Browsing by Subject "adults"

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  • Tammi, Rilla (Helsingin yliopisto, 2021)
    Added sugar intake has been associated with several adverse health issues, such as obesity, type 2 diabetes, and cardiovascular diseases. However, the knowledge of added sugar intake’s associations with overall diet quality and population subgroups is currently scarce. Our objective was to examine the association of added sugar intake with overall diet quality and population subgroups formed by sociodemographic factors, lifestyle factors, and obesity measures in the Finnish adult population. We also explored whether the association between added sugar intake and overall diet quality differs in the population subgroups. We applied the data from the cross-sectional population-based national FinHealth 2017 Study, and our analytical sample comprised 5094 Finnish adults. Dietary intake was assessed with a validated food frequency questionnaire and added sugar intake was estimated by a newly developed calculation method utilizing food item disaggregation based on the national food composition database Fineli ®. Overall diet quality was assessed by the modified Baltic Sea Diet Score (mBSDS), depicting a healthy Nordic diet. The analyses were established separately for women and men, and associations were calculated by chi-square tests and linear and logistic regression analyses, adjusting for age, education level, smoking, physical activity, BMI, and energy intake. Interactions were investigated with interaction terms and stratified analyses. Added sugar intake was inversely associated with education (P = 0.032 women; P = 0.001 men), smoking (P = 0.002 women; P < 0.0001 men), and physical activity (P < 0.0001) in both sexes. An inverse association was found with BMI in men (P = 0.003). Higher added sugar intake was associated with lower overall diet quality (P < 0.0001) and lower consumption of healthy perceived mBSDS components (P ≤ 0.001). An inverse association was also found with red and processed meat consumption in men (P = 0.011), while there was no association in women. Of the studied population subgroups, a significant interaction was found in physical activity subgroups in men (P = 0.005), the inverse association between added sugar intake and overall diet quality being stronger among active men compared with moderately active and inactive men. In conclusion, our findings suggest that high added sugar intake was associated with lower overall diet quality, lower education, and unhealthy lifestyle habits. The findings of this study can be utilized as background information when establishing new incentives to reduce added sugar intake or maintain a satisfactory intake level in the Finnish adult population. More research, especially longitudinal studies, is needed of added sugar intake’s associations with sociodemographic factors, lifestyle factors, obesity measures, and overall diet quality in the population and population subgroups.
  • Piirtola, Maarit; Kaprio, Jaakko; Svedberg, Pia; Silventoinen, Karri; Ropponen, Annina (2020)
  • Micai, M; Ciaramella, A; Salvitti, T; Fulceri, F; Fatta, LM; Poustka, L; Diehm, R; Iskrov, G; Stefanov, R; Guillon, Q; Roge, B; Staines, A; Sweeney, MR; Boilson, AM; Leosdottir, T; Saemundsen, E; Moilanen, I; Ebeling, H; Yliherva, A; Gissler, M; Parviainen, T; Tani, P; Kawa, R; Vicente, A; Rasga, C; Budisteanu, M; Dale, I; Povey, C; Flores, N; Jenaro, C; Monroy, ML; Primo, PG; Charman, T; Cramer, S; Warberg, CK; Canal-Bedia, R; Posada, M; Scattoni, ML; Schendel, D (2021)
    The Autism Spectrum Disorders in the European Union (ASDEU) survey investigated the knowledge and health service experiences of users and providers to generate new hypotheses and scientific investigations that would contribute to improvement in health care for autistic adults. An online survey designed for autistic adults, carers of autistic adults, and professionals in adult services was translated into 11 languages and distributed electronically by organizations and in-country adult service facilities in 2017; 522 autistic adults, 442 carers, and 113 professionals provided answers to the health questions. Professionals, the majority in non-medical services, appeared to be poorly informed about whether certain co-occurring conditions were more frequent in autistic adults than typical adults-especially some medical conditions, suicide attempts, accidents, and pain. A minority of autistic adults reported preventive health behaviors such as routine health check-ups. The majority of users and providers expressed the desire to make health care services more user-friendly for autistic adults. Among the three groups,
