Browsing by Subject "prevention"

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  • Blain, H.; Masud, T.; Dargent-Molina, P.; Martin, F. C.; Rosendahl, E.; van der Velde, N.; Bousquet, J.; Benetos, A.; Cooper, C.; Kanis, J. A.; Reginster, J. Y.; Rizzoli, R.; Cortet, B.; Barbagallo, M.; Dreinhofer, K. E.; Vellas, B.; Maggi, S.; Strandberg, T.; Eugms Falls Fracture Interest Grp; Int Assoc Gerontology Geriatri; European Union Med Specialists EUM; Fragility Fracture Network FFN; European Soc Clinical Econ Aspects; Int Osteoporosis Fdn IOF (2016)
    Prevention of fragility fractures in older people has become a public health priority, although the most appropriate and cost-effective strategy remains unclear. In the present statement, the Interest Group on Falls and Fracture Prevention of the European Union Geriatric Medicine Society (EUGMS), in collaboration with the International Association of Gerontology and Geriatrics for the European Region (IAGG-ER), the European Union of Medical Specialists (EUMS), the International Osteoporosis Foundation - European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, outlines its views on the main points in the current debate in relation to the primary and secondary prevention of falls, the diagnosis and treatment of bone fragility, and the place of combined falls and fracture liaison services for fracture prevention in older people.
  • Shiri, Rahman; Heliövaara, Markku; Ahola, Kirsi; Kaila-Kangas, Leena; Haukka, Eija; Kausto, Johanna; Saastamoinen, Peppiina; Leino-Arjas, Päivi; Lallukka, Tea (2018)
    Objective This study aimed to develop and validate a risk screening tool using a points system to assess the risk of future disability retirement due to musculoskeletal disorders (MSD). Methods The development population, the Health 2000 Survey, consisted of a nationally representative sample of Finnish employees aged 30-60 years (N=3676), and the validation population, the Helsinki Health Study, consisted of employees of the City of Helsinki aged 40-60 years (N=6391). Both surveys were linked to data on disability retirement awards due to MSD from national register for an 11-year follow-up. Results The discriminative ability of the model with seven predictors was good (Gonen and Heller's K concordance statistic=0.821). We gave points to seven predictors: sex-dependent age, level of education, pain limiting daily activities, multisite musculoskeletal pain, history of arthritis, and surgery for a spinal disorder or carpal tunnel syndrome. A score of >= 3 out of 7 (top 30% of the index) had good sensitivity (83%) and specificity (70%). Individuals at the top 30% of the risk index were at 29 [95% confidence interval (CI) 15-55) times higher risk of disability retirement due to MSD than those at the bottom 40%. Conclusion This easy-to-use screening tool based on self-reported risk factor profiles can help identify individuals at high risk for disability retirement due to MSD.
  • Lehtisalo, J.; Lindstrom, J.; Ngandu, T.; Kivipelto, M.; Ahtiluoto, S.; Ilanne-Parikka, P.; Keinanen-Kiukaanniemi, S.; Eriksson, J. G.; Uusitupa, M.; Tuomilehto, J.; Luchsinger, J.; Finnish Diabet Prevention Study DP (2016)
    Objectives: To investigate associations of long-term nutrient intake, physical activity and obesity with later cognitive function among the participants in the Finnish Diabetes Prevention Study, in which a lifestyle intervention was successful in diabetes prevention. Design: An active lifestyle intervention phase during middle age (mean duration 4 years) and extended follow-up (additional 9 years) with annual lifestyle measurements, followed by an ancillary cognition assessment. Setting: 5 research centers in Finland. Participants: Of the 522 middle-aged, overweight participants with impaired glucose tolerance recruited to the study, 364 (70%) participated in the cognition assessment (mean age 68 years). Measurements: A cognitive assessment was executed with the CERAD test battery and the Trail Making Test A on average 13 years after baseline. Lifestyle measurements included annual clinical measurements, food records, and exercise questionnaires during both the intervention and follow-up phase. Results: Lower intake of total fat (p=0.021) and saturated fatty acids (p=0.010), and frequent physical activity (p=0.040) during the whole study period were associated with better cognitive performance. Higher BMI (p= 0.012) and waist circumference (p= 0.012) were also associated with worse performance, but weight reduction prior to the cognition assessment predicted worse performance as well (decrease vs. increase, p= 0.008 for BMI and p= 0.002 for waist). Conclusions: Long-term dietary fat intake, BMI, and waist circumference have an inverse association with cognitive function in later life among people with IGT. However, decreases in BMI and waist prior to cognitive assessment are associated with worse cognitive performance, which could be explained by reverse causality.
