Browsing by Subject "DECLINE"

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  • Nivette, Amy E.; Zahnow, Renee; Aguilar, Raul; Ahven, Andri; Amram, Shai; Ariel, Barak; Burbano, Maria Jose Arosemena; Astolfi, Roberta; Baier, Dirk; Bark, Hyung-Min; Beijers, Joris E. H.; Bergman, Marcelo; Breetzke, Gregory; Concha-Eastman, I. Alberto; Curtis-Ham, Sophie; Davenport, Ryan; Diaz, Carlos; Fleitas, Diego; Gerell, Manne; Jang, Kwang-Ho; Kääriäinen, Juha; Lappi-Seppala, Tapio; Lim, Woon-Sik; Revilla, Rosa Loureiro; Mazerolle, Lorraine; Mesko, Gorazd; Pereda, Noemi; Peres, Maria F. T.; Poblete-Cazenave, Ruben; Rose, Simon; Svensson, Robert; Trajtenberg, Nico; van der Lippe, Tanja; Veldkamp, Joran; Perdomo, Carlos J. Vilalta; Eisner, Manuel P. (2021)
    The implementation of COVID-19 stay-at-home policies was associated with a considerable drop in urban crime in 27 cities across 23 countries. More stringent restrictions over movement in public space were predictive of larger declines in crime. The stay-at-home restrictions to control the spread of COVID-19 led to unparalleled sudden change in daily life, but it is unclear how they affected urban crime globally. We collected data on daily counts of crime in 27 cities across 23 countries in the Americas, Europe, the Middle East and Asia. We conducted interrupted time series analyses to assess the impact of stay-at-home restrictions on different types of crime in each city. Our findings show that the stay-at-home policies were associated with a considerable drop in urban crime, but with substantial variation across cities and types of crime. Meta-regression results showed that more stringent restrictions over movement in public space were predictive of larger declines in crime.
  • Hellstrand, Julia Ingrid Sofia; Nisén, Jessica; Myrskylä, Mikko (2020)
    The ongoing period fertility decline in the Nordic countries is particularly strong in Finland, where the total fertility rate (TFR) reached an all-time low of 1.41 in 2018. We analyse the decrease in Finland's TFR in 2010–17, and assess its consequences for cohort fertility using complementary approaches. Decomposition of this fertility decline shows that first births and women aged <30 are making the largest contributions. However, women aged 30–39 are also, for the first time in decades, experiencing a sustained fertility decline. Tempo adjustments to the TFR suggest that quantum change is part of the decline. Several forecasting methods indicate that cohort fertility is likely to decline from the long-lasting level of 1.85–1.95 to 1.75 or lower among women born in the mid-1980s. Without an exceptionally strong recovery in fertility, Finnish cohort fertility is likely to decline to levels currently observed among countries with very low fertility.
  • Kivimäki, Mika; Singh-Manoux, Archana; Batty, G. David; Sabia, Severine; Sommerlad, Andrew; Floud, Sarah; Jokela, Markus; Vahtera, Jussi; Beydoun, May A.; Suominen, Sakari B.; Koskinen, Aki; Väänänen, Ari; Goldberg, Marcel; Zins, Marie; Alfredsson, Lars; Westerholm, Peter J. M.; Knutsson, Anders; Nyberg, Solja T.; Sipilä, Pyry N.; Lindbohm, Joni V.; Pentti, Jaana; Livingston, Gill; Ferrie, Jane E.; Strandberg, Timo (2020)
    This cohort study examines the association of overall consumption of alcohol and resultant loss of consciousness with risk for dementia. Question Are alcohol-induced loss of consciousness and heavy weekly alcohol consumption associated with increased risk of future dementia? Findings In this multicohort study of 131x202f;415 adults, a 1.2-fold excess risk of dementia was associated with heavy vs moderate alcohol consumption. Those who reported having lost consciousness due to alcohol consumption, regardless of their overall weekly consumption, had a 2-fold increased risk of dementia compared with people who had not lost consciousness and were moderate drinkers. Meaning The findings of this study suggest that alcohol-induced loss of consciousness is a long-term risk factor for dementia among both heavy and moderate drinkers. Importance Evidence on alcohol consumption as a risk factor for dementia usually relates to overall consumption. The role of alcohol-induced loss of consciousness is uncertain. Objective To examine the risk of future dementia associated with overall alcohol consumption and alcohol-induced loss of consciousness in a population of current drinkers. Design, Setting, and