  • van Hedel, Karen; Martikainen, Pekka; Moustgaard, Heta; Myrskylä, Mikko (2018)
    Marriage is associated with better mental health. While research on the mental health of cohabiting individuals has increased in recent years, it has yielded mixed results thus far. We assessed whether the mental health of cohabiters is comparable to that of married individuals or those living alone using longitudinal data on psychotropic medication purchases. Panel data from an 11% random sample of the population residing in Finland for the years 1995 to 2007, with annual measurements of all covariates, were used. Ordinary least squares (OLS) models were applied to disentangle the relation between cohabitation and psychotropic medication purchases while controlling for relevant time-varying factors (age, education, economic activity, and number of children), and individual fixed effects (FE) models to further account for unobserved time-invariant individual factors. Our sample consisted of 63,077 men and 61,101 women aged 25 to 39 years in 1995. Descriptive results and the OLS model indicated that the likelihood of purchasing psychotropic medication was lowest for married individuals, higher for cohabiters, and highest for individuals living alone. This difference between cohabiting and married individuals disappeared after controlling for time-varying covariates (percent difference [% diff] for men: 0.3, 95% confidence interval [CI]: -0.0, 0.6; % diff for women: -0.2, 95% CI: -0.6, 0.2). Further controlling for unobserved confounders in the FE models did not change this non-significant difference between cohabiting and married individuals. The excess purchases of psychotropic medication among individuals living alone compared to those cohabiting decreased to 1.2 (95% CI: 1.0, 1.4) and 1.4 (95% CI: 1.1, 1.6) percentage-points in the fully-adjusted FE model for men and women, respectively. Similar results were found for all subcategories of psychotropic medication. In summary, these findings suggested that the mental health difference between cohabiting and married individuals, but not the difference between cohabiting individuals and those living alone, was largely due to selection.
  • Lassmann-Klee, Paul G.; Lehtimäki, Lauri; Lindholm, Tuula; Malmberg, Leo Pekka; Sovijärvi, Anssi R. A.; Piirilä, Päivi Liisa (2019)
    In clinical practice, assessment of expiratory nitric oxide (F-ENO) may reveal eosinophilic airway inflammation in asthmatic and other pulmonary diseases. Currently, measuring of F-ENO is standardized to exhaled flow level of 50 ml s(-1), since the expiratory flow rate affects the F-ENO results. To enable the comparison of F-ENO measured with different expiratory flows, we firstly aimed to establish a conversion model to estimate F-ENO at the standard flow level, and secondly, validate it in five external populations. F-ENO measurements were obtained from 30 volunteers (mixed adult population) at the following multiple expiratory flow rates: 50, 30, 100 and 300 ml s(-1), after different mouthwash settings, and a conversion model was developed. We tested the conversion model in five populations: healthy adults, healthy children, and patients with COPD, asthma and alveolitis. F-ENO conversions in the mixed adult population, in healthy adults and in children, showed the lowest deviation between estimated FENO from 100 ml s(-1) and measured F-ENO at 50 mL s(-1): -0 center dot 28 ppb, -0 center dot 44 ppb and 0 center dot 27 ppb, respectively. In patients with COPD, asthma and alveolitis, the deviation was -1 center dot 16 ppb, -1 center dot 68 ppb and 1 center dot 47 ppb, respectively. We proposed a valid model to convert F-ENO in healthy or mixed populations, as well as in subjects with obstructive pulmonary diseases and found it suitable for converting F-ENO measured with different expiratory flows to the standard flow in large epidemiological data, but not on individual level. In conclusion, a model to convert F-ENO from different flows to the standard flow was established and validated.
