Browsing by Subject "DETERMINANTS"

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  • Mäkitie, Antti; Kamali, Alexander; Mroueh, Rayan; Lindford, Andrew; Koivunen, Petri; Autio, Timo; Lassus, Patrik; Halle, Martin; Bäck, Leif; Palmgren, Björn; Hammarstedt-Nordenvall, Lalle (2020)
    Background and aims: Stage II cancer of the tongue is mostly managed surgically both locally and regionally. However, indications for postoperative radiotherapy and reconstructive options vary between centers. This paper aims to describe differences in treatment in a geographically homogenous cohort. Methods: A retrospective comparison was made between two cohorts of clinical T2N0 tongue cancer from Finland and Sweden. The Finnish cohort included 75 patients and the Swedish 54. All patients had curative intent of treatment and no previous head and neck cancer. Data analyzed consisted of pathological stage, size and thickness of tumor, frequency of reconstruction, radiotherapy delivered, and survival. Results: The Finnish cohort included a higher proportion of patients managed with reconstructive surgery (67%) than the Swedish cohort (0%), p <.00001. More patients were treated with postoperative radiotherapy (84%) in the Swedish cohort than in the Finnish (54%), p <.0002. The Finnish cohort had a higher level of survival and included more frequent downstaging (cTNM to pTNM).
  • Minviel, Jean Joseph; Sipiläinen, Timo (2021)
    This article introduces a dynamic stochastic frontier analysis (SFA) framework with unobserved heterogeneity, persistent and transient inefficiency effects, based on recent advances in the SFA literature. The newly developed dynamic frontier model is applied on a sample of French crop-livestock farms. The estimates provide useful insights for the estimation of the technical efficiency scores as well as for the analysis of the associations of contextual drivers, such as public subsidies and indebtedness, with technical efficiency.
  • Elovainio, Marko; Hakulinen, Christian; Pulkki-Raback, Laura; Juonala, Markus; Raitakari, Olli T. (2020)
    We modeled early psychosocial risks as a network of interconnected variables to study their associations with later depressive symptoms and cardiometabolic outcomes. The participants were a nationally representative sample of 2580 men and women aged 3-18 years in 1980. Their parents reported the psychosocial risks in 1980, including the following: (1) child-specific life events, (2) parental health behavior, (3) parental socioeconomic status, and (4) parental psychological problems. Adulthood depressive symptoms and cardiometabolic outcomes were measured in 2007-2012. The most central risks (most number of connections to other risks) were socioeconomic risks that also predicted health outcomes more consistently than others.
  • Nuotio, Marja-Liisa; Pervjakova, Natalia; Joensuu, Anni; Karhunen, Ville; Hiekkalinna, Tero; Milani, Lili; Kettunen, Johannes; Järvelin, Marjo-Riitta; Jousilahti, Pekka; Metspalu, Andres; Salomaa, Veikko; Kristiansson, Kati; Perola, Markus (2020)
    The role of metabolic syndrome (MetS) as a preceding metabolic state for type 2 diabetes and cardiovascular disease is widely recognised. To accumulate knowledge of the pathological mechanisms behind the condition at the methylation level, we conducted an epigenome-wide association study (EWAS) of MetS and its components, testing 1187 individuals of European ancestry for approximately 470 000 methylation sites throughout the genome. Methylation site cg19693031 in gene TXNIP -previously associated with type 2 diabetes, glucose and lipid metabolism, associated with fasting glucose level (P=1.80x10(-8)). Cg06500161 in gene ABCG1 associated both with serum triglycerides (P=5.36x10(-9)) and waist circumference (P=5.21x10(-9)). The previously identified type 2 diabetes-associated locus cg08309687 in chromosome 21 associated with waist circumference for the first time (P=2.24x10(-7)). Furthermore, a novel HDL association with cg17901584 in chromosome 1 was identified (P=7.81x10(-8)). Our study supports previous genetic studies of MetS, finding that lipid metabolism plays a key role in pathology of the syndrome. We provide evidence regarding a close interplay with glucose metabolism. Finally, we suggest that in attempts to identify methylation loci linking separate MetS components, cg19693031 appears to represent a strong candidate.