Participants Seven cohort studies from the UK, France, Sweden, and Finland (IPD-Work consortium) including 131x202f;415 participants were examined. At baseline (1986-2012), participants were aged 18 to 77 years, reported alcohol consumption, and were free of diagnosed dementia. Dementia was examined during a mean follow-up of 14.4 years (range, 12.3-30.1). Data analysis was conducted from November 17, 2019, to May 23, 2020. Exposures Self-reported overall consumption and loss of consciousness due to alcohol consumption were assessed at baseline. Two thresholds were used to define heavy overall consumption: greater than 14 units (U) (UK definition) and greater than 21 U (US definition) per week. Main Outcomes and Measures Dementia and alcohol-related disorders to 2016 were ascertained from linked electronic health records. Results Of the 131x202f;415 participants (mean [SD] age, 43.0 [10.4] years; 80x202f;344 [61.1%] women), 1081 individuals (0.8%) developed dementia. After adjustment for potential confounders, the hazard ratio (HR) was 1.16 (95% CI, 0.98-1.37) for consuming greater than 14 vs 1 to 14 U of alcohol per week and 1.22 (95% CI, 1.01-1.48) for greater than 21 vs 1 to 21 U/wk. Of the 96x202f;591 participants with data on loss of consciousness, 10x202f;004 individuals (10.4%) reported having lost consciousness due to alcohol consumption in the past 12 months. The association between loss of consciousness and dementia was observed in men (HR, 2.86; 95% CI, 1.77-4.63) and women (HR, 2.09; 95% CI, 1.34-3.25) during the first 10 years of follow-up (HR, 2.72; 95% CI, 1.78-4.15), after excluding the first 10 years of follow-up (HR, 1.86; 95% CI, 1.16-2.99), and for early-onset (= 65 y: HR, 2.25; 95% CI, 1.38-3.66) dementia, Alzheimer disease (HR, 1.98; 95% CI, 1.28-3.07), and dementia with features of atherosclerotic cardiovascular disease (HR, 4.18; 95% CI, 1.86-9.37). The association with dementia was not explained by 14 other alcohol-related conditions. With moderate drinkers (1-14 U/wk) who had not lost consciousness as the reference group, the HR for dementia was twice as high in participants who reported having lost consciousness, whether their mean weekly consumption was moderate (HR, 2.19; 95% CI, 1.42-3.37) or heavy (HR, 2.36; 95% CI, 1.57-3.54). Conclusions and Relevance The findings of this study suggest that alcohol-induced loss of consciousness, irrespective of overall alcohol consumption, is associated with a subsequent increase in the risk of dementia.
  • Teräs, Tea; Rovio, Suvi; Pentti, Jaana; Head, Jenny; Kivimäki, Mika; Stenholm, Sari (2023)
    Study Objectives Sleep duration and difficulties have been shown to associate with cognitive function. This study examined how changes in sleep and in cognitive function are associated during retirement transition. Methods The study population consisted of 2980 Whitehall II study participants, who retired during the follow-up, whose sleep was queried, and cognitive function measured (inductive reasoning and verbal memory) before and after retirement (follow-up 16 years). Using the last information on sleep before and the first after retirement, participants were categorized into constantly without (59%), increasing (13%), decreasing (11%), and constantly with (18%) sleep difficulties; and constantly short (26%), increasing (19%), decreasing (8.5%), and constantly mid-range (47%) sleep duration. Change in cognitive function during retirement transition was examined by sleep change groups using linear regression analyses with generalized estimating equations. Results More pronounced decline in inductive reasoning during retirement transition was observed among participants with increasing sleep difficulties (-1.96, 95% CI -2.52 to -1.41) compared to those constantly without sleep difficulties (-1.25, 95% CI -1.52 to -0.98) and constantly with sleep difficulties (-1.26, 95% CI -1.75 to -0.92). Decreasing sleep difficulties (-0.64, 95% CI -0.86 to -0.43) were associated with a more pronounced decline in verbal memory when compared to constantly without sleep difficulties (-0.42, 95% CI -0.52 to -0.32) in post-retirement period. No statistically significant differences across sleep duration groups in cognitive function were observed. Conclusions Increasing and decreasing sleep difficulties may be associated with accelerated decline in cognitive function during retirement transition and post-retirement.