  • Silventoinen, Karri; Jelenkovic, Aline; Sund, Reijo; Yokoyama, Yoshie; Hur, Yoon-Mi; Cozen, Wendy; Hwang, Amie E.; Mack, Thomas M.; Honda, Chika; Inui, Fujio; Iwatani, Yoshinori; Watanabe, Mikio; Tomizawa, Rie; Pietilainen, Kirsi H.; Rissanen, Aila; Siribaddana, Sisira H.; Hotopf, Matthew; Sumathipala, Athula; Rijsdijk, Fruhling; Tan, Qihua; Zhang, Dongfeng; Pang, Zengchang; Piirtola, Maarit; Aaltonen, Sari; Oncel, Sevgi Y.; Aliev, Fazil; Rebato, Esther; Hjelmborg, Jacob B.; Christensen, Kaare; Skytthe, Axel; Kyvik, Kirsten O.; Silberg, Judy L.; Eaves, Lindon J.; Cutler, Tessa L.; Ordonana, Juan R.; Sanchez-Romera, Juan F.; Colodro-Conde, Lucia; Song, Yun-Mi; Yang, Sarah; Lee, Kayoung; Franz, Carol E.; Kremen, William S.; Lyons, Michael J.; Busjahn, Andreas; Nelson, Tracy L.; Whitfield, Keith E.; Kandler, Christian; Jang, Kerry L.; Gatz, Margaret; Butler, David A.; Stazi, Maria A.; Fagnani, Corrado; D'Ippolito, Cristina; Duncan, Glen E.; Buchwald, Dedra; Martin, Nicholas G.; Medland, Sarah E.; Montgomery, Grant W.; Jeong, Hoe-Uk; Swan, Gary E.; Krasnow, Ruth; Magnusson, Patrik Ke; Pedersen, Nancy L.; Aslan, Anna K. Dahl; McAdams, Tom A.; Eley, Thalia C.; Gregory, Alice M.; Tynelius, Per; Baker, Laura A.; Tuvblad, Catherine; Bayasgalan, Gombojav; Narandalai, Danshiitsoodol; Spector, Timothy D.; Mangino, Massimo; Lachance, Genevieve; Burt, S. Alexandra; Klump, Kelly L.; Harris, Jennifer R.; Brandt, Ingunn; Nilsen, Thomas S.; Krueger, Robert F.; Mcgue, Matt; Pahlen, Shandell; Corley, Robin P.; Huibregtse, Brooke M.; Bartels, Meike; van Beijsterveldt, Catharina E. M.; Willemsen, Gonneke; Goldberg, Jack H.; Rasmussen, Finn; Tarnoki, Adam D.; Tarnoki, David L.; Derom, Catherine A.; Vlietinck, Robert F.; Loos, Ruth J. F.; Hopper, John L.; Sung, Joohon; Maes, Hermine H.; Turkheimer, Eric; Boomsma, Dorret I.; Sorensen, Thorkild I. A.; Kaprio, Jaakko (2017)
    Background: Genes and the environment contribute to variation in adult body mass index [BMI (in kg/m(2))], but factors modifying these variance components are poorly understood. Objective: We analyzed genetic and environmental variation in BMI between men and women from young adulthood to old age from the 1940s to the 2000s and between cultural-geographic regions representing high (North America and Australia), moderate (Europe), and low (East Asia) prevalence of obesity. Design: We used genetic structural equation modeling to analyze BMI in twins >= 20 y of age from 40 cohorts representing 20 countries (140,379 complete twin pairs). Results: The heritability of BMI decreased from 0.77 (95% CI: 0.77, 0.78) and 0.75 (95% CI: 0.74, 0.75) in men and women 2029 y of age to 0.57 (95% CI: 0.54, 0.60) and 0.59 (95% CI: 0.53, 0.65) in men 70-79 y of age and women 80 y of age, respectively. The relative influence of unique environmental factors correspondingly increased. Differences in the sets of genes affecting BMI in men and women increased from 20-29 to 60-69 y of age. Mean BMI and variances in BMI increased from the 1940s to the 2000s and were greatest in North America and Australia, followed by Europe and East Asia. However, heritability estimates were largely similar over measurement years and between regions. There was no evidence of environmental factors shared by co-twins affecting BMI. Conclusions: The heritability of BMI decreased and differences in the sets of genes affecting BMI in men and women increased from young adulthood to old age. The heritability of BMI was largely similar between cultural-geographic regions and measurement years, despite large differences in mean BMI and variances in BMI. Our results show a strong influence of genetic factors on BMI, especially in early adulthood, regardless of the obesity level in the population.