  • Skarstein, Frode; Wolff, Lili-Ann (2020)
    The field of geography is important for any sustainability education. The aim of geography education is to enable students to understand the environment, its influence on human activity, and how humans influence the environment. In this article we present a study on how the interplay between the three pillars of sustainability thinking (environment, society and economy) play out on smaller and larger scales of time, space and multitude in geography education. In this paper, we argue that central issues in high quality sustainability education in geography relates to students’ deeper grasp of how to shift between magnitudes of time, space and multitude patterns. We show how an appreciation of many core issues in sustainability education require students to understand and traverse different magnitudes of the scalable concepts of time, space and multitude. Furthermore, we argue and exemplify how common sustainability misconceptions arise due to an inability to make the cognitive shift between relevant magnitudes on these scalable concepts. Finally, we briefly discuss useful educational approaches to mediating this problem, including the use of digital tools in order to allow geography teachers to facilitate the students’ better understanding of different magnitudes of slow, fast, small and large scale entities and processes.
  • Lankinen, Petteri; Laasik, Raul; Kivimäki, Mika; Aalto, Ville; Saltychev, Mikhail; Vahtera, Jussi; Mäkelä, Keijo (2019)
    Background: Osteoarthritis is one of the leading causes of disability in working-age patients. The total number of working-age patients undergoing total-knee arthroplasty (TKA) is continuously increasing. The purpose of this study was to identify predictive factors related to general health, health risk behaviors and socioeconomic status influencing the rate of return to work after a TKA. Methods: Overall there were 151,901 patients included in the Finnish Public Sector (FPS) study. The response rate varied between 65 and 73% during the study period. We used Cox proportional hazard models to examine patient-related predictive factors that may influence the rate of return to work after TKA in a cohort of patients (n = 452; n = 362 female; mean age 56.4 years). Predictive factors were measured on average 3.6 years before the operation. Results: Of the patients, 87% returned to work within one year after TKA at a mean of 116 calendar days. In multivariate analysis, patients at sick-leave 30 days of sick-leave. Compared with patients in manual work, those in higher or lower level non-manual work showed a 2.6-fold (1.95-3.52) and 1.5-fold (1.15-1.92) increased probability of returning to work. Age, sex, health risk behaviors, obesity, physical comorbidities, common mental disorders, and other studied health-related factors were not associated with the rate of return to work. Conclusions: Non-manual job, good self-rated general health and preoperative sick leave
  • Zhang, Ge; Bacelis, Jonas; Lengyel, Candice; Teramo, Kari; Hallman, Mikko; Helgeland, Oyvind; Johansson, Stefan; Myhre, Ronny; Sengpiel, Verena; Njolstad, Pal Rasmus; Jacobsson, Bo; Muglia, Louis (2015)
    Background Observational epidemiological studies indicate that maternal height is associated with gestational age at birth and fetal growth measures (i.e., shorter mothers deliver infants at earlier gestational ages with lower birth weight and birth length). Different mechanisms have been postulated to explain these associations. This study aimed to investigate the casual relationships behind the strong association of maternal height with fetal growth measures (i.e., birth length and birth weight) and gestational age by a Mendelian randomization approach. Methods and Findings We conducted a Mendelian randomization analysis using phenotype and genome-wide single nucleotide polymorphism (SNP) data of 3,485 mother/infant pairs from birth cohorts collected from three Nordic countries (Finland, Denmark, and Norway). We constructed a genetic score based on 697 SNPs known to be associated with adult height to index maternal height. To avoid confounding due to genetic sharing between mother and infant, we inferred parental transmission of the height-associated SNPs and utilized the haplotype genetic score derived from nontransmitted alleles as a valid genetic instrument for maternal height. In observational analysis, maternal height was significantly associated with birth length (p = 6.31 x 10(-9)), birth weight (p = 2.19 x 10(-15)), and gestational age (p = 1.51 x 10(-7)). Our parental-specific haplotype score association analysis revealed that birth length and birth weight were significantly associated with the maternal transmitted haplotype score as well as the paternal transmitted haplotype score. Their association with the maternal nontransmitted haplotype score was far less significant, indicating a major fetal genetic influence on these fetal growth measures. In contrast, gestational age was significantly associated with the nontransmitted haplotype score (p = 0.0424) and demonstrated a significant (p = 0.0234) causal effect of every 1 cm increase in maternal height resulting in similar to 0.4 more gestational d. Limitations of this study include potential influences in causal inference by biological pleiotropy, assortative mating, and the nonrandom sampling of study subjects. Conclusions Our results demonstrate that the observed association between maternal height and fetal growth measures (i.e., birth length and birth weight) is mainly defined by fetal genetics. In contrast, the association between maternal height and gestational age is more likely to be causal. In addition, our approach that utilizes the genetic score derived from the nontransmitted maternal haplotype as a genetic instrument is a novel extension to the Mendelian randomization methodology in casual inference between parental phenotype (or exposure) and outcomes in offspring.
