Browsing by Subject "NETHERLANDS"

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  • Grönthal, Thomas; Eklund, Marjut; Thomson, Katariina; Piiparinen, Heli; Sironen, Tarja; Rantala, Merja (2017)
    Objectives: To investigate antimicrobial susceptibility in Staphylococcus pseudintermedius and the occurrence of methicillin-resistant S. pseudintermedius (MRSP), to explore the molecular structure of the MRSP population and to analyse risk factors for MRSP. Methods: Susceptibility data for clinical S. pseudintermedius isolates in 2011-15 were analysed using WHONET. All MRSP isolates in 2010-14 (n = 362) were typed using PFGE. Representative isolates (n = 87) of clusters were analysed using MLST and staphylococcal cassette chromosome mec (SCCmec) typing. Risk factors were analysed using logistic regression. Results: Of the clinical S. pseudintermedius (n-1958; 98% from dogs), 14% were MRSP. Resistance to other antimicrobials varied between 12% and 39%. No trends were observed over time. Among clinical specimens (from infection sites) and screening specimens (from potential carriers), respectively, 2.5% (267/10813) and 9% (211/2434) revealed MRSP. MLST revealed 42 different STs, including 19 new ones. Clonal complexes 71, 45 and 258 were the most common, but the MRSP population diversified over the years. A clinical S. pseudintermedius isolate was more likely to be MRSP if the patient was on antimicrobials at the time of sampling or was male. The presence of MRSP in screening specimens was more likely if the patient was on multiple antimicrobials at the time of sampling. Specimens from private clinics (versus the Veterinary Teaching Hospital of the University of Helsinki) had a higher likelihood of MRSP in both analyses. Conclusions: Resistance to antimicrobials among S. pseudintermedius in Finland is high, emphasizing the importance of infection control measures and susceptibility testing prior to therapy. The diverse MRSP population indicates non-clonal spread.
  • Macharey, Georg; Gissler, Mika; Rahkonen, Leena; Ulander, Veli-Matti; Vaisanen-Tommiska, Mervi; Nuutila, Mika; Heinonen, Seppo (2017)
    Purpose The aim of this study was to estimate whether breech presentation at term was associated with known individual obstetric risk factors for adverse fetal outcome. Methods This was a retrospective, nationwide Finnish population-based cohort study. Obstetric risks in all breech and vertex singleton deliveries at term were compared between the years 2005 and 2014. A multivariable logistic regression model was used to determine significant risk factors. Results The breech presentation rate at term for singleton pregnancies was 2.4%. The stillbirth rate in term breech presentation was significantly higher compared to cephalic presentation (0.2 vs 0.1%). The odds ratios (95% CIs) for fetal growth restriction, oligohydramnios, gestational diabetes, a history of cesarean section and congenital fetal abnormalities were 1.19 CI (1.07-1.32), 1.42 CI (1.27-1.57), 1.06 CI (1.00-1.13), 2.13 (1.98-2.29) and 2.01 CI (1.92-2.11). Conclusions The study showed that breech presentation at term on its own was significantly associated with antenatal stillbirth and a number of individual obstetric risk factors for adverse perinatal outcomes. The risk factors included oligohydramnios, fetal growth restriction, gestational diabetes, history of caesarean section and congenital anomalies.
  • Hu, Yannan; van Lenthe, Frank J.; Judge, Ken; Lahelma, Eero; Costa, Giuseppe; de Gelder, Rianne; Mackenbach, Johan P. (2016)
    Background: Between 1997 and 2010, the English government pursued an ambitious programme to reduce health inequalities, the explicit and sustained commitment of which was historically and internationally unique. Previous evaluations have produced mixed results. None of these evaluations have, however, compared the trends in health inequalities within England with those in other European countries. We carried out an innovative analysis to assess whether changes in trends in health inequalities observed in England after the implementation of its programme, have been more favourable than those in other countries without such a programme. Methods: Data were obtained from nationally representative surveys carried out in England, Finland, the Netherlands and Italy for years around 1990, 2000 and 2010. A modified difference-in-difference approach was used to assess whether trends in health inequalities in 2000-2010 were more favourable as compared to the period 1990-2000 in England, and the changes in trends in inequalities after 2000 in England were then compared to those in the three comparison countries. Health outcomes were self-assessed health, long-standing health problems, smoking status and obesity. Education was used as indicator of socioeconomic position. Results: After the implementation of the English strategy, more favourable trends in some health indicators were observed among low-educated people, but trends in health inequalities in 2000-2010 in England were not more favourable than those observed in the period 1990-2000. For most health indicators, changes in trends of health inequalities after 2000 in England were also not significantly different from those seen in the other countries. Conclusions: In this rigorous analysis comparing trends in health inequalities in England both over time and between countries, we could not detect a favourable effect of the English strategy. Our analysis illustrates the usefulness of a modified difference-in-difference approach for assessing the impact of policies on population-level health inequalities.