  • Suomi, Johanna; Ranta, Jukka; Tuominen, Pirkko; Hallikainen, Anja; Putkonen, Tiina; Bäckman, Christina; Ovaskainen, Marja-Leena; Virtanen, Suvi; Savela, Kirsti (Evira, 2013)
    Eviran tutkimuksia 2/2013
    Nitraattia esiintyy luonnostaan monissa kasviksissa ja talousvedessä. Osa syödystä nitraatista muuttuu elimistössä nitriitiksi. Nitraattia ja nitriittiä käytetään myös elintarvikelisäaineina, koska ne hillitsevät haitallisten mikrobien kasvua. Toisaalta niiden suuren saannin katsotaan aiheuttavan terveyshaittoja. Esitetty probabilistinen riskinarviointi perustuu vuosina 2004 – 2012 tutkittuihin valvonta- ja tutkimusprojektinäytteisiin sekä kirjallisuustietoihin. Lisäksi käytettiin Terveyden ja hyvinvoinnin laitokselta saatuja Finravinto 2007- ja DIPP-ravintotutkimuksen tuottamia aikuisten ja lasten ruoankulutustietoja. Nitraattialtistus lisäainelähteistä on vähäistä. Valtaosa nitraattialtistuksesta saadaan luontaisista lähteistä: vihanneksista, hedelmistä ja vedestä. Kasvisten käsittely ja hyvä viljelykäytäntö vähentävät saantia. Paljon nitraattia sisältävien kasvisten suurkuluttajien altistus voi ylittää nitraatin hyväksyttävän päivittäissaannin (ADI). Nitriittialtistus elintarvikkeista ja talousvedestä voi ylittää ADI-arvon noin 14 %:lla 3-vuotiaista ja 11 %:lla 6-vuotiaista suomalaislapsista. Suurin altistuslähde ovat ruokamakkarat. Toisaalta jos nitriittipitoisuuksia alennettaisiin nykytasosta, hygieniavaatimuksia ja kylmäketjuhallintaa olisi tehostettava.
  • Ylonen, Venla; Lindfors, Katri; Repo, Marleena; Huhtala, Heini; Fuchs, Valma; Saavalainen, Päivi; Musikka, Alex; Laurila, Kaija; Kaukinen, Katri; Kurppa, Kalle (2020)
    Non-biopsy diagnosis of celiac disease is possible in children with anti-transglutaminase 2 antibodies (TGA) > 10x the upper limit of normal (ULN) and positive anti-endomysial antibodies (EMA). Similar criteria have been suggested for adults, but evidence with different TGA assays is scarce. We compared the performance of four TGA tests in the diagnosis of celiac disease in cohorts with diverse pre-test probabilities. Serum samples from 836 adults with either clinical suspicion or family risk of celiac disease were tested with four commercial TGA assays, EmA and celiac disease-associated genetics. The diagnosis was set based on duodenal lesion or, in some cases, using special methods. 137 (57%) patients with clinical suspicion and 85 (14%) of those with family risk had celiac disease. Positive predictive value (PPV) for 10xULN was 100% in each TGA test. The first non-diagnostic investigations were encountered with ULN 1.0x-5.1x in the clinical cohort and 1.3x-4.9x in the family cohort, respectively. Using the assays' own cut-offs (1xULN) the PPVs ranged 84-100%. Serology-based diagnosis of celiac disease was accurate in adults using different commercial kits and pre-test probabilities using 10xULN. The results also suggest that the ULN threshold for biopsy-omitting approach could be lower.
