Browsing by Subject "ABILITY"

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  • Ahlberg, Sara; Grace, Delia; Kiarie, Gideon; Kirino, Yumi; Lindahl, Johanna (2018)
    Aflatoxin M1 (AFM1), a human carcinogen, is found in milk products and may have potentially severe health impacts on milk consumers. We assessed the risk of cancer and stunting as a result of AFM1 consumption in Nairobi, Kenya, using worst case assumptions of toxicity and data from previous studies. Almost all (99.5%) milk was contaminated with AFM1. Cancer risk caused by AFM1 was lower among consumers purchasing from formal markets (0.003 cases per 100,000) than for low-income consumers (0.006 cases per 100,000) purchasing from informal markets. Overall cancer risk (0.004 cases per 100,000) from AFM1 alone was low. Stunting is multifactorial, but assuming only AFM1 consumption was the determinant, consumption of milk contaminated with AFM1 levels found in this study could contribute to 2.1% of children below three years in middle-income families, and 2.4% in low-income families, being stunted. Overall, 2.7% of children could hypothetically be stunted due to AFM1 exposure from milk. Based on our results AFM1 levels found in milk could contribute to an average of −0.340 height for age z-score reduction in growth. The exposure to AFM1 from milk is 46 ng/day on average, but children bear higher exposure of 3.5 ng/kg bodyweight (bw)/day compared to adults, at 0.8 ng/kg bw/day. Our paper shows that concern over aflatoxins in milk in Nairobi is disproportionate if only risk of cancer is considered, but that the effect on stunting children might be much more significant from a public health perspective; however, there is still insufficient data on the health effects of AFM1.
  • Shiri, Rahman; Heliövaara, Markku; Ahola, Kirsi; Kaila-Kangas, Leena; Haukka, Eija; Kausto, Johanna; Saastamoinen, Peppiina; Leino-Arjas, Päivi; Lallukka, Tea (2018)
    Objective This study aimed to develop and validate a risk screening tool using a points system to assess the risk of future disability retirement due to musculoskeletal disorders (MSD). Methods The development population, the Health 2000 Survey, consisted of a nationally representative sample of Finnish employees aged 30-60 years (N=3676), and the validation population, the Helsinki Health Study, consisted of employees of the City of Helsinki aged 40-60 years (N=6391). Both surveys were linked to data on disability retirement awards due to MSD from national register for an 11-year follow-up. Results The discriminative ability of the model with seven predictors was good (Gonen and Heller's K concordance statistic=0.821). We gave points to seven predictors: sex-dependent age, level of education, pain limiting daily activities, multisite musculoskeletal pain, history of arthritis, and surgery for a spinal disorder or carpal tunnel syndrome. A score of >= 3 out of 7 (top 30% of the index) had good sensitivity (83%) and specificity (70%). Individuals at the top 30% of the risk index were at 29 [95% confidence interval (CI) 15-55) times higher risk of disability retirement due to MSD than those at the bottom 40%. Conclusion This easy-to-use screening tool based on self-reported risk factor profiles can help identify individuals at high risk for disability retirement due to MSD.
  • Svedholm-Häkkinen, Annika M.; Lindeman, Marjaana (2018)
    Actively open-minded thinking (AOT) is often used as a proxy for reflective thinking in research on reasoning and related fields. It is associated with less biased reasoning in many types of tasks. However, few studies have examined its psychometric properties and criterion validity. We developed a shortened, 17-item version of the AOT for quicker administration. AOT17 is highly correlated with the original 41-item scale and has highly similar relationships to other thinking dispositions, social competence and supernatural beliefs. Our analyses revealed that the AOT is not a unitary construct, but comprises four distinct dimensions, some of which concern attitudes towards knowledge, and others concern attitudes towards people. This factor structure was replicated in another data-set, and correlations with other measures in four data-sets (total N = 3345) support the criterion validity of these dimensions. Different dimensions were responsible for the AOT's relationships with other thinking dispositions.