  • Basnet, Syaron; Merikanto, Ilona; Lahti, Tuuli; Männistö, Satu; Laatikainen, Tiina; Vartiainen, Erkki; Partonen, Timo (2016)
  • Young, T. Kue; Kelly, Janet J.; Friborg, Jeppe; Soininen, Leena; Wong, Kai O. (2016)
    Objectives. To determine and compare the incidence of cancer among the 8 Arctic States and their northern regions, with special focus on 3 cross-national indigenous groups - Inuit, Athabaskan Indians and Sami. Methods. Data were extracted from national and regional statistical agencies and cancer registries, with direct age-standardization of rates to the world standard population. For comparison, the "world average'' rates as reported in the GLOBOCAN database were used. Findings. Age-standardized incidence rates by cancer sites were computed for the 8 Arctic States and 20 of their northern regions, averaged over the decade 2000 - 2009. Cancer of the lung and colon/rectum in both sexes are the commonest in most populations. We combined the Inuit from Alaska, Northwest Territories, Nunavut and Greenland into a "Circumpolar Inuit'' group and tracked cancer trends over four 5-year periods from 1989 to 2008. There has been marked increase in lung, colorectal and female breast cancers, while cervical cancer has declined. Compared to the GLOBOCAN world average, Inuit are at extreme high risk for lung and colorectal cancer, and also certain rare cancers such as nasopharyngeal cancer. Athabaskans (from Alaska and Northwest Territories) share some similarities with the Inuit but they are at higher risk for prostate and breast cancer relative to the world average. Among the Sami, published data from 3 cohorts in Norway, Sweden and Finland show generally lower risk of cancer than non-Sami. Conclusions. Cancer among certain indigenous people in the Arctic is an increasing public health concern, especially lung and colorectal cancer.
  • Seppänen, H.; Puolakkainen, P. (2020)
    Background: Acute pancreatitis is a common disease, the incidence of which is 75-100/100,000/year in Finland. The worldwide incidence of acute pancreatitis is increasing. The identified mildcases usually show rapid recovery with conservative treatment allowing early discharge. Severe cases need early intensive care to reduce the risk of serious complications such as multi-organ failure. The revised Atlanta classification of acute pancreatitis was introduced in 2012-2013. A recurrent acute pancreatitis is defined as two or more well-documented separate attacks of acute pancreatitis with complete resolution in between. Alcoholic pancreatitis is the most common recurrent acute pancreatitis type. Methods: In this review current severity classifications and literature on the prevention of recurrent acute pancreatitis are analyzed. Results: The severity of the disease is classified as mild, moderately severe, and severe acute pancreatitis. Novel entities include acute peripancreatic fluid collections in mild acute pancreatitis and acute necrotic collections in necrotizing acute pancreatitis lesser than 4 weeks after the onset and pancreatic pseudocyst in mild acute pancreatitis and walled-off necrosis in necrotizing acute pancreatitis more than 4 weeks after the onset of the disease. After the first attack of alcohol-induced acute pancreatitis, 46% of the patients develop at least one recurrence within 10- to 20-year follow-up. With repeated intervention against alcohol consumption, it is possible to reduce the recurrences. Removing the gall bladder after biliary pancreatitis is the key preventing recurrences. In mild cases, even during the index admission; in severe cases, it is recommended to wait until the inflammatory changes have resolved. Of total, 59% of the idiopathic pancreatitis had sludge of stones in the gall bladder. In other etiologies, addressing the etiological factor may prevent recurrent acute pancreatitis. Conclusions: This review describes current use of novel severity classifications and also different possibilities to prevent recurrent acute pancreatitis with different etiologies including idiopathic.
