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Kainalainen A, Korhonen P, Penttinen MA, Liira J. Job stress and burnout among Finnish municipal employees without depression or anxiety. Occup Med (Lond) 2024:kqae019. [PMID: 38661817 DOI: 10.1093/occmed/kqae019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Job burnout is associated with job stress but also with mental health symptoms, depression and anxiety. AIMS This study aims to evaluate the effect of job stress on burnout without the effect of depression and anxiety. METHODS A cross-sectional study was conducted in 2015 among 673 employees (88% female) from four public service sectors in Pori, Finland. Job burnout was assessed with the Bergen Burnout Indicator (BBI-15). Job stress was assessed by combining psychological risk factors (demand control, effort rewards and mental workload). Respondents who reported symptoms of depression and anxiety were excluded from the analyses. RESULTS Of the eligible study subjects (n = 617), 10% reported symptoms of at least mild burnout but only 1% severe burnout. The burnout symptoms varied from 6% to 21% by sector of public service. Job burnout was cumulatively associated with job stress factors. One job stress factor increased the risk of burnout 2-fold (relative risk [RR] 2.13; confidence interval [CI] 0.97-4.68), two factors 6-fold (RR 6.56; 2.92-14.8Or), and three factors even more (RR 23.5; CI 8.67-63.8). Similar trends were observed in the analysis of job burnout components (exhaustion, cynicism and professional inadequacy). CONCLUSIONS Our results indicate that job burnout is also strongly associated with job stress in employees who do not have depressive or anxiety symptoms. As job burnout may precede clinical depression or reduce productivity and well-being at work, it is essential to perform surveys to monitor burnout symptoms among the workforce, and design interventions to prevent remarkable job strain.
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Affiliation(s)
- A Kainalainen
- Department of Occupational Health, University of Turku, 20014 Turku, Finland
- Finnish Institute of Occupational Health, 20014 Turku, Finland
| | - P Korhonen
- Department of General Practice, University of Turku, Turku University Hospital, 20014 Turku, Finland
| | - M A Penttinen
- Department of General Practice, University of Turku, Suomen Terveystalo, 20014 Turku, Finland
| | - J Liira
- Department of Occupational Health, University of Turku, 20014 Turku, Finland
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Kummel M, Luther-Tontasse E, Koskenniemi J, Vahlberg T, Viitanen M, Johansson J, Korhonen P, Viikari L, Salminen M. National treatment guidelines poorly achieved among older subjects with type 2 diabetes - call to action! Prim Care Diabetes 2024; 18:126-131. [PMID: 38342666 DOI: 10.1016/j.pcd.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/17/2024] [Accepted: 01/21/2024] [Indexed: 02/13/2024]
Abstract
OBJECTIVE To assess risk factors and factors associated with nonachievement of the treatment target levels among 75-year-old Finns with type 2 diabetes (T2D). DESIGN Cross-sectional study. SETTING Outpatient. SUBJECTS Seventy-five-year-old participants of the Turku Senior Health Clinic Study (N = 1296) with T2D (n = 247). MAIN OUTCOME MEASURES Nonachievement of fasting blood glucose (FBG), low-density lipoprotein (LDL-C), and blood pressure (BP) levels set by the national treatment guidelines. RESULTS Nonachievement rates of FBG, BP and LDL-C were 47%, 85%, and 47%, respectively. Non-usage of T2D medication was negatively (adjusted OR 0.38, 95% CI 0.16-0.88) and central obesity positively (1.88, 1.09-3.24) related to nonachievement of FBG target level; alcohol use was positively (3.71, 1.04-13.16) and decreased self-rated health negatively (0.34, 0.12-0.97) related to the nonachievement of BP target level. Nonachievement of LDL-C target level was positively related to poor financial status (3.50, 1.19-10.28) and non-use of lipid-lowering medication (7.70, 4.07-14.56). CONCLUSIONS Nonachievement rates of the national treatment goals were high among older T2D patients, and nonachievement was related to use of medication, obesity, alcohol use, poor health, and poor financial status. We emphasize the importance of customized target setting by risk factor levels and active treatment.
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Affiliation(s)
- Maika Kummel
- Turku University of Applied Sciences/Health and Well-being, Turku, Finland; Faculty of Medicine/Clinical Medicine, Department of General Practice, University of Turku and The wellbeing services county of Southwest Finland, Turku, Finland
| | - Emma Luther-Tontasse
- Health Station Services, The wellbeing services county of Southwest Finland, Turku, Finland; University of Turku Graduate School UTUGS and Doctoral Programmes, Doctoral Programme in Clinical Research (DPCR), Turku, Finland
| | - Jaana Koskenniemi
- Turku University Hospital Services/Geriatric Medicine, The wellbeing services county of Southwest Finland, Turku, Finland
| | - Tero Vahlberg
- Faculty of Medicine, Department of Biostatistics, University of Turku and Turku University Hospital, Turku, Finland
| | - Matti Viitanen
- Turku University Hospital Services/Geriatric Medicine, The wellbeing services county of Southwest Finland, Turku, Finland; Faculty of Medicine/Clinical Medicine, Department of Geriatric Medicine, University of Turku and Turku University Hospital, Turku, Finland; Division of clinical geriatrics, NVS, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - Jouni Johansson
- Faculty of Medicine/Clinical Medicine, Department of General Practice, University of Turku and The wellbeing services county of Southwest Finland, Turku, Finland; Health Station Services, The wellbeing services county of Southwest Finland, Turku, Finland
| | - Päivi Korhonen
- Faculty of Medicine/Clinical Medicine, Department of General Practice, University of Turku and The wellbeing services county of Southwest Finland, Turku, Finland
| | - Laura Viikari
- Faculty of Medicine/Clinical Medicine, Department of Geriatric Medicine, University of Turku and Turku University Hospital, Turku, Finland; Tyks Acute/Turku University Hospital, The wellbeing services county of Southwest Finland, Turku, Finland
| | - Marika Salminen
- Faculty of Medicine/Clinical Medicine, Department of General Practice, University of Turku and The wellbeing services county of Southwest Finland, Turku, Finland; Turku University Hospital Services/Geriatric Medicine, The wellbeing services county of Southwest Finland, Turku, Finland.
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Salonen S, Tammela O, Koivisto AM, Korhonen P. Umbilically and Peripherally Inserted Thin Central Venous Catheters Have Similar Risks of Complications in Very Low-Birth-Weight Infants. Clin Pediatr (Phila) 2023; 62:1361-1368. [PMID: 36942607 PMCID: PMC10548765 DOI: 10.1177/00099228231161299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Catheter complications can be life-threatening in very low-birth-weight (VLBW) infants. We retrospectively evaluated non-elective removals of the first thin (1-2F) umbilical vein catheters (tUVCs (n = 92)) and peripherally inserted central venous catheters (PICCs (n = 103)) among 195 VLBW infants. Catheters were removed non-electively in 78 infants (40%), typically due to suspected infection (n = 42) or catheter dislocation (n = 30). Infants with complications had lower birth weights and gestational ages than others. The frequencies and causes of catheter removal were similar in the tUVC and PICC groups. Thirty-one infants had true catheter infections. The number of infections/1000 catheter days was higher in the tUVC group than in the PICC group. In a multivariable analysis, gestational age was associated with catheter infection, but catheter type was not. The odds of catheter complications decreased with increasing gestational age, but no clear association with thin catheter type was found.
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Affiliation(s)
- S. Salonen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - O. Tammela
- Tampere Center for Child Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University Hospital, Tampere University, Tampere, Finland
| | - A. M. Koivisto
- Faculties of Social Science and Health Science, Tampere University, Tampere, Finland
| | - P. Korhonen
- Tampere Center for Child Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University Hospital, Tampere University, Tampere, Finland
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Kuusisto A, Saranto K, Korhonen P, Haavisto E. Social and healthcare professionals' experiences of end-of-life care planning and documentation in palliative care. Nurs Open 2023; 10:6445-6454. [PMID: 37334750 PMCID: PMC10416050 DOI: 10.1002/nop2.1894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 04/28/2023] [Accepted: 06/05/2023] [Indexed: 06/20/2023] Open
Abstract
AIM To explore social and healthcare professionals' experiences of end-of-life (EOL) care planning and documentation in palliative care. DESIGN A qualitative study with narrative methodology. METHODS A narrative method with interviews was used. Data were collected from purposively selected registered nurses (n = 18), practical nurses (n = 5), social workers (n = 5) and physicians (n = 5) working in palliative care unit in five hospitals in three hospital districts. Content analysis within narrative methodologies was undertaken. RESULTS Two main categories - patient-oriented EOL care planning and multi-professional EOL care planning documentation- were formed. Patient-oriented EOL care planning included treatment goals planning, disease treatment planning and EOL care setting planning. Multi-professional EOL care planning documentation included healthcare professionals' and social professionals' perspectives. Healthcare professionals' perspectives on EOL care planning documentation included benefits of structured documentation and poor support of electronic health record (EHR) for documentation. Social professionals' perspective on EOL care planning documentation included usefulness of multi-professional documentation and externality of social professionals in multi-professional documentation. CONCLUSION The results of this interdisciplinary study demonstrated a gap between what healthcare professionals consider important in Advance Care Planning (ACP), that is, proactive, patient-oriented and multi-professional EOL care planning and the ability to access and document this in a useful and accessible way in the EHR. RELEVANCE TO CLINICAL PRACTICE Knowledge of the patient-centered EOL care planning and multi-professional documentation processes and their challenges are prerequisites for documentation to be supported by technology. REPORTING METHOD The Consolidated Criteria for Reporting Qualitative Research checklist was followed. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Anne Kuusisto
- Department of Nursing ScienceUniversity of TurkuTurkuFinland
- The Wellbeing Services County of Satakunta, Satasairaala Central Hospital PoriPoriFinland
| | - Kaija Saranto
- Department of Health and Social ManagementUniversity of Eastern FinlandKuopioFinland
| | - Päivi Korhonen
- Department of General Practice, Turku University HospitalUniversity of TurkuTurkuFinland
| | - Elina Haavisto
- Department of Nursing ScienceUniversity of TurkuTurkuFinland
- Health Sciences Unit of the Faculty of Social SciencesTampere UniversityTampereFinland
- Tampere University HospitalTampereFinland
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Kuusisto A, Saranto K, Korhonen P, Haavisto E. End-of-Life Discussions From the Perspective of Social Care and Healthcare Professionals in Palliative Care. Omega (Westport) 2023:302228231185172. [PMID: 37342869 DOI: 10.1177/00302228231185172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Abstract
This study describes the state of end-of-life discussions in Finland. A qualitative descriptive study with thematic interviews was conducted. Data were gathered from palliative care unit nurses, physicians and social workers. Inductive content analysis was used. According to interviewees (n = 33), the state of end-of-life discussion included three main categories. First, optimal end-of-life discussion time included early end-of-life discussion, end-of-life discussion at different phases of severe illness, and flexibility and challenges in scheduling end-of-life discussion. Second, end-of-life discussion initiators included both healthcare professionals and non-healthcare professionals. Third, social care and healthcare professionals' experiences of end-of-life discussion consisted of the importance and challenge of end-of-life discussion, end-of-life communication skills development in multiprofessional care context, and end-of-life communication in multi-cultural care context. The results can be used to justify the need of a national strategy and systematic implementation on Advance Care Planning (ACP), considering the multiprofessional, multicultural and internationalizing operating environment.
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Affiliation(s)
- Anne Kuusisto
- Department of Nursing Science, University of Turku Finland, Turku, Finland
- The Wellbeing Services County of Satakunta, Pori, Finland
- Satasairaala Central Hospital, Pori, Finland
| | - Kaija Saranto
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
| | - Päivi Korhonen
- Department of General Practice, Turku University Hospital, University of Turku, Turku, Finland
| | - Elina Haavisto
- Department of Nursing Science, University of Turku Finland, Turku, Finland
- Health Sciences Unit of the Faculty of Social Sciences, Tampere University, Tampere, Finland
- Tampere University Hospital, Tampere, Finland
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Kuusisto A, Saranto K, Korhonen P, Haavisto E. Continuity of Patient Information to Palliative Care. Stud Health Technol Inform 2023; 302:141-142. [PMID: 37203631 DOI: 10.3233/shti230086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
The purpose of this study was to describe the sharing of knowledge and information to palliative care in terms of information content, information structure and information quality by means of Advance Care Planning (ACP). This study used a descriptive qualitative study design. Purposively selected nurses, physicians and social workers working in palliative care in Finland took part in thematic interviews in five hospitals in three hospital districts in 2019. The data (n = 33) were analyzed by means of content analysis. The results demonstrate the evidence-based practices of ACP in terms of information content, structure and quality. The results of this study can be utilized in the development of sharing knowledge and information and as the basis in the development of an ACP instrument.