  • Janssen, Niels; Handels, Ron L.; Wimo, Anders; Antikainen, Riitta; Laatikainen, Tiina; Soininen, Hilkka; Strandberg, Timo; Tuomilehto, Jaakko; Kivipelto, Miia; Evers, Silvia M. A. A.; Verhey, Frans R. J.; Ngandu, Tiia (2022)
    Background: The association between health-related quality of life (HRQoL) and care costs in people at risk for cognitive decline is not well understood. Studying this association could reveal the potential benefits of increasing HRQoL and reducing care costs by improving cognition. Objective: In this exploratory data analysis we investigated the association between cognition, HRQoL utilities and costs in a well-functioning population at risk for cognitive decline. Methods: An exploratory data analysis was conducted using longitudinal 2-year data from the FINGER study (n= 1,120). A change score analysis was applied using HRQoL utilities and total medical care costs as outcome. HRQoL utilities were derived from the Short Form Health Survey-36 (SF-36). Total care costs comprised visits to a general practitioner, medical specialist, nurse, and days at hospital. Analyses were adjusted for activities of daily living (ADL) and depressive symptoms. Results: Although univariable analysis showed an association between cognition and HRQoL utilities, multivariable analysis showed no association between cognition, HRQoL utilities and total care costs. A one-unit increase in ADL limitations was associated with a -0.006 (p Conclusion: The level of cognition in people at-risk for cognitive decline does not seem to be associated with HRQoL utilities. Future research should examine the level at which cognitive decline starts to affect HRQoL and care costs. Ideally, this would be done by means of cross-validation in populations with various stages of cognitive functioning and decline.
  • Leppänen, Marja H.; Sääksjärvi, Katri; Vepsäläinen, Henna; Ray, Carola; Hiltunen, Pauliina; Koivusilta, Leena; Erkkola, Maijaliisa; Sajaniemi, Nina; Roos, Eva (2020)
    Screen time is increasing rapidly in young children. The aim of this study was to examine associations of long-term stress and temperament with screen time in Finnish preschool children and the moderating role of socioeconomic status. Cross-sectional DAGIS data were utilized. Long-term stress was assessed using hair cortisol concentration, indicating values of the past 2 months. Temperament was reported by the parents using the Children's Behavior Questionnaire (the Very Short Form), and three broad temperament dimensions were constructed: surgency, negative affectivity, and effortful control. Screen time was reported by the parents over 7 days. The highest education level in the household was used as an indicator of socioeconomic status. In total, 779 children (mean age, 4.7 +/- 0.9 years, 52% boys) were included in the study. Of the temperament dimensions, a higher effortful control was associated with less screen time (B = - 6.70, p = 0.002). There was no evidence for an association between hair cortisol concentration and screen time nor a moderating role of socioeconomic status in the associations (p > 0.05). Conclusion: Our findings indicate that preschool children with a higher score in effortful control had less screen time. Because effortful control reflects general self-regulatory abilities, promoting these skills may be effective in reducing screen time in young children.What is Known: center dot Screen time has increased rapidly during the last decades, and higher screen time has been linked with numerous adverse health consequences in children. center dot There are no previous studies investigating associations of long-term stress and temperament with screen time in young children.What is New: center dot Of the temperament dimensions, effortful control was associated with higher screen time in preschool children, but there was no association found between long-term stress and screen time. center dot Since effortful control reflects general self-regulatory abilities, promoting these skills may be effective in reducing screen time in young children.
  • Maki, Jenni M.; Kirjavainen, Pirkka V.; Täubel, Martin; Piippo-Savolainen, Eija; Backman, Katri; Hyvarinen, Anne; Tuoresmaki, Pauli; Jayaprakash, Balamuralikrishna; Heinrich, Joachim; Herberth, Gunda; Standl, Marie; Pekkanen, Juha; Karvonen, Anne M. (2021)
    Living with dogs appears to protect against allergic diseases and airway infections, an effect possibly linked with immunomodulation by microbial exposures associated with dogs. The aim of this study was to characterize the influence of dog ownership on house dust microbiota composition. The bacterial and fungal microbiota was characterized with Illumina MiSeq sequencing from floor dust samples collected from homes in a Finnish rural-suburban (LUKAS2, N=182) birth cohort, and the results were replicated in a German urban (LISA, N=284) birth cohort. Human associated bacteria variable was created by summing up the relative abundances of five bacterial taxa. Bacterial richness, Shannon index and the relative abundances of seven bacterial genera, mostly within the phyla Proteobacteria and Firmicutes, were significantly higher in the dog than in the non-dog homes, whereas the relative abundance of human associated bacteria was lower. The results were largely replicated in LISA. Fungal microbiota richness and abundance of Leucosporidiella genus were higher in dog homes in LUKAS2 and the latter association replicated in LISA. Our study confirms that dog ownership is reproducibly associated with increased bacterial richness and diversity in house dust and identifies specific dog ownership-associated genera. Dogs appeared to have more limited influence on the fungal than bacterial indoor microbiota.