  • Ylilauri, Maija P. T.; Hantunen, Sari; Lonnroos, Eija; Salonen, Jukka T.; Tuomainen, Tomi-Pekka; Virtanen, Jyrki K. (2022)
    Purpose To investigate if dairy, meat, and fish intakes associate with dementia and cognitive performance. Methods We included 2497 dementia-free men from Eastern Finland, aged 42-60 years in 1984-1989 at the baseline examinations. Data on cognitive tests [Mini Mental State Exam (MMSE), trail making test (TMT), verbal fluency test (VFL), selective reminding test (SRT), and Russell's adaptation of the visual reproduction test (VRT)] at the 4-year re-examinations were available for 482 men and on the ApoE phenotype for 1259 men. Data on dementia events were obtained by linkage to national health registers. Diet was assessed with baseline 4-day food records. Cox regression and analysis of covariance were used for analyses. Results During a mean 22-year follow-up, 337 men had a dementia diagnosis. Among the foods, only cheese intake associated with dementia risk (hazard ratio in the highest vs. the lowest quartile = 0.72, 95% confidence interval = 0.52-0.99, P-trend = 0.05). In the cognitive tests, higher non-fermented dairy and milk intakes associated with worse verbal fluency (VFT). Higher processed red meat intake associated with worse verbal (SRT) and visual memory (VRT), whereas higher unprocessed red meat intake associated with better general cognitive functioning (MMSE) and processing speed and executive functioning (TMT). Higher fish intake associated with better verbal memory (SRT). Among APOE-epsilon 4 carriers, especially non-fermented dairy intake associated with higher risk of dementia outcomes, and higher fish intake indicated better cognitive performance. Conclusion Although higher intake of some food groups associated with cognitive performance, we found little evidence for associations with dementia risk.
  • FinnDiane Study Grp; SDRN Type 1 Bioresource Collabora; Colombo, Marco; Valo, Erkka; Sandholm, Niina; Groop, Per-Henrik; Forsblom, Carol; Colhoun, Helen M. (2019)
    Aims/hypothesis We aimed to identify a sparse panel of biomarkers for improving the prediction of renal disease progression in type 1 diabetes. Methods We considered 859 individuals recruited from the Scottish Diabetes Research Network Type 1 Bioresource (SDRNT1BIO) and 315 individuals from the Finnish Diabetic Nephropathy (FinnDiane) study. All had an entry eGFR between 30 and 75 ml min(-1)[1.73 m](-2), with those from FinnDiane being oversampled for albuminuria. A total of 297 circulating biomarkers (30 proteins, 121 metabolites, 146 tryptic peptides) were measured in non-fasting serum samples using the Luminex platform and LC electrospray tandem MS (LC-MS/MS). We investigated associations with final eGFR adjusted for baseline eGFR and with rapid progression (a loss of more than 3 ml min(-1)[1.73 m](-2) year(-1)) using linear and logistic regression models. Panels of biomarkers were identified using a penalised Bayesian approach, and their performance was evaluated through 10-fold cross-validation and compared with using clinical record data alone. Results For final eGFR, 16 proteins and 30 metabolites or tryptic peptides showed significant association in SDRNT1BIO, and nine proteins and five metabolites or tryptic peptides in FinnDiane, beyond age, sex, diabetes duration, study day eGFR and length of follow-up (all at p <10(-4)). The strongest associations were with CD27 antigen (CD27), kidney injury molecule 1 (KIM-1) and alpha 1-microglobulin. Including the Luminex biomarkers on top of baseline covariates increased the r(2) for prediction of final eGFR from 0.47 to 0.58 in SDRNT1BIO and from 0.33 to 0.48 in FinnDiane. At least 75% of the increment in r(2) was attributable to CD27 and KIM-1. However, using the weighted average of historical eGFR gave similar performance to biomarkers. The LC-MS/MS platform performed less well. Conclusions/interpretation Among a large set of associated biomarkers, a sparse panel of just CD27 and KIM-1 contains most of the predictive information for eGFR progression. The increment in prediction beyond clinical data was modest but potentially useful for oversampling individuals with rapid disease progression into clinical trials, especially where there is little information on prior eGFR trajectories.
