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  • The CMS collaboration; Sirunyan, A. M.; Eerola, P.; Forthomme, L.; Kirschenmann, H.; Österberg, K.; Voutilainen, M.; Garcia, F.; Havukainen, J.; Heikkilä, J. K.; Kim, M. S.; Kinnunen, R.; Lampen, T.; Lassila-Perini, K.; Laurila, S.; Lehti, S.; Linden, T.; Luukka, P.; Mäenpää, T.; Siikonen, H.; Tuominen, E.; Tuominiemi, J.; Viinikainen, J.; Pekkanen, J.; Tuuva, T.; Karimäki, V.; Tumasyan, A. (2020)
    A direct search for the standard model Higgs boson, H, produced in association with a vector boson, V (W or Z), and decaying to a charm quark pair is presented. The search uses a data set of proton-proton collisions corresponding to an integrated luminosity of 35.9 fb(-1), collected by the CMS experiment at the LHC in 2016, at a centre-of-mass energy of 13 TeV. The search is carried out in mutually exclusive channels targeting specific decays of the vector bosons: W -> l nu, Z -> ll, and Z -> nu nu, where l is an electron or a muon. To fully exploit the topology of the H boson decay, two strategies are followed. In the first one, targeting lower vector boson transverse momentum, the H boson candidate is reconstructed via two resolved jets arising from the two charm quarks from the H boson decay. A second strategy identifies the case where the two charm quark jets from the H boson decay merge to form a single jet, which generally only occurs when the vector boson has higher transverse momentum. Both strategies make use of novel methods for charm jet identification, while jet substructure techniques are also exploited to suppress the background in the merged-jet topology. The two analyses are combined to yield a 95% confidence level observed (expected) upper limit on the cross section sigma(VH) corresponding to 70 (37) times the standard model prediction.
  • Malde, S.; Umbach, R.; Wheeler, J.R.; Lytvyn, L.; Cornu, J.-N.; Gacci, M.; Gratzke, C.; Herrmann, T.R.W.; Mamoulakis, C.; Rieken, M.; Speakman, M.J.; Gravas, S.; Drake, M.J.; Guyatt, G.H.; Tikkinen, K.A.O. (2021)
    Context: Understanding men's values and preferences in the context of personal, physical, emotional, relational, and social factors is important in optimising patient counselling, facilitating treatment decision-making, and improving guideline recommendations. Objective: To systematically review the available evidence regarding the values, preferences, and expectations of men towards the investigation and treatment (conservative, pharmacological, and surgical) of male lower urinary tract symptoms (LUTS). Evidence acquisition: We searched electronic databases until August 31, 2020 for quantitative and qualitative studies that reported values and preferences regarding the investigation and treatment of LUTS in men. We assessed the quality of evidence and risk of bias using the Grading of Recommendation, Assessment, Development and Evaluation (GRADE) and GRADE Confidence in the Evidence from Reviews of Qualitative Research (CERQual) approaches. Evidence synthesis: We included 25 quantitative studies, three qualitative studies, and one mixed-methods study recruiting 9235 patients. Most men reported urodynamic testing to be acceptable, despite discomfort or embarrassment, as it significantly informs treatment decisions (low certainty evidence). Men preferred conservative and less risky treatment options, but the preference varied depending on baseline symptom severity and the risk/benefit characteristics of the treatment (moderate certainty). Men preferred pharmacological treatments with a low risk of erectile dysfunction and those especially improving urgency incontinence (moderate certainty). Other important preference considerations included reducing the risk of acute urinary retention or surgery (moderate certainty). Conclusions: Men prefer lower-risk management options that have fewer sexual side effects and are primarily effective at improving urgency incontinence and nocturia. Overall, the evidence was rated to be of low to moderate certainty. This review can facilitate the treatment decision-making process and improve the trustworthiness of guideline recommendations. Patient summary: We thoroughly reviewed the evidence addressing men's values and preferences regarding the management of urinary symptoms and found that minimising adverse effects is particularly important. Further research to understand other factors that matter to men is required. (C) 2020 European Association of Urology. Published by Elsevier B.V. All rights reserved.