  • Ahlberg, Sara; Randolph, Delia; Okoth, Sheila; Lindahl, Johanna (2019)
    Aflatoxins continue to be a food safety problem globally, especially in developing regions. A significant amount of effort and resources have been invested in an attempt to control aflatoxins. However, these efforts have not substantially decreased the prevalence nor the dietary exposure to aflatoxins in developing countries. One approach to aflatoxin control is the use of binding agents in foods, and lactic acid bacteria (LAB) have been studied extensively for this purpose. However, when assessing the results comprehensively and reviewing the practicality and ethics of use, risks are evident, and concerns arise. In conclusion, our review suggests that there are too many issues with using LAB for aflatoxin binding for it to be safely promoted. Arguably, using binders in human food might even worsen food safety in the longer term.
  • Annanmaki, Tua; Palmu, Kirsi; Murros, Kari; Partanen, Juhani (2017)
    The diagnosis of cognitive impairment and dementia often occurring with Parkinson's disease (PD) is still based on the clinical picture and neuropsychological examination. Ancillary methods to detect cognitive decline in these patients are, therefore, needed. Alterations in the latencies and amplitudes of evoked response potential (ERP) components N100 and P200 have been described in PD. Due to limited number of studies their relation to cognitive deficits in PD remains obscure. The present study was designed to examine if alterations in the N100- and P200-potentials associate with neuropsychological impairment in PD. EEG-ERP was conducted to 18 PD patients and 24 healthy controls. The patients underwent a thorough neuropsychological evaluation. The controls were screened for cognitive impairment with Consortium to Establish Alzheimer's disease (CERAD)-testing and a normal result were required to be included in the study. The N100-latency was prolonged in the patients compared to the controls (p = 0.05). In the patients, the N100 latency correlated significantly with a visual working memory task (p = 0.01). Also N100 latency was prolonged and N100 amplitude habituation diminished in the patients achieving poorly in this task. We conclude that prolonged N100-latency and diminished amplitude habituation associate with visual working memory impairment in PD.
  • Khemiri, Lotfi; Larsson, Henrik; Kuja-Halkola, Ralf; D'Onofrio, Brian M.; Lichtenstein, Paul; Jayaram-Lindstrom, Nitya; Latvala, Antti (2020)
    Aims To assess whether parental substance use disorder (SUD) is associated with lower cognitive ability in offspring, and whether the association is independent of shared genetic factors. Design A population family-based cohort study utilizing national Swedish registries. Linear regression with increased adjustment of covariates was performed in the full population. In addition, the mechanism of the association was investigated with children-of-sibling analyses using fixed-effects regression with three types of sibling parents with increasing genetic relatedness (half-siblings, full siblings and monozygotic twins). Setting and participants A total of 3 004 401 people born in Sweden between 1951 and 1998. Measurements The exposure variable was parental SUD, operationalized as having a parent with life-time SUD diagnosis or substance-related criminal conviction in the National Patient Register or Crime Register, respectively. Outcomes were cognitive test score at military conscription and final school grades when graduating from compulsory school. Covariates included in the analyses were sex, birth year, parental education, parental migration status and parental psychiatric comorbid diagnoses. Findings In the full population, parental SUD was associated with decreased cognitive test stanine scores at conscription [4.56, 95% confidence interval (CI) = 4.55-4.57] and lower Z-standardized school grades (-0.43, 95% CI = -0.43 to -0.42) compared to people with no parental SUD (cognitive test: 5.17, 95% CI = 5.17-5.18; grades: 0.09, 95% CI = 0.08-0.09). There was evidence of a dose-response relationship, in that having two parents with SUD (cognitive test: 4.17, 95% CI = 4.15-4.20; grades: -0.83, 95% CI = -0.84 to -0.82) was associated with even lower cognitive ability than having one parent with SUD (cognitive test: 4.60, 95% CI = 4.59-4.60; grades: -0.38, 95% CI = -0.39 to -0.380). In the children-of-siblings analyses when accounting for genetic relatedness, these negative associations were attenuated, suggestive of shared underlying genetic factors. Conclusions There appear to be shared genetic factors between parental substance use disorder (SUD) and offspring cognitive function, suggesting that cognitive deficits may constitute a genetically transmitted risk factor in SUD.