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Affiliation(s)
- Anne Kuusisto
- University of Turku
- The wellbeing services county of Satakunta
| | | | | | - Elina Haavisto
- University of Turku
- University of Tampere
- Tampere University Hospital
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Viljanen A, Salminen M, Irjala K, Korhonen P, Vahlberg T, Viitanen M, Löppönen M, Viikari L. Re-examination of successful agers with lower biological than chronological age still after a 20-year follow-up period. BMC Geriatr 2023; 23:128. [PMID: 36882768 PMCID: PMC9990196 DOI: 10.1186/s12877-023-03844-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 02/24/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Successful ageing is the term often used for depicting exceptional ageing but a uniform definition is lacking. The aim was to re-examine and describe the successful agers living at home at the age of 84 years or over after a 20-year follow-up. The purpose was also to identify possible factors leading to their successful ageing. METHODS Successful ageing was defined as the ability to live at home without daily care. Data on the participants' functional ability, objective health, self-rated health and satisfaction with life were gathered at baseline and after a 20-year follow-up period. A measurement of personal biological age (PBA) was established and the difference between the PBA and the chronological age (CA) was counted. RESULTS The participants' mean age was 87.6 years (Standard deviation 2.5, range 84-96). All analyzed variables depicted poorer physical ability and subjective health at re-examination than at baseline. Still, 99% of the participants were at least moderately satisfied with their lives. The PBA at baseline was 6.5 years younger than CA, and at re-examination, the difference was even more pronounced at 10.5 years. DISCUSSION Even though the participants were chronologically older, had poorer physical ability and subjective health, they were still satisfied with their lives indicating possible psychological resilience. The difference between the PBA and CA was greater at re-examination than at baseline indicating that they were also biologically successful agers. CONCLUSIONS Successful agers were satisfied with life despite hardships and had a lower biological than chronological age. Further research is needed to evaluate causality.
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Affiliation(s)
- Anna Viljanen
- Wellbeing Services County of Southwest Finland, Turku University Hospital, Domain of General Practice and Rehabilitation, Turku, Finland. .,Department of Clinical Medicine, Faculty of Medicine, Unit of Geriatric Medicine, University of Turku and Turku City Hospital, Kunnallissairaalantie 20, 20700, Turku, Finland.
| | - Marika Salminen
- Wellbeing Services County of Southwest Finland, Turku University Hospital, Medical Domain, Geriatric Medicine, Turku, Finland.,Faculty of Medicine, Department of Clinical Medicine, Unit of General Practice, University of Turku and Turku University Hospital, 20014, Turku, Finland
| | - Kerttu Irjala
- Faculty of Medicine, Department of Clinical Medicine, Unit of Clinical Chemistry, University of Turku and Turku University Hospital, 20521, Turku, Finland
| | - Päivi Korhonen
- Faculty of Medicine, Department of Clinical Medicine, Unit of General Practice, University of Turku and Turku University Hospital, 20014, Turku, Finland
| | - Tero Vahlberg
- Faculty of Medicine, Department of Clinical Medicine, Unit of Biostatistics, University of Turku and Turku University Hospital, Turku, Finland
| | - Matti Viitanen
- Department of Clinical Medicine, Faculty of Medicine, Unit of Geriatric Medicine, University of Turku and Turku City Hospital, Kunnallissairaalantie 20, 20700, Turku, Finland.,Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - Minna Löppönen
- Wellbeing Services County of Southwest Finland, Turku University Hospital, Domain of General Practice and Rehabilitation, Turku, Finland
| | - Laura Viikari
- Department of Clinical Medicine, Faculty of Medicine, Unit of Geriatric Medicine, University of Turku and Turku City Hospital, Kunnallissairaalantie 20, 20700, Turku, Finland.,Wellbeing Services County of Southwest Finland, Turku University Hospital, Medical Domain, Geriatric Medicine, Turku, Finland
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Salminen M, Stenholm S, Koskenniemi J, Korhonen P, Pitkänen T, Viikari P, Wuorela M, Viitanen M, Viikari L. Senior Health Clinic for 75-year-old home-dwelling Finns - study design, clinic protocol and non-response analysis. BMC Health Serv Res 2023; 23:210. [PMID: 36864394 PMCID: PMC9981251 DOI: 10.1186/s12913-023-09199-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 02/19/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND In the Finnish policy on older people preventive activities, which maintain functional capacity and independent living, are emphasized. The Turku Senior Health Clinic, aimed at maintaining independent coping of all home-dwelling 75-year-old citizens in the city of Turku, was founded in the beginning of 2020. The aim of this paper is to describe design and protocol of the Turku Senior Health Clinic Study (TSHeC) and provide results of the non-response analysis. METHODS The non-response analysis used data from 1296 participants (71% of those eligible) and 164 non-participants of the study. Sociodemographic, health status, psychosocial and physical functional ability indicators were included in the analysis. Participants and non-participants were also compared in respect to their neighborhood socioeconomic disadvantage. Differences between participants and non-participants were tested using the Chi squared or Fisher´s exact test for categorical variables and t-test for continuous variable. RESULTS The proportions of women (43% vs. 61%) and of those with only satisfying, poor or very poor self-rated financial status (38% vs. 49%) were significantly lower in non-participants than in participants. Comparison of the non-participants and participants in respect to their neighborhood socioeconomic disadvantage showed no differences. The prevalence of hypertension (66% vs. 54%), chronic lung disease (20% vs. 11%), and kidney failure (6% vs. 3%) were higher among non-participants compared to participants. Feelings of loneliness were less frequent among non-participants (14%) compared to participants (32%). The proportions of those using assistive mobility devices (18% vs. 8%) as well as those having previous falls (12% vs. 5%) were higher in non-participants than in participants. CONCLUSIONS The participation rate of TSHeC was high. No neighborhood differences in participation were found. Health status and physical functioning of non-participants seemed to be slightly worse than those of the participants, and more women than men participated. These differences may weaken the generalizability of the findings of the study. The differences have to be taken into account when recommendation for the content and implementation of preventive nurse-managed health clinic in primary health care in Finland is going to be given. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05634239; registration date; 1st of December 2022. Retrospectively registered.
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Affiliation(s)
- Marika Salminen
- Turku University Hospital/Medical domain, Wellbeing services county of Southwest Finland, Turku, FIN-20521 Turku, Finland. .,Faculty of Medicine, Department of General Practice, University of Turku, Joukahaisenkatu 3-5 A, Turku, 20014, Finland.
| | - Sari Stenholm
- grid.1374.10000 0001 2097 1371Department of Public Health, Faculty of Medicine, University of Turku and Turku University Hospital, 20014 Turku, Finland ,grid.1374.10000 0001 2097 1371Centre for Population Health Research, University of Turku and Turku University Hospital, 20014 Turku, Finland
| | - Jaana Koskenniemi
- grid.1374.10000 0001 2097 1371Turku University Hospital/Medical domain, Wellbeing services county of Southwest Finland, Turku, FIN-20521 Turku Finland
| | - Päivi Korhonen
- grid.1374.10000 0001 2097 1371Faculty of Medicine, Department of General Practice, University of Turku, Joukahaisenkatu 3-5 A, Turku, 20014 Finland
| | - Tiina Pitkänen
- grid.1374.10000 0001 2097 1371Turku University Hospital/Medical domain, Wellbeing services county of Southwest Finland, Turku, FIN-20521 Turku Finland
| | - Paula Viikari
- grid.1374.10000 0001 2097 1371Faculty of Medicine, Department of Geriatric Medicine, University of Turku and Turku University Hospital, Kunnallissairaalantie 20, Turku, 20700 Finland
| | - Maarit Wuorela
- grid.1374.10000 0001 2097 1371Faculty of Medicine, Department of Geriatric Medicine, University of Turku and Turku University Hospital, Kunnallissairaalantie 20, Turku, 20700 Finland
| | - Matti Viitanen
- grid.1374.10000 0001 2097 1371Faculty of Medicine, Department of Geriatric Medicine, University of Turku and Turku University Hospital, Kunnallissairaalantie 20, Turku, 20700 Finland ,grid.4714.60000 0004 1937 0626Division of Clinical Geriatrics, NVS, Karolinska Institutet, Karolinska University Hospital, Huddinge, 14186 Stockholm, Sweden
| | - Laura Viikari
- grid.1374.10000 0001 2097 1371Faculty of Medicine, Department of Geriatric Medicine, University of Turku and Turku University Hospital, Kunnallissairaalantie 20, Turku, 20700 Finland
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Fomenko E, Keygnaert I, Van Poel E, Collins C, Gómez Bravo R, Korhonen P, Laine MK, Murauskiene L, Tatsioni A, Willems S. Screening for and Disclosure of Domestic Violence during the COVID-19 Pandemic: Results of the PRICOV-19 Cross-Sectional Study in 33 Countries. Int J Environ Res Public Health 2023; 20:3519. [PMID: 36834213 PMCID: PMC9964689 DOI: 10.3390/ijerph20043519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/12/2023] [Accepted: 02/14/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic left no one untouched, and reports of domestic violence (DV) increased during the crisis. DV victims rarely seek professional help, yet when they do so, they often disclose it to their general practitioner (GP), with whom they have a trusting relationship. GPs rarely screen and hence rarely take the initiative to discuss DV with patients, although victims indicate that offering this opportunity would facilitate their disclosure. This paper aims to describe the frequency of screening for DV by GPs and disclosure of DV by patients to the GP during the COVID-19 pandemic, and to identify key elements that could potentially explain differences in screening for and disclosure of DV. The PRICOV-19 data of 4295 GP practices from 33 countries were included in the analyses, with practices nested in countries. Two stepwise forward clustered ordinal logistic regressions were performed. Only 11% of the GPs reported (much) more disclosure of DV by patients during COVID-19, and 12% reported having screened for DV (much). Most significant associations with screening for and disclosure of DV concerned general (pro)active communication. However, (pro)active communication was performed less frequently for DV than for health conditions, which might indicate that GPs are insufficiently aware of the general magnitude of DV and its impact on patients and society, and its approach/management. Thus, professional education and training for GPs about DV seems highly and urgently needed.
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Affiliation(s)
- Elizaveta Fomenko
- Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
| | - Ines Keygnaert
- Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
| | - Esther Van Poel
- Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
| | - Claire Collins
- Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
- Research Centre, Irish College of General Practitioners, D02 XR68 Dublin, Ireland
| | - Raquel Gómez Bravo
- Centre Hospitalier Neuropsychiatrique, Rehaklinik, L-9002 Ettelbruck, Luxembourg
- Research Group Self-Regulation and Health, Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, Faculty of Humanities, Education and Social Sciences, University of Luxembourg, L-4366 Esch-sur-Alzette, Luxembourg
| | - Päivi Korhonen
- Department of General Practice, University of Turku and Turku University Hospital, 20521 Turku, Finland
| | - Merja K. Laine
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, Finland
- Folkhälsan Research Center, 00280 Helsinki, Finland
| | - Liubove Murauskiene
- Public Health Department, Faculty of Medicine, Vilnius University, LT-01513 Vilnius, Lithuania
| | - Athina Tatsioni
- Research Unit for General Medicine and Primary Health Care, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
| | - Sara Willems
- Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
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Eriksson MD, Eriksson JG, Korhonen P, Koponen H, Salonen MK, Mikkola TM, Kajantie E, Wasenius NS, von Bonsdorff M, Kautiainen H, Laine MK. Depressive symptoms and mortality-findings from Helsinki birth cohort study. Acta Psychiatr Scand 2023; 147:175-185. [PMID: 36263580 PMCID: PMC10092352 DOI: 10.1111/acps.13512] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 09/28/2022] [Accepted: 10/16/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND Individuals with depression and depressive symptoms have a higher mortality rate than non-depressed individuals. The increased comorbidity and mortality associated with depression has remained largely unexplained. The underlying pathophysiological differences between depressive subtypes, melancholic and non-melancholic, may provide some explanation to this phenomenon. METHODS One thousand nine hundred and ninety five participants (mean age 61 years) from the Helsinki Birth Cohort Study were recruited for this prospective study and followed up for a mean of 14.1 years. Information regarding medical history, lifestyle, and biochemical parameters were obtained. Depressive symptoms were assessed using the Beck Depression Inventory. Standardized mortality ratios were calculated. RESULTS Participants were followed up for a total of 28,044 person-years. The melancholic depressive group had an increased adjusted risk of mortality [HR 1.49 (95% CI: 1.02-2.20)] when compared to the non-depressive group. Comparing mortality to the whole population of Finland using standardized mortality ratios (SMR) both the non-melancholic [1.11 (95% CI: 0.85-1.44)] and melancholic depressive [1.26 (95% CI: 0.87-1.81)] groups had higher mortality than the non-depressive group [0.82 (95% CI: 0.73-0.93)]. CONCLUSIONS Melancholic depressive symptoms are most strongly related to a higher mortality risk.