  • Soininen, Paivi; Putkonen, Hanna; Joffe, Grigori; Korkeila, Jyrki; Puukka, Pauli; Pitkanen, Anneli; Valimaki, Maritta (2013)
  • Poelman, Randy; Schuffenecker, Isabelle; Van Leer-Buter, Coretta; Josset, Laurence; Niesters, Hubert G. M.; Lina, Bruno; Vuorinen, Tytti; ESCV-ECDC EV-D68 Study Grp; Lappalainen, Maija; Jääskeläinen, Anne; Smura, Teemu (2015)
    Background: In August and September 2014, unexpected clusters of enterovirus-D68 (EV-D68) infections associated with severe respiratory disease emerged from North-America. In September, the European Centre for Disease Prevention and Control (ECDC) asked European countries to strengthen respiratory sample screening for enterovirus detection and typing in cases with severe respiratory presentations. Objectives: To provide a detailed picture of EV-D68 epidemiology in Europe by conducting a retrospective and prospective laboratory analysis of clinical specimens. Study design: An initiative supported by the European Society for Clinical Virology (ESCV) and ECDC was launched to screen for EV-D68 in respiratory specimens between July 1st and December 1st 2014 in Europe and to sequence the VP1 region of detected viruses for phylogenetic analytic purposes. Results: Forty-two institutes, representing 51 laboratories from 17 European countries, analyzed 17,248 specimens yielding 389 EV-D68 positive samples (2.26%) in 14 countries. The proportion of positive samples ranged between 0 and 25% per country. These infections resulted primarily in mild respiratory disease, mainly detected in young children presenting with wheezing and in immuno-compromised adults. The viruses detected in Europe are genetically very similar to those of the North-American epidemic and the majority (83%) could be assigned to clade B. Except for 3 acute flaccid paralysis (AFP) cases, one death and limited ICU admissions, no severe cases were reported. Conclusions: The European study showed that EV-D68 circulated in Europe during summer and fall of 2014 with a moderate disease burden and different pathogenic profile compared to the North-American epidemic. (C) 2015 The Authors. Published by Elsevier B.V.
  • Karlsson, Linda C.; Antfolk, Jan; Putkonen, Hanna; Amon, Sabine; da Silva Guerreiro, Joao; de Vogel, Vivienne; Flynn, Sandra; Weizmann-Henelius, Ghitta (2021)
    Familicides have received relatively little attention and are mostly discussed in studies with broader aims. Here, we reviewed 67 studies from 18 countries on familicides, in which an offender killed or attempted to kill their current or former spouse/intimate partner and one or more of their biological or stepchildren. We conducted a systematic literature search in PubMed, PsycINFO, and Google Scholar. Eight studies investigated familicide specifically, while the remaining reported on familicide cases as a subsample. We retrieved data on offenders' gender, age, and background as well as on victims and their relationship to the offender. We also retrieved data on contextual factors and offense characteristics (i.e., modus operandi, offense location, premeditation, and whether or not the offender had committed suicide). We also coded methodological aspects of the studies. Familicides were almost exclusively committed by men and about half of the familicide cases led to the suicide of the offender. Mental health problems, relationship problems, and financial difficulties were prevalent. Because few studies reported population base rates of the investigated characteristics, it is difficult to draw conclusions about specific risk factors. Future research should further investigate typologies of familicide and examine risk factors for different types of familicides.