  • Tornivuori, Anna; Tuominen, Outi; Salantera, Sanna; Kosola, Silja (2020)
    Aims To define digital health services that have been studied among chronically ill adolescents and to describe e-health coaching elements that may have an impact on transition outcomes. Design Systematic review without meta-analysis. Data sources MEDLINE (Ovid), Pub Med, Scopus and CINAHL on 28 May 2018. Review methods Peer-reviewed articles published between January 2008-May 2018 were reviewed following the Cochrane Handbook for Systematic Reviews of Interventions and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. Results Twelve randomized controlled trials were included. The interventions varied significantly in duration and content. E-coaching that included human and social support showed positive impact on transition outcomes. Digital health services incorporated into usual care provide efficient and accessible care. Conclusion E-coaching elements enable tailoring and personalization and present a tool for supporting and motivating chronically ill adolescents during transition of care. Future research should evaluate the effectiveness of e-coaching elements. Impact Digital services are considered a means for increasing adolescents' motivation for self-care and for increasing their accessibility to health care. The coaching elements in digital services consist of a theoretical basis, human support, interactive means and social support. Included interventions varied in terms of duration, dose, content and design. Our results may serve the development of digital health services for adolescents in transition. E-coaching can be used to engage and motivate chronically ill adolescents to improve health behaviour and self-management during transition of care.
  • Bieron, Jacek; Filippin, Livio; Gaigalas, Gediminas; Godefroid, Michel; Jönsson, Per; Pyykkö, Pekka (2018)
    The relativistic multiconfiguration Dirac-Hartree-Fock and the nonrelativistic multiconfiguration Hartree-Fock methods have been employed to calculate the magnetic dipole and electric quadrupole hyperfine structure constants of zinc. The calculated electric field gradients for the 4s4p P-3(1)degrees and 4s4p P-3(2)degrees states, together with experimental values of the electric quadrupole hyperfine structure constants, made it possible to extract a nuclear electric quadrupole moment Q((67) Zn) = 0.122(10) b. The error bar was evaluated in a quasistatistical approach-the calculations were carried out with 11 different methods, and then the error bar was estimated from the differences between the results obtained with those methods.
  • Arora, Geeti P.; Almgren, Peter; Brons, Charlotte; Thaman, Richa G.; Vaag, Allan A.; Groop, Leif; Prasad, Rashmi B. (2018)
    Background: Gestational diabetes (GDM) is a more common problem in India than in many other parts of the world but it is not known whether this is due to unique environmental factors or a unique genetic background. To address this question we examined whether the same genetic variants associated with GDM and Type 2 Diabetes (T2D) in Caucasians also were associated with GDM in North Indian women. Methods: Five thousand one hundred pregnant women of gestational age 24-28 weeks from Punjab were studied by a 75 g oral glucose tolerance test (OGTT). GDM was diagnosed by both WHO1999 and 2013 criteria. 79 single nucleotide polymorphisms (SNPs) previously associated with T2D and glycemic traits (12 of them also with GDM) and 6 SNPs from previous T2D associations based on Indian population (some also with European) were genotyped on a Sequenom platform or using Taqman assays in DNA from 4018 women. Results: In support of previous findings in Caucasian GDM, SNPs at KCJN11 and GRB14 loci were nominally associated with GDM1999 risk in Indian women (both p = 0.02). Notably, T2D risk alleles of the variant rs1552224 near CENTD2, rs11708067 in ADCY5 and rs11605924 in CRY2 genes associated with protection from GDM regardless of criteria applied (p <0.025). SNPs rs7607980 near COBLL1 (p = 0.0001), rs13389219 near GRB14 (p = 0.026) and rs10423928 in the GIPR gene (p = 0.012) as well as the genetic risk score (GRS) for these previously shown insulin resistance loci here associated with insulin resistance defined by HOMA2-IR and showed a trend towards GDM. GRS comprised of 3 insulin secretion loci here associated with insulin secretion but not GDM. Conclusions: GDM in women from Punjab in Northern India shows a genetic component, seemingly driven by insulin resistance and secretion and partly shared with GDM in other parts of the world. Most previous T2D loci discovered in European studies did not associate with GDM in North India, indicative of different genetic etiology or alternately, differences in the linkage disequilibrium (LD) structure between populations in which the associated SNPs were identified and Northern Indian women. Interestingly some T2D risk variants were in fact indicative of being protective for GDM in these Indian women.