  • Ventä, Irja; Vehkalahti, Miira M; Huumonen, Sisko; Suominen, Anna Liisa (2020)
    Objectives The aim of the study was to examine the prevalence of third molars in panoramic radiographs in a population-based study of adults aged >= 30 years. Methods Out of a sample of 8028 inhabitants of Finland, selected with two-staged stratified cluster-sampling method for the Health 2000 Survey, 5989 participated in clinical oral examination and panoramic radiography. Mean age was 52.5 years (SD 14.6; range 30-97 years). The following variables were included in the analysis: participant characteristics, clinical number of all teeth, and radiographic prevalence and characteristics of third molars. Statistics included chi-squared, Fisher's exact, and Kruskal-Wallis tests and SAS-SUDAAN calculations. Results A total of 5912 third molars in 47.8% of the study population were recorded from panoramic radiographs. At least one impacted third molar was found in 21.9% of the study population. More than half (57.3%) of the remaining third molars were located in the mandible. A preponderance of participants with all third molars missing were observed in the oldest age group, women, those with lower education and those living in the countryside. Third molars or remnants thereof were observed radiographically in 3.9% of clinically edentulous study population. Conclusions The panoramic radiographs disclosed many remaining third molars in adult Finns aged >= 30 years. One-third of the third molars located impacted which may cause unexpected need for care.
  • Rehn, Marius; Chew, Michelle S.; Olkkola, Klaus T.; Sigurdsson, Martin Ingi; Yli-Hankala, Arvi; Moller, Morten Hylander (2022)
    The Clinical Practice Committee of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine endorses the clinical practice guideline Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. The guideline serves as a useful bedside decision aid for clinicians managing adults with suspected and confirmed septic shock and sepsis-associated organ dysfunction.
  • Niskanen, Riikka (Helsingfors universitet, 2016)
    Introduction: Working conditions have not only been found to impact work ability and productivity, but the overall health of employees. The working environment is a relevant health factor for a considerable part of the population. In research, work-related mental strain has been associated with body weight change, yet no causal relationship can be confirmed based on the existing evidence. Of the psychosocial factors, low job control, as well as both high and low job demands have been associated with weight gain. Most of the research so far has been done with cross-sectional data; long-term follow-ups are scarce and only little research has been done on the association between changing working conditions and body weight change. Aim: The general aim of this study was to examine the association between changes in psychosocial working conditions and body weight change among midlife women and men. The association between two psychosocial work characteristics, job demands and job control, and weight gain during the follow-up was examined in a cohort study among the employees of the City of Helsinki in Finland. The main research question was: (i) Is change in job demands and job control associated with major weight gain during a 10- to 12-year follow-up period among midlife employees? In addition, the contribution of several background and lifestyle factors were taken into account. Especially the contribution of baseline BMI-status, dietary habits and leisure-time physical activity to the association between psychosocial working conditions and major weight gain was studied. Methods: The data were collected from a mail survey among the employees of the City of Helsinki in 2000–2002, 2007 and 2012. The study sample consisted of employees who were 40, 45, 50, 55 and 60 years old at the beginning of the survey in 2000–2002. Exclusion criterions were BMI <18.5kg/m2 in phase 1, retiring before phase 2, and drop out before phase 3. Hence, the final study sample (n=4,630) consisted 52% of the original study population, of which 83% were women. Psychosocial working conditions were assessed with a validated Job Content Questionnaire (JCQ) by Karasek and Theorell in phase 1 and 2. Weight change was assessed between phases 1 and 3, and major weight gain was defined as at least 10% weight gain during that time period. Dietary habits were assessed using a 20-item Food Frequency questionnaire (FFQ). Based on the current national dietary recommendations, nine food habits were chosen and their usage frequency was used as a determinant of healthy food habits. Leisure time physical activity was assessed with metabolic equivalent tasks (METs). Logistic regression analysis was used to examine the associations between changing job demands, job control, and major weight gain. All the analyses were stratified by gender. In addition, further stratification was made by the baseline BMI. Results: Weight gain was common among the study population. Major weight gain was observed among 27% of women and 15% of men. A weak association between change in job demands and major weight gain was found among both genders. Among women, the risk of major weight gain was higher among those who reported persistent high job demands (OR 1.22 95% CI 1.02–1.48 full adjusted model) compared with those with persistent low job demands. Among men, in contrast, the risk was higher among those who reported decreased job demands compared with those who reported persistent low job demands (OR 1.80 95% CI 1.02–3.16 full adjusted model). When further stratified by the BMI in phase 1, the risk was higher only among overweight or obese women, whereas among men the increase in risk was seen among both normal weight and overweight or obese participants. Dietary habits and leisure time physical activity did not affect the association of changing psychosocial working conditions with major weight gain. However, they had a minor own effect on the risk. Change in job control was not associated with the risk of major weight gain. Conclusions: The study shows that change in job demands is weakly associated with major weight gain. Future research is needed especially among other employers than municipalities, and especially among men. Changing working conditions should be studied with shorter follow-up periods, while taking into account also the role of social support at the workplace.