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Affiliation(s)
- Mia D Eriksson
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Folkhälsan Research Center, Helsinki, Finland.,Doctoral Programme of Population Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Johan G Eriksson
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Folkhälsan Research Center, Helsinki, Finland.,Department of Obstetrics & Gynecology and Human Potential Translational Research programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Päivi Korhonen
- Turku University Hospital and University of Turku, Turku, Finland
| | - Hannu Koponen
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Minna K Salonen
- Folkhälsan Research Center, Helsinki, Finland.,Department of Public Health Solutions, Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Tuija M Mikkola
- Folkhälsan Research Center, Helsinki, Finland.,Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Eero Kajantie
- Department of Public Health Solutions, Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.,PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Niko S Wasenius
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Folkhälsan Research Center, Helsinki, Finland
| | - Mikaela von Bonsdorff
- Folkhälsan Research Center, Helsinki, Finland.,Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Hannu Kautiainen
- Folkhälsan Research Center, Helsinki, Finland.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Merja K Laine
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Folkhälsan Research Center, Helsinki, Finland
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11
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Mohamed A, Ohtonen S, Giudice L, Schroderus AM, Závodná T, Krejčik Z, Rössner P, Kanninen K, Kinnunen T, Topinka J, Muala A, Sandström T, Korhonen P, Malm T. P07-16 Biometrics for the impact of acute air pollution on human peripheral immunity. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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12
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Kuusisto A, Saranto K, Korhonen P, Haavisto E. Accessibility of care plan information from previous treatment setting in palliative care unit: A qualitative study. Nurs Open 2022; 10:498-508. [PMID: 36053745 PMCID: PMC9834523 DOI: 10.1002/nop2.1315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 07/15/2022] [Accepted: 07/29/2022] [Indexed: 01/16/2023] Open
Abstract
AIM To describe accessibility of care plan information from patients' previous treatment setting in palliative care. DESIGN A qualitative descriptive study. METHODS A total of 33 nurses, social workers and physicians were interviewed. Data were analysed by deductive and inductive content analysis. The Fit between Individuals, Task and Technology (FITT) framework was used as a deductive analysis framework. RESULTS Individual-task Fit was described in relation to professional-specific care plan information in palliative care and use of time to obtain care plan information. Individual-technology Fit was described in relation to health informatics competencies and HIS usability. Task-technology Fit was described in relation to interoperability between care settings and healthcare providers and lack of interoperability between care settings and healthcare providers. RELEVANCE TO CLINICAL PRACTICE The study confirms the need to review the HIS as a whole from a holistic and patient-oriented perspective to ensure the continuity of palliative care.
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Affiliation(s)
- Anne Kuusisto
- Department of Nursing ScienceUniversity of Turku FinlandTurkuFinland,Satakunta Hospital DistrictPoriFinland
| | - Kaija Saranto
- Department of Health and Social ManagementUniversity of Eastern FinlandKuopioFinland
| | - Päivi Korhonen
- Department of General Practice, Turku University HospitalUniversity of TurkuTurkuFinland
| | - Elina Haavisto
- Department of Nursing ScienceUniversity of Turku FinlandTurkuFinland,Satakunta Hospital DistrictPoriFinland,Department of Health SciencesTampere UniversityTampereFinland
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13
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Kuusisto A, Saranto K, Korhonen P, Haavisto E. Quality of information transferred to palliative care. J Clin Nurs 2022. [PMID: 35844084 DOI: 10.1111/jocn.16453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/17/2022] [Accepted: 06/27/2022] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES To describe the quality of information coming from previous care units to palliative care. BACKGROUND Information quality is an interconnected concept that includes different dimensions and can be viewed from different perspectives. More knowledge is needed from a multi-professional perspective on the information quality coming to palliative care. DESIGN Descriptive qualitative study. METHODS Altogether 33 registered nurses, practical nurses, social workers and physicians working in palliative care were purposively selected to participate in thematic interviews. The research was carried out in six palliative care units in three hospital districts. The data were analysed by using deductive and inductive content analysis. The COREQ checklist was used. RESULTS Three main categories with thirteen categories were identified in connection with the deductive analysis based on the Clinical Information Quality framework: (1). Informativeness of information coming from previous care units to palliative care included accuracy, completeness, interpretability, plausibility, provenance and relevance. (2). Availability of information coming from previous care units to palliative care included accessibility, portability, security and timeliness. (3). Usability of information coming from previous care units to palliative care included conformance, consistency and maintainability. Each category is divided into sub-categories followed by narratives of their content. CONCLUSIONS This study provides new knowledge on the quality of information coming to palliative care from a multi-professional perspective. Professionals working in palliative care units highlight issues describing good information quality, but also point out quality issues and areas for improvement. RELEVANCE TO CLINICAL PRACTICE The results can guide the development of documentation practices and Health Information System development as well as be used in the generation of a new audit instrument of information quality.
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Affiliation(s)
- Anne Kuusisto
- University of Turku Finland, Department of Nursing Science, Turku, Finland.,Satakunta Hospital District, Pori, Finland
| | - Kaija Saranto
- University of Eastern Finland, Department of Health and Social Management, Kuopio, Finland
| | - Päivi Korhonen
- University of Turku, Department of General Practice, Turku University Hospital, University of Turku, Turku, Finland
| | - Elina Haavisto
- University of Turku Finland, Department of Nursing Science, Turku, Finland.,Satakunta Hospital District, Pori, Finland.,Tampere University, The Health Sciences Unit of the Faculty of Social Sciences, Tampere, Finland
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14
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Uusitalo A, Tikkakoski A, Reinikainen M, Lehtinen P, Ylänen K, Korhonen P, Poutanen T. Extrasystoles or short bradycardias of the newborn seldom require subsequent 24-hour electrocardiographic monitoring. Acta Paediatr 2022; 111:979-984. [PMID: 35100437 PMCID: PMC10138749 DOI: 10.1111/apa.16259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 12/28/2021] [Accepted: 01/17/2022] [Indexed: 11/29/2022]
Abstract
AIM To retrospectively assess the indications for and findings on 24-hour electrocardiographic (Holter) monitoring in newborns, focussing on bradycardias and extrasystoles. METHODS Data included 337 term-born infants. Holter indications were categorised into bradycardias below 80 beats per minute, extrasystoles, any tachycardia and other. Heart rate below 60 beats per minute, pathological atrioventricular conduction, supraventricular or ventricular tachycardia, or either atrial premature contractions over 10% or ventricular premature contractions over 5% of total beats were defined as significant arrhythmia on Holter. RESULTS The median age was 6 days (range: 2-62 days). Bradycardia (42%) or extrasystoles (32%) were the most common Holter indications. Fifty-three infants (16%) had significant arrhythmia on Holter. Heart disease or 12-lead electrocardiogram expressing extrasystoles or conduction abnormalities were associated with significant arrhythmias (p = 0.046 and p < 0.001, respectively). Twenty-seven of 109 infants (25%) with extrasystoles as a Holter indication had abnormal Holter results, but only seven (6.4%) had significant arrhythmia on Holter if the 12-lead electrocardiogram was normal. No pathology was found behind bradycardias below 80 beats per minute in the absence of heart disease. CONCLUSION Among term newborns with extrasystoles or bradycardias, Holter monitoring could be targeted to infants with heart disease or abnormal electrocardiograms.
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Affiliation(s)
- Asta Uusitalo
- Department of Paediatrics Tampere University Hospital Tampere Finland
- Tampere Center for Child, Adolescent and Maternal Health Research Faculty of Medicine and Health Technology Tampere University Tampere Finland
| | - Antti Tikkakoski
- Department of Clinical Physiology and Nuclear Medicine Tampere University Hospital Tampere Finland
| | - Miika Reinikainen
- Faculty of Medicine and Health Technology Tampere University Tampere Finland
| | - Pieta Lehtinen
- Department of Clinical Physiology and Nuclear Medicine Tampere University Hospital Tampere Finland
| | - Kaisa Ylänen
- Department of Paediatrics Tampere University Hospital Tampere Finland
- Tampere Center for Child, Adolescent and Maternal Health Research Faculty of Medicine and Health Technology Tampere University Tampere Finland
| | - Päivi Korhonen
- Department of Paediatrics Tampere University Hospital Tampere Finland
- Tampere Center for Child, Adolescent and Maternal Health Research Faculty of Medicine and Health Technology Tampere University Tampere Finland
| | - Tuija Poutanen
- Department of Paediatrics Tampere University Hospital Tampere Finland
- Tampere Center for Child, Adolescent and Maternal Health Research Faculty of Medicine and Health Technology Tampere University Tampere Finland
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15
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Eriksson MD, Eriksson JG, Korhonen P, Salonen MK, Mikkola TM, Kajantie E, Wasenius NS, von Bonsdorff M, Kautiainen H, Laine MK. Non-melancholic depressive symptoms are associated with above average fat mass index in the Helsinki birth cohort study. Sci Rep 2022; 12:6987. [PMID: 35484274 PMCID: PMC9051115 DOI: 10.1038/s41598-022-10592-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 04/11/2022] [Indexed: 11/17/2022] Open
Abstract
There is an existing link between two of the most common diseases, obesity and depression. These are both of great public health concern, but little is known about the relationships between the subtypes of these conditions. We hypothesized that non-melancholic depressive symptoms have a stronger relationship with both body composition (lean mass and fat mass) and dysfunctional glucose metabolism than melancholic depression. For this cross-sectional study 1510 participants from the Helsinki Birth Cohort Study had their body composition evaluated as lean mass and fat mass (Lean Mass Index [LMI, kg/m2] + Fat Mass Index [FMI kg/m2] = Body Mass Index). Participants were evaluated for depressive symptoms utilizing the Beck depression inventory, and had laboratory assessments including an oral glucose tolerance test. Higher than average FMI was associated with a higher percentage (mean [%], 95% CI) of participants scoring in the depressive range of the Beck depression inventory (20.2, 17.2–23.2) compared to those with low FMI (16.3, 13.8–18.9; p = 0.048) when adjusted for age, sex, education, and fasting plasma glucose concentration. Higher FMI was associated with a higher likelihood of having depressive symptoms (OR per 1-SD FMI = 1.37, 95% CI 1.13–1.65), whereas higher LMI was associated with a lower likelihood of having depressive symptoms (OR per 1-SD LMI = 0.76, 95% CI 0.64–0.91). Participants with an above average FMI more frequently (mean [%], 95% CI) had non-melancholic depressive symptoms (14.7, 11.8–17.7) as compared to those with low FMI (9.7, 7.6–11.9; p = 0.008) regardless of LMI levels. There was no difference between the body composition groups in the likelihood of having melancholic depressive symptoms. The non-melancholic group had higher (mean [kg/m2], SD) FMI (9.6, 4.1) than either of the other groups (BDI < 10: 7.7, 3.1; melancholic: 7.9, 3.6; p < 0.001), and a higher (mean [mmol/l], SD) 2-h glucose concentration (7.21, 1.65) than the non-depressed group (6.71, 1.70; p = 0.005). As hypothesized, non-melancholic depressive symptoms are most closely related to high fat mass index and dysfunctional glucose metabolism.
