Browsing by Subject "SWEDEN"

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  • 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
  • Oinonen, Markku; Alenius, Teija; Arppe, Laura; Bocherens, Hervé; Etu-Sihvola, Heli; Helama, Samuli; Huhtamaa, Heli; Lahtinen, Maria; Mannermaa, Kristiina; Onkamo, Päivi; Palo, Jukka; Sajantila, Antti; Salo, Kati; Sundell, Tarja; Vanhanen, Santeri; Wessman, Anna (2020)
    Levanluhta is a unique archaeological site with the remains of nearly a hundred Iron Age individuals found from a water burial in Ostrobothnia, Finland. The strongest climatic downturn of the Common Era, resembling the great Fimbulvinter in Norse mythology, hit these people during the 6th century AD. This study establishes chronological, dietary, and livelihood synthesis on this population based on stable carbon and nitrogen isotopic and radiocarbon analyses on human remains, supported by multidisciplinary evidence. Extraordinarily broad stable isotopic distribution is observed, indicating three subgroups with distinct dietary habits spanning four centuries. This emphasizes the versatile livelihoods practiced at this boundary of marine, freshwater, and terrestrial ecosystems. While the impact of the prolonged cold darkness of the 6th century was devastating for European communities relying on cultivation, the broad range of livelihoods provided resilience for the Levanluhta people to overcome the abrupt climatic decline.
  • Carstensen, Bendix; Read, Stephanie H.; Friis, Soren; Sund, Reijo; Keskimaki, Ilmo; Svensson, Ann-Marie; Ljung, Rickard; Wild, Sarah H.; Kerssens, Joannes J.; Harding, Jessica L.; Magliano, Dianna J.; Gudbjornsdottir, Soffia; Diabet Canc Res Consortium (2016)
    An excess cancer incidence of 20-25% has been identified among persons with diabetes, most of whom have type 2 diabetes. We aimed to describe the association between type 1 diabetes and cancer incidence. Persons with type 1 diabetes were identified from five nationwide diabetes registers: Australia (2000-2008), Denmark (1995-2014), Finland (1972-2012), Scotland (1995-2012) and Sweden (1987-2012). Linkage to national cancer registries provided the numbers of incident cancers in people with type 1 diabetes and in the general population. We used Poisson models with adjustment for age and date of follow up to estimate hazard ratios for total and site-specific cancers. A total of 9,149 cancers occurred among persons with type 1 diabetes in 3.9 million person-years. The median age at cancer diagnosis was 51.1 years (interquartile range 43.5-59.5). The hazard ratios (HRs) (95% CIs) associated with type 1 diabetes for all cancers combined were 1.01 (0.98, 1.04) among men and 1.07 (1.04, 1.10) among women. HRs were increased for cancer of the stomach (men, HR 1.23 [1.04, 1.46]; women, HR 1.78 [1.49, 2.13]), liver (men, HR 2.00 [1.67, 2.40]; women, HR 1.55 [1.14, 2.10]), pancreas (men, HR 1.53 [1.30, 1.79]; women, HR 1.25 [1.02,1.53]), endometrium (HR 1.42 [1.27, 1.58]) and kidney (men, HR 1.30 [1.12, 1.49]; women, HR 1.47 [1.23, 1.77]). Reduced HRs were found for cancer of the prostate (HR 0.56 [0.51, 0.61]) and breast (HR 0.90 [0.85, 0.94]). HRs declined with increasing diabetes duration. Type 1 diabetes was associated with differences in the risk of several common cancers; the strength of these associations varied with the duration of diabetes.