  • Gatej, Alexandra-Raluca; Lamers, Audri; van Domburgh, Lieke; Crone, Matty; Ogden, Terje; Rijo, Daniel; Aronen, Eeva; Barroso, Ricardo; Boomsma, Dorret I.; Vermeiren, Robert (2019)
    Background: Severe behavioural problems (SBPs(1)) in childhood are highly prevalent, impair functioning, and predict negative outcomes later in life. Over the last decade, clinical practice guidelines for SBPs have been developed across Europe to facilitate the translation of scientific evidence into clinical practice. This study outlines the results of an investigation into academic experts' perspectives on the current prevalence, implementation, and utility of clinical guidelines for SBPs in children aged 6-12 across Europe. Methods: An online semi-structured questionnaire was completed by 28 psychiatry and psychology experts from 23 countries. Results: Experts indicated that approximately two thirds of the included European countries use at least an unofficial clinical document such as textbooks, while nearly half possess official guidelines for SBPs. Experts believed that, although useful for practice, guidelines' benefits would be maximised if they included more specific recommendations and were implemented more conscientiously. Similarly, experts suggested that unofficial clinical documents offer a wide range of treatment options to individualise treatment from. However, they stressed the need for more consistent, evidence-based clinical practices, by means of developing national and European clinical guidelines for SBPs. Conclusions: This study offers a preliminary insight into the current successes and challenges perceived by experts around Europe associated with guidelines and documents for SBPs, acting as a stepping stone for future systematic, in-depth investigations of guidelines. Additionally, it establishes experts' consensus for the need to develop official guidelines better tailored to clinical practice, creating a momentum for a transition towards European clinical guidelines for this population. (c) 2019 The Authors. Published by Elsevier Masson SAS. This is an open access article under the CC BY-NC-ND license (
  • Skytthe, Axel; Harris, Jennifer R.; Czene, Kamila; Mucci, Lorelei; Adami, Hans-Olov; Christensen, Kaare; Hjelmborg, Jacob; Holm, Niels V.; Nilsen, Thomas S.; Kaprio, Jaakko; Pukkala, Eero (2019)
    The Nordic countries have comprehensive, population-based health and medical registries linkable on individually unique personal identity codes, enabling complete long-term follow-up. The aims of this study were to describe the NorTwinCan cohort established in 2010 and assess whether the cancer mortality and incidence rates among Nordic twins are similar to those in the general population. We analyzed approximately 260,000 same-sexed twins in the nationwide twin registers in Denmark, Finland, Norway and Sweden. Cancer incidence was determined using follow-up through the national cancer registries. We estimated standardized incidence (SIR) and mortality (SMR) ratios with 95% confidence intervals (CI) across country, age, period, follow-up time, sex and zygosity. More than 30,000 malignant neoplasms have occurred among the twins through 2010. Mortality rates among twins were slightly lower than in the general population (SMR 0.96; CI 95% [0.95, 0.97]), but this depends on information about zygosity. Twins have slightly lower cancer incidence rates than the general population, with SIRs of 0.97 (95% CI [0.96, 0.99]) in men and 0.96 (95% CI [0.94, 0.97]) in women. Testicular cancer occurs more often among male twins than singletons (SIR 1.15; 95% CI [1.02, 1.30]), while cancers of the kidney (SIR 0.82; 95% CI [0.76, 0.89]), lung (SIR 0.89; 95% CI [0.85, 0.92]) and colon (SIR 0.90; 95% CI [0.87, 0.94]) occur less often in twins than in the background population. Our findings indicate that the risk of cancer among twins is so similar to the general population that cancer risk factors and estimates of heritability derived from the Nordic twin registers are generalizable to the background populations.