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Affiliation(s)
- Mia D Eriksson
- Primary Health Care Unit, Helsinki University Hospital (HUS), Helsinki, Finland. .,Folkhälsan Research Center, Helsinki, Finland.
| | - Johan G Eriksson
- Folkhälsan Research Center, Helsinki, Finland.,Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Obstetrics and Gynecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Päivi Korhonen
- Department of General Practice, Turku University Hospital and University of Turku, Turku, Finland
| | - Minna K Salonen
- Folkhälsan Research Center, Helsinki, Finland.,Department of Public Health Solutions, Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Tuija M Mikkola
- Folkhälsan Research Center, Helsinki, Finland.,Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Eero Kajantie
- Department of Public Health Solutions, Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.,PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Niko S Wasenius
- Folkhälsan Research Center, Helsinki, Finland.,Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Mikaela von Bonsdorff
- Folkhälsan Research Center, Helsinki, Finland.,Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Hannu Kautiainen
- Folkhälsan Research Center, Helsinki, Finland.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Merja K Laine
- Folkhälsan Research Center, Helsinki, Finland.,Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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16
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Kallio M, Korkeila J, Malmberg M, Gunn J, Rautava P, Korhonen P, Kytö V. Impaired long-term outcomes of patients with schizophrenia spectrum disorder after coronary artery bypass surgery: nationwide case-control study. BJPsych Open 2022; 8:e48. [PMID: 35144708 PMCID: PMC8867870 DOI: 10.1192/bjo.2022.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Patients with schizophrenia spectrum disorder have increased risk of coronary artery disease. AIMS To investigate long-term outcomes of patients with schizophrenia spectrum disorder and coronary artery disease after coronary artery bypass grafting surgery (CABG). METHOD Data from patients with schizophrenia spectrum disorder (n = 126) were retrospectively compared with propensity-matched (1:20) control patients without schizophrenia spectrum disorder (n = 2520) in a multicentre study in Finland. All patients were treated with CABG. The median follow-up was 7.1 years. The primary outcome was all-cause mortality. RESULTS Patients with diagnosed schizophrenia spectrum disorder had an elevated risk of 10-year mortality after CABG, compared with control patients (42.7 v. 30.3%; hazard ratio 1.56; 95% CI 1.13-2.17; P = 0.008). Schizophrenia spectrum diagnosis was associated with a higher risk of major adverse cardiovascular events during follow-up (49.9 v. 32.6%, subdistribution hazard ratio 1.59; 95% CI 1.18-2.15; P = 0.003). Myocardial infarction (subdistribution hazard ratio 1.86; P = 0.003) and cardiovascular mortality (subdistribution hazard ratio 1.65; P = 0.017) were more frequent in patients with versus those without schizophrenia spectrum disorder, but there was no difference for stroke. Psychiatric ward admission, antipsychotic medication, antidepressant use and benzodiazepine use before CABG were not associated with outcome differences. After CABG, patients with schizophrenia spectrum disorder received statin therapy less often and had lower doses; the use of other cardiovascular medications was similar between schizophrenia spectrum and control groups. CONCLUSIONS Patients with schizophrenia spectrum disorder have higher long-term risks of death and major adverse cardiovascular events after CABG. The results underline the vulnerability of these patients and highlight the importance of intensive secondary prevention and risk factor optimisation.
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Affiliation(s)
- Mika Kallio
- Department of Psychiatry, University of Turku and Turku University Hospital, Finland
| | - Jyrki Korkeila
- Department of Psychiatry, University of Turku and Turku University Hospital, Finland; and Department of Psychiatry, Hospital District of Satakunta, Finland
| | - Markus Malmberg
- Heart Center, Turku University Hospital and University of Turku, Finland
| | - Jarmo Gunn
- Heart Center, Turku University Hospital and University of Turku, Finland
| | - Päivi Rautava
- Department of Public Health, University of Turku, Finland; and Turku Clinical Research Centre, Turku University Hospital, Finland
| | - Päivi Korhonen
- Turku Clinical Research Centre, Turku University Hospital, Finland; and Department of General Practice, University of Turku and Turku University Hospital, Finland
| | - Ville Kytö
- Heart Center, Turku University Hospital and University of Turku, Finland; Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Finland; Center for Population Health Research, Turku University Hospital and University of Turku, Finland; Administrative Center, Hospital District of Southwest Finland, Finland; and Department of Public Health, Faculty of Medicine, University of Helsinki, Finland
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17
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Korhonen P, Tihtonen K, Isojärvi J, Ojala R, Ashorn U, Ashorn P, Tammela O. Calcium supplementation during pregnancy and long‐term offspring outcome: a systematic literature review and meta‐analysis. Ann N Y Acad Sci 2022; 1510:36-51. [PMID: 34978718 PMCID: PMC9304138 DOI: 10.1111/nyas.14729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/04/2021] [Accepted: 11/04/2021] [Indexed: 11/29/2022]
Abstract
The World Health Organization currently recommends calcium supplementation for pregnant women, especially those with low calcium intakes, to reduce the risk of hypertension and preeclampsia. We aimed to evaluate the effect of this intervention on selected offspring outcomes. A systematic search was conducted in 11 databases for published randomized controlled trials (RCTs) on the effect of maternal calcium supplementation with or without vitamin D during pregnancy on selected offspring cardiovascular, growth, and metabolic and neurodevelopmental outcomes. Screening of titles and abstracts of 3555 records and full texts of 31 records yielded six RCTs (nine reports, n = 1616). Forest plot analyses were performed if at least two studies presented comparable data on the same outcome. In one study (n = 591), high‐dose calcium supplementation during pregnancy was associated with a decreased risk of offspring high systolic blood pressure at 5–7 years of age (risk ratio = 0.59; 95% confidence interval: 0.39–0.90). The effects of the intervention on offspring growth, metabolic, and neurodevelopmental outcomes remain unknown because of conflicting or insufficient data. High risk of attrition bias decreased the quality of the evidence. Limited available data from RCTs do not provide sufficient evidence to conclude that prenatal calcium supplementation influences offspring health outcomes beyond the newborn period.
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Affiliation(s)
- Päivi Korhonen
- Department of Pediatrics Tampere University Hospital Tampere Finland
- Faculty of Medicine and Health Technology, Center for Child, Adolescent, and Maternal Health Research Tampere University Tampere Finland
| | - Kati Tihtonen
- Faculty of Medicine and Health Technology, Center for Child, Adolescent, and Maternal Health Research Tampere University Tampere Finland
- Department of Obstetrics and Gynecology Tampere University Hospital Tampere Finland
| | | | - Riitta Ojala
- Department of Pediatrics Tampere University Hospital Tampere Finland
- Faculty of Medicine and Health Technology, Center for Child, Adolescent, and Maternal Health Research Tampere University Tampere Finland
| | - Ulla Ashorn
- Faculty of Medicine and Health Technology, Center for Child, Adolescent, and Maternal Health Research Tampere University Tampere Finland
| | - Per Ashorn
- Department of Pediatrics Tampere University Hospital Tampere Finland
- Faculty of Medicine and Health Technology, Center for Child, Adolescent, and Maternal Health Research Tampere University Tampere Finland
| | - Outi Tammela
- Department of Pediatrics Tampere University Hospital Tampere Finland
- Faculty of Medicine and Health Technology, Center for Child, Adolescent, and Maternal Health Research Tampere University Tampere Finland
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18
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Eriksson MD, Eriksson JG, Kautiainen H, Salonen MK, Mikkola TM, Kajantie E, Wasenius N, von Bonsdorff M, Korhonen P, Laine MK. Higher carotid-radial pulse wave velocity is associated with non-melancholic depressive symptoms in men - findings from Helsinki Birth Cohort Study. Ann Med 2021; 53:531-540. [PMID: 33769182 PMCID: PMC8011688 DOI: 10.1080/07853890.2021.1904277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Depression and cardiovascular disease (CVD) are major causes of global disease burden that are interrelated through mostly unknown mechanisms. We studied the relationship of melancholic and non-melancholic depressive symptoms with arterial stiffness, an important underlying mechanism of CVD. METHODS The Helsinki Birth Cohort Study recruited 683 previously extensively phenotyped subjects for this sub-study. Cross-sectional data along with responses regarding depressive symptoms were obtained for each participant. For evaluation of depressive symptoms, the Beck Depression Inventory (BDI)and subscales were used to measure melancholic and non-melancholic depressive symptoms. Arterial stiffness was assessed as pulse wave velocity (PWV) that was measured between the carotid and radial artery, and carotid and femoral artery. RESULTS Of the participants, 532 scored <10 on the BDI and were classified as not having depressive symptoms. Of the 151 participants that scored ≥10 on the BDI, 122 were classified as having non-melancholic depressive symptoms and 29 as having melancholic depressive symptoms. Men had higher carotid-radial PWV (crPWV) values than women (p < .001). A positive relationship between BDI scores and crPWV (p < .001) was found in men. We also found higher crPWV in men with non-melancholic depressive symptoms compared to all others. No such differences were found in women. DISCUSSION Arterial stiffness has a relationship with depressive symptoms and subtypes of depressive symptoms, at least in men. There is a significant relationship between higher PWV and non-melancholic depressive symptoms in men. Due to the intricate nature of the disease causality or directionality is impossible to infer solely based on this study. Further studies into the subtypes of depressive symptoms may be of benefit to understanding depression.KEY MESSAGESIt is known that arterial stiffness contributes to cardiovascular disease, and is associated with depression.Higher Beck Depression Inventory scores are associated with higher carotid-radial pulse wave velocity in men.Non-melancholic depressive symptoms are associated with higher carotid-radial pulse wave velocity in men.
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Affiliation(s)
- Mia D Eriksson
- Primary Health Care Unit, Helsinki University Hospital (HUS), Helsinki, Finland
| | - Johan G Eriksson
- Folkhälsan Research Center, Helsinki, Finland.,Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Obstetrics & Gynecology and Human Potential Translational Research Programme Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Hannu Kautiainen
- Folkhälsan Research Center, Helsinki, Finland.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Minna K Salonen
- Folkhälsan Research Center, Helsinki, Finland.,Department of Public Health Solutions, Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Tuija M Mikkola
- Folkhälsan Research Center, Helsinki, Finland.,Faculty of Medicine, Clinicum, University of Helsinki, Helsinki, Finland
| | - Eero Kajantie
- Department of Public Health Solutions, Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.,PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Niko Wasenius
- Folkhälsan Research Center, Helsinki, Finland.,Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Mikaela von Bonsdorff
- Folkhälsan Research Center, Helsinki, Finland.,Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Päivi Korhonen
- Department of General Practice, Turku University Hospital and University of Turku, Turku, Finland
| | - Merja K Laine
- Folkhälsan Research Center, Helsinki, Finland.,Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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19
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Tihtonen K, Korhonen P, Isojärvi J, Ojala R, Ashorn U, Ashorn P, Tammela O. Calcium supplementation during pregnancy and maternal and offspring bone health: a systematic review and meta-analysis. Ann N Y Acad Sci 2021; 1509:23-36. [PMID: 34780069 PMCID: PMC9298950 DOI: 10.1111/nyas.14705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 09/26/2021] [Indexed: 11/29/2022]
Abstract
Insufficient calcium intake during pregnancy may lead to maternal bone resorption and lower bone density of offspring. We evaluated the impact of supplementary calcium with or without vitamin D during pregnancy on maternal and offspring bone mineral density (BMD) and teeth firmness of the offspring. Randomized controlled trials (RCTs) were searched systematically in 11 databases. Two researchers independently screened the titles and abstracts of 3555 records and the full texts of 31 records to examine eligibility. The search yielded seven RCTs (11 reports, n = 1566). No advantage of calcium supplementation was found on maternal BMD after delivery or during breastfeeding, or on offspring BMD, even when dietary calcium intake was low. The results were neither modified by the dose of calcium nor concomitant vitamin D administration. A suspicion of some long‐term harm of the intervention on maternal BMD and growth of female offspring was raised based on the data. One study suggested some benefit of high‐dose calcium supplementation on offspring teeth firmness at 12 years old. A low number of the studies and abundant missing data reduced the quality of the findings. The impact of calcium supplementation on maternal and offspring bone health was deemed unknown because of inconclusive research results.