  • Koivuhovi, Satu; Vainikainen, Mari-Pauliina; Kalalahti, Mira; Niemivirta, Markku (2019)
    This study examined changes in pupils' agency beliefs and control expectancy from grade four to grade six, and whether they were associated with studying in a class with a special emphasis on a subject as compared to studying in a class without emphasis. After controlling for the effects of mother's education, prior school achievement, and gender, we found that the average pattern of change varied for different action-control beliefs, and that class membership did not moderate these changes. Mother's education, pupils' prior school achievement, and gender all predicted class membership, but their effects on action-control beliefs varied depending on the type of belief. Implications for educational policy will be discussed.
  • 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.
  • Smith, Martine M.; Batorowicz, Beata; Sandberg, Annika Dahlgren; Murray, Janice; Stadskleiv, Kristine; van Balkom, Hans; Neuvonen, Kirsi; von Tetzchner, Stephen (2018)
    Narratives are a pervasive form of discourse and a rich source for exploring a range of language and cognitive skills. The limited research base to date suggests that narratives generated using aided communication may be structurally simple, and that features of cohesion and reference may be lacking. This study reports on the analysis of narratives generated in interactions involving aided communication in response to short, silent, video vignettes depicting events with unintended or unexpected consequences. Two measures were applied to the data: the Narrative Scoring Scheme and the Narrative Analysis Profile. A total of 15 participants who used aided communication interacted with three different communication partners (peers, parents, professionals) relaying narratives about three video events. Their narratives were evaluated with reference to narratives of 15 peers with typical development in response to the same short videos and to the narratives that were interpreted by their communication partners. Overall, the narratives generated using aided communication were shorter and less complete than those of the speaking peers, but they incorporated many similar elements. Topic maintenance and inclusion of scene-setting elements were consistent strengths. Communication partners offered rich interpretations of aided narratives. Relative to the aided narratives, these interpreted narratives were typically structurally more complete and cohesive and many incorporated more elaborated semantic content. The data reinforce the robust value of narratives in interaction and their potential for showcasing language and communication achievements in aided communication.
  • Berthelsen, Hanne; Hakanen, Jari J.; Westerlund, Hugo (2018)
    Aim This study aims at investigating the nomological validity of the Copenhagen Psychosocial Questionnaire (COPSOQ II) by using an extension of the Job Demands-Resources (JD-R) model with aspects of work ability as outcome. Material and methods The study design is cross-sectional. All staff working at public dental organizations in four regions of Sweden were invited to complete an electronic questionnaire (75% response rate, n = 1345). The questionnaire was based on COPSOQ II scales, the Utrecht Work Engagement scale, and the one-item Work Ability Score in combination with a proprietary item. The data was analysed by Structural Equation Modelling. Results This study contributed to the literature by showing that: A) The scale characteristics were satisfactory and the construct validity of COPSOQ instrument could be integrated in the JD-R framework; B) Job resources arising from leadership may be a driver of the two processes included in the JD-R model; and C) Both the health impairment and motivational processes were associated with WA, and the results suggested that leadership may impact WA, in particularly by securing task resources. Conclusion In conclusion, the nomological validity of COPSOQ was supported as the JD-R model can be operationalized by the instrument. This may be helpful for transferral of complex survey results and work life theories to practitioners in the field.