  • Lietzen, Raija; Virtanen, Pekka; Kivimaki, Mika; Korkeila, Jyrki; Suominen, Sakari; Sillanmaki, Lauri; Koskenvuo, Markku; Vahtera, Jussi (2017)
    Objective: This prospective, population-based cohort study of 1102 Finnish adults with asthma, examined whether exposure to stressful life events is associated with the intensity of usage of inhaled short-acting beta(2)-agonists. Methods: Survey data was collected by two postal questionnaires. Baseline characteristics were obtained in 1998 and data on 19 specific stressful events (e.g. death of a child or spouse or divorce) within the six preceding months in 2003. Exposure to life events was indicated by a sum score weighted by mean severity of the events. Participants were linked to records of filled prescriptions for inhaled short-acting beta(2)-agonists from national registers from 2000 through 2006. The rates of purchases of short-acting beta(2)-agonists before (2000 2001), during (2002 2003) and after (2004-2006) the event exposure were estimated using repeated-measures Poisson regression analyses with the generalized estimating equation. Results: Of the 1102 participants, 162 (15%) were exposed to highly stressful events, 205 (19%) to less stressful events. During the 7-year observation period, 5955 purchases of filled prescription for inhaled short-acting beta(2)-agonists were recorded. After exposure to highly stressful events, the rate of purchases of beta(2)-agonists was 1.50 times higher (95% confidence interval (CI): 1.05, 2.13) than before the stressful event occurred. Among those with low or no exposure to life events, the corresponding rate ratios were not elevated (rate ratio 0.81, 95% CI: 0.66, 0.99 and 0.95, 95% CI: 0.83, 1.09 respectively). Conclusion: An increase in beta(2)-agonist usage after severe life events suggests that stressful experiences may worsen asthma symptoms.
  • Heylen, H.; Babcock, C.; Beerwerth, R.; Billowes, J.; Bissell, M. L.; Blaum, K.; Bonnard, J.; Campbell, P.; Cheal, B.; Goodacre, T. Day; Fedorov, D.; Fritzsche, S.; Ruiz, R. F. Garcia; Geithner, W.; Geppert, Ch.; Gins, W.; Grob, L. K.; Kowalska, M.; Kreim, K.; Lenzi, S. M.; Moore, I. D.; Maass, B.; Malbrunot-Ettenauer, S.; Marsh, B.; Neugart, R.; Neyens, G.; Noertershaeuser, W.; Otsuka, T.; Papuga, J.; Rossel, R.; Rothe, S.; Sanchez, R.; Tsunoda, Y.; Wraith, C.; Xie, L.; Yang, X. F.; Yordanov, D. T. (2016)
    The hyperfine spectra of Mn-51,Mn-53-64 were measured in two experimental runs using collinear laser spectroscopy at ISOLDE, CERN. Laser spectroscopy was performed on the atomic 3d(5) 4s(2) S-6(5/2)-> 3d(5) 4s4p P-6(3/2) and ionic 3d(5) 4s S-5(2)-> 3d(5) 4p P-5(3) transitions, yielding two sets of isotope shifts. The mass and field shift factors for both transitions have been calculated in the multiconfiguration Dirac-Fock framework and were combined with a King plot analysis in order to obtain a consistent set of mean-square charge radii which, together with earlier work on neutron-deficient Mn, allow the study of nuclear structure changes from N = 25 across N = 28 up to N = 39. A clear development of deformation is observed towards N = 40, confirming the conclusions of the nuclear moments studies. From a Monte Carlo shell-model study of the shape in the Mn isotopic chain, it is suggested that the observed development of deformation is not only due to an increase in static prolate deformation but also due to shape fluctuations and triaxiality. The changes in mean-square charge radii are well reproduced using the Duflo-Zuker formula except in the case of large deformation.