  • Hakala, JO; Pahkala, K; Juonala, M; Salo, P; Kahonen, M; Hutri-Kahonen, N; Lehtimaki, T; Laitinen, TP; Jokinen, E; Taittonen, L; Tossavainen, P; Viikari, JSA; Raitakari, OT; Rovio, SP (2021)
    Background: Cardiovascular risk factors, such as high blood pressure, adverse serum lipids, and elevated body mass index in midlife, may harm cognitive performance. It is important to note that longitudinal accumulation of cardiovascular risk factors since childhood may be associated with cognitive performance already since childhood, but the previous evidence is scarce. We studied the associations of cardiovascular risk factors from childhood to midlife, their accumulation, and midlife cognitive performance. Methods: From 1980, a population-based cohort of 3596 children (3-18 years of age) have been repeatedly followed up for 31 years. Blood pressure, serum lipids, and body mass index were assessed in all follow-ups. Cardiovascular risk factor trajectories from childhood to midlife were identified using latent class growth mixture modeling. Cognitive testing was performed in 2026 participants 34 to 49 years of age using a computerized test. The associations of the cardiovascular risk factor trajectories and cognitive performance were studied for individual cardiovascular risk factors and cardiovascular risk factor accumulation. Results: Consistently high systolic blood pressure (beta=-0.262 SD [95% CI, -0.520 to -0.005]) and serum total cholesterol (beta=-0.214 SD [95% CI, -0.365 to -0.064]) were associated with worse midlife episodic memory and associative learning compared with consistently low values. Obesity since childhood was associated with worse visual processing and sustained attention (beta=-0.407 SD [95% CI, -0.708 to -0.105]) compared with normal weight. An inverse association was observed for the cardiovascular risk factor accumulation with episodic memory and associative learning (P for trend=0.008; 3 cardiovascular risk factors: beta=-0.390 SD [95% CI, -0.691 to -0.088]), with visual processing and sustained attention (P for trend Conclusions: Longitudinal elevated systolic blood pressure, high serum total cholesterol, and obesity from childhood to midlife were inversely associated with midlife cognitive performance. It is important to note that the higher the number of cardiovascular risk factors, the worse was the observed cognitive performance. Therefore, launching preventive strategies against cardiovascular risk factors beginning from childhood might benefit primordial promotion of cognitive health in adulthood.
  • Alenius, Minna; Koskinen, Sanna; Hallikainen, Ilona; Ngandu, Tiia; Lipsanen, Jari; Sainio, Päivi; Tuulio-Henriksson, Annamari; Hänninen, Tuomo (2019)
    Background/Aims: To detect cognitive decline in older adults, measures of verbal fluency and verbal memory are widely used. Less is known about performance in these measures in younger persons or according to education level and gender. We investigated cognitive performance according to age, education and gender among cognitively healthy adults aged 30-100 years. Methods: The study population comprised 4,174 cognitively healthy persons participating in the nationally representative Finnish Health 2011 survey. Cognitive assessment included verbal fluency, word list memory, word list recall and word list savings from the Consortium to Establish a Registry for Alzheimer's Disease neuropsychological battery. Results: Total variance in the cognitive test performance explained by age, education and gender varied from 12.3 to 31.2%. A decreasing trend in cognitive performance existed in all subtests by advancing age, with differences appearing between 50 and 55 years. Persons with the highest-education level performed best for all measures. For the participants <55 years, education explained part of the variance, while age and gender did not. Conclusions: When assessing cognition, age and education should be accounted for in more detail in research and clinical practice. Additionally, the cohort effect and its potential impact on the renewal cycle of future normative values for cognitive tests should be considered. (C) 2019 The Author(s) Published by S. Karger AG, Basel
  • Heldbjerg, Henning; Fox, Anthony D.; Lehikoinen, Aleksi; Sunde, Peter; Aunins, Ainars; Balmer, Dawn E.; Calvi, Gianpiero; Chodkiewicz, Tomasz; Chylarecki, Przemek; Escandell, Virginia; Foppen, Ruud; Gamero, Anna; Hristov, Iordan; Husby, Magne; Jiguet, Frederic; Kmecl, Primoz; Kalas, John A.; Lewis, Lesley J.; Lindstrom, Ake; Moshoj, Charlotte; Nellis, Renno; Paquet, Jean-Y; Portolou, Danae; Ridzon, Jozef; Schmid, Hans; Skorpilova, Jana; Szabo, Zoltan D.; Szep, Tibor; Teufelbauer, Norbert; Trautmann, Sven; van Turnhout, Chris; Vermouzek, Zdenek; Vorisek, Petr; Weiserbs, Anne (2019)
    The greatest loss of biodiversity in the EU has occurred on agricultural land. The Common Starling (Sturnus vulgaris) is one of the many numerous and widespread European farmland breeding bird species showing major population declines linked to European agricultural intensification. Here we present results based on monitoring data collected since 1975 in 24 countries to examine the influence of changing extent of grassland and cattle abundance (based on results of earlier studies showing the importance of lowland cattle grazed grassland for the species), wintering provenance and temperature on national breeding population trends of Starlings across Europe. Positive Starling population trends in Central-East Europe contrast with negative trends in North and West Europe. Based on this indicative approach, we found some support for the importance of cattle stock and no support for grassland, temperature or wintering provenance to explain Starling population trends in Europe. However, we acknowledge such a European-wide analysis may conceal regional differences in responses and suggest that currently accessible national land use datamight be insufficient to describe the detailed current changes in animal husbandry and grassland management that may be responsible for changes in food availability and hence breeding Starling abundance and their differences across Europe. Reviewing results from local studies relating Starling population trends to local agricultural change offer contradictory results, suggesting complex interacting processes at work. We recommend combining national datasets on demography, land-use/agricultural practices and from autecological research to better explain the reasons for contrasting Starling trends across Europe, to enable us to predict how changing agriculture will affect Starlings and potentially suggest mitigation measures to restore local populations where possible.