  • Kaarakka, Lilli; Hyvönen, Riitta; Strömgren, Monika; Palviainen, Marjo; Persson, Tryggve; Olsson, Bengt A; Launonen, Erno; Vegerfors, Birgitta; Helmisaari, Heljä-Sisko (2016)
    The use of forest-derived biomass has steadily increased in Finland and Sweden during the past decades leading to more intensive forest management practices in the region, such as whole-tree harvesting, both above- and belowground. Stump harvesting results in a direct removal of stump and coarse-root carbon (C) from the stand and can cause extensive soil disturbance, which has been suggested to increase C mineralization. In this study, the effects of stump harvesting on soil C and nitrogen (N) mineralization, and soil surface disturbance were studied in two different clear-felled Norway spruce (Picea abies) sites in Central Finland. The treatments were whole-tree harvesting (WTH, removal of stems and logging residues), and WTH and stump harvesting (WTH + S). Both sites, Honkola (2 stands) and Haukilahti (6 stands) were mounded. In both treatments, soil samples were taken from different soil layers down to a total depth of 20 cm in the mineral soil from (i) mounds, (ii) undisturbed soil and (iii) pits. The sampling was performed 11-12 years after treatments. Soil C and N mineralization rates were determined in laboratory incubation experiments. In addition, total C and N pools (g m(2)) were estimated for each disturbance class and soil layer. Soil C and N pools had a tendency to be lower following stump harvesting, but no statistically significant treatment effect was detected. Stump harvesting increased soil mixing as indicated by a significant decrease in C concentration in the mound disturbance class. There was no significant effect of stump harvesting on soil C mineralization rates. A combination of mineralization rates and soil pool data showed that field C mineralization (g CO2-C m(-2) yr(-1)) did not significantly differ between stands where stumps were removed or were retained. Further, stump harvesting did not seem to have any stimulating effect on soil CO2 efflux 11-12 years after treatment. (C) 2016 Elsevier B.V. All rights reserved.
  • Riihimaki, Matias; Hemminki, Akseli; Sundquist, Kristina; Hemminki, Kari (2014)
  • Kröger, Björn; Aubrechtová, Martina (2018)
    The cephalopods of the reef limestones of the Vasalemma Formation, northern Estonia, are highly diverse and comprise 22 species belonging to 10 families and seven orders in a sample of >300 specimens. Most of the specimens were collected from shell concentrations in synsedimentary cavities and are interpreted as parautochthonous, washed in from nearby habitats. Nearly all of the shells are fragmented and nearly 15% are partially encrusted by epibionts. The assemblage is dominated by small (mostly less than 30mm wide), straight-shelled actinocerids and orthocerids; in addition, coiled tarphycerids are common. The high-level taxonomic composition of the Vasalemma cephalopod assemblage, with a dominance of actinocerids and an absence of endocerids, is in agreement with deposition in a warm-water (tropical or subtropical), shallow, subtidal regime. At the species level the assemblage is highly endemic, but the generic composition allows for a statistical comparison with other faunas. A cluster analysis of contemporary assemblages reveals a high degree of similarity with late Sandbian cephalopod faunas of epicontinental Laurentia. The palaeogeographical distribution pattern is similar to that of brachiopods, which supports earlier interpretations of these clusters as mainly controlled by water temperature and depositional depth. Several of the Vasalemma genera became conspicuous elements of epicontinental Laurentia during the Katian, which emphasizes that immigration towards Laurentia was an important factor in Late Ordovician diversity dynamics. Of the described taxa, the following are new: Beloitoceras cautis sp. nov., Curtoceras abditus sp. nov., Hemibeloitoceras arduum sp. nov., H. molis sp. nov., Hoeloceras muroni sp. nov., Isorthoceras cavi sp. nov., I. maris sp. nov., I. padisense sp. nov., I. vexilli sp. nov., Ordogeisonoceras tartuensis sp. nov., Orthonybyoceras isakari sp. nov., O. moisense sp. nov., Pleurorthoceras organi sp. nov., Rummoceras rummuensis gen. et sp. nov. and Trocholites gennadii sp. nov.http://zoobank.org/urn:lsid:zoobank.org:pub:E5211305-A5D0-4366-AAB1-08F96F817122
  • Rapo-Pylkkö, Susanna; Haanpää, Maija; Liira, Helena (2016)