  • Sääksjärvi, Katri; Lehto, Elviira; Lehto, Reetta; Suhonen, Eira; Leppänen, Marja; Michels, Nathalie; Saha, Mari; Ray, Carola; Vepsäläinen, Henna; Pajulahti, Riikka; Heiman-Lindh, Anu; Sainio, Taina; Erkkola, Maijaliisa; Roos, Eva; Sajaniemi, Nina (2021)
    Associations between hair cortisol concentration (HCC), diurnal salivary cortisol (sCort) and alpha-amylase (sAA), and temperament dimensions were examined among 3-6-year-old Finnish children (n = 833). Children's hair samples were collected at preschool, while parents collected five saliva samples from children during one weekend day and completed a questionnaire assessing child's temperament dimensions i.e. surgency, negative affectivity, and effortful control (HCC, n = 677; AUCg of sAA, n = 380; AUCg of sCort, n = 302; temperament dimensions, n = 751). In linear regression analysis, diurnal sCort associated positively with HCC, the association persisting after adjustments (beta 0.31, 95% CI 0.20-0.42). In logistic regression analysis, increasing scores in effortful control associated with higher likelihood of having high HCC (OR 1.47, 95% CI 1.07-2.03), the association slightly attenuating to non-significant after adjustments. Otherwise, no clear indication for associations between temperament and stress-related biomarkers were found.
  • Tandon, Anushree; Dhir, Amandeep; Kaur, Puneet; Kushwah, Shiksha; Salo, Jari (2020)
    Consumers' rising interest in organic food has drawn the attention of the academic community. The literature on the topic is growing, but it mostly focuses either on the acceptance of or resistance toward organic food. However, marketing scholars argue that the development of more in-depth insights into consumers' reasoning processes, and especially the roles of values and context-specific reasons are needed. The present study bridges this gap by utilizing the novel behavioral reasoning theory (BRT) framework. Cross-sectional data from 307 consumers and non-consumers from India were collected to investigate associations among attitudes, reasoning, value, and purchase intentions. This research studies the moderating role of food safety concerns and buying involvement. Additionally, the mediating role of reasons and attitudes is examined. The results suggest that value was positively associated with reasons (for and against), whereas attitude and reasons (for) resulted in favorable purchase intentions. Reasons (for and against) fully mediate the association between value and attitude. Furthermore, attitude partially mediates the association of reasons and purchase intentions. The moderation effect was not found for food safety concerns, but a limited effect among studied associations was observed for buying involvement. The findings raise significant implications for marketers and policymakers.
  • Qiu, Tianyi; Yang, Yiyan; Qiu, Jingxuan; Huang, Yang; Xu, Tianlei; Xiao, Han; Wu, Dingfeng; Zhang, Qingchen; Zhou, Chen; Zhang, Xiaoyan; Tang, Kailin; Xu, Jianqing; Cao, Zhiwei (2018)
    Major challenges in vaccine development include rapidly selecting or designing immunogens for raising cross-protective immunity against different intra-or inter-subtypic pathogens, especially for the newly emerging varieties. Here we propose a computational method, Conformational Epitope (CE)-BLAST, for calculating the antigenic similarity among different pathogens with stable and high performance, which is independent of the prior binding-assay information, unlike the currently available models that heavily rely on the historical experimental data. Tool validation incorporates influenza-related experimental data sufficient for stability and reliability determination. Application to dengue-related data demonstrates high harmonization between the computed clusters and the experimental serological data, undetectable by classical grouping. CE-BLAST identifies the potential cross-reactive epitope between the recent zika pathogen and the dengue virus, precisely corroborated by experimental data. The high performance of the pathogens without the experimental binding data suggests the potential utility of CE-BLAST to rapidly design cross-protective vaccines or promptly determine the efficacy of the currently marketed vaccine against emerging pathogens, which are the critical factors for containing emerging disease outbreaks.