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Affiliation(s)
- Kati Tihtonen
- Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Health Technology, Center for Child, Adolescent, and Maternal Health Research, Tampere University, Tampere, Finland
| | - Päivi Korhonen
- Faculty of Medicine and Health Technology, Center for Child, Adolescent, and Maternal Health Research, Tampere University, Tampere, Finland.,Department of Pediatrics, Tampere University Hospital, Tampere, Finland
| | | | - Riitta Ojala
- Faculty of Medicine and Health Technology, Center for Child, Adolescent, and Maternal Health Research, Tampere University, Tampere, Finland.,Department of Pediatrics, Tampere University Hospital, Tampere, Finland
| | - Ulla Ashorn
- Faculty of Medicine and Health Technology, Center for Child, Adolescent, and Maternal Health Research, Tampere University, Tampere, Finland
| | - Per Ashorn
- Faculty of Medicine and Health Technology, Center for Child, Adolescent, and Maternal Health Research, Tampere University, Tampere, Finland.,Department of Pediatrics, Tampere University Hospital, Tampere, Finland
| | - Outi Tammela
- Faculty of Medicine and Health Technology, Center for Child, Adolescent, and Maternal Health Research, Tampere University, Tampere, Finland.,Department of Pediatrics, Tampere University Hospital, Tampere, Finland
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Kuusisto A, Saranto K, Korhonen P, Haavisto E. Accessibility of information on patients' and family members' end-of-life wishes in advance care planning. Nurs Open 2021; 9:428-436. [PMID: 34582133 PMCID: PMC8685785 DOI: 10.1002/nop2.1081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 08/11/2021] [Accepted: 09/08/2021] [Indexed: 11/09/2022] Open
Abstract
AIM To describe healthcare professionals' accessibility and transfer of patients' and family members' end-of-life wishes in ACP to the palliative care unit. DESIGN The study used a qualitative descriptive study design. METHODS Purposive sampling was used. The data (N = 33) were collected through interviews with physicians, registered nurses, practical nurses and social workers. The data were analysed by inductive content analysis. RESULTS Two main categories emerged. Patients' and family members' end-of-life wishes documentation in relation to changing information needs was described in relation to patients' condition and care context. Transfer of patients' and family members' end-of-life wishes to palliative care unit included written and verbal communication. Results showed lack of implementation of ACP early, lack of implementation about the holistic interpretation of ACP into medical notes and lack of transferability of ACP into documenting systems impacting on accessibility and realization for the patient and family members at the end-of-life.
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Affiliation(s)
- Anne Kuusisto
- Department of Nursing Science, University of Turku Finland, Turku, Finland.,Satakunta Central Hospital, Pori, Finland
| | - Kaija Saranto
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
| | - Päivi Korhonen
- Department of General Practice, Turku University Hospital, University of Turku, Turku, Finland
| | - Elina Haavisto
- Department of Nursing Science, University of Turku Finland, Turku, Finland.,Satakunta Central Hospital, Pori, Finland
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21
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Tahkola A, Korhonen P, Kautiainen H, Niiranen T, Mäntyselkä P. The impact of antihypertensive treatment initiation on health-related quality of life and cardiovascular risk factor levels: a prospective, interventional study. BMC Cardiovasc Disord 2021; 21:444. [PMID: 34530733 PMCID: PMC8447729 DOI: 10.1186/s12872-021-02252-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 08/16/2021] [Indexed: 11/17/2022] Open
Abstract
Background Effective prevention and treatment of hypertension is one of the most potential interventions in terms of preventing cardiovascular deaths and disabilities. However, the treatment control is often poor. This may be partly explained by the impact of hypertension diagnoses and treatment on health-related quality of life. Quality of life is also an important outcome for a hypertensive patient. Most of the previous studies on health-related quality of life in hypertension have concentrated on patients with treated hypertension and less is known about the initiation of medication and the first treatment year. Methods In this interventional study, we followed 111 primary care patients with newly diagnosed hypertension in real world primary care setting in Finland for 12 months. Results We found significant decrease in both systolic and diastolic blood pressure levels, as well as modest decrease in cholesterol levels and alcohol consumption. However, the health-related quality of life also slightly deteriorated during the first treatment year. Conclusions Our study shows that the initiation of hypertension treatment results in cardiovascular risk decrease among newly diagnosed Finnish hypertensive patients, but it is accompanied by small negative impact on health-related quality of life. However, the deterioration in health-related quality of life is of small magnitude and earlier research demonstrates several measures to enhance treatment and avoid impairment in health-related quality of life. Trial registration ClinicalTrials NCT02377960 (Date of registration: 04/03/2015).
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Affiliation(s)
| | | | | | | | - Pekka Mäntyselkä
- Primary Health Care Unit, Kuopio University Hospital and University of Eastern Finland, University of Eastern Finland, Kuopio, Finland
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22
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Abstract
OBJECTIVE Overweight and obesity are increasing globally. General practitioners (GP's) are at the first point of contact for medical support and consequently have a major role in resolving this overwhelming problem. The aim of this study was to assess the effectiveness of a brief lifestyle counselling on weight management and on the participants' quality of life (QoL). DESIGN A cohort study with a one-year follow-up. SETTING Occupational health care, city of Pori in southwestern Finland. PARTICIPANTS Female municipal employees (n = 625) with a mean age of 48 (SD 9) years. INTERVENTION A nurse and a physiotherapist gave lifestyle counselling to all the participants; however, only the overweight/obese subjects were recommended to lose at least 5% of their initial weight. MAIN OUTCOME MEASURE Success in weight management and quality of life. RESULTS At the follow-up visit, 10.4% (95% CI: 7.5-14.0) of the overweight/obese subjects had lost at least 5% of their weight, but 10.0% (95% CI: 6.7-14.3) of the normal-weight participants had become overweight. The mean weight change was +0.1 kg (95% CI: -0.3-0.5) in the overweight/obese group and +0.5 kg (95% CI: 0.2-0.8) in the normal weight group. The change in QoL was inversely correlated with relative weight change in overweight/obese subjects, albeit the effect size was small. CONCLUSION Weight management counselling should also be directed to individuals with a normal weight. Even with brief lifestyle counselling it may be possible to stabilize weight gain. Successful weight loss may improve the QoL of overweight/obese individuals.KEY POINTSPrimary health care has to deal with the increasing problem of overweight and obesity.Brief lifestyle counselling performed by a nurse and a physiotherapist seems to be quite effective in weight stabilization, considering the effort needed.People with normal weight tend to gain weight and weight management counselling should also be directed to them. Successful weight management may improve the quality of life of overweight/obese people.
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Affiliation(s)
- Jenni Virtanen
- Department of General Practice, Turku University and Turku University Hospital, Turku, Finland
- Perusturvakuntayhtyma Akseli, Masku, Finland
- CONTACT Jenni Virtanen Department of General Practice, University of Turku and Turku University Hospital, Joukahaisenkatu 3-5, Turku, 20014, FI, Finland
| | - Markus Penttinen
- Department of General Practice, Turku University and Turku University Hospital, Turku, Finland
- Terveystalo, Turku, Finland
| | - Hannu Kautiainen
- Folkhälsan Research Center, Helsinki, Finland
- Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland
| | - Päivi Korhonen
- Department of General Practice, Turku University and Turku University Hospital, Turku, Finland
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23
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Viljanen A, Salminen M, Irjala K, Heikkilä E, Isoaho R, Kivelä SL, Korhonen P, Vahlberg T, Viitanen M, Wuorela M, Löppönen M, Viikari L. Chronic conditions and multimorbidity associated with institutionalization among Finnish community-dwelling older people: an 18-year population-based follow-up study. Eur Geriatr Med 2021; 12:1275-1284. [PMID: 34260040 PMCID: PMC8626405 DOI: 10.1007/s41999-021-00535-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 07/01/2021] [Indexed: 11/25/2022]
Abstract
Aim The aim of the study is to assess the association of chronic conditions and multimorbidity with institutionalization in older people. Findings Having dementia, mood or neurological disorder and/or five or more chronic conditions were associated with a higher risk of institutionalization. Message These risk factors should be recognized in primary care when providing and targeting care and support for home-dwelling older people. Supplementary Information The online version contains supplementary material available at 10.1007/s41999-021-00535-y. Purpose The ageing population is increasingly multimorbid. This challenges health care and elderly services as multimorbidity is associated with institutionalization. Especially dementia increases with age and is the main risk factor for institutionalization. The aim of this study was to assess the association of chronic conditions and multimorbidity with institutionalization in home-dwelling older people, with and without dementia. Methods In this prospective study with 18-year follow-up, the data on participants’ chronic conditions were gathered at the baseline examination, and of conditions acquired during the follow-up period from the municipality’s electronic patient record system and national registers. Only participants institutionalized or deceased by the end of the follow-up period were included in this study. Different cut-off-points for multimorbidity were analyzed. Cox regression model was used in the analyses. Death was used as a competing factor. Results The mean age of the participants (n = 820) was 74.7 years (64.0‒97.0). During the follow-up, 328 (40%) were institutionalized. Dementia, mood disorders, neurological disorders, and multimorbidity defined as five or more chronic conditions were associated with a higher risk of institutionalization in all the participants. In people without dementia, mood disorders and neurological disorders increased the risk of institutionalization. Conclusion Having dementia, mood or neurological disorder and/or five or more chronic conditions were associated with a higher risk of institutionalization. These risk factors should be recognized when providing and targeting care and support for older people still living at home. Supplementary Information The online version contains supplementary material available at 10.1007/s41999-021-00535-y.
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Affiliation(s)
- Anna Viljanen
- Health Care Center, Municipality of Lieto, Hyvättyläntie 7, 21420, Lieto, Finland. .,Unit of Geriatrics, Department of Clinical Medicine, Faculty of Medicine, Turku City Hospital, FI-20014 University of Turku, Kunnallissairaalantie 20, 20700, Turku, Finland.
| | - Marika Salminen
- Welfare Division, City of Turku, Yliopistonkatu 30, 20101, Turku, Finland.,Unit of Family Medicine, Department of Clinical Medicine, Faculty of Medicine, University of Turku and Turku University Hospital, 20014, Turku, Finland
| | - Kerttu Irjala
- Unit of Clinical Chemistry, Department of Clinical Medicine, Faculty of Medicine, TYKSLAB, 20521, Turku, Finland
| | - Elisa Heikkilä
- Unit of Clinical Chemistry, Department of Clinical Medicine, Faculty of Medicine, TYKSLAB, 20521, Turku, Finland
| | - Raimo Isoaho
- Unit of Family Medicine, Department of Clinical Medicine, Faculty of Medicine, University of Turku and Turku University Hospital, 20014, Turku, Finland.,Social and Health Care, City of Vaasa, Ruutikellarintie 4, 65101, Vaasa, Finland
| | - Sirkka-Liisa Kivelä
- Unit of Family Medicine, Department of Clinical Medicine, Faculty of Medicine, University of Turku and Turku University Hospital, 20014, Turku, Finland.,Division of Social Pharmacy, Faculty of Pharmacy, University of Helsinki, 00014, Helsinki, Finland
| | - Päivi Korhonen
- Unit of Family Medicine, Department of Clinical Medicine, Faculty of Medicine, University of Turku and Turku University Hospital, 20014, Turku, Finland
| | - Tero Vahlberg
- Unit of Biostatistics, Department of Clinical Medicine, Faculty of Medicine, University of Turku, Turku, Finland
| | - Matti Viitanen
- Unit of Geriatrics, Department of Clinical Medicine, Faculty of Medicine, Turku City Hospital, FI-20014 University of Turku, Kunnallissairaalantie 20, 20700, Turku, Finland.,Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet and Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - Maarit Wuorela
- Unit of Geriatrics, Department of Clinical Medicine, Faculty of Medicine, Turku City Hospital, FI-20014 University of Turku, Kunnallissairaalantie 20, 20700, Turku, Finland.,Welfare Division, City of Turku, Yliopistonkatu 30, 20101, Turku, Finland
| | - Minna Löppönen
- Social and Health Care for Elderly, City of Raisio, Sairaalakatu 5, 21200, Raisio, Finland
| | - Laura Viikari
- Unit of Geriatrics, Department of Clinical Medicine, Faculty of Medicine, Turku City Hospital, FI-20014 University of Turku, Kunnallissairaalantie 20, 20700, Turku, Finland.,Welfare Division, City of Turku, Yliopistonkatu 30, 20101, Turku, Finland
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24
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Penttinen MA, Virtanen J, Laaksonen M, Erkkola M, Vepsäläinen H, Kautiainen H, Korhonen P. The Association between Healthy Diet and Burnout Symptoms among Finnish Municipal Employees. Nutrients 2021; 13:nu13072393. [PMID: 34371901 PMCID: PMC8308766 DOI: 10.3390/nu13072393] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 06/28/2021] [Accepted: 07/07/2021] [Indexed: 01/01/2023] Open
Abstract
Background: Burnout is an undesirable mental condition, which may have a negative impact on individuals’ health and work ability. This study aimed to evaluate the relationship between diet and burnout symptoms among female public sector employees. Methods: A cross-sectional study was conducted in 2015 among 630 female employees from 10 municipal work units of the city of Pori, Finland. Burnout symptoms were assessed with the Bergen Burnout Indicator (BBI). The consumption of food items was determined using the food frequency questionnaire (FFQ). The main food groups were categorized into healthy and unhealthy foods based on the Nordic Nutrition Recommendations for a healthy and balanced diet. Results: In multivariate linear regression analysis, consumption of healthy food items had an inverse relationship with the severity of burnout symptoms independently of age, education years, physical activity, and depressive symptoms. De-tailed analysis revealed that subjects with lower BBI score consumed more often low-fat dairy produce, vegetables, fruit and berries, vegetable food, and white meat. Conclusions: Frequent consumption of healthy food items is associated with low level of burnout symptoms. Our results emphasize the importance of diverse and balanced healthy diet to promote work well-being.