  • Hoikka, Marko; Silfvast, Tom; Ala-Kokko, Tero I. (2018)
    Objectives: The prehospital research field has focused on studying patient survival in cardiac arrest, as well as acute coronary syndrome, stroke, and trauma. There is little known about the overall short-term mortality and its predictability in unselected prehospital patients. This study examines whether a prehospital National Early Warning Score (NEWS) predicts 1-day and 30-day mortalities. Methods: Data from all emergency medical service (EMS) situations were coupled to the mortality data obtained from the Causes of Death Registry during a six-month period in Northern Finland. NEWS values were calculated from first clinical parameters obtained on the scene and patients were categorized to the low, medium and high-risk groups accordingly. Sensitivities, specificities, positive predictive values (PPVs), negative predictive values (NPVs), and likelihood ratios (PLRs and NLRs) were calculated for 1-day and 30-day mortalities at the cut-off risks. Results: A total of 12,426 EMS calls were included in the study. The overall 1-day and 30-day mortalities were 1.5 and 4.3%, respectively. The 1-day mortality rate for NEWS values = 13 higher than 20%. The high-risk NEWS group had sensitivities for 1-day and 30-day mortalities 0.801 (CI 0.74-0.86) and 0.42 (CI 0.38-0.47), respectively. Conclusion: In prehospital environment, the high risk NEWS category was associated with 1-day mortality well above that of the medium and low risk NEWS categories. This effect was not as noticeable for 30-day mortality. The prehospital NEWS may be useful tool for recognising patients at early risk of death, allowing earlier interventions and responds to these patients.
  • Karhula, Kati; Salo, Paula; Koskinen, Aki; Ojajärvi, Anneli; Oksanen, Tuula; Puttonen, Sampsa; Kivimäki, Mika; Härmä, Mikko (2019)
    We aimed to study the association of perceived control over scheduling of shifts with objectively measured working hour characteristics in shift workers. The participants were 5128 hospital employees (91% women, 85% nursing personnel, average age 43 years) in period-based work (114:45h/3 weeks) from the 2015 Finnish Public Sector study. Survey responses to a measure of control over scheduling of shifts were linked to payroll data on working hour characteristics during the 91 days preceding the survey. We used multinomial logistic regression to assess differences in dichotomized proportion of working hour characteristics (being full-time worker, number of work shifts, long work weeks (>40h and >48h/week), long work shifts (>12-h), evening and night shifts, quick returns (4 consecutive work shifts, and variability of shift length with cut points at 10% or 25% between employees with high, intermediate, or low control over scheduling of shifts. Analyses were adjusted for age, sex, education, full-/part-time work (where applicable), duration of shift work experience, perceived work ability, children <18 years in the household, and overall stressfulness of the life situation. Differences between age groups, men and women, and levels of work ability were examined using interaction terms. In adjusted analyses, the proportion of full-time workers was lower among employees with intermediate control over scheduling of shifts compared to those with high control (OR 0.78, 95% CI 0.61-0.98). High proportion (>25%) of weekend work was lower among employees with low control over scheduling of shifts compared to high control (OR 0.75, 95% CI 0.61-0.93). High proportion (>25%) of having >4 consecutive work shifts was associated with lower control over scheduling of shifts (OR 1.35, 95% CI 1.13-1.62). Variability of shift length was lower among employees with intermediate and low control over scheduling of shifts compared to those with high control (OR 0.78, 95% CI 0.66-0.93; OR 0.62, 95% CI 0.51-0.75, respectively). No association was observed between the level of control over scheduling of shifts and high proportion of long work weeks (>25% of >40h weeks and >10% of >48h weeks), long work shifts (>25%), quick returns (>25%), single days off (>25%), and evening or night shifts (>10%) in the whole sample. In subgroup analyses, women with low control over scheduling shifts had lower odds ratio (OR 0.58, 95% CI 0.37-0.91) and men had higher odds ratio (OR 2.97, 95% CI 1.26-6.98) for large proportion of >12-h shifts. In conclusion, the employees with high control over scheduling of shifts had slightly more often unsocial working hour characteristics than those with intermediate or low control over scheduling of shifts. The findings, however, suggest that good work time control in shift work can be possible without compromising shift ergonomics.