  • Bosqui, Tania; O'Reilly, Dermot; Vaananen, Ari; Patel, Kishan; Donnelly, Michael; Wright, David; Close, Ciara; Kouvonen, Anne (2019)
    PurposeThere is a recent and growing migrant population in Northern Ireland. However, rigorous research is absent regarding access to mental health care by different migrant groups. In order to address this knowledge gap, this study aimed to identify the relative use of psychotropic medication between the largest first generation migrant groups in Northern Ireland and the majority population.MethodsCensus (2011) data was linked to psychotropic prescriptions for the entire enumerated population of Northern Ireland using data linkage methodology through the Administrative Data Research Centre Northern Ireland (ADRC-NI).ResultsLower prescription dispensation for all psychotropic medication types, particularly antidepressants (OR=0.35, CI 95% 0.33-0.36) and anxiolytics (OR=0.42, CI 95% 0.40-0.44), was observed for all migrant groups with the exception of migrants from Germany.ConclusionsIt is likely that the results reflect poorer access to services and indicate a need to improve access and the match between resources, services and the health and social care needs of migrants. Further research is required to identify barriers to accessing primary care and mental health services.
  • Roikonen, Petri; Häkkinen, Antti (2019)
    This study analyses social heterogamy in western and southern Finland during the early stages of industrialisation, from 1700 to 1910. Marriage patterns are examined by comparing the social classes of spouses' parents, which can be understood as the social origin of the spouse. The rate of heterogamy within the freeholder class was only 19.8%, whereas it was 71.1% in the upper classes, 59.7% in the tenant class and 76.5% in the labour class. In addition, only roughly 20-30% of grooms whose fathers were landowners married brides from lower social classes. Certain individual- and family-level characteristics increased the odds of a heterogamous marriage: remarrying, age difference, being an illegitimate child or a single mother, and the first marriages of those in the labour class. Regarding macro-level variables, we found that higher rates of emigration and poor-relief recipients, along with having a larger Finnish-speaking population, led to higher levels of heterogamy. Other issues increasing the odds of heterogamy included living in the more urbanised or industrialised regions and moving to different regions. This study identified strict marriage patterns, which did not significantly change with respect to heterogamy. Nevertheless, indications exist that industrialisation and urbanisation began eroding the prevailing traditions.
  • Eskelä, Elina (2018)
    Although relatively understudied, the role of affordable and acceptable housing in the accelerating global competition for talent is of utmost importance, especially if highly skilled migrants are to be absorbed into the permanent labour force. This paper concerns the housing of skilled Indian migrants in the Helsinki metropolitan area in Finland, and contributes to the literature on international migration and the housing of ethnic minorities. It presents a case study on how to analyse migrants' housing pathways, examining the meaning of housing in the transnational lives of this relatively affluent migrant group. The results show that homeownership is a not a simple indicator of commitment to the host society, and that those responsible for national housing policy need to ensure the supply, quality and reasonable price of accommodation in order to fulfil the housing needs of skilled migrants.
  • Siikamäki, Heli Marja-Sisko; Kivelä, Pia; Lyytikainen, Outi; Kantele, Anu (2013)
  • Mitt, Mario; Kals, Mart; Parn, Kalle; Gabriel, Stacey B.; Lander, Eric S.; Palotie, Aarno; Ripatti, Samuli; Morris, Andrew P.; Metspalu, Andres; Esko, Tonu; Magi, Reedik; Palta, Priit (2017)
    Genetic imputation is a cost-efficient way to improve the power and resolution of genome-wide association (GWA) studies. Current publicly accessible imputation reference panels accurately predict genotypes for common variants with minor allele frequency (MAF) >= 5% and low-frequency variants (0.5
  • Kontturi, Antti; Soini, Hanna; Ollgren, Jukka; Salo, Eeva (2018)
    Background. Epidemiological data on childhood nontuberculous mycobacterial (NTM) disease is scarce and the protective effect of bacille Calmette-Guerin (BCG) vaccination remains debated. In 2006, the BCG policy in Finland changed from universal to selective. We aimed to study the effect of the BCG coverage decrease on the incidence of childhood NTM infections in Finland. Methods. We conducted a nationwide, population-based, retrospective study of NTM notifications recorded to the National Infectious Diseases Register between 1995 and 2016 and identified native-born children aged 0-4 years infected with NTM. Poisson log-linear model was used to estimate the change in the incidence rate of cohorts born during universal or selective BCG policy between 1995 and 2015. Results. We identified 97 native-born children aged Conclusions. After infant BCG coverage in Finland decreased, childhood NTM infections increased drastically. As there is no other apparent cause for the increase, this indicates that BCG offers protection against childhood NTM disease. 'phis observation adds to the understanding of childhood NTM epidemiology and might explain why the disease is emerging in some countries.