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Affiliation(s)
- Markus A. Penttinen
- Department of General Practice, Turku University and Turku University Hospital, Turku University, 20014 Turku, Finland; (J.V.); (P.K.)
- Suomen Terveystalo, 20520 Turku, Finland
- Correspondence:
| | - Jenni Virtanen
- Department of General Practice, Turku University and Turku University Hospital, Turku University, 20014 Turku, Finland; (J.V.); (P.K.)
- Basic Social Security Federation of Municipalities Akseli, 21250 Masku, Finland
| | | | - Maijaliisa Erkkola
- Department of Food and Nutrition, University of Helsinki, 00014 Helsinki, Finland; (M.E.); (H.V.)
| | - Henna Vepsäläinen
- Department of Food and Nutrition, University of Helsinki, 00014 Helsinki, Finland; (M.E.); (H.V.)
| | - Hannu Kautiainen
- Unit of Primary Health Care, Kuopio University Hospital, 70210 Kuopio, Finland;
- Folkhälsan Research Centre, University of Helsinki, 00290 Helsinki, Finland
| | - Päivi Korhonen
- Department of General Practice, Turku University and Turku University Hospital, Turku University, 20014 Turku, Finland; (J.V.); (P.K.)
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25
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Viljanen A, Salminen M, Irjala K, Heikkilä E, Isoaho R, Kivelä SL, Korhonen P, Vahlberg T, Viitanen M, Wuorela M, Löppönen M, Viikari L. Subjective and objective health predicting mortality and institutionalization: an 18-year population-based follow-up study among community-dwelling Finnish older adults. BMC Geriatr 2021; 21:358. [PMID: 34112108 PMCID: PMC8193868 DOI: 10.1186/s12877-021-02311-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 05/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Objective health measures, such as registered illnesses or frailty, predict mortality and institutionalization in older adults. Also, self-reported assessment of health by simple self-rated health (SRH) has been shown to predict mortality and institutionalization. The aim of this study was to assess the association of objective and subjective health with mortality and institutionalization in Finnish community-dwelling older adults. METHODS In this prospective study with 10- and 18-year follow-ups, objective health was measured by registered illnesses and subjective health was evaluated by simple SRH, self-reported walking ability (400 m) and self-reported satisfaction in life. The participants were categorized into four groups according to their objective and subjective health: 1. subjectively and objectively healthy, 2. subjectively healthy and objectively unhealthy, 3. subjectively unhealthy and objectively healthy and 4. subjectively and objectively unhealthy. Cox regression model was used in the analyses. Death was used as a competing factor in the institutionalization analyses. RESULTS The mean age of the participants (n = 1259) was 73.5 years (range 64.0-100.0). During the 10- and 18-year follow-ups, 466 (37%) and 877 (70%) died, respectively. In the institutionalization analyses (n = 1106), 162 (15%) and 328 (30%) participants were institutionalized during the 10- and 18-year follow-ups, respectively. In both follow-ups, being subjectively and objectively unhealthy, compared to being subjectively and objectively healthy, was significantly associated with a higher risk of institutionalization in unadjusted models and with death both in unadjusted and adjusted models. CONCLUSIONS The categorization of objective and subjective health into four health groups was good at predicting the risk of death during 10- and 18-year follow-ups, and seemed to also predict the risk of institutionalization in the unadjusted models during both follow-ups. Poor subjective health had an additive effect on poor objective health in predicting mortality and could therefore be used as part of an older individual's health evaluation when screening for future adverse outcomes.
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Affiliation(s)
- Anna Viljanen
- Municipality of Lieto, Health Care Center, Hyvättyläntie 7, 21420, Lieto, Finland. .,Faculty of Medicine, Department of Clinical Medicine, Unit of Geriatrics, FI-20014 University of Turku, Turku City Hospital, Kunnallissairaalantie 20, 20700, Turku, Finland.
| | - Marika Salminen
- City of Turku, Welfare Division, Yliopistonkatu 30, 20101, Turku, Finland.,Faculty of Medicine, Department of Clinical Medicine, Unit of Family Medicine, University of Turku and Turku University Hospital, 20014, Turku, Finland
| | - Kerttu Irjala
- Faculty of Medicine, Department of Clinical Medicine, Unit of Clinical Chemistry, TYKSLAB, 20521, Turku, Finland
| | - Elisa Heikkilä
- Faculty of Medicine, Department of Clinical Medicine, Unit of Clinical Chemistry, TYKSLAB, 20521, Turku, Finland
| | - Raimo Isoaho
- Faculty of Medicine, Department of Clinical Medicine, Unit of Family Medicine, University of Turku and Turku University Hospital, 20014, Turku, Finland.,City of Vaasa, Social and Health Care, Ruutikellarintie 4, 65101, Vaasa, Finland
| | - Sirkka-Liisa Kivelä
- Faculty of Medicine, Department of Clinical Medicine, Unit of Family Medicine, University of Turku and Turku University Hospital, 20014, Turku, Finland.,Faculty of Pharmacy, Division of Social Pharmacy, University of Helsinki, 00014, Helsinki, Finland
| | - Päivi Korhonen
- Faculty of Medicine, Department of Clinical Medicine, Unit of Family Medicine, University of Turku and Turku University Hospital, 20014, Turku, Finland
| | - Tero Vahlberg
- Faculty of Medicine, Department of Clinical Medicine, Unit of Biostatistics, University of Turku, Turku, Finland
| | - Matti Viitanen
- Faculty of Medicine, Department of Clinical Medicine, Unit of Geriatrics, FI-20014 University of Turku, Turku City Hospital, Kunnallissairaalantie 20, 20700, Turku, Finland.,Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - Maarit Wuorela
- Faculty of Medicine, Department of Clinical Medicine, Unit of Geriatrics, FI-20014 University of Turku, Turku City Hospital, Kunnallissairaalantie 20, 20700, Turku, Finland.,City of Turku, Welfare Division, Yliopistonkatu 30, 20101, Turku, Finland
| | - Minna Löppönen
- City of Raisio, Social and Health Care for Elderly, Sairaalakatu 5, 21200, Raisio, Finland
| | - Laura Viikari
- Faculty of Medicine, Department of Clinical Medicine, Unit of Geriatrics, FI-20014 University of Turku, Turku City Hospital, Kunnallissairaalantie 20, 20700, Turku, Finland.,City of Turku, Welfare Division, Yliopistonkatu 30, 20101, Turku, Finland
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26
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Affiliation(s)
- Päivi Korhonen
- Professor of General Practice Turku University and Turku University Hospital, Turku, Finland
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27
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Viljanen A, Salminen M, Irjala K, Korhonen P, Wuorela M, Isoaho R, Kivelä SL, Vahlberg T, Viitanen M, Löppönen M, Viikari L. Frailty, walking ability and self-rated health in predicting institutionalization: an 18-year follow-up study among Finnish community-dwelling older people. Aging Clin Exp Res 2021; 33:547-554. [PMID: 32306371 PMCID: PMC7943499 DOI: 10.1007/s40520-020-01551-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 04/01/2020] [Indexed: 01/07/2023]
Abstract
Background In clinical practice, there is a need for an instrument to screen older people at risk of institutionalization. Aims To analyze the association of frailty, walking-ability and self-rated health (SRH) with institutionalization in Finnish community-dwelling older people. Methods In this prospective study with 10- and 18-year follow-ups, frailty was assessed using FRAIL Scale (FS) (n = 1087), Frailty Index (FI) (n = 1061) and PRISMA-7 (n = 1055). Walking ability was assessed as self-reported ability to walk 400 m (n = 1101). SRH was assessed by a question of general SRH (n = 1105). Cox regression model was used to analyze the association of the explanatory variables with institutionalization. Results The mean age of the participants was 73.0 (range 64.0‒97.0) years. Prevalence of institutionalization was 40.8%. In unadjusted models, frailty was associated with a higher risk of institutionalization by FS in 10-year follow-up, and FI in both follow-ups. Associations by FI persisted after age- and gender-adjustments in both follow-ups. By PRISMA-7, frailty predicted a higher risk of institutionalization in both follow-ups. In unadjusted models, inability to walk 400 m predicted a higher risk of institutionalization in both follow-ups and after adjustments in 10-year follow-up. Poor SRH predicted a higher risk of institutionalization in unadjusted models in both follow-ups and after adjustments in 10-year follow-up. Discussion Simple self-reported items of walking ability and SRH seemed to be comparable with frailty indexes in predicting institutionalization among community-dwelling older people in 10-year follow-up. Conclusions In clinical practice, self-reported walking ability and SRH could be used to screen those at risk. Electronic supplementary material The online version of this article (10.1007/s40520-020-01551-x) contains supplementary material, which is available to authorized users.
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Tuokko AT, Murtola T, Korhonen P, Kaipia A. Hyperuricemia Is Not an Independent Predictor of Erectile Dysfunction. Sex Med 2021; 9:100319. [PMID: 33621708 PMCID: PMC8072167 DOI: 10.1016/j.esxm.2020.100319] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 12/28/2020] [Accepted: 12/28/2020] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION Erectile dysfunction (ED) is strongly associated with physiological and metabolic disturbances, and hyperuricemia has been proposed to predict the onset of ED. AIM To investigate if hyperuricemia is an independent predictor for ED when all relevant confounding factors are taken into account. METHODS This is a cross-sectional study of men aged between 45 and 70 years. The population was well characterized for established cardiovascular risk factors, metabolic syndrome, as well as kidney function, depression, and socioeconomic factors. Analysis was limited to 254 men with complete data and also serum uric acid (SUA) measurements were available. This included 150 men with and 104 without ED. The presence and severity of ED was evaluated using International Index of Erectile Function-5 questionnaire. Risk of ED by SUA level was calculated using univariate and multivariable-adjusted logistic regression. Effect modification by participant characteristics were evaluated in subgroup analyses. MAIN OUTCOME MEASURES The main outcome measures of this study are prevalence and severity of erectile dysfunction. RESULTS Patients with ED (59% of the study population) were older than men without ED (59 vs 54 years) and had lower serum testosterone (14.3, 95% CI 11.3-17.3 vs 15.1 nmol/l, 95% CI 12.1-18.8, respectively). Regarding all other variables, the groups were comparable. No significant difference was found for SUA by ED. SUA was not associated with ED risk in univariate or multivariable analysis (multivariable-adjusted OR 1.14, 95% CI 0.59-2.19, P = .7) for SUA level higher than median compared with median or lesser (OR 1.00, 95% CI 0.997-1.006, P = .7 for continuous variable). No subgroup analysis modified the association. After multivariable adjustment age, education level and depression were statistically significant predictors of ED. CONCLUSIONS Elevated SUA was not found to be an independent risk factor for ED. Metabolic syndrome, glomerular filtration rate, or cardiovascular risk factors did not modify this result. ED cannot be predicted based on the level of SUA. A Tuokko, T Murtola, P Korhonen, et al. Hyperuricemia Is Not an Independent Predictor of Erectile Dysfunction. Sex Med 2021;9:100319.