  • Akerstrom, Ulf; Reitamo, Sakari; Langeland, Tor; Berg, Mats; Rustad, Lisbeth; Korhonen, Laura; Loden, Marie; Wiren, Karin; Grande, Mats; Skare, Petra; Svensson, Ake (2015)
    Atopic dermatitis (AD) affects adults and children and has a negative impact on quality of life. The present multicentre randomized double-blind controlled trial showed a barrier-improving cream (5% urea) to be superior to a reference cream in preventing eczema relapse in patients with AD (hazard ratio 0.634, p = 0.011). The risk of eczema relapse was reduced by 37% (95% confidence interval (95% CI) 10-55%). Median time to relapse in the test cream group and in the reference cream group was 22 days and 15 days, respectively (p = 0.013). At 6 months 26% of the patients in the test cream group were still eczema free, compared with 10% in the reference cream group. Thus, the barrier-improving cream significantly prolonged the eczema-free time compared with the reference cream and decreased the risk of eczema relapse. The test cream was well tolerated in patients with AD.
  • Sorsa, Minna Anneli; Kylmä, Jari; Bondas, Terese Elisabet (2021)
    Perinatal psychological distress (PPD) may cause delays in help-seeking in the perinatal period, which is crucial for families with small children. Help-seeking theories focus on rational processes of behavior wherein 'help-seeking' is viewed as a decision-making process, in which action is preceded by recognizing a problem. We identified the phase prior to actual help-seeking actions as a life situation and a phenomenon through which to gain a deeper understanding from women's own perspectives. The aim of this study was to integrate and synthesize knowledge of women's experiences of contemplating seeking help for PPD. We chose interpretative meta-ethnography by Noblit and Hare (1988) and implemented eMERGe guidelines in reporting. The search was performed systematically, and the 14 included studies were evaluated with Critical Appraisal Skills Programme checklist (CASP). We identified seven themes and a metaphor in a lines-of-argument synthesis, showing that contemplating help-seeking is a multidimensional phenomenon. We did not observe a straightforward and linear process (as previous research suggests) but instead a complex process of contemplating help-seeking. A clinical implication is that service providers should work with outreach and develop their tools to connect with mothers with PPD. Another suggestion is to improve training in mental health literacy prior to or during pregnancy.
  • Solomon, Alina; Handels, Ron; Wimo, Anders; Antikainen, Riitta; Laatikainen, Tiina; Levälahti, Esko; Peltonen, Markku; Soininen, Hilkka; Strandberg, Timo; Tuomilehto, Jaakko; Kivipelto, Miia; Ngandu, Tiia (2021)
    We investigated the effect of a multidomain lifestyle intervention on the risk of dementia estimated using the validated CAIDE risk score (post-hoc analysis). The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) is a 2-year randomized controlled trial among 1,260 at-risk older adults (60-77 years). Difference in the estimated mean change in CAIDE score at 2 years in the intervention compared to the control group was -0.16 (95 % CI -0.31 to 0.00) (p = 0.013), corresponding to a relative dementia risk reduction between 6.04-6.50%. This could be interpreted as a reflection of the prevention potential of the intervention.
  • Nurmi, Johanna; Knittle, Keegan; Ginchev, Todor; Khattak, Fida; Helf, Christopher; Zwickl, Patrick; Castellano-Tejedor, Carmina; Lusilla-Palacios, Pilar; Costa-Requena, Jose; Ravaja, Niklas; Haukkala, Ari (2020)
    Background: Most adults do not engage in sufficient physical activity to maintain good health. Smartphone apps are increasingly used to support physical activity but typically focus on tracking behaviors with no support for the complex process of behavior change. Tracking features do not engage all users, and apps could better reach their targets by engaging users in reflecting their reasons, capabilities, and opportunities to change. Motivational interviewing supports this active engagement in self-reflection and self-regulation by fostering psychological needs proposed by the self-determination theory (ie, autonomy, competence, and relatedness). However, it is unknown whether digitalized motivational interviewing in a smartphone app engages users in this process. Objective: This study aimed to describe the theory- and evidence-based development of the Precious app and to examine how digitalized motivational interviewing using a smartphone app engages users in the behavior change process. Specifically, we aimed to determine if use of the Precious app elicits change talk in participants and how they perceive autonomy support in the app. Methods: A multidisciplinary team built the Precious app to support engagement in the behavior change process. The Precious app targets reflective processes with motivational interviewing and spontaneous processes with gamified tools, and builds on the principles of self-determination theory and control theory by using 7 relational techniques and 12 behavior change techniques. The feasibility of the app was tested among 12 adults, who were asked to interact with the prototype and think aloud. Semistructured interviews allowed participants to extend their statements. Participants’ interactions with the