  • Ramos-Diaz, Jose Martin; Kantanen, Katja Annika; Edelmann, Minnamari; Suhonen, Heikki; Sontag-Strohm, Tuula; Jouppila, Kirsi; Piironen, Vieno (2022)
    A new generation of plant-based texturized meat analogues attempts to boost the consumption of dietary fiber. In the present study, oat fiber concentrate (OFC) and pea protein isolate (PPI) were combined (30:70; 50:50; 70:30) and processed with high-moisture extrusion (long cooling die temperature [LCDT]: 40, 60 and 80 °C; screw speed [SS]: 300, 400 and 500 rpm) to obtain meat-mimicking fibrous meat analogues (FMAs). The results showed that OFC reduced the structural strength (e.g., hardness, chewiness) of the FMAs, whereas LCDT strengthened the structure. Microtomography imaging revealed that FMAs containing more OFC presented smaller void thickness, thus reducing the FMAs' water holding capacity. An in-vitro gastrointestinal model showed that the extractability and viscosity of β-glucan were well preserved, particularly at low LCDT. Overall, it was possible to add substantial amounts of OFC (30–50%) to FMAs while maintaining fibrous meat-mimicking structures and retaining the oat fiber's viscous properties.
  • Ramos-Diaz, J. M.; Kantanen, Katja; Edelmann, Minnamari; Jouppila, Kirsi; Sontag-Strohm, Tuula; Piironen, Vieno (2022)
    Oat has been recognized for its health-promoting fiber, beta-glucan, while protein-rich faba bean has remained underutilized in Nordic countries despite its good nutritional quality. This research investigated the functionality of oat fiber concentrate and faba bean protein concentrate in plant-based substitutes for minced meat (SMs). The resulting product aimed at mimicking the mechanical and physicochemical characteristics of beef minced meat (BM) and its applications (i.e., fried and burger patty). In this regard, the mechanical properties (e.g., chewiness, Young's modulus) of original/fried SMs were comparable to or higher than those of original/fried BM. SM patties (45% SMs) were structurally weaker than beef burger patties (100% BM). The rheological analysis showed that the presence of oat fiber concentrate increased the gel-like properties of the blend, which correlated with the overall strength of original SMs (e.g., Young's modulus). The results suggested that SMs could be used as BM for the preparation of vegetarian meat-like products.
  • Trampush, J. W.; Yang, M. L. Z.; Yu, J.; Knowles, E.; Davies, G.; Liewald, D. C.; Starr, J. M.; Djurovic, S.; Melle, I.; Sundet, K.; Christoforou, A.; Reinvang, I.; DeRosse, P.; Lundervold, A. J.; Steen, V. M.; Espeseth, T.; Räikkönen, Katri; Widen, E.; Palotie, A.; Eriksson, J. G.; Giegling, I.; Konte, B.; Roussos, P.; Giakoumaki, S.; Burdick, K. E.; Payton, A.; Ollier, W.; Horan, M.; Chiba-Falek, O.; Attix, D. K.; Need, A. C.; Cirulli, E. T.; Voineskos, A. N.; Stefanis, N. C.; Avramopoulos, D.; Hatzimanolis, A.; Arking, D. E.; Smyrnis, N.; Bilder, R. M.; Freimer, N. A.; Cannon, T. D.; London, E.; Poldrack, R. A.; Sabb, F. W.; Congdon, E.; Conley, E. D.; Scult, M. A.; Dickinson, D.; Straub, R. E.; Donohoe, G.; Morris, D.; Corvin, A.; Gill, M.; Hariri, A. R.; Weinberger, D. R.; Pendleton, N.; Bitsios, P.; Rujescu, D.; Lahti, J.; Le Hellard, S.; Keller, M. C.; Andreassen, O. A.; Deary, I. J.; Glahn, D. C.; Malhotra, A. K.; Lencz, T. (2017)
    The complex nature of human cognition has resulted in cognitive genomics lagging behind many other fields in terms of gene discovery using genome-wide association study (GWAS) methods. In an attempt to overcome these barriers, the current study utilized GWAS meta-analysis to examine the association of common genetic variation (similar to 8M single-nucleotide polymorphisms (SNP) with minor allele frequency >= 1%) to general cognitive function in a sample of 35 298 healthy individuals of European ancestry across 24 cohorts in the Cognitive Genomics Consortium (COGENT). In addition, we utilized individual SNP lookups and polygenic score analyses to identify genetic overlap with other relevant neurobehavioral phenotypes. Our primary GWAS meta-analysis identified two novel SNP loci (top SNPs: rs76114856 in the CENPO gene on chromosome 2 and rs6669072 near LOC105378853 on chromosome 1) associated with cognitive performance at the genome-wide significance level (P