  • Vähämurto, Lauri; Pahkala, Katja; Magnussen, Costan G.; Hutri-Kähönen, Nina; Kähönen, Mika; Laitinen, Tomi; Taittonen, Leena; Tossavainen, Päivi; Lehtimäki, Terho; Jokinen, Eero; Telama, Risto; Rönnemaa, Tapani; Viikari, Jorma; Juonala, Markus; Raitakari, Olli T. (2019)
    Background and aims: In the 1960s and 1970s, Finland, mortality due to coronary heart disease (CHD) was over 30% higher among Finns residing in the east of the country compared with those residing in the west. Today, CHD mortality remains 20% higher among eastern Finns. The higher incidence of CHD mortality among eastern Finns has largely been explained by higher risk factor levels. Using a unique longitudinal cohort, we aimed to determine if participants who resided in eastern Finland during childhood had higher CHD risk factors in adulthood and from childhood to adulthood. Methods: The study population included 2063 participants of the Cardiovascular Risk in Young Finns Study, born during the period 1962-1977, with risk factor data available from baseline (1980) when participants were aged 3-18 years, and had risk factor data collected again in adulthood (2011) when aged 34-49 years. Results: Adult CHD risk factor profile was similar for those who resided in eastern or western Finland in childhood. Over life-course from 1980 to 2011, those subjects with childhood residency in eastern Finland had, on average, higher systolic (p = 0.006) and diastolic (p = 0.0009) blood pressures, total (p = 0.01) and LDLcholesterol (p = 0.01), triglycerides (p = 0.04), apoB (p = 0.02), and serum glucose (p Conclusions: Our sample of adult Finns aged 34-49 years had a similar CHD risk factor profile irrespective of whether they resided in eastern or western Finland during their childhood. However, when considering participants risk factor profiles over a 31-year period, those who resided in eastern Finland in childhood were associated with a less favorable CHD risk factor profile than those who resided in western Finland in childhood. The observed differences suggest that future CHD mortality might remain higher in eastern Finland compared with western Finland.
  • Lehtisalo, Jenni; Lindstrom, Jaana; Ngandu, Tiia; Kivipelto, Miia; Ahtiluoto, Satu; Ilanne-Parikka, Pirjo; Keinanen-Kiukaanniemi, Sirkka; Eriksson, Johan G.; Uusitupa, Matti; Tuomilehto, Jaakko; Luchsinger, Jose A.; Finnish Diabet Prevention Study DP (2016)
    BackgroundType 2 diabetes is linked with cognitive dysfunction and dementia in epidemiological studies, but these observations are limited by lack of data on the exact timing of diabetes onset. We investigated diabetes, dysglycaemia, and cognition in the Finnish Diabetes Prevention Study, in which the timing and duration of diabetes are well documented. MethodsThe Finnish Diabetes Prevention Study comprised middle-aged, overweight participants with impaired glucose tolerance but no diabetes at baseline (n=522), randomized to lifestyle intervention or a control group. After an intervention period (mean duration 4years) and follow-up (additional 9years), cognitive assessment with the CERAD test battery and Trail Making Test A (TMT) was executed twice within a 2-year interval. Of the 364 (70%) participants with cognitive assessments, 171 (47%) had developed diabetes. ResultsCognitive function did not differ between those who developed diabetes and those who did not. Lower mean 2-h glucose at an oral glucose tolerance test (OGTT) and HbA(1C) during the intervention period predicted better performance in the TMT (p=0.012 and 0.024, respectively). Those without diabetes or with short duration of diabetes improved in CERAD total score between the two assessments (p=0.001) whereas those with long duration of diabetes did not (p=0.844). ConclusionsBetter glycemic control among persons with baseline impaired glucose tolerance predicted better cognitive performance 9years later in this secondary analysis of the Finnish Diabetes Prevention Study population. In addition, learning effects in cognitive testing were not evident in people with long diabetes duration. Copyright (c) 2015 John Wiley & Sons, Ltd.