  • Rausalu, Kai; Utt, Age; Quirin, Tania; Varghese, Finny S.; Zusinaite, Eva; Das, Pratyush Kumar; Ahola, Tero; Merits, Andres (2016)
    Chikungunya virus (CHIKV), genus Alphavirus, family Togaviridae, has a positive-stand RNA genome approximately 12 kb in length. In infected cells, the genome is translated into non-structural polyprotein P1234, an inactive precursor of the viral replicase, which is activated by cleavages carried out by the non-structural protease, nsP2. We have characterized CHIKV nsP2 using both cell-free and cell-based assays. First, we show that Cys478 residue in the active site of CHIKV nsP2 is indispensable for P1234 processing. Second, the substrate requirements of CHIKV nsP2 are quite similar to those of nsP2 of related Semliki Forest virus (SFV). Third, substitution of Ser482 residue, recently reported to contribute to the protease activity of nsP2, with Ala has almost no negative effect on the protease activity of CHIKV nsP2. Fourth, Cys478 to Ala as well as Trp479 to Ala mutations in nsP2 completely abolished RNA replication in CHIKV and SFV trans-replication systems. In contrast, trans-replicases with Ser482 to Ala mutation were similar to wild type counterparts. Fifth, Cys478 to Ala as well as Trp479 to Ala mutations in nsP2 abolished the rescue of infectious virus from CHIKV RNA transcripts while Ser482 to Ala mutation had no effect. Thus, CHIKV nsP2 is a cysteine protease.
  • Koskinen, Juhani S.; Kytö, Ville; Juonala, Markus; Viikari, Jorma S. A.; Nevalainen, Jaakko; Kähönen, Mika; Lehtimäki, Terho; Hutri-Kähönen, Nina; Laitinen, Tomi; Tossavainen, Päivi; Jokinen, Eero; Magnussen, Costan G.; Raitakari, Olli T. (2020)
    Background and aims: Carotid plaque is a specific sign of atherosclerosis and adults with carotid plaque are at increased risk for cardiovascular outcomes. Atherosclerosis has roots in childhood and pediatric guidelines provide cut-off values for cardiovascular risk factors. However, it is unknown whether these cut-offs predict adulthood advanced atherosclerosis. Methods: The Cardiovascular Risk in Young Finns Study is a follow-up of children that begun in 1980 when 2653 participants with data for the present analyses were aged 3-18 years. In 2001 and 2007 follow-ups, in addition to adulthood cardiovascular risk factors, carotid ultrasound data was collected. Long-term burden, as the area under the curve, was evaluated for childhood (6-18 years) risk factors. To study the associations of guideline-based cut-offs with carotid plaque, both childhood and adult risk factors were classified according to clinical practice guidelines. Results: Carotid plaque, defined as a focal structure of the arterial wall protruding into lumen > 50% compared to adjacent intima-media thickness, was present in 88 (3.3%) participants. Relative risk for carotid plaque, when adjusted for age and sex, was 3.03 (95% CI, 1.76-5.21) for childhood dyslipidemia, 1.51 (95% CI, 0.99-2.32) for childhood elevated systolic blood pressure, and 1.93 (95% CI, 1.26-2.94) for childhood smoking. Childhood dyslipidemia and smoking remained independent predictors of carotid plaque in models additionally adjusted for adult risk factors and family history of coronary heart disease. Carotid plaque was present in less than 1% of adults with no childhood risk factors. Conclusions: Findings reinforce childhood prevention efforts and demonstrate the utility of guideline-based cutoffs in identifying children at increased risk for adulthood atherosclerosis.
  • Määttä, Suvi; Gubbels, Jessica; Ray, Carola; Koivusilta, Leena; Nislin, Mari; Sajaniemi, Nina; Erkkola, Maijaliisa; Roos, Eva (2019)
    The physical environment in preschool, covering all indoor and outdoor equipment, and the surfaces of the preschool yard, may have a large potential for increasing children's physical activity (PA). However, it is less clear which specific physical environmental factors are associated with children's PA. Cross-sectional associations between the individual observed items (e.g. fixed and portable equipment, surfaces, terrain in the grounds) as well as composite scores for the PA equipment on the one hand, and children's PA, measured by accelerometers, on the other, were investigated in a sample of 3-6 year old children (N = 778) attending preschool in Finland. Having balance equipment and trampolines in group facilities, having balance equipment, gym mats and sticks in the gym and having skipping ropes, sand and mostly hilly terrain on the outdoor playground were associated with children's higher PA, regardless of gender. On the contrary, having gravel as the terrain in the playground and having a seesaw outdoors were associated with lower PA levels, regardless of gender. Four significant interactions with gender were found, but none of the environmental predictors remained significant in the post-hoc gender-stratified analyses. Variety in PA equipment and playground terrain may be beneficial for increasing children's PA in preschools. (C) 2018 Elsevier Inc. All rights reserved.