  • Mattila, Tiina; Hasala, Hannele; Kreivi, Hanna-Riikka; Avellan-Hietanen, Heidi; Bachour, Adel; Herse, Fredrik; Leskelä, Riikka-Leena; Toppila-Salmi, Sanna; Erhola, Marina; Haahtela, Tari; Vasankari, Tuula (2022)
    Background In the current century, sleep apnoea has become a significant public health problem due to the obesity epidemic. To increase awareness, improve diagnostics, and improve treatment, Finland implemented a national sleep apnoea programme from 2002 to 2010. Here, we present changes in the societal burden caused by sleep apnoea from 1996 to 2018. Methods National register data were collected from the Care Register for Health Care, Statistics Finland, the Social Insurance Institution of Finland, and the Finnish Centre for Pensions. Disease prevalence, use of healthcare and social services, and societal costs were estimated. Findings The number of sleep apnoea patients increased in secondary care from 8 600 in 1996 to 61 000 in 2018. There was a continuous increase in outpatient visits in secondary care from 9 700 in 1996 to 122 000 in 2018 (1 160%) and in primary care from 10 000 in 2015 to 29 000 in 2018 (190%). Accordingly, the cumulative annual number of days off work for sleep apnoea increased from 1 100 to 46 000. However, disability pensions for sleep apnoea decreased from 820 to 550 (33%) during the observation period. Societal costs per patient decreased over 50% during the observation period ((sic) 2 800 to (sic)1 200). Interpretation The number of sleep apnoea patients in Finland increased remarkably during the observation period. To control this burden, diagnostic methods and treatment were revised and follow up was reorganised. Consequently, there was a significant decrease in societal costs per patient. The decrease in disability pensions suggests earlier diagnosis and improved treatment. The national sleep apnoea programme was one of the initiators for these improved outcomes. Funding The Finnish Institute for Health and Welfare and the Hospital District of Helsinki and Uusimaa (HUH), Helsinki, Finland. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (
  • Lehtinen, Matti; Apter, Dan; Baussano, Iacopo; Eriksson, Tiina; Natunen, Kari; Paavonen, Jorma; Vanska, Simopekka; Bi, Dan; David, Marie-Pierre; Datta, Sanjoy; Struyf, Frank; Jenkins, David; Pukkala, Eero; Garnett, Geoff; Dubin, Gary (2015)
  • Kauppi, Paula; Linna, Miika; Jantunen, Juha; Martikainen, Jaana E.; Haahtela, Tari; Pelkonen, Anna; Mäkelä, Mika (2015)
    Background. We aimed to study the prevalence of chronic comorbidities in asthma patients and the costs of health care use associated with asthma with comorbidities. Material and Methods. We analysed the prevalence of the four most common chronic diseases in asthma patients in 2008-2014 in Finland. Prevalence of coronary artery disease, diabetes and dyslipidaemia, hypertension, epilepsy, inflammatory bowel disease, rheumatic diseases, and severe psychiatric disease was studied by register of the Social Insurance Institution of Finland. The costs of health care services were collected from the registries maintained by the National Institute for Health and Welfare (THL). Results. Prevalence of asthma was 4.6% in 2014. Diabetes was among the four most common comorbidities in all the age groups. The other common comorbidities were hypertension (>= 46 years; 12.9-37.6%), severe psychiatric disorders (age groups of 16-59 years; 1.4-3.5%), and ischaemic heart disease (>= 60 years; 10-25%). In patients with both asthma and diabetes, the costs of hospitalization were approximately 169% compared with patients with asthma alone. Conclusions. Prevalence of asthma increases by tenfold when aging. The comorbidity diversity and rate are age-dependent. Prevalence of diabetes as comorbidity in asthma has increased. Costs of hospitalizations in asthma approximately double with chronic comorbidities.