  • Lehtisalo, Jenni; Levälahti, Esko; Lindström, Jaana; Hänninen, Tuomo; Paajanen, Teemu; Peltonen, Markku; Antikainen, Riitta; Laatikainen, Tiina; Strandberg, Timo; Soininen, Hilkka; Tuomilehto, Jaakko; Kivipelto, Miia; Ngandu, Tiia (2019)
    Introduction: Association between healthy diet and better cognition is well established, but evidence is limited to evaluate the effect of dietary changes adopted in older age. Methods: We investigated the role of dietary changes in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) with 1260 at-risk participants (60-77 years) who were randomized to intensive multidomain intervention (including dietary counseling) or regular health advice for 2 years. Parallel process latent growth curves of adherence to dietary recommendations and cognitive performance were analyzed. Results: Adherence to healthy diet at baseline predicted improvement in global cognition, regardless of intervention allocation (P = .003). Dietary improvement was associated with beneficial changes in executive function, especially in the intervention group (P = .008; P = .051 for groups combined). Discussion: Dietary changes initiated during the intervention were related to changes in executive function in 2 years. Long-term diet appeared more influential for global cognition. (C) 2018 The Authors. Published by Elsevier Inc.
  • Garcia-Larsen, Vanessa; Thawer, Narjis; Charles, David; Cassidy, Aedin; van Zele, Thibaut; Thilsing, Trine; Ahlström, Matti; Haahtela, Tari; Keil, Thomas; Matricardi, Paolo M.; Brozek, Grzegorz; Kowalski, Marek L.; Makowska, Joanna; Nizankowska-Mogilnicka, Ewa; Rymarczyk, Barbara; Loureiro, Carlos; Bom, Ana Todo; Bachert, Claus; Forsberg, Bertil; Janson, Christer; Toren, Kjell; Potts, James F.; Burney, Peter G. J. (2018)
    Background: Flavonoids exert anti-inflammatory properties and modulate oxidative stress in vitro, suggesting a protective effect on lung function, but epidemiological studies examining this association are scarce. Methods: A stratified random sample was drawn from the GA(2)LEN screening survey, in which 55,000 adults aged 15 to 75 answered a questionnaire on respiratory symptoms. Post-bronchodilator spirometry was obtained from 2850 subjects. Forced vital capacity (FVC), the ratio between the forced exhaled volume in 1 second (FEV1) and FVC (FEV1/FVC), FVC below lower limit of normal (FVC <LLN), and FEV1/FVC <LLN were calculated. Intake of the six main subclasses of flavonoids was estimated using the GA(2)LEN Food Frequency Questionnaire. Adjusted associations between outcomes and each subclass of flavonoids were examined with multivariate regressions. Simes' procedure was used to test for multiple comparisons. Results: A total of 2599 subjects had valid lung function and dietary data. A lower prevalence of FVC <LLN (airway restriction) was observed in those with higher total flavonoid (adjusted odds ratio (aOR), higher vs. lowest quintile intake 0.58; 95% Confidence Interval (CI) 0.36, 0.94), and pro-anthocyanidin intakes (aOR 0.47; 95% CI 0.27, 0.81). A higher FEV1/FVC was associated with higher intakes of total flavonoids and pro-anthocyanidins (adjusted correlation coefficient (a -coeff 0.33; 0.10, 0.57 and a -coeff 0.44; 95% CI 0.19, 0.69, respectively). After Simes' procedure, the statistical significance of each of these associations was attenuated but remained below 0.05, with the exception of total flavonoids and airway restriction. Conclusions: This population-based study in European adults provides cross-sectional evidence of a positive association of total flavonoid intake and pro-anthocyanidins and ventilatory function, and a negative association with spirometric restriction in European adults.
  • Niemi, Hannele; Niu, Shuanghong Jenny (2021)
    The aim of this study was to uncover how digital storytelling advances students’ self-efficacy in mathematics learning and what kinds of learning experiences contribute to self-efficacy. Four Chinese classes with 10- to 11-year-old students (N = 121) participated in the project. The mathematics learning theme was geometry. Quantitative data was collected with questionnaires. The qualitative data was based on teachers’ and students’ interviews and observations. Both data sets showed that the students’ self-efficacy increased significantly during the project. The most important mediator was students’ perception of the meaningfulness of mathematics learning; digital storytelling enhanced the students’ ability to see mathematics learning as useful. They became more confident that they could learn mathematics and understand what they had learned. They also felt more confident in talking with their classmates about mathematical concepts. The role of self-efficacy was twofold: it supported students’ learning during the project and it increased due to meaningful mathematics learning experiences.
