability to study are highly needed. Objective: The purpose of this study was to build an intervention course for university students, which promotes both students' well-being as well as their learning and study skills, and to describe the experimental study design that explores the effects of this intervention course. Methods: Research has shown that psychological flexibility has a great effect on the well-being as well as the study skills of students pursuing higher education. The basis of our intervention course was to promote psychological flexibility and students' study skills with the help of peer support and reflection. Results: This course was offered as a voluntary course to all the students at the University of Helsinki twice during the academic year 2020-2021. The first course was from October to December and the second course was from January to March. This course was advertised in fall 2020 through social media and by different student organizations and program leaders at different faculties of the University of Helsinki. As of October 2020, we enrolled 566 students comprising 310 students for the course in fall 2020 and 256 students for the course in spring 2021. Of the 256 students who enrolled in the second course, 170 students voluntarily participated in this study and they answered the questionnaires, including all the measures, simultaneously with the participants in the first group and thus served as the control group. The effect of this course will be measured with multiple data, including questionnaire data, reflective journals, and physiological data of well-being with a longitudinal experimental design. This research very strictly follows the ethical guidelines drawn up by the Finnish National Board on Research Integrity. We expect to publish the results of this study in fall 2021 at the latest. Conclusions: We argue that a web-based, 8-week intervention course, which promotes both student well-being and their study skills, is a good way to support students pursuing higher education, and both aspects should be considered when supporting university students.
  • Javanainen, Mervi Hannele; Scheinin, Tom; Mustonen, Harri; Leivonen, Marja (2017)
    The current understanding of prophylaxis of pulmonary complications in bariatric surgery is weak. Purpose: The aim of this study was to observe how changes in perioperative and postoperative treatments affect the incidence of pulmonary complications in bariatric patients. Materials: This is a retrospective clinical study of 400 consecutive bariatric patients. The patients, who either underwent a sleeve gastrectomy or a Roux-en-Y gastric bypass, were divided consecutively into four subgroups with different approaches to perioperative treatment. Methods: The first group (patients 0-100) was recovered in the intensive care unit with minimal mobilization (ICU). They had a urinary catheter and a drain. The second group (patients 101-200) was similar to the first group, but the patients used a continuous positive airway pressure (CPAP) device intermittently (ICU-CPAP). The third group (patients 201-300) was recovered on a normal ward without a urinary catheter or a drain and used a CPAP device (ward-slow). The fourth group (patients 301-400) walked to the operating theater and was mobilized in the recovery room during the first 2 h after the operation (ward-fast). CPAP was also used. Primary endpoints were pulmonary complications, pneumonia, and infection, non-ultra descriptus (NUD). Results: The number of pulmonary complications among the groups was significantly different. A long operation time increased the risk for infection (p <0.001 95 % CI from 2.02 to 6.59 %). Conclusions: Operation time increases the risk for pulmonary complications. Changes in perioperative care toward the ERAS protocol may have a positive effect on the number of pulmonary complications.
  • Aaltonen, Kari I.; Rosenström, Tom; Jylhä, Pekka; Holma, Irina; Holma, Mikael; Pallaskorpi, Sanna; Riihimäki, Kirsi; Suominen, Kirsi; Vuorilehto, Maria; Isometsä, Erkki T. (2020)
    Background: Preceding suicide attempts strongly predict future suicidal acts. However, whether attempting suicide per se increases the risk remains undetermined. We longitudinally investigated among patients with mood disorders whether after a suicide attempt future attempts occur during milder depressive states, indicating a possible lowered threshold for acting. Methods: We used 5-year follow-up data from 581 patients of the Jorvi Bipolar Study, Vantaa Depression Study, and Vantaa Primary Care Depression Study cohorts. Lifetime suicide attempts were investigated at baseline and during the follow-up. At follow-up interviews, life-chart data on the course of the mood disorder were generated and suicide attempts timed. By using individual-level data and multilevel modeling, we investigated at each incident attempt the association between the lifetime ordinal number of the attempt and the major depressive episode (MDE) status (full MDE, partial remission, or remission). Results: A total of 197 suicide attempts occurred among 90 patients, most during MDEs. When the dependencies between observations and individual liabilities were modeled, no association was found between the number of past suicide attempts at the time of each attempt and partial remissions. No association between adjusted inter-suicide attempt times and the number of past attempts emerged during follow-up. No indication for direct risk-increasing effects was found. Conclusion: Among mood disorder patients, repeated suicide attempts do not tend to occur during milder depressive states than in the preceding attempts. Previous suicide attempts may indicate underlying diathesis, future risk being principally set by the course of the disorder itself.