    Objective: To present the occurrence, characteristics, etiology, interference, and medication of chronic pain among the elderly living independently at home. Design/setting: A total of 460 subjects in three cohorts aged 75, 80 and 85 years respectively received visits by communal home-care department nurses for a cross-sectional survey. Of them, 175 had chronic (duration 3 months) pain with an average intensity of 4/10 and/or moderate interference in daily life. Main outcome measures: Clinical assessment was performed for consenting subjects to define the location, intensity, etiology, type, interference and medications of chronic pain. Results: According to home visits, elderly people with chronic pain rated their health and mobility worse and felt sadder, lonelier and more tired than those without chronic pain. A geriatrician made clinical assessments for 106 patients with chronic pain in 2009-2013. Of them, 66 had three, 35 had two and 5 had one pain condition. The worst pain was musculoskeletal in 88 (83%) of patients. Pain was pure nociceptive in 61 (58%), pure neuropathic in 9 (8%), combined nociceptive and neuropathic pain in 34 (32%), and idiopathic in 2 (2%) patients. On a numerical rating scale from 0 to 10, the mean and maximal intensity of the worst pain was 5.7 and 7.7, respectively, while the mean pain interference was 5.9. Mean pain intensity and maximal pain intensity decreased by age. Duration of pain was longer than 5 years in 51 (48%) patients. Regular pain medication was used by 82 (77%) patients, most commonly paracetamol or NSAIDs. Although pain limited the lives of the elderly with chronic pain, they were as satisfied with their lives as those without chronic pain. Conclusions: Elderly people in our study often suffered from chronic pain, mostly musculoskeletal pain, and the origin of pain was neuropathic in up to 40% of these cases. However, elderly people with chronic pain rarely used the medications specifically for neuropathic pain. Based on increased loneliness, sadness and tiredness, as well as decreased subjective health and mobility, the quality of life was decreased among those with chronic pain compared with those without pain.
  • Airaksinen, N.; Nurmi-Luthje, I.; Luthje, P. (2016)
    Background and Aims: The coverage of the official statistics is poor in motorcycle and moped accidents. The aim of this study was to analyze the severity of motorcycle and moped crashes, and to define the degree of under-reporting in official statistics. Material and Methods: All first attendances due to an acute motorcyclist or moped driver injury registered in the emergency department between June 2004 and May 2006 were analyzed. The severity of the injuries was classified using the Abbreviated Injury Scale score and the New Injury Severity Score. The hospital injury data were compared to the traffic accident statistics reported by the police and compiled and maintained by Statistics Finland. Results: A total of 49 motorcyclists and 61 moped drivers were involved in crashes, leading to a total of 94 and 109 injuries, respectively. There were slightly more vertebral and midfoot fractures among motorcyclists than among moped drivers (p=0.038 and 0.016, respectively). No significant differences were found between the severity (maximum Abbreviated Injury Scale and median New Injury Severity Scores) of the motorcycle and moped crashes. There was no in-hospital mortality. The degree of agreement (overlap) between the hospital dataset and the official statistics was 32%. The rate of under-reporting was 68%. Conclusions: According to the maximum Abbreviated Injury Scale and New Injury Severity Scores, the injury severity was equal for motorcycle and moped crashes. The degree of agreement between the hospital dataset and the official statistics was 32%.
  • Riihimaeki, Matias; Thomsen, Hauke; Hemminki, Akseli; Sundquist, Kristina; Hemminki, Kari (2013)
  • Laaksonen, Maija; Sajanti, Eeva; Sormunen, Jani J.; Penttinen, Ritva; Hanninen, Jari; Ruohomaki, Kai; Saaksjarvi, Ilari; Vesterinen, Eero J.; Vuorinen, Ilppo; Hytonen, Jukka; Klemola, Tero (2017)
    A national crowdsourcing-based tick collection campaign was organized in 2015 with the objective of producing novel data on tick distribution and tick-borne pathogens in Finland. Nearly 20 000 Ixodes ticks were collected. The collected material revealed the nationwide distribution of I. persulcatus for the first time and a shift northwards in the distribution of I. ricinus in Finland. A subset of 2038 tick samples containing both species was screened for Borrelia burgdorferi sensu lato (the prevalence was 14.2% for I. ricinus and 19.8% for I. persulcatus), B. miyamotoi (0.2% and 0.4%, respectively) and tick-borne encephalitis virus (TBEV; 0.2% and 3.0%, respectively). We also report new risk areas for TBEV in Finland and, for the first time, the presence of B. miyamotoi in ticks from mainland Finland. Most importantly, our study demonstrates the overwhelming power of citizen science in accomplishing a collection effort that would have been impossible with the scientific community alone.