  • Koljonen, V.; Tuimala, J.; Haglund, C.; Tukiainen, E.; Vuola, J.; Juvonen, E.; Lauronen, J.; Krusius, T. (2016)
    Introduction: Burn anemia represents a common complication following a burn injury. Burn anemia etiology carries distinct features occurring at each stage of the post-injury and treatment periods resulting from different causes. We aimed to analyze the use of blood components in Finnish burn victims and to identify patient- and injury-related factors influencing their use. Methods: To study the use of blood products in burn patients, we used data collected from the Optimal Use of Blood registry, developed through co-operation between 10 major hospital districts and the Finnish Red Cross Blood Service. Burn patients 18years treated at the Helsinki University Hospital between 2005 and 2011 with an in-hospital stay 1day who received at least one transfusion during their hospital stay were included in this study. Results: Among all 558 burn patients, 192 (34%) received blood products during their hospital stay. The transfused cohort comprised 192 burn patients. The study cohort received a total of 6087units of blood components, 2422units of leukoreduced red blood cells, 1728units of leukoreduced platelets, and 420units of single-donor fresh frozen plasma or, after 2007, 1517units of Octaplas((R)) frozen plasma. All three types of blood components were administered to 29% of patients, whereas 45% received only red blood cells and 6% received only Octaplas. Transfused patients were significantly older (p Discussion: We show that Finnish adult burn patients received ample transfusions. The number of blood components transfused varied according to the anatomical location of the injury and patient survival. Whether the additional mortality is related directly to transfusions or is merely a manifestation of the more severe burn injury remains unknown.
  • Wiklund, E.; Koskinen, Seppo Kalervo; Linder, F.; Aslund, P-E; Eklof, H. (2016)
    Background: Whole body computed tomography in trauma (WBCTT) is a standardized CT examination of trauma patients. It has a relatively high radiation dose. Therefore, well-defined clinical indications and imaging protocols are needed. This information regarding Nordic countries is limited. Purpose: To identify Nordic countries' WBCTT imaging protocols, radiation dose, and integration in trauma care, and to inquire about the need for common Nordic guidelines. Material and Methods: A survey with 23 multiple choice questions or free text responses was sent to 95 hospitals and 10 trauma centers in and outside the Nordic region, respectively. The questions were defined and the hospitals selected in collaboration with board members of "Nordic Forum for Trauma and Emergency Radiology" ( Results: Two Nordic hospitals declined to take part in the survey. Out of the remaining 93 Nordic hospitals, 56 completed the questionnaire. Arterial visualization is routine in major trauma centers but only in 50% of the Nordic hospitals. The CT scanner is located within 50 m of the emergency department in all non-Nordic trauma centers but only in 60% of Nordic hospitals. Radiation dose for WBCTT is in the range of 900-3600 mGy x cm. Of the 56 responding Nordic hospitals, 84% have official guidelines for WBCTT. Eighty-nine percent of the responders state there is a need for common guidelines. Conclusion: Scanning protocols, radiation doses, and routines differ significantly between hospitals and trauma centers. Guideline for WBCTT is presently defined locally in most Nordic hospitals. There is an interest in most Nordic hospitals to endorse new and common guidelines for WBCTT.