  • Talvenmaki, Harri; Saartama, Niina; Haukka, Anna; Lepikko, Katri; Pajunen, Virpi; Punkari, Milla; Yan, Guoyong; Sinkkonen, Aki; Piepponen, Tuomas; Silvennoinen, Hannu; Romantschuk, Martin (2021)
    A residential lot impacted by spills from a leaking light heating oil tank was treated with a combination of chemical oxidation and bioremediation to avoid technically challenging excavation. The tank left emptied in the ground was used for slow infiltration of the remediation additives to the low permeability, clayey soil. First, hydrogen peroxide and citrate chelate was added for Fenton's reaction-based chemical oxidation, resulting in a ca. 50% reduction from the initial 25,000 mg/kg average oil concentration in the soil below the tank. Part of this was likely achieved through mobilization of oily soil into the tank, which was beneficial in regards to the following biological treatment. By first adding live bacteria in a soil inoculum, and then oxygen and nutrients in different forms, an approximately 90% average reduction was achieved. To further enhance the effect, methyl-beta-cyclodextrin surfactant (CD) was added, resulting finally in a 98% reduction from the initial average level. The applicability of the surfactant was based on laboratory-scale tests demonstrating that CD promoted oil degradation and, unlike pine soap, was not utilized by the bacteria as a carbon source, and thus inhibiting degradation of oils regardless of the positive effect on biological activity. The effect of CD on water solubility for different hydrocarbon fractions was tested to serve as the basis for risk assessment requirements for authorizing the use of the surfactant at the site.
  • Fernandez, Janani; Sivonen, Ville; Pulkki, Ville (2022)
    Objective: The objective of this study was to investigate the localization ability of bilateral cochlear implant (BiCI) users for virtual sound sources produced over a limited loudspeaker arrangement. Design: Ten BiCI users and 10 normal-hearing subjects participated in listening tests in which amplitude- and time-panned virtual sound sources were produced over a limited loudspeaker setup with varying azimuth angles. Three stimuli were utilized: speech, band-passed pink noise between 20 Hz and 1 kHz, and band-passed pink noise between 1 kHz and 8 kHz. The data were collected via a two-alternative forced-choice procedure and used to calculate the minimum audible angle (MAA) of each subject, which was subsequently compared to the results of previous studies in which real sound sources were employed. Result The median MAAs of the amplitude-panned speech, low-frequency pink noise, and high-frequency pink noise stimuli for the BiCI group were calculated to be 20 degrees, 38 degrees, and 12 degrees, respectively. For the time-panned stimuli, the MAAs of the BiCI group for all three stimuli were calculated to be close to the upper limit of the listening test. Conclusions: The computed MAAs of the BiCI group for amplitude-panned speech were marginally larger than BiCI users' previously reported MAAs for real sound sources, whereas their computed MAAs for the time-panned stimuli were significantly larger. Subsequent statistical analysis indicated a statistically significant difference in the performances of the BiCI group in localizing the amplitude-panned sources and the time-panned sources. It follows that time-panning over limited loudspeaker arrangements may not be a useful clinical tool, whereas amplitude-panning utilizing such a setup may be further explored as such. Additionally, a comparison with the patient demographics indicated correlations between the results and the patients' age at time of diagnoses and the time passed between date of diagnosis and their implant surgeries.