  • Heikkilä, Juha Markus; Parkkamäki, Stina; Salimäki, Johanna; Westermarck, Sari; Pohjanoksa-Mantyla, Marika (2018)
    Background and purpose: COPD is one of the leading causes of morbidity and mortality worldwide. Although medication counseling interventions by pharmacists have been found to support the management of COPD, little is known about pharmacists' knowledge concerning COPD and regular practices and perceptions concerning medication counseling of COPD patients. The purpose of this study was to research these topics among Finnish community pharmacists. Materials and methods: In January 2017, an electronic survey was e-mailed to Finnish community pharmacies (n=741) via the Association of the Finnish Pharmacies. One pharmacist from each pharmacy, preferably a specialist in asthma, was invited to answer the survey. Results: Completed responses were received from 263 pharmacists (response rate =35%), of whom 196 pharmacists were specialists in asthma. Response rate among asthma pharmacists was 42%. Pharmacists were positive about their role in medication counseling and in support of the self-management of COPD patients. COPD-related knowledge was self-assessed as being good and was on a good level in respect of basic facts. However, almost half (46%) of the pharmacists did not know that COPD is considered a national public health issue, and similar to 50% of the pharmacists were not familiar with the current care guideline on COPD. Medication counseling was found to be more medicinal product-driven and less advisory concerning lifestyle changes such as smoking cessation and physical exercise. Conclusion: Although the pharmacists' knowledge of COPD was good on general topics, there were some gaps in their knowledge on the current care guideline and status of the disease. Pharmacists should more systematically individually target medication counseling according to patients' needs. In addition, lifestyle treatments, including smoking cessation and physical exercise, should be part of the medication counseling.
  • Andreevskaya, Margarita; Hultman, Jenni; Johansson, Per; Laine, Pia; Paulin, Lars; Auvinen, Petri; Björkroth, Johanna (2016)
    Leuconostoc gelidum subsp. gasicomitatum is a predominant lactic acid bacterium (LAB) in spoilage microbial communities of different kinds of modified-atmosphere packaged (MAP) food products. So far, only one genome sequence of a poultry-originating type strain of this bacterium (LMG 18811T) has been available. In the current study, we present the completely sequenced and functionally annotated genome of strain KG16-1 isolated from a vegetable-based product. In addition, six other vegetable-associated strains were sequenced to study possible “niche” specificity suggested by recent multilocus sequence typing. The genome of strain KG16-1 consisted of one circular chromosome and three plasmids, which together contained 2,035 CDSs. The chromosome carried at least three prophage regions and one of the plasmids encoded a galactan degradation cluster, which might provide a survival advantage in plant-related environments. The genome comparison with LMG 18811T and six other vegetable strains suggests no major differences between the meat- and vegetable-associated strains that would explain their “niche” specificity. Finally, the comparison with the genomes of other leuconostocs highlights the distribution of functionally interesting genes across the L. gelidum strains and the genus Leuconostoc.
  • The CMS collaboration; Sirunyan, A. M.; Tumasyan, A.; Eerola, P.; Forthomme, Laurent; Kirschenmann, H.; Österberg, K.; Voutilainen, M.; Brücken, Erik; Garcia, F.; Havukainen, J.; Heikkilä, Jaana; Karimäki, Veikko; Kim, Minsuk; Kinnunen, R.; Lampén, T.; Lassila-Perini, K.; Laurila, S.; Lehti, S.; Lindén, T.; Luukka, P.; Pekkanen, Juska; Siikonen, H.; Tuominen, E.; Tuominiemi, J.; Viinikainen, Jussi; Tuuva, T. (2021)
    The CMS experiment at the LHC has measured the differential cross sections of Z bosons decaying to pairs of leptons, as functions of transverse momentum and rapidity, in lead-lead collisions at a nucleon-nucleon center-of-mass energy of 5.02 TeV. The measured Z boson elliptic azimuthal anisotropy coefficient is compatible with zero, showing that Z bosons do not experience significant final-state interactions in the medium produced in the collision. Yields of Z bosons are compared to Glauber model predictions and are found to deviate from these expectations in peripheral collisions, indicating the presence of initial collision geometry and centrality selection effects. The precision of the measurement allows, for the first time, for a data-driven determination of the nucleon-nucleon integrated luminosity as a function of lead-lead centrality, thereby eliminating the need for its estimation based on a Glauber model.