  • Khawaja, T.; Kirveskari, J.; Johansson, S.; Väisänen, J.; Djupsjöbacka, A.; Nevalainen, A.; Kantele, A. (2017)
    Objectives: The pandemic spread of multidrug-resistant (MDR) bacteria poses a threat to healthcare worldwide, with highest prevalence in indigent regions of the (sub) tropics. As hospitalization constitutes a major risk factor for colonization, infection control management in low-prevalence countries urgently needs background data on patients hospitalized abroad. Methods: We collected data on 1122 patients who, after hospitalization abroad, were treated at the Helsinki University Hospital between 2010 and 2013. They were screened for methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE), vancomycin-resistant enterococci, carbapenemase-producing Enterobacteriaceae (CPE), multiresistant Pseudomonas aeruginosa and multiresistant Acinetobacter baumannii. Risk factors for colonization were explored by multivariate analysis. Results: MDR colonization rates were higher for those hospitalized in the (sub) tropics (55%; 208/377) compared with temperate zones (17%; 125/745). For ESBL-PE the percentages were 50% (190/377) versus 12% (92/745), CPE 3.2% (12/377) versus 0.4% (3/745) and MRSA 6.6% (25/377) versus 2.4% (18/745). Colonization rates proved highest in those returning from South Asia (77.6%; 38/49), followed by those having visited Latin America (60%; 9/16), Africa (60%; 15/25) and East and Southeast Asia (52.5%; 94/179). Destination, interhospital transfer, short time interval to hospitalization, young age, surgical intervention, residence abroad, visiting friends and relatives, and antimicrobial use proved independent risk factors for colonization. Conclusions: Post-hospitalization colonization rates proved higher in the (sub) tropics than elsewhere; 11% (38/333) of carriers developed an MDR infection. We identified several independent risk factors for contracting MDR bacteria. The data provide a basis for infection control guidelines in low-prevalence countries (C) 2017 The Author(s). Published by Elsevier Ltd on behalf of European Society of Clinical Microbiology and Infectious Diseases.
  • Hoffmann, Rasmus; Borsboom, Gerard; Saez, Marc; Mari Dell'Olmo, Marc; Burstrom, Bo; Corman, Diana; Costa, Claudia; Deboosere, Patrick; Felicitas Dominguez-Berjon, M.; Dzurova, Dagmar; Gandarillas, Ana; Gotsens, Merce; Kovacs, Katalin; Mackenbach, Johan; Martikainen, Pekka; Maynou, Laia; Morrison, Joana; Palencia, Laia; Perez, Gloria; Pikhart, Hynek; Rodriguez-Sanz, Maica; Santana, Paula; Saurina, Carme; Tarkiainen, Lasse; Borrell, Carme (2014)
  • Paukkunen, Juho; Pöyry, Juha; Kuussaari, Mikko (2018)
    1. Kleptoparasitic and parasitoid insects are expected to be particularly sensitive to changes in habitat availability due to their high trophic position and small population sizes compared with their hosts, but there are only few quantitative studies on their population changes. 2. Here, we studied the distribution and abundance of 48 kleptoparasitic and parasitoid species of cuckoo wasps (Chrysididae) and eight selected host species recorded in Finland from 1840 to 2015 based on an extensive survey of entomological collections. Population trends were assessed by studying changes in occupancy in 10 9 10 km grid squares between two study periods, 1840-1967 and 1968-2015. 3. Statistically significant decreases in occurrence were found for 11 cuckoo wasp species and one host species, while significant increases were not observed for any species. Trends of cuckoo wasps and their hosts were positively correlated, and changes were generally stronger in cuckoo wasps than in their hosts. 4. In a comparative analysis of species traits, abundance, body size and nesting type of host were related to occurrence changes of cuckoo wasps. Scarce and small species that use above ground-nesting hosts declined more than abundant and large species that use ground-nesting hosts. 5. Cuckoo wasp species dependent on dead wood are more vulnerable to changes in the environment than species associated with open sandy habitats. While both groups of species have probably suffered from habitat loss, the emergence of secondary habitats may have benefitted species living in sandy areas and compensated for the negative impact of habitat destruction.