  • Laulajainen-Hongisto, Anu; Aarnisalo, Antti A.; Jero, Jussi (2016)
    Acute otitis media is a common infection in children. Most acute otitis media episodes can be treated at an outpatient setting with antimicrobials, or only expectant observation. Hospital treatment with parenteral medication, and myringotomy or tympanostomy, may be needed to treat those with severe, prolonged symptoms, or with complications. The most common intratemporal complication of acute otitis media is acute mastoiditis. If a child with acute mastoiditis does not respond to this treatment, or if complications develop, further examinations and other surgical procedures, including mastoidectomy, are considered. Since the treatment of complicated acute otitis media and complicated acute mastoiditis differs, it is important to differentiate these two conditions. This article focuses on the differential diagnostics of acute otitis media and acute mastoiditis in children.
  • Lindqvist, U.; Gudbjornsson, B.; Iversen, L.; Laasonen, L.; Ejstrup, L.; Ternowitz, T.; Stahle, M. (2017)
    Objective: To describe the social status and health-related quality of life of patients with psoriatic arthritis mutilans (PAM) in the Nordic countries.Method: Patients with at least one mutilated joint confirmed by radiology were studied. Disease activity involving joints and skin, physician-assessed disease activity, and patient's education and work status were recorded. Data from the 36-item Short Form Health Survey, Health Assessment Questionnaire and Dermatology Life Quality Index questionnaire were gathered and correlated with disease duration, pain, and general well-being (visual analogue scale). The controls were 58 Swedish patients with long-standing psoriatic arthritis sine PAM.Results: Sixty-seven patients were included. Patients with PAM had a protracted disease history (3314years) and disease onset at a relatively early age (30 +/- 12years). Overall inflammatory activity at inclusion was mild to moderate. The mean number of mutilated joints was 8.2 and gross deformity was found in 16% of patients. Forty per cent were treated with biological and 32% with conventional synthetic disease-modifying anti-rheumatic drugs. Forty-two per cent had retired early or were on sick leave. Impaired functional capacity with little or no ability to perform self-care or everyday tasks was reported by 21% of the patients. Patients between 45 and 60years of age reported the most impaired quality of life in comparison to the control group.Conclusion: PAM seriously affects social functioning. Whether early recognition of PAM and new forms of therapy can improve disease outcome and quality of life remains to be studied.
  • 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.
  • Launonen, Antti P.; Huttunen, Tuomas T.; Lepola, Vesa; Niemi, Seppo T.; Kannus, Pekka; Felländer-Tsai, Li; Berg, Hans E.; Laitinen, Minna K.; Mattila, Ville M. (2020)
    Purpose Distal biceps tendon rupture is a relatively rare injury usually occurring with excess external extension force applied to a flexed elbow. The aim of this study was to examine the incidence of distal biceps tendon rupture surgery in the Finnish and Swedish adult population between the years 1997 and 2016. A secondary aim was to investigate the distal biceps rupture incidence in the Swedish population in 2001 to 2016. Methods We assessed the number and rate of distal biceps tendon rupture surgery using the Finnish and Swedish Hospital Discharge Register as databases. The study included the entire Finnish and Swedish adult population aged 18 years and older between January 1, 1997 and of December 31, 2016. Results During the study period, 2,029 patients had a distal biceps tendon rupture in Finland, and the corresponding figure was 2,000 in Sweden. The rate of distal biceps tendon rupture surgery increased steeply, but equally, in both countries, in Finnish men from 1.3 per 100,000 person-years in 1997 to 9.6 in 2016, and in Swedish men from 0.2 in 1997 to 5.6 in 2016. The incidence of distal biceps tendon rupture in Sweden increased in men from 1.6 to 10.0 per 100,000 person-years from 2001 to 2016. Conclusions There was a 7-fold and a 28-fold increase in the incidence of distal biceps tendon rupture surgery in Finnish and Swedish men during 1997 to 2016. The incidence of distal biceps tendon rupture rose 6-fold in Swedish men in 2001 to 2016. Copyright (C) 2020 by the American Society for Surgery of the Hand. Published by Elsevier Inc.