  • Frank, Mariana; Huitu, Katri; Mondal, Subhadeep (2019)
    We analyze supersymmetric models augmented by an extra U(1) gauge group. To avoid anomalies in these models without introducing exotics, we allow for family-dependent U(1)' charges, and choose a simple form for these, dependent on one U(1)' charge parameter only. With this choice, Z' decays into ditaus but not dileptons, weakening considerably the constraints on its mass. In the supersymmetric sector, the effect is to lower the singlino mass, allowing it to be the dark matter candidate. We investigate the dark matter constraints and collider implications of such models, with mostly singlinos, mostly Higgsinos, or a mixture of the two as the lightest supersymmetric particles. In these scenarios, Z' decays significantly into chargino or neutralino pairs, and thus indirectly into final state leptons. We devise benchmarks which, with adequate cuts, can yield signals visible at the high-luminosity LHC.
  • the TRIGR Invest; Virtanen, Suvi M.; Cuthbertson, David; Nucci, Anita M.; Hyytinen, Mila; Salonen, Marja; Savilahti, Erkki; Knip, Mikael (2021)
    The international Trial to Reduce IDDM in the Genetically at Risk (TRIGR) tested the hypothesis whether extensively hydrolyzed casein-based versus regular cow's milk-based infant formula reduces the risk of type 1 diabetes. We describe dietary compliance in the trial in terms of study formula intake, feeding of nonrecommended foods, and serum cow's milk antibody concentration reflecting intake of cow's milk protein among 2,159 eligible newborn infants with a biological first-degree relative affected by type 1 diabetes and with HLA-conferred susceptibility to type 1 diabetes. The participating infants were introduced to the study formula feeding at the median age of 15 days with a median duration of study formula use of 63 days. During the intervention, 80% of the infants received study formula. Of these, 57% received study formula for at least 2 months. On average, 45.5 l of study formula were used per infant. Only 13% of the population had received a nonrecommended food by the age of 6 months. The dietary compliance was similar in the intervention and control arm. The reported cow's milk consumption by the families matched very well with measured serum casein IgA and IgG antibody concentration. To conclude, good compliance was observed in this randomized infant feeding trial. Compliance varied between the regions and those infants who were breastfed for a longer period of time had a shorter exposure to the study formula. High dietary compliance in infant feeding trial is necessary to allow accurate interpretation of study results.
  • Idehen, Esther E.; Koponen, Päivikki; Härkänen, Tommi; Kangasniemi, Mari; Pietilä, Anna-Maija; Korhonen, Tellervo (2018)
    Background: Cervical cancer is currently ranked as the fourth commonly diagnosed cancer in women globally. A higher incidence has been reported in low- and-middle-income countries, and the disease poses significant public health challenges. Evidence suggests that this disease is preventable by means of regular screening using the Papanicolaou (Pap) test. However, limited knowledge exists about disparities in cervical screening participation among immigrants compared with non-immigrants, in countries with universal cervical screening programmes. We aimed to examine disparities in cervical screening participation among women of Russian, Somali, and Kurdish, origin in Finland, comparing them with the general Finnish population (Finns). We controlled for differences in several socio-demographic and health-related variables as potential confounders. Methods: We employed data from the Finnish Migrant Health and Well-being Study 2010-2012 and the National Health 2011 Survey. Data collection involved face-to-face interviews. Data on screening participation in the previous five years from women aged 29-60 were available from 537 immigrants (257 Russians, 113 Somalis, 167 Kurds) and from 436 Finns. For statistical analyses, we used multiple logistic regression. Results: Age-adjusted screening participation rates were as follows: Russians 79% (95% Cl 72.9-84.4), Somalis 41% (95% Cl 31.4-50.1), and Kurds 64% (95% Cl 57.2-70.8), compared with 94% (95% Cl 91.4-95.9) among Finns. After additionally adjusting for socio-demographic and health-related confounders, all the immigrant groups showed a significantly lower likelihood of screening participation when compared with Finns. The Odds Ratios were as follows: Russians 0.32 (95% Cl 0.18-0.58), Somalis 0.10 (95% Cl 0.04-0.23), and Kurds 0.17 (95% Cl 0.09-0.35). However, when additionally accounting for country of origin-confounder interactions, such differences were attenuated. Conclusions: Our results indicate disparities in screening participation among these immigrants and a lower likelihood of screening participation compared with the general Finnish population. To improve equity in cervical cancer screening participation, appropriate culturally tailored intervention programmes for each immigrant group might be beneficial.