app were video recorded, transcribed, and analyzed with deductive thematic analysis to identify the theoretical themes related to autonomy support and change talk. Results: Participants valued the autonomy supportive features in the Precious app (eg, freedom to pursue personally relevant goals and receive tailored feedback). We identified the following five themes based on the theory-based theme autonomy support: valuing the chance to choose, concern about lack of autonomy, expecting controlling features, autonomous goals, and autonomy supportive feedback. The motivational interviewing features actively engaged participants in reflecting their outcome goals and reasons for activity, producing several types of change talk and very little sustain talk. The types of change talk identified were desire, need, reasons, ability, commitment, and taking steps toward change. Conclusions: The Precious app takes a unique approach to engage users in the behavior change process by targeting both reflective and spontaneous processes. It allows motivational interviewing in a mobile form, supports psychological needs with relational techniques, and targets intrinsic motivation with gamified elements. The motivational interviewing approach shows promise, but the impact of its interactive features and tailored feedback needs to be studied over time. The Precious app is undergoing testing in a series of n-of-1 randomized controlled trials. KEYWORDS health app; mHealth; human-computer interaction; prevention; service design; usability design; intrinsic motivation; reflective processes; spontaneous processes; engagement; self-determination theory; autonomous motivation; gamification; physical activity
  • Wardlaw, Joanna M; Debette, Stephanie; Jokinen, Hanna; De Leeuw, Frank-Erik; Pantoni, Leonardo; Chabriat, Hugues; Staals, Julie; Doubal, Fergus; Rudilosso, Salvatore; Eppinger, Sebastian; Schilling, Sabrina; Ornello, Raffaele; Enzinger, Christian; Cordonnier, Charlotte; Taylor-Rowan, Martin; Lindgren, Arne G. (2021)
    'Covert' cerebral small vessel disease (ccSVD) is common on neuroimaging in persons without overt neurological manifestations, and increases the risk of future stroke, cognitive impairment, dependency, and death. These European Stroke Organisation (ESO) guidelines provide evidence-based recommendations to assist with clinical decisions about management of ccSVD, specifically white matter hyperintensities and lacunes, to prevent adverse clinical outcomes. The guidelines were developed according to ESO standard operating procedures and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. We prioritised the clinical outcomes of stroke, cognitive decline or dementia, dependency, death, mobility and mood disorders, and interventions of blood pressure lowering, antiplatelet drugs, lipid lowering, lifestyle modifications, glucose lowering and conventional treatments for dementia. We systematically reviewed the literature, assessed the evidence, formulated evidence-based recommendations where feasible, and expert consensus statements. We found little direct evidence, mostly of low quality. We recommend patients with ccSVD and hypertension to have their blood pressure well controlled; lower blood pressure targets may reduce ccSVD progression. We do not recommend antiplatelet drugs such as aspirin in ccSVD. We found little evidence on lipid lowering in ccSVD. Smoking cessation is a health priority. We recommend regular exercise which may benefit cognition, and a healthy diet, good sleep habits, avoiding obesity and stress for general health reasons. In ccSVD, we found no evidence for glucose control in the absence of diabetes or for conventional Alzheimer dementia treatments. Randomised controlled trials with clinical endpoints are a priority for ccSVD.
  • Lindholm, Vivian M.; Isoherranen, Kirsi M.; Schröder, Marika T.; Pitkänen, Sari T. (2020)
    Below-knee dermatological surgery has a high risk of complications such as wound infection, bleeding, and necrosis. In this study, we evaluated the impact of preoperative appointments on complication risks. We searched the medical records of the Helsinki University Central Hospital (HUS) Dermatosurgery unit for all below-knee surgeries during 2016, when no preoperative nurse appointments were carried out, and compared it with 2018, when preoperative appointments for risk patients were introduced. The study included 187 patients in 2016 and 179 patients in 2018, of whom 68 (about one third) attended preoperative appointments. At the appointments, risk factors were evaluated, and compression therapy was introduced when possible. The results show complication rates of 13.4% in 2016 vs 10.1% in 2018 (P = .33), despite significantly higher risks in the 2018 patient group. The odds ratio for complications in appointment attendees vs non-attendees was reduced after adjustments to 0.58; however, this was insignificant (P = .47). The odds of complications for skin grafts were considerably higher: 11.33 vs other surgery techniques (P = .00). In conclusion, the introduction of preoperative appointments appeared to reduce complications in below-knee surgery. For graft reconstructions, complication risk is high, even with carefully planned pre- and postoperative care. Further studies are needed to evaluate preventable risk factors of below-knee graft reconstructions.