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Affiliation(s)
- Antti T Tuokko
- Department of Urology, Tampere University Hospital, Tampere, Finland.
| | - Teemu Murtola
- Department of Urology, Tampere University Hospital, Tampere, Finland; Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland; Department of Surgery, Seinäjoki Central Hospital, Seinäjoki, Finland
| | - Päivi Korhonen
- Department of General Practice, Turku University and Turku University Hospital, Turku, Finland; Central Satakunta Health Federation of Municipalities, Harjavalta, Finland
| | - Antti Kaipia
- Department of Urology, Tampere University Hospital, Tampere, Finland
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Ylilehto E, Palomäki O, Korhonen P, Huhtala H, Uotila J. Impact of mode of delivery on perinatal outcome in moderately and late preterm twin birth. Int J Gynaecol Obstet 2020; 153:106-112. [PMID: 33040352 DOI: 10.1002/ijgo.13418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 08/05/2020] [Accepted: 10/08/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To examine the impact of the mode of delivery on neonatal and maternal outcomes in moderately and late preterm twin birth. METHODS This single-center cohort study included 275 live diamniotic moderately and late preterm twin deliveries at 32+0 -36+6 weeks of gestation. These twin deliveries were divided into two groups according to the planned mode of delivery: trial of labor (TOL) (N=199, 72.4%) and planned cesarean section (CS) (N=76, 27.6%). The primary outcome was neonatal morbidity. Maternal outcome and the effects of gestational age and chorionicity on neonatal outcome were also studied. RESULTS Of the women in the TOL group, 170 (85.4%) delivered vaginally. Both for the first and second twin, and for dichorionic or monochorionic deliveries, there were no differences between the TOL and CS groups in composite neonatal morbidity or in other neonatal outcomes. No significant differences were found between the TOL and CS groups when the moderately and late preterm gestational age cohorts were studied separately. Mothers in the planned CS group more often had puerperal infection and surgical complications in comparison with mothers in the TOL group. CONCLUSION Among 275 moderately and late preterm twin deliveries, planned mode of delivery did not affect neonatal outcome.
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Affiliation(s)
- Elina Ylilehto
- Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Outi Palomäki
- Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Päivi Korhonen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Pediatrics, Tampere University Hospital, Tampere, Finland
| | - Heini Huhtala
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Jukka Uotila
- Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
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Salminen M, Viljanen A, Eloranta S, Viikari P, Wuorela M, Vahlberg T, Isoaho R, Kivelä SL, Korhonen P, Irjala K, Löppönen M, Viikari L. Frailty and mortality: an 18-year follow-up study among Finnish community-dwelling older people. Aging Clin Exp Res 2020; 32:2013-2019. [PMID: 31654244 PMCID: PMC7532963 DOI: 10.1007/s40520-019-01383-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 10/11/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND There is a lack of agreement about applicable instrument to screen frailty in clinical settings. AIMS To analyze the association between frailty and mortality in Finnish community-dwelling older people. METHODS This was a prospective study with 10- and 18-year follow-ups. Frailty was assessed using FRAIL scale (FS) (n = 1152), Rockwood's frailty index (FI) (n = 1126), and PRISMA-7 (n = 1124). To analyze the association between frailty and mortality, Cox regression model was used. RESULTS Prevalence of frailty varied from 2 to 24% based on the index used. In unadjusted models, frailty was associated with higher mortality according to FS (hazard ratio 7.96 [95% confidence interval 5.10-12.41] in 10-year follow-up, and 6.32 [4.17-9.57] in 18-year follow-up) and FI (5.97 [4.13-8.64], and 3.95 [3.16-4.94], respectively) in both follow-ups. Also being pre-frail was associated with higher mortality according to both indexes in both follow-ups (FS 2.19 [1.78-2.69], and 1.69 [1.46-1.96]; FI 1.81[1.25-2.62], and 1.31 [1.07-1.61], respectively). Associations persisted even after adjustments. Also according to PRISMA-7, a binary index (robust or frail), frailty was associated with higher mortality in 10- (4.41 [3.55-5.34]) and 18-year follow-ups (3.78 [3.19-4.49]). DISCUSSION Frailty was associated with higher mortality risk according to all three frailty screening instrument used. Simple and fast frailty indexes, FS and PRISMA-7, seemed to be comparable with a multidimensional time-consuming FI in predicting mortality among community-dwelling Finnish older people. CONCLUSIONS FS and PRISMA-7 are applicable frailty screening instruments in clinical setting among community-dwelling Finnish older people.
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Affiliation(s)
- Marika Salminen
- City of Turku, Welfare Division, Yliopistonkatu 30, 20101, Turku, Finland.
- Faculty of Medicine, Department of Clinical Medicine, Unit of Family Medicine, University of Turku, 20014, Turku, Finland.
| | - Anna Viljanen
- Faculty of Medicine, Department of Clinical Medicine, Unit of Geriatrics, University of Turku, Turku City Hospital, Kunnallissairaalantie 20, 20700, Turku, Finland
- Municipality of Lieto Health Care Centre, Hyvättyläntie 7, 21420, Lieto, Finland
| | - Sini Eloranta
- Faculty of Medicine, Department of Nursing Science, University of Turku, 20014, Turku, Finland
- Turku University of Applied Science, Health and Well-being, Joukahaisenkatu 3, 20520, Turku, Finland
| | - Paula Viikari
- City of Turku, Welfare Division, Yliopistonkatu 30, 20101, Turku, Finland
- Faculty of Medicine, Department of Clinical Medicine, Unit of Geriatrics, University of Turku, Turku City Hospital, Kunnallissairaalantie 20, 20700, Turku, Finland
| | - Maarit Wuorela
- City of Turku, Welfare Division, Yliopistonkatu 30, 20101, Turku, Finland
- Faculty of Medicine, Department of Clinical Medicine, Unit of Geriatrics, University of Turku, Turku City Hospital, Kunnallissairaalantie 20, 20700, Turku, Finland
| | - Tero Vahlberg
- Department of Clinical Medicine, Biostatistics, University of Turku, Turku, Finland
| | - Raimo Isoaho
- Faculty of Medicine, Department of Clinical Medicine, Unit of Family Medicine, University of Turku, 20014, Turku, Finland
- City of Vaasa, Social and Health Care, Ruutikellarintie 4, 65101, Vaasa, Finland
| | - Sirkka-Liisa Kivelä
- Faculty of Medicine, Department of Clinical Medicine, Unit of Family Medicine, University of Turku, 20014, Turku, Finland
- Faculty of Pharmacy, Division of Social Pharmacy, University of Helsinki, 00014, Helsinki, Finland
| | - Päivi Korhonen
- Faculty of Medicine, Department of Clinical Medicine, Unit of Family Medicine, University of Turku, 20014, Turku, Finland
| | - Kerttu Irjala
- Faculty of Medicine, Department of Clinical Medicine, Unit of Clinical Chemistry, TYKSLAB, 20521, Turku, Finland
| | - Minna Löppönen
- City of Raisio, Social and Health Care for Elderly, Sairaalakatu 5, 21200, Raisio, Finland
| | - Laura Viikari
- City of Turku, Welfare Division, Yliopistonkatu 30, 20101, Turku, Finland
- Faculty of Medicine, Department of Clinical Medicine, Unit of Geriatrics, University of Turku, Turku City Hospital, Kunnallissairaalantie 20, 20700, Turku, Finland
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Majaluoma S, Seppälä T, Kautiainen H, Korhonen P. Type D personality and metabolic syndrome among Finnish female municipal workers. BMC Womens Health 2020; 20:202. [PMID: 32928173 PMCID: PMC7489202 DOI: 10.1186/s12905-020-01052-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 08/18/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Type D personality is a combination of high negative affectivity (NA) and high social inhibition (SI). This personality trait is suspected to impair cardiovascular patients' recovery. The 2016 European Guidelines on cardiovascular disease prevention in clinical practice recommend screening of psychosocial risk factors as Type D personality. The aim of this study was to assess the relationship between Type D personality and Metabolic syndrome (MetS) in working-age female population. METHODS Six hundred thirty-four female employees with mean age of 48 ± 10 years were evaluated. Type D personality and its components (NA) and (SI) were screened with DS14 questionnaire. The definition of MetS was based on measurements done by trained medical staff. We investigated the relationship between Mets and Type D personality, NA and SI using the logistic regression models adjusting for age, education years, leisure-time physical activity, smoking, alcohol use and depressive symptoms. RESULTS The prevalence of Type D personality was 10.6% (n = 67) [95% CI: 8.3 to 13.2] and MetS 34.7% (n = 220). Type D personality or its subcomponents were not associated with MetS. Women with Type D personality had significantly worse quality of sleep and lower LTPA. They were also more often unsatisfied with their economic situation, they had more often depressive symptoms and psychiatric disorders than non-D type persons. There were no differences in risk factors for cardiovascular diseases. CONCLUSION Screening for Type D personality among working- age, reasonably healthy female population seems not to be practical method for finding persons with risk for cardiovascular disease.
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Affiliation(s)
- Susa Majaluoma
- Institute of Clinical Medicine, Family Medicine, University of Turku and Turku University Hospital University of Turku, 20500, Turku, Finland. .,University Hospital, Kiinamyllynkatu 4-8, 20521, Turku, Finland. .,Health Center of Pori, Siltapuistokatu 2, 28100, Pori, Finland.
| | - Tellervo Seppälä
- Institute of Clinical Medicine, Family Medicine, University of Turku and Turku University Hospital University of Turku, 20500, Turku, Finland.,University Hospital, Kiinamyllynkatu 4-8, 20521, Turku, Finland.,Health Center of Pori, Siltapuistokatu 2, 28100, Pori, Finland
| | - Hannu Kautiainen
- Department of General practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, University of Helsinki, Yliopistonkatu 4, 00100, Helsinki, Finland.,Helsinki University Hospital, Helsingin ja Uudenmaan sairaanhoitopiiri, Stenbäckinkatu 9, PL 100, 00029 HUS, Helsinki, Finland.,Folkhälsan Research Center, Haartmaninkatu 8, 00290, Helsinki, Finland.,Unit of Primary Health Care, University of Kuopio, University Hospital Kuopio. University of Kuopio, Yliopistonranta 1, 70210, Kuopio, Finland.,University Hospital of Kuopio, Puijonlaaksontie 2, 70210, Kuopio, Finland
| | - Päivi Korhonen
- Institute of Clinical Medicine, Family Medicine, University of Turku and Turku University Hospital University of Turku, 20500, Turku, Finland.,University Hospital, Kiinamyllynkatu 4-8, 20521, Turku, Finland.,Unit of Primary Health Care, University of Kuopio, University Hospital Kuopio. University of Kuopio, Yliopistonranta 1, 70210, Kuopio, Finland.,University Hospital of Kuopio, Puijonlaaksontie 2, 70210, Kuopio, Finland.,Central Satakunta Health Federation of Municipalities, Koulukatu 2, 29200, Harjavalta, Finland
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Tahkola A, Korhonen P, Kautiainen H, Niiranen T, Mäntyselkä P. Personalized text message and checklist support for initiation of antihypertensive medication: the cluster randomized, controlled check and support trial. Scand J Prim Health Care 2020; 38:201-209. [PMID: 32362175 PMCID: PMC8570747 DOI: 10.1080/02813432.2020.1753380] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective: To assess whether the use of a checklist combined with text message support improves systolic blood pressure (SBP) control.Design and setting: A cluster randomized controlled trial in Finnish primary care.Interventions: Personalized text message support and a checklist for initiation of antihypertensive medication.Patients: 111 newly diagnosed hypertensive patients aged 30-75 years.Main outcome measures: The proportion of patients achieving 1) the office SBP target <140 mmHg or 2) the home SBP target <135 mmHg at 12 months.Results: 28% (n = 16) and 31% (n = 17) of patients in the intervention and control groups met the office SBP target, respectively (p = 0.51). The corresponding proportions were 36% (n = 18) and 42% (n = 21) for the home SBP target (p = 0.21). Office SBP decreased 23 mmHg (95% CI: 29-17) in the intervention group and 21 mmHg (95% CI: 27-15) in the control group (p = 0.61). Medication changes, number of antihypertensives at 12 months and health care utilization were similar in both study groups. Patients considered checklist and text message support useful and important.Conclusion: Only a small proportion of patients in the intervention and control groups reached their treatment target despite multiple health care contacts and medication changes. The study interventions did not improve SBP control. However, this study demonstrates new information about hypertension control, antihypertensive medication and health service utilization during the first treatment year.