  • Ge, Jielin; Berg, Björn; Xie, Zongqiang (2019)
    Abstract Evergreen and deciduous broad-leaved tree species can coexist across the globe and constitute different broad-leaved forests along large-scale geographical and climatic gradients. A better understanding of climatic influence on the distribution of mixed evergreen and deciduous broad-leaved forest is of fundamental importance when assessing this mixed forest's resilience and predicting potential dynamics of broad-leaved forests under future climate change. Here, we quantified the horizontal distribution of this mixed forest in mountains in relation to climate seasonality by compiling vegetation information from the earlier records and our own field sampling on major subtropical mountains of China. We found that the probability of occurrence of this forest in subtropical mountains was positively associated with the latitude but not the longitude. The occurrence probability of this forest was observed at high-temperature but not precipitation seasonality mountains. Temperature seasonality was five times more important than precipitation seasonality in explaining the total variation of occurrence of this mixed forest. For its distribution, our results shed light on that temperature seasonality was generally a more powerful predictor than precipitation seasonality for montane mixed forest distribution. Collectively, this study clearly underscores the important role of temperature seasonality, a previously not quantified climatic variable, in the occurrence of this mixed forest along geographical gradients and hence yields useful insight into our understanding of climate?vegetation relationships and climate change vulnerability assessment in a changing climate.
  • 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.
  • Ortiz, Rebekka M.; Scheperjans, Filip; Mertsalmi, Tuomas; Pekkonen, Eero (2019)
    Background Cervical dystonia (CD) is the most common form of dystonia. The onset of CD is usually before 60 years of age and it may cause severe functional and psychosocial impairment in everyday life. Recently non-motor symptoms have been reported to occur in CD substantially affecting the quality of life. Methods/patients We studied comorbidities of patients with primary focal CD in Finland based on ICD-10 codes obtained from the care registry and patient records of 937 confirmed adult isolated focal CD patients between the years 2007-2016. The retirement months and diagnosis of retirement were calculated from pension registry information. The results were compared with 3746 age and gender-matched controls. Results Most prominent comorbidities with primary focal CD were depression (14%), anxiety (7%), and back pain (11%). The retirement age was significantly younger in CD patients compared to control group controls (59.0 years, 95% CI 58.5-59.5 vs. 61.7 years, 95% CI 61.6-61.9) years, p <0.001). For dystonia patients the most common diagnoses for retirement due to sickness were dystonia (51%), depression (14%), and anxiety (8%). Patients with anxiety and depression retired earlier than other dystonia patients. Discussion Cervical dystonia considerably reduces working ability and leads to earlier retirement. Anxiety and depression are most notable comorbidities and their co-occurrence further reduces working ability. Our results suggest that more health care resources should be administered in treatment of CD to longer maintain working ability of CD patients. Further, psychiatric comorbidities should be taken into consideration in CD treatment.
  • Murto, Tiina; Yngve, Agneta; Svanberg, Agneta Skoog; Altmae, Signe; Salumets, Andres; Wanggren, Kjell; Stavreus-Evers, Anneli (2017)
    Background: Folate has been discussed in relation to fertility among women, but studies on women under treatment for infertility are lacking. Objective: The objective of this study was to investigate folic acid supplement use and folate status among women under treatment for infertility (hereafter infertile) and fertile women also in regard to socioeconomic and lifestyle factors. Design: Lifestyle and dietary habits, and use of dietary supplements were assessed using a questionnaire. Blood samples were obtained for analysis of folate status. 24-hour recall interviews were also performed. Results: Highly educated, employed and infertile women were most prone to using folic acid supplements. The infertile women had a significantly better folate status than the fertile women. Folate status did not correlate with socioeconomic or lifestyle factors. The infertile women were physically more active, smoked less and were employed. Our questionnaire data had only fair agreement with the data from 24-hour recalls, but the folate status data was clearly correlated to our questionnaire results. Conclusions: Infertile women were most prone to using folic acid supplements and had better folate status than the controls. High educational and employment status were found to be key factors for high compliance to the recommended use folic acid supplements.