  • Nisen, Jessica; Klüsener, Sebastian; Dahlberg, Johan; Dommermuth, Lars; Jasilioniene, Aiva; Kreyenfeld, Michaela; Lappegard, Trude; Li, Peng; Martikainen, Pekka; Neels, Karel; Riederer, Bernhard; te Riele, Saskia; Szabó, Laura; Trimarchi, Alessandra; Viciana, Francisco; Wilson, Ben; Myrskylä, Mikko (2021)
    Educational differences in female cohort fertility vary strongly across high-income countries and over time, but knowledge about how educational fertility differentials play out at the sub-national regional level is limited. Examining these sub-national regional patterns might improve our understanding of national patterns, as regionally varying contextual conditions may affect fertility. This study provides for the first time for a large number of European countries a comprehensive account of educational differences in the cohort fertility rate (CFR) at the sub-national regional level. We harmonise data from population registers, censuses, and large-sample surveys for 15 countries to measure women's completed fertility by educational level and region of residence at the end of the reproductive lifespan. In order to explore associations between educational differences in CFRs and levels of economic development, we link our data to regional GDP per capita. Empirical Bayesian estimation is used to reduce uncertainty in the regional fertility estimates. We document an overall negative gradient between the CFR and level of education, and notable regional variation in the gradient. The steepness of the gradient is inversely related to the economic development level. It is steepest in the least developed regions and close to zero in the most developed regions. This tendency is observed within countries as well as across all regions of all countries. Our findings underline the variability of educational gradients in women's fertility, suggest that higher levels of development may be associated with less negative gradients, and call for more in-depth sub-national-level fertility analyses by education.
  • Arroyo-Quiroz, Carmen; o'flaherty, Martin; Guzman-Castillo, Maria; Capewell, Simon; Chuquiure-Valenzuela, Eduardo; Jerjes-Sanchez, Carlos; Barrientos-Gutierrez, Tonatiuh (2020)
    Background Mexico is still in the growing phase of the epidemic of coronary heart disease (CHD), with mortality increasing by 48% since 1980. However, no studies have analyzed the drivers of these trends. We aimed to model CHD deaths between 2000 and 2012 in Mexico and to quantify the proportion of the mortality change attributable to advances in medical treatments and to changes in population-wide cardiovascular risk factors. Methods We performed a retrospective analysis using the previously validated IMPACT model to explain observed changes in CHD mortality in Mexican adults. The model integrates nationwide data at two-time points (2000 and 2012) to quantify the effects on CHD mortality attributable to changes in risk factors and therapeutic trends. Results From 2000 to 2012, CHD mortality rates increased by 33.8% in men and by 22.8% in women. The IMPACT model explained 71% of the CHD mortality increase. Most of the mortality increases could be attributed to increases in population risk factors, such as diabetes (43%), physical inactivity (28%) and total cholesterol (24%). Improvements in medical and surgical treatments together prevented or postponed 40.3% of deaths; 10% was attributable to improvements in secondary prevention treatments following MI, while 5.3% to community heart failure treatments. Conclusions CHD mortality in Mexico is increasing due to adverse trends in major risk factors and suboptimal use of CHD treatments. Population-level interventions to reduce CHD risk factors are urgently needed, along with increased access and equitable distribution of therapies
  • Buechley, Evan R.; Santangeli, Andrea; Girardello, Marco; Neate-Clegg, Montague H.C.; Oleyar, Dave; McClure, Christopher J.W.; Şekercioğlu, Çagan H. (2019)
    Abstract Aim Raptors serve critical ecological functions, are particularly extinction-prone and are often used as environmental indicators and flagship species. Yet, there is no global framework to prioritize research and conservation actions on them. We identify for the first time the factors driving extinction risk and scientific attention on raptors and develop a novel research and conservation priority index (RCPI) to identify global research and conservation priorities. Location Global. Methods We use random forest models based on ecological traits and extrinsic data to identify the drivers of risk and scientific attention in all raptors. We then map global research and conservation priorities. Lastly, we model where priorities fall relative to country-level human social indicators. Results Raptors with small geographic ranges, scavengers, forest-dependent species and those with slow life histories are particularly extinction-prone. Research is extremely biased towards a small fraction of raptor species: 10 species (1.8% of all raptors) account for one-third of all research, while one-fifth of species have no publications. Species with small geographic ranges and those inhabiting less developed countries are greatly understudied. Regions of Latin America, Africa and Southeast Asia are identified as particularly high priority for raptor research and conservation. These priorities are highly concentrated in developing countries, indicating a global mismatch between priorities and capacity for research and conservation. Main conclusions A redistribution of scientific attention and conservation efforts towards developing tropical countries and the least-studied, extinction-prone species is critical to conserve raptors and their ecological functions worldwide. We identify clear taxonomic and geographic research and conservation priorities for all raptors, and our methodology can be applied across other taxa to prioritize scientific investment.