  • Karalis, Elina; Gissler, Mika; Tapper, Anna-Maija; Ulander, Veli-Matti (2016)
    Objective: To evaluate the influence of delivery unit size and on-call staffing in the performance of low-risk deliveries in Finland. Study design: A population-based study of hospital size and level based on Medical Birth Register data. Population was all hospital births in Finland in 2005-2009. Inclusion criteria were singleton births (birth weight 2500 g or more) without major congenital anomalies or birth defects. Additionally, only intrapartum stillbirths were included. Birthweights and maternal background characteristics were adjusted for by logistic regression. Main outcome measures were intrapartum or early neonatal mortality, neonatal asphyxia and newborns' need for intensive care or transfer to other hospital and longer duration of care. On-call arrangements were asked from each of the hospitals. Results: Intrapartum mortality was higher in units where physicians were at home when on-call (OR 1.25; 95% CI 1.02-1.52). A tendency to a higher mortality was also recorded in non-university hospitals (OR 1.18; 95% CI 0.99-1.40). Early neonatal mortality was twofold in units with less than 1000 births annually (OR 2.11; 95% CI 0.97-4.56) and in units where physicians were at home when on-call (OR 1.85; 95% CI 0.91-3.76). These results did not reach statistical significance. No differences between the units were found regarding Apgar scores or umbilical cord pH. Conclusion: The differences in mortality rates between different level hospitals suggest that adverse outcomes during delivery should be studied in detail in relation to hospital characteristics, such as size or level, and more international studies determining obstetric patient safety indicators are required. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
  • Liira, Helena; Koskela, Tuomas; Thulesius, Hans; Pitkala, Kaisu (2016)
    Objective: Research and PhDs are relatively rare in family medicine and primary care. To promote research, regular one-year research courses for primary care professionals with a focus on clinical epidemiology were started. This study explores the academic outcomes of the first four cohorts of research courses and surveys the participants' perspectives on the research course. Design: An electronic survey was sent to the research course participants. All peer-reviewed scientific papers published by these students were retrieved by literature searches in PubMed. Setting: Primary care in Finland. Subjects: A total of 46 research course participants who had finished the research courses between 2007 and 2012. Results: Of the 46 participants 29 were physicians, eight nurses, three dentists, four physiotherapists, and two nutritionists. By the end of 2014, 28 of the 46 participants (61%) had published 79 papers indexed in PubMed and seven students (15%) had completed a PhD. The participants stated that the course taught them critical thinking, and provided basic research knowledge, inspiration, and fruitful networks for research. Conclusion: A one-year, multi-professional, clinical epidemiology based research course appeared to be successful in encouraging primary care research as measured by research publications and networking. Activating teaching methods, encouraging focus on own research planning, and support from peers and tutors helped the participants to embark on research projects that resulted in PhDs for 15% of the participants.
  • Graesner, Jan-Thorsten; Lefering, Rolf; Koster, Rudolph W.; Masterson, Siobhan; Boettiger, Bernd W.; Herlitz, Johan; Wnent, Jan; Tjelmeland, Ingvild B. M.; Rosell Ortiz, Fernando; Maurer, Holger; Baubin, Michael; Mols, Pierre; Hadzibegovic, Irzal; Ioannides, Marios; Skulec, Roman; Wissenberg, Mads; Salo, Ari; Hubert, Herve; Nikolaou, Nikolaos I.; Loczi, Gerda; Svavarsdottir, Hildigunnur; Semeraro, Federico; Wright, Peter J.; Clarens, Carlo; Pijls, Ruud; Cebula, Grzegorz; Correia, Vitor Gouveia; Cimpoesu, Diana; Raffay, Violetta; Trenkler, Stefan; Markota, Andrej; Stroemsoee, Anneli; Burkart, Roman; Perkins, Gavin D.; Bossaert, Leo L.; EuReCa ONE Collaborators (2016)
    Introduction: The aim of the EuReCa ONE study was to determine the incidence, process, and outcome for out of hospital cardiac arrest (OHCA) throughout Europe. Methods: This was an international, prospective, multi-centre one-month study. Patients who suffered an OHCA during October 2014 who were attended and/or treated by an Emergency Medical Service (EMS) were eligible for inclusion in the study. Data were extracted from national, regional or local registries. Results: Data on 10,682 confirmed OHCAs from 248 regions in 27 countries, covering an estimated population of 174 million. In 7146 (66%) cases, CPR was started by a bystander or by the EMS. The incidence of CPR attempts ranged from 19.0 to 104.0 per 100,000 population per year. 1735 had ROSC on arrival at hospital (25.2%), Overall, 662/6414 (10.3%) in all cases with CPR attempted survived for at least 30 days or to hospital discharge. Conclusion: The results of EuReCa ONE highlight that OHCA is still a major public health problem accounting for a substantial number of deaths in Europe. EuReCa ONE very clearly demonstrates marked differences in the processes for data collection and reported outcomes following OHCA all over Europe. Using these data and analyses, different countries, regions, systems, and concepts can benchmark themselves and may learn from each other to further improve survival following one of our major health care events. (C) 2016 The Author(s). Published by Elsevier Ireland Ltd.