  • Somersalo, Erik Sakari Johannes (Helsingfors universitet, 2016)
    Målet med avhandlingen är att undersöka hur kvinnor som insjuknade i graviditetsdiabetes (GDM) under den första trimestern skiljer sig från andra överviktiga kvinnor med hög risk för GDM. Undersökningen gjordes på ett material som insamlats för The Finnish Gestational Diabetes Study (RADIEL), som är ett randomiserat livsstilsinterventionsprojekt som riktar in sig på kvinnor som befinner sig i riskgruppen för GDM. Informationen insamlades i huvudsak via frågeformulär, blodprov och kostdagböcker. Studien påvisade att tidigare graviditeter och övervikt ökar risken för graviditetsdiabetes i ett tidigt skede. l laboratorieundersökningarna sågs att HDL-kolesterol var lägre, hs-CRP högre och adiponektin lägre i gruppen med GDM under den första trimestern. Förutom två timmars glukosbelastningsprovet (OGTT) kunde dessa laboratorieundersökningar användas vid sållandet av GDM. Förhoppningsvis skulle då flera högriskindividers GDM upptäckas i ett tidigt skede vilket skulle minska komplikationerna hos både mamman och barnet.
  • Christensen, Pia; Larsen, Thomas Meinert; Westerterp-Plantenga, Margriet; Macdonald, Ian; Martinez, J. Alfredo; Handjiev, Svetoslav; Poppitt, Sally; Hansen, Sylvia; Ritz, Christian; Astrup, Arne; Pastor-Sanz, Laura; Sando-Pedersen, Finn; Pietiläinen, Kirsi H.; Sundvall, Jouko; Drummen, Mathijs; Taylor, Moira A.; Navas-Carretero, Santiago; Handjieva-Darlenska, Teodora; Brodie, Shannon; Silvestre, Marta P.; Huttunen-Lenz, Maija; Brand-Miller, Jennie; Fogelholm, Mikael; Raben, Anne (2018)
    Aims Materials and methods The PREVIEW lifestyle intervention study ( Identifier: NCT01777893) is, to date, the largest, multinational study concerning prevention of type-2 diabetes. We hypothesized that the initial, fixed low-energy diet (LED) would induce different metabolic outcomes in men vs women. All participants followed a LED (3.4 MJ/810 kcal/daily) for 8 weeks (Cambridge Weight Plan). Participants were recruited from 8 sites in Europe, Australia and New Zealand. Those eligible for inclusion were overweight (BMI >= 25 kg/m(2)) individuals with pre-diabetes according to ADA-criteria. Outcomes of interest included changes in insulin resistance, fat mass (FM), fat-free mass (FFM) and metabolic syndrome Z-score. Results Conclusions In total, 2224 individuals (1504 women, 720 men) attended the baseline visit and 2020 (90.8%) completed the follow-up visit. Following the LED, weight loss was 16% greater in men than in women (11.8% vs 10.3%, respectively) but improvements in insulin resistance were similar. HOMA-IR decreased by 1.50 +/- 0.15 in men and by 1.35 +/- 0.15 in women (ns). After adjusting for differences in weight loss, men had larger reductions in metabolic syndrome Z-score, C-peptide, FM and heart rate, while women had larger reductions in HDL cholesterol, FFM, hip circumference and pulse pressure. Following the LED, 35% of participants of both genders had reverted to normo-glycaemia. An 8-week LED induced different effects in women than in men. These findings are clinically important and suggest gender-specific changes after weight loss. It is important to investigate whether the greater decreases in FFM, hip circumference and HDL cholesterol in women after rapid weight loss compromise weight loss maintenance and future cardiovascular health.
  • Salin, Denise (Svenska handelshögskolan, 2006)
    Working Papers
    Although workplace bullying and other inappropriate treatment in the workplace have received growing attention, especially in Northern Europe, in the past few decades, little research has so far been conducted about the prevention of and intervention in such phenomena. This paper provides a review of different organizational measures typically recommended for preventing and intervening in workplace bullying and other forms of inappropriate treatment in the workplace. These measures include anti-bullying policies, training and information, appropriate job designs, active monitoring, and early intervention. As for intervention, both informal and formal strategies are discussed. Furthermore, the paper reports findings from a study among Finnish municipalities on the extent to which these measures are actually used in Finland, a country that has fairly recently introduced anti-bullying legislation.