  • Pena, Sebastian; Carranza, Macarena; Cuadrado, Cristobal; Parra, Diana C.; Villalobos Dintrans, Pablo; Castillo, Cecilia; Cortinez-O'Ryan, Andrea; Espinoza, Paula; Muller, Valeska; Rivera, Cristian; Genovesi, Romina; Riesco, Juan; Kontto, Jukka; Cerda, Ricardo; Zitko, Pedro (2021)
    Objective The aim of this study was to examine the effectiveness of a school-based gamification strategy to prevent childhood obesity. Methods Schools were randomized in Santiago, Chile, between March and May 2018 to control or to receive a nutrition and physical activity intervention using a gamification strategy (i.e., the use of points, levels, and rewards) to achieve healthy challenges. The intervention was delivered for 7 months and participants were assessed at 4 and 7 months. Primary outcomes were mean difference in BMI z score and waist circumference (WC) between trial arms at 7 months. Secondary outcomes were mean difference in BMI and systolic and diastolic blood pressure between trial arms at 7 months. Results A total of 24 schools (5 controls) and 2,197 students (653 controls) were analyzed. Mean BMI z score was lower in the intervention arm compared with control (adjusted mean difference -0.133, 95% CI: -0.25 to -0.01), whereas no evidence of reduction in WC was found. Mean BMI and systolic blood pressure were lower in the intervention arm compared with control. No evidence of reduction in diastolic blood pressure was found. Conclusions The multicomponent intervention was effective in preventing obesity but not in reducing WC. Gamification is a potentially powerful tool to increase the effectiveness of school-based interventions to prevent obesity.
  • Halonen, J. I.; Solovieva, S.; Pentti, J.; Kivimaki, M.; Vahtera, J.; Viikari-Juntura, E. (2016)
    Objectives Policies have been introduced to reduce sickness absence, but their effectiveness is largely unknown. In a natural experiment, we examined effects of legislative changes on return to work and work participation. Methods The source population consisted of up to 72164 Finnish public sector employees with a permanent job contract in 2008-2011 (before) and in 2013-2014 (after). We used employees with a continuous sickness absence of at least 30 calendar-days (n=5708-6393), 60 compensated days (n=1481-1655) and 90 compensated days (n=766-932). We examined sustainable return to work (a minimum of 28 consecutive working days) with survival analysis as well as monthly work participation after a sickness absence, and annual gain in work participation after the intervention, using trajectory analyses. Results Sustainable return to work after 60days of sickness absence occurred earlier after the legislative changes (p value 0.017), although the effect reduced towards the end of the follow-up. There were no differences in return to work after a 30 or 90days of sickness absence. The largest annual gain, postintervention versus preintervention, in monthly work participation was observed among employees with 60days of sickness absence and was 230.9 person-years/10000 employees. The corresponding annual gains among those with 30days and 90days of sickness absence were 51.8 and 39.6, respectively. Conclusions Our findings suggest that the legislative changes, obligating early notification of prolonged sickness absences as well as assessment of remaining work ability and possibilities to continue working, may enhance sustainable return to work in the short term. Other measures will be needed to enhance work participation, especially in the long term.