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Affiliation(s)
- Aapo Tahkola
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland;
- Health Centre of Jyväskylä Cooperation Area, Jyväskylä, Finland;
- CONTACT Aapo Tahkola Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | | | | | - Teemu Niiranen
- National Institute for Health and Welfare, Helsinki, Finland;
| | - Pekka Mäntyselkä
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland;
- Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland
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Tahkola A, Korhonen P, Kautiainen H, Niiranen T, Mäntyselkä P. Lifetime risk assessment in cholesterol management among hypertensive patients: observational cross-sectional study based on electronic health record data. BMC Fam Pract 2020; 21:62. [PMID: 32290820 PMCID: PMC7155316 DOI: 10.1186/s12875-020-01138-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 04/06/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND In hypertensive patients, reducing plasma low-density lipoprotein cholesterol level (LDL-C) is one of the main interventions for preventing chronic cardiovascular diseases (CVD). However, LDL-C control remains generally insufficient, also in patients with hypertension. We analyzed Electronic Health Record (EHR) data of 7117 hypertensive patients to find the most potential age and sex subgroups in greatest need for improvement in real life dyslipidemia treatment. Taking into account the current discussion on lifetime CVD risk, we focused on the age dependence in LDL-C control. METHODS In this observational cross-sectional study, based on routine electronic health record (EHR) data, we investigated LDL-C control of hypertensive, non-diabetic patients without renal dysfunction or CVD, aged 30 years or more in Finnish primary care setting. RESULTS More than half (54% of women and 53% of men) of untreated patients did not meet the LDL-C target of < 3 mmol/l and one third (35% of women and 33% of men) of patients did not reach the target even with the lipid-lowering medication (LLM). Furthermore, higher age was strongly associated with better LDL-C control (p < 0.001) and lower LDL-C level (p < 0.001) in individuals with and without LLM. Higher age was also strongly associated with LLM prescription (p < 0.001). In total, about half of the patients were on LLM (53% of women and 51% of men). CONCLUSIONS Our findings indicate that dyslipidemia treatment among Finnish primary care hypertensive patients is generally insufficient, particularly in younger age groups who might benefit the most from CVD risk reduction over time. Clinicians should probably rely more on the lifetime risk of CVD, especially when treating working age hypertensive patients.
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Affiliation(s)
- Aapo Tahkola
- University of Eastern Finland, Institute of Public Health and Clinical Nutrition, Kuopio, Finland
- Health Centre of Jyväskylä Cooperation Area, Jyväskylä, Finland
| | | | | | - Teemu Niiranen
- National Institute for Health and Welfare, Helsinki, Finland
- Department of Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Pekka Mäntyselkä
- University of Eastern Finland, Institute of Public Health and Clinical Nutrition, Kuopio, Finland
- Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland
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Haataja P, Korhonen P, Ojala R, Hirvonen M, Korppi M, Gissler M, Luukkaala T, Tammela O. Hospital admissions for lower respiratory tract infections after early-, late-, and post-term birth. Paediatr Perinat Epidemiol 2020; 34:139-149. [PMID: 32010990 DOI: 10.1111/ppe.12631] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 11/19/2019] [Accepted: 12/01/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Recent data suggest that early-term births are associated with later respiratory morbidity (LRTI), and post-term births may decrease this risk. OBJECTIVES The objective was to determine the impact of early-term, late-term, and post-term birth on hospital admission for LRTI up to the age of seven years. Additionally, we explored maternal and perinatal factors associated with the risk of admission for LRTIs. METHODS The association of early-term (37+0 -38+6 weeks), late-term (41+0 -41+6 weeks), and post-term (≥42 weeks) birth with hospital admissions for lower respiratory tract infections (LRTI) in comparison with infants born full-term (39+0 -40+6 weeks) was assessed and early predictors of LRTI were established. The register study included 948 695 infants born in Finland in 1991-2008. Data were analysed in four-term subgroups. Hospital admissions for bronchiolitis/bronchitis and pneumonia were collected up to 7 years of age. Adjusted Cox proportional hazards models were used to assess risk factors of LRTI admissions. RESULTS The rates of hospital admission in the early-, full-, late-, and post-term groups were 6.7%, 5.5%, 5.1%, and 4.8% for bronchiolitis/bronchitis, and 2.8%, 2.4%, 2.3%, and 2.3% for pneumonia. Early-term birth was associated with an increased risk of admission for bronchiolitis/bronchitis (hazard ratio HR 1.21, 95% confidence interval CI 1.18, 1.23) and pneumonia (HR 1.16, 95% CI 1.12, 1.20), while late-term (HR 0.93, 95% CI 0.91, 0.95) and post-term births (HR 0.89, 95% CI 0.85, 0.93) were associated with a decreased risk of bronchiolitis/bronchitis admission compared with the full-term group. Maternal age ≤ 20 years, smoking during pregnancy, male sex, caesarean delivery, small for gestational age, 1-minute Apgar score < 4, ventilator support, and neonatal antibiotic therapy were associated with an increased risk of LRTI admission, while being firstborn, born in a level-II hospital and in the Northern region was associated with decreased risk. CONCLUSION Early-term birth was associated with a higher risk of all LRTI admissions while late-term and post-term births were associated with lower risk of bronchiolitis/bronchitis admission. Modifiable risk factors of LRTIs were smoking during pregnancy, birth by elective caesarean delivery, neonatal ventilator support, and antibiotic therapy.
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Affiliation(s)
- Paula Haataja
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland.,Tampere Center for Child Health Research, Tampere University, Tampere, Finland
| | - Päivi Korhonen
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland.,Tampere Center for Child Health Research, Tampere University, Tampere, Finland
| | - Riitta Ojala
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland.,Tampere Center for Child Health Research, Tampere University, Tampere, Finland
| | - Mikko Hirvonen
- Tampere Center for Child Health Research, Tampere University, Tampere, Finland.,Central Finland Health Care District, Jyväskylä, Finland
| | - Matti Korppi
- Tampere Center for Child Health Research, Tampere University, Tampere, Finland
| | - Mika Gissler
- Information Services Department, Finnish Institute for Health and Welfare, Helsinki, Finland.,Research Centre for Child Psychiatry, University of Turku, Turku, Finland.,Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Tiina Luukkaala
- School of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland.,Research, Innovation and Development Centre, Tampere University Hospital, Tampere, Finland
| | - Outi Tammela
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland.,Tampere Center for Child Health Research, Tampere University, Tampere, Finland
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Kuusisto A, Santavirta J, Saranto K, Korhonen P, Haavisto E. Advance care planning for patients with cancer in palliative care: A scoping review from a professional perspective. J Clin Nurs 2020; 29:2069-2082. [PMID: 32045048 DOI: 10.1111/jocn.15216] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 01/13/2020] [Accepted: 02/03/2020] [Indexed: 12/28/2022]
Abstract
AIMS AND OBJECTIVES To describe advance care planning (ACP) for patients with cancer in palliative care from professionals' perspective. BACKGROUND The number of patients with cancer is increasing. Palliative care should be based on timely ACP so that patients receive the care they prefer. DESIGN A scoping review. METHODS A systematic literature search was conducted in January 2019. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist was used. The methodological quality of the studies was evaluated using the Joanna Briggs Institute (JBI) Critical Appraisal tools. Data were analysed with content analysis. RESULTS Of 739 studies identified, 12 were eligible for inclusion. The settings were inpatient and outpatient facilities in special and primary care including oncology, palliative and hospice care. ACP consisted of patient-oriented issues, current and future treatment, and end-of-life matters. The participants were nursing, medical or social professionals. ACP conversations rarely occurred; if they did, they took place at the onset, throughout and late in the cancer. CONCLUSIONS Professionals could not separate day-to-day care planning and ACP. ACP documentation was scattered and difficult to find and use. Professionals were unfamiliar with ACP, and established practices were lacking. ACP conversations mostly occurred in late cancer. Further research clarifying concepts and exploring the significance of ACP for patients and relatives is recommended. RELEVANCE TO CLINICAL PRACTICE Our results support the use of ACP by a multidisciplinary team from the early stages of cancer as a discussion forum around patients' wishes and choices. We showed the need to raise professionals' awareness of ACP. Education and appropriate data tools for ACP are important as they may reduce reluctance and promote ACP use. This paper contributes to the wider global clinical community by pointing out the importance of standardising ACP contents and practices.
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Affiliation(s)
- Anne Kuusisto
- Department of Nursing Science, University of Turku, Turku, Finland.,Satakunta Hospital District, Pori, Finland.,The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute Affiliated Group, Helsinki, Finland
| | | | - Kaija Saranto
- The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute Affiliated Group, Helsinki, Finland.,Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
| | - Päivi Korhonen
- Department of General Practice, Turku University Hospital, University of Turku, Turku, Finland
| | - Elina Haavisto
- Department of Nursing Science, University of Turku, Turku, Finland.,Satakunta Hospital District, Pori, Finland
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Butzkueven H, Korhonen P, Hillert J, Trojano M, Aydemir A, Magyari M, Khanfir H, Pinuaga C, Sabidó M. Long Term, Registry-Based, Prospective, Post-Authorization Safety Study Evaluating Adverse Events of Special Interest in Patients with Highly Active Relapsing Multiple Sclerosis Newly Started on Cladribine Tablets − CLARION. Mult Scler Relat Disord 2020. [DOI: 10.1016/j.msard.2019.11.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Abstract
OBJECTIVE In addition to acute health problems, various aspects of health behavior, work-related and sociodemographic factors have been shown to influence the rate of sickness absence. The aim of this study was to concomitantly examine factors known to have an association with absenteeism. We hypothesized the prevalence of chronic diseases being the most important factor associated with sickness absence. DESIGN A cross-sectional study. SETTING Occupational health care in the region of Pori, Finland. SUBJECTS 671 municipal employees (89% females) with a mean age of 49 (SD 10) years. Information about the study subjects was gathered from medical records, by physical examination and questionnaires containing information about physical and mental health, health behavior, work-related and sociodemographic factors. The number of sickness absence days was obtained from the records of the city of Pori. MAIN OUTCOME MEASURES The relationship of absenteeism rate with sociodemographic, health- and work-related risk factors. RESULTS In the multivariate analysis, the mean number of chronic diseases (IRR 1.24, 95% CI 1.13 to 1.36), work ability (IRR 0.83, 95% CI 0.76 to 0.91), and length of years in education (IRR 0.90, 95% CI 0.85 to 0.95) remained as independent factors associated with absenteeism. CONCLUSION According to our results, chronic diseases, self-perceived work ability and length of years in education are the most important determinants of the rate of sickness absence. This implies that among working-aged people the treatment of chronic medical conditions is also worth prioritizing, not only to prevent complications, but also to avoid sickness absences. KEY POINTS Various sociodemographic, health- and work- related risk factors have been shown to influence sickness absence. The study aimed to find the most important determinants of absenteeism among several known risk factors in Finnish municipal employees. Chronic diseases, self-perceived work ability and education years remained as the most important determinants of sickness absence rates. Treatment of chronic medical conditions should be prioritized in order to reduce sickness absence rate.
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Affiliation(s)
- Tiina Vuorio
- Department of Family Medicine, Institute of Clinical Medicine, University of Turku and Turku University Hospital, Turku, Finland;
- CONTACT Tiina Vuorio Department of Family Medicine, Institute of Clinical Medicine, University of Turku, Yleislääketiede, 20014 Turun yliopisto, Finland and Turku University Hospital, Turku, Finland
| | - Sakari Suominen
- Department of Public Health, University of Turku, Turku, Finland;
- School of Health and Education, University of Skövde, Skövde, Sweden;
| | - Hannu Kautiainen
- Folkhälsan Research Center