  • Ikonen, A (Kela, 2012)
    Studies in social security and health 120
    Suomessa suurin osa työnantajista tarjoaa työntekijöilleen ehkäisevän työterveyshuollon lisäksi sairaan-hoitopalveluja. Tämän tutkimuksen tarkoitus oli selvittää työterveyshuollon asemaa työssä käyvien terveydenhuollossa ja työterveyshuollon sairaanhoidon yhteyttä ennaltaehkäisyyn ja työhön liittyviin teki-jöihin. Tämä tutkimus osoitti, että yli 50 % työntekijöistä käytti pelkästään työterveyshuollon sairaanhoitoa ja julkisen terveydenhuollon käyttö väheni. Erityisesti miehet näyttivät sairastuessaan valitsevan työterveyshuollon. Työterveyshuollossa lääkärissäkäyntien osuus nousi verrattuna muuhun työterveyshenkilöstöön. Tuki- ja liikuntaelinsairaudet, mielenterveysongelmat ja pitkäaikaiset työkykyyn vaikuttavat sairaudet olivat yhteydessä sairaanhoitokäynteihin työterveyshuollossa, mutta noin puolet niistä, joilla oli näitä ongelmia, eivät käyneet työterveyshuollossa. Työterveyshoitajan rooli näytti tärkeältä unettomuuden, työuupumuksen ja masennuksen havaitsemisessa. Työperäisiä oireita ja työkykyä arvioidaan usein työterveyshuollon sairaanhoidon yhteydessä. Yli puolet työterveyslääkäreillä käynneistä olivat työhön liittyviä, kun käynnin syy oli ainakin osittain työn aiheuttama tai kun sairausloman tarve otettiin huomioon. Epäasiallinen kohtelu työpaikalla ja vähäiset mahdollisuudet vaikuttaa omaan työhön olivat yhteydessä työterveyshoitajalla tai -lääkärissäkäynteihin. Tämä osoitti, että työterveyshuollon henkilöstöllä on mahdollisuus saada tietoa työhön liittyvistä tekijöistä sairaanhoidon yhteydessä. Vaatimus sairauslomatodistuksesta ensimmäisestä sairauslomapäivästä lähtien liittyi työterveyshuollon käynteihin miehillä. Lyhyiden sairauslomien seurannassa voitaisiin lisätä esimiesten roolia. Vaikka terveysneuvontaa ja työhön kohdistuvia interventioita tehtiin sairaanhoidon yhteydessä, työpaikkoihin kohdistuvien interventioiden määrää voitaisiin lisätä. Sairaanhoito työterveyshuollossa tukee ennalta ehkäisevää työtä ja usein liittyy työntekijöiden työhön ja työkykyyn. - Englanninkielinen julkaisu.
  • Tötterman, Katarina (Helsingin yliopisto, 2017)
    Probiotika som primärprevention av allergier och speciellt atopiskt eksem hos högriskbarn, har gett lovande resultat under de senaste åren, men inga rekommendationer i området finns än. Det här är en uppföljningsstudie till en dubbelblindad randomiserad studie, där 1223 mammor till högriskbarn fick 4 olika probiotikapreparat eller placebo i graviditetens sista månad, efter födsel fick barnen samma preparat i 6 månaders tid. Tidigare resultat vid 2 år visade skillnader i speciellt atopiskt eksem mellan probiotika- och placebogrupperna. Vid 5 år sågs fortfarande en skillnad, där barn födda med kejsarsnitt som fått probiotikapreparat hade mindre prevalens av atopiskt eksem än barnen i placebogruppen. Vid 10 år sågs ingen skillnad i prevalens av atopiskt eksem eller andra allergiska sjukdomar mellan de två behandlingsgrupperna. Inte heller barn födda med kejsarsnitt som fått probiotika sågs ha mindre atopiskt eksem längre i 10 års åldern i jämförelse med barnen som fått placebo.