  • Rossow, Heidi; Forbes, Kristian M.; Tarkka, Eveliina; Kinnunen, Paula M.; Hemmila, Heidi; Huitu, Otso; Nikkari, Simo; Henttonen, Heikki; Kipar, Anja; Vapalahti, Olli (2014)
  • Idehen, Esther E.; Korhonen, Tellervo; Castaneda, Anu; Juntunen, Teppo; Kangasniemi, Mari; Pietila, Anna-Maija; Koponen, Paivikki (2017)
    Background: Previous studies revealed low participation in cervical cancer screening among immigrants compared with non-immigrants. Only a few studies about factors associated with immigrants' lower participation rates have been conducted in European countries that have universal access for all eligible women. Our study aimed to explore factors associated with cervical screening participation among women of Russian, Somali, and Kurdish origin in Finland. Methods: We used data from the Migrant Health and Well-being Survey, 2010-2012. Structured face-to-face interviews of groups of immigrants aged 25-60 yielded 620 responses concerning screening participation in the previous five years. Statistical analysis employed logistic regression. Results: The age-adjusted participation rates were as follows: among women of Russian origin 73.9% (95% CI 68.1-79.7), for Somalis 34.7% (95% CI 26.4-43.0), and for Kurds 61.3% (95% CI 55.0-67.7). Multiple logistic regressions showed that the most significant factor increasing the likelihood of screening participation among all groups was having had at least one gynecological check-up in the previous five years (Odds ratio [OR] = 6.54-26.2; p <0.001). Other factors were higher education (OR = 2.63; p = 0.014), being employed (OR = 4.31; p = 0.007), and having given birth (OR = 9.34; p= 0.014), among Kurds; and literacy in Finnish/Swedish (OR = 3.63; p = 0.003) among Russians. Conclusions: Our results demonstrate that women who refrain from using reproductive health services, those who are unemployed and less educated, as well as those with poor language proficiency, might need more information on the importance of screening participation. Primary and occupational healthcare services may have a significant role in informing immigrant women about this importance.
  • Zheng, Guoqiao; Yu, Hongyao; Kanerva, Anna; Försti, Asta; Sundquist, Kristina; Hemminki, Kari (2018)
    Ovarian cancer is a heterogeneous disease. Data regarding familial risks for specific proband, age at diagnosis and histology are limited. Such data can assist genetic counseling and help elucidate etiologic differences among various histologic types of ovarian malignancies. By using the Swedish Family-Cancer Database, we calculated relative risks (RRs) for detailed family histories using a two-way comparison, which implied e.g. estimation of RRs for overall ovarian cancer when family history was histology-specific ovarian cancer, and conversely, RRs for histology-specific ovarian cancer when family history was overall ovarian cancer. In families of only mother, only sisters or both mother and sisters diagnosed with ovarian cancer, cancer risks for ovary were 2.40, 2.59 and 10.40, respectively; and were higher for cases diagnosed before the age of 50 years. All histological types showed a familial risk in two-way analyses, except mucinous and sex cord-stromal tumors. RRs for concordant histology were found for serous (2.47), endometrioid (3.59) and mucinous ovarian cancers (6.91). Concordant familial risks were highest for mucinous cancer; for others, some discordant associations, such as endometrioid-undifferentiated (9.27) and serous-undifferentiated (4.80), showed the highest RRs. Familial risks are high for early-onset patients and for those with multiple affected relatives. Sharing of different histological types of ovarian cancer is likely an indication of the complexity of the underlying mechanisms.