  • Hu, Yannan; van Lenthe, Frank J.; Platt, Stephen; Master, Jizzo R. Bosdriesz; Lahelma, Eero; Menvielle, Gwenn; Regidor, Enrique; Santana, Paula; de Gelder, Rianne; Mackenbach, Johan P. (2017)
    Background: It is uncertain whether tobacco control policies have contributed to a narrowing or widening of socioeconomic inequalities in smoking in European countries during the past two decades. This paper aims to investigate the impact of price and non-price related population-wide tobacco control policies on smoking by socioeconomic group in nine European countries between 1990 and 2007. Methods: Individual-level education, occupation and smoking status were obtained from nationally representative surveys. Country-level price-related tobacco control policies were measured by the relative price of cheapest cigarettes and of cigarettes in the most popular price category. Country-level non-price policies were measured by a summary score covering four policy domains: smoking bans or restrictions in public places and workplaces, bans on advertising and promotion, health warning labels, and cessation services. The associations between policies and smoking were explored using logistic regressions, stratified by education and occupation, and adjusted for age, Gross Domestic Product, period and country fixed effects. Results: The price of popular cigarettes and non-price policies were negatively associated with smoking among men. The price of the cheapest cigarettes was negatively associated with smoking among women. While these favorable effects were generally in the same direction for all socioeconomic groups, they were larger and statistically significant in lower socioeconomic groups only. Conclusions: Tobacco control policies as implemented in nine European countries, have probably helped to reduce the prevalence of smoking in the total population, particularly in lower socioeconomic groups. Widening inequalities in smoking may be explained by other factors. Policies with larger effects on lower socioeconomic groups are needed to reverse this trend. Implications: Socioeconomic inequalities in smoking widened between the 1990s and the 2000s in Europe. During the same period, there were intensified tobacco control policies in many European countries. It is uncertain whether tobacco control policies have contributed to a narrowing or widening of socioeconomic inequalities in smoking in European countries. This study shows that tobacco control policies as implemented in the available European countries have helped to reduce the prevalence of smoking in the total population, particularly in lower socioeconomic groups. Widening inequalities in smoking may be explained by other factors.
  • Jurgilevich, Alexandra; Birge, Traci; Kentala-Lehtonen, Johanna; Korhonen-Kurki, Kaisa; Pietikäinen, Janna; Saikku, Laura; Schösler, Hanna (2016)
    Growing population and increased demand for food, inefficient resource use and food distribution, environmental impacts, and high rates of food wasted at all stages of the food system are all calling for transition towards more sustainable practices. In this article we apply the concept of circular economy to the case of a sustainable food system. Furthermore, we explore the transition towards a circular food system through the lens of socio-technical transition theory towards sustainability. We discuss challenges and potential solutions for the production stage (focusing on nutrient flow), the consumption stage (focusing on meat consumption), and food waste and surplus management and prevention.
  • Aalto, Anna-Mari; Elovainio, Marko; Tynkkynen, Liina-Kaisa; Reissell, Eeva; Vehko, Tuulikki; Chydenius, Miisa; Sinervo, Timo (2018)
    Background: The ongoing Finnish health and social service reform will expand choice by opening the market for competition between public and private service providers. This study examined the attitudes of primary care patients towards choice and which patient-related factors are associated with these attitudes. Methods: A sample of attenders during one week in health centres of 12 big cities and municipal consortiums (including seven outsourced local units) and in primary care units of one private company providing outsourced services for municipalities (aged 18-95, n=8128) was used. The questionnaire included questions on choice-related attitudes, sociodemographic factors, health status, use of health services and patient satisfaction. Results: Of the responders, 77% regarded choice to be important, 49% perceived genuine opportunities to make choices and 35% were satisfied with the choice-relevant information. Higher age, low education, having a chronic illness, frequent use of services, having a personal physician and being satisfied with the physician and with waiting times were related to assigning more importance on choice. Younger patients, those with higher education as well as those with chronic illness regarded their opportunities of choosing the service provider and availability of choice-relevant information poorer. Conclusions: The Finnish primary care patients value choice, but they are critical of the availability of choice-relevant information. Choices of patients with complex health care needs should be supported by developing integrated care alternatives and by increasing the availability of information on existing care alternatives to meet their needs.