  • Andreassen, Trude; Hansen, Bo T.; Engesaeter, Birgit; Hashim, Dana; Stoer, Nathalie C.; Trope, Ameli; Moen, Kare; Ursin, Giske; Weiderpass, Elisabete (2019)
    From 2015, Norway has implemented high-risk human papilloma virus (hrHPV) testing in primary screening for cervical cancer. Women aged 34-69 years, living in four counties, have been pseudo-randomly assigned (1:1 randomization) to either hrHPV testing every 5 years (followed by cytology if hrHPV is positive), or cytology testing every 3 years (followed by hrHPV testing if low-grade cytology is detected). We compared anxiety and depression scores among participants by screening arm and results. In total, 1,008 women answered a structured questionnaire that included the validated Patient Health Questionnaire-4 (PHQ-4). The Relative Risk Ratio (RRR) of mild vs. normal anxiety and depression scores, and moderate/severe vs. normal anxiety and depression scores, were estimated by multinomial logistic regression with 95% confidence intervals (95% CIs). Compared to women who were screened with cytology, women randomized to hrHPV testing were not more likely to have mild anxiety and depression scores (RRR 0.96, CI 0.70-1.31) nor more likely to have moderate/severe anxiety and depression scores (RRR 1.14, CI 0.65-2.02). Women with five different combinations of abnormal screening test results were not more likely to have mild or moderate/severe vs. normal anxiety and depression scores than women with normal screening results. The likelihood of having abnormal long-term (4-24 months after the screening) anxiety or depression scores among women 34 years and older was not affected by screening method or screening results. The results of our study suggest that a change to hrHPV testing in primary screening would not increase psychological distress among participants.
  • Okkonen, Marjo; Havulinna, Aki S.; Ukkola, Olavi; Huikuri, Heikki; Pietilä, Arto; Koukkunen, Heli; Lehto, Seppo; Mustonen, Juha; Ketonen, Matti; Airaksinen, Juhani; Kesäniemi, Y. Antero; Salomaa, Veikko (2021)
    Aims To evaluate risk factors for major adverse cardiac event (MACE) after the first acute coronary syndrome (ACS) and to examine the prevalence of risk factors in post-ACS patients. Methods We used Finnish population-based myocardial infarction register, FINAMI, data from years 1993-2011 to identify survivors of first ACS (n = 12686), who were then followed up for recurrent events and all-cause mortality for three years. Finnish FINRISK risk factor surveys were used to determine the prevalence of risk factors (smoking, hyperlipidaemia, diabetes and blood pressure) in post-ACS patients (n = 199). Results Of the first ACS survivors, 48.4% had MACE within three years of their primary event, 17.0% were fatal. Diabetes (p = 4.4 x 10(-7)), heart failure (HF) during the first ACS attack hospitalization (p = 6.8 x 10(-15)), higher Charlson index (p = 1.56 x 10(-19)) and older age (p = .026) were associated with elevated risk for MACE in the three-year follow-up, and revascularization (p = .0036) was associated with reduced risk. Risk factor analyses showed that 23% of ACS survivors continued smoking and cholesterol levels were still high (>5mmol/l) in 24% although 86% of the patients were taking lipid lowering medication. Conclusion Diabetes, higher Charlson index and HF are the most important risk factors of MACE after the first ACS. Cardiovascular risk factor levels were still high among survivors of first ACS.
  • Basnet, Syaron; Merikanto, Ilona; Lahti, Tuuli; Mannisto, Satu; Laatikainen, Tiina; Vartiainen, Erkki; Partonen, Timo (2016)
    The purpose of this study was to assess how seasonality is associated with some of the most common non-communicable diseases (NCDs) in the general Finnish population. The global seasonality score (GSS) was used to measure the magnitude of seasonality in 4689 participants, in addition to which they reported the extent to which the seasonal variations in mood and behavior were experienced as a problem. Regression models and the odds ratios were adopted to analyze the associations adjusted for a range of covariates. Seventy percent of the participants had seasonal variations in sleep duration, social activity, mood, or energy level, and forty percent those in weight and appetite. Angina pectoris and depression were significantly associated with seasonality throughout the analysis. Hypertension, high cholesterol levels, diabetes, other (than rheumatoid) joint diseases and other (than depressive) psychological illnesses were significantly associated with experiencing a problem due to the seasonal variations, with an increase in the GSS, and with seasonal affective disorder and its subsyndromal form. The co-occurrence of the seasonal variations in mood and behavior with certain common NCDs warrants future research to have insights into the etiology and potentially shared pathways and mechanisms of action. (C) 2016 Elsevier Ireland Ltd. All rights reserved.