  • GBD 2016 Dementia Collaborators; Nichols, Emma; Szoeke, Cassandra E. I.; Vollset, Stein Emil; Kivimäki, Mika; Meretoja, Atte (2019)
    Background The number of individuals living with dementia is increasing, negatively affecting families, communities, and health-care systems around the world. A successful response to these challenges requires an accurate understanding of the dementia disease burden. We aimed to present the first detailed analysis of the global prevalence, mortality, and overall burden of dementia as captured by the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2016, and highlight the most important messages for clinicians and neurologists. Methods GBD 2016 obtained data on dementia from vital registration systems, published scientific literature and surveys, and data from health-service encounters on deaths, excess mortality, prevalence, and incidence from 195 countries and territories from 1990 to 2016, through systematic review and additional data-seeking efforts. To correct for differences in cause of death coding across time and locations, we modelled mortality due to dementia using prevalence data and estimates of excess mortality derived from countries that were most likely to code deaths to dementia relative to prevalence. Data were analysed by standardised methods to estimate deaths, prevalence, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs; computed as the sum of YLLs and YLDs), and the fractions of these metrics that were attributable to four risk factors that met GBD criteria for assessment (high body-mass index [BMI], high fasting plasma glucose, smoking, and a diet high in sugarsweetened beverages). Findings In 2016, the global number of individuals who lived with dementia was 43.8 million (95% uncertainty interval [UI] 3 7. 8-51.0), increased from 20.2 million (17. 4-23 5) in 1990. This increase of 117% (95% UI 114-121) contrasted with a minor increase in age-standardised prevalence of 1.7% (1.0-2.4), from 701 cases (95% UI 602-815) per 100 000 population in 1990 to 712 cases (614-828) per 100 000 population in 2016. More women than men had dementia in 2016 (27.0 million, 95% UI 23 .3-31. 4, vs 16.8 million, 14.4-19.6), and dementia was the fifth leading cause of death globally, accounting for 2.4 million (95% UI 2.1-2.8) deaths. Overall, 28.8 million (95% UI 24. 5-34. 0) DALYs were attributed to dementia; 6.4 million (95% UI 3 .4-10. 5) of these could be attributed to the modifiable GBD risk factors of high BMI, high fasting plasma glucose, smoking, and a high intake of sugar-sweetened beverages. Interpretation The global number of people living with dementia more than doubled from 1990 to 2016, mainly due to increases in population ageing and growth. Although differences in coding for causes of death and the heterogeneity in case-ascertainment methods constitute major challenges to the estimation of the burden of dementia, future analyses should improve on the methods for the correction of these biases. Until breakthroughs are made in prevention or curative treatment, dementia will constitute an increasing challenge to health-care systems worldwide. (C) 2018 The Author(s). Published by Elsevier Ltd.
  • Lindgren, Noora; Kaprio, Jaakko; Rinne, Juha; Vuoksimaa, Eero (2019)
    Objective To investigate the effect of familial risk for dementia on verbal learning by comparing cognitively healthy twins who had demented co-twins with cognitively healthy twins who had cognitively healthy co-twins. Methods 4367 twins aged >= 65 years including 1375 twin pairs (533 monozygotic (MZ), 823 dizygotic (DZ) and 19 unknown zygosity pairs) from a population-based Finnish Twin Cohort participated in a cross-sectional telephone assessment for dementia and in a single free recall trial of a 10-item word list. Results Cognitively healthy twins with demented co-twins (n=101 pairs) recalled less words than cognitively healthy twins with cognitively healthy co-twins (n=770 pairs) after adjusting for age, sex and education, B=-0.44, 95% C I (-0.73 to -0.14), p=0.003. The effect size was similar in MZ (n=31) twins (3.88 vs 4.29 words, B=-0.41, 95% C I (-0.96 to 0.13)) and DZ (n=66) twins (3.70 vs 4.17 words, B=-0.47, 95% C I (-0.84 to -0.10)). The heritability estimate of immediate recall (IR) was 0.37, 95% C I (0.21 to 0.43). Conclusions The results demonstrate that familial risk for dementia is reflected in the IR performance of cognitively healthy older persons. The finding of poorer IR performance in non-affected siblings compared with the general population, together with substantial heritability of IR, supports IR as a useful endophenotype for molecular genetic studies of dementia.