  • Tiainen, Kristina; Raitanen, Jani; Vaara, Elina; Hervonen, Antti; Jylha, Marja (2015)
    Background: Several studies have focused on predictors of mobility limitations and disabilities. Yet little is known about the pace and patterns of mobility changes among very old people. This study examined changes in functional mobility among individuals aged 90 years and older during a 2-9-year follow-up. In addition, we were interested in the patterns of mobility changes. Methods: Data were collected through a mailed questionnaire in the years 2001, 2003, 2007 and 2010. The study population (n = 948) consisted of individuals from three cohorts (2001, 2003, 2007) who participated in at least two survey rounds and answered the mobility questions. The length of the follow-up varied from 2-9 years between individuals as well as according to how many times an individual took part in the survey. Multilevel ordinal logistic regression analysis was used to evaluate the effects of time, age, gender, cohort and chronic conditions on changes in mobility. Results: At the baseline, "younger" old people, men and individuals in the cohorts for 2003 and 2007 had significantly better mobility compared with women, older individuals and individuals in the 2001 cohort. In addition, individuals with fewer chronic conditions had better mobility than those with more diseases. Mobility declined for most of the participants during the follow-up. The difference in the change in mobility over time for gender, age or chronic conditions was not statistically significant. The analyses were performed with a subgroup of participants aged 90-91 years at the baseline, and results did not differ substantially from the results for the entire study sample. However, the effect of chronic conditions on the change in mobility was statistically significant among participants aged 90-91years. Conclusions: No differences were observed in the rate of mobility decline over time between age or gender. The effect of chronic conditions on the change in mobility was significant only among individuals aged 90-91 years. The prevention efforts are important and should focus even more, also among the oldest-old, on additional modifiable risk factors such as maintaining muscle strength.
  • Hoikka, Marko; Länkimäki, Sami; Silfvast, Tom; Ala-Kokko, Tero I. (2016)
    Background: In Finland, calls for emergency medical services are prioritized by educated non-medical personnel into four categories-from A (highest risk) to D (lowest risk)-following a criteria-based national dispatch protocol. Discrepancies in triage may result in risk overestimation, leading to inappropriate use of emergency medical services units and to risk underestimation that can negatively impact patient outcome. To evaluate dispatch protocol accuracy, we assessed association between priority assigned at dispatch and the patient's condition assessed by emergency medical services on the scene using an early warning risk assessment tool. Methods: Using medical charts, clinical variables were prospectively recorded and evaluated for all emergency medical services missions in two hospital districts in Northern Finland during 1.1.2014-30.6.2014. Risk assessment was then re-categorized as low, medium, or high by calculating the National Early Warning Score (NEWS) based on the patients' clinical variables measured at the scene. Results: A total of 12,729 emergency medical services missions were evaluated, of which 616 (4.8%) were prioritized as A, 3193 (25.1%) as B, 5637 (44.3%) as C, and 3283 (25.8%) as D. Overall, 67.5% of the dispatch missions were correctly estimated according to NEWS. Of the highest dispatch priority missions A and B, 76.9 and 78.3%, respectively, were overestimated. Of the low urgency missions (C and D), 10.7% were underestimated; 32.0% of the patients who were assigned NEWS indicating high risk had initially been classified as low urgency C or D priorities at the dispatch. Discussion and conclusion: The present results show that the current Finnish medical dispatch protocol is suboptimal and needs to be further developed. A substantial proportion of EMS missions assessed as highest priority were categorized as lower risk according to the NEWS determined at the scene, indicating over-triage with the protocol. On the other hand, only a quarter of the high risk NEWS patients were classified as the highest priority at dispatch, indicating considerable under-triage with the protocol.
  • Zhang, Junfeng; Kuusisto, Elina; Nokelainen, Petri; Tirri, Kirsi (2020)
    Given that little is known how peer feedback reflects adolescents’ academic well-being in different cultures, this study investigates, by means of multiple-group structural equation modeling (SEM), the influence of peer feedback on the mindset and academic motivation of Chinese (N = 992) and Finnish (N = 870) students in the fourth to the ninth school grades. Within this investigation, we also explore the culture-invariant and culture-dependent nature of student feedback, mindset and academic motivation. The results indicate that the way students praise their peers in their feedback primes and modifies their mindsets and academic motivation. Person-focused praise reflects a fixed mindset and negative academic motivation (i.e., avoidance), whereas process-focused praise undermines negative academic motivation. The pupils in the two samples had growth mindsets. However, the Finnish students preferred to bestow neutral praise and to be more negative with regard to their academic motivation whereas the Chinese students favored process- and person-focused praise, the former reflecting not only their growth mindset but also their positive academic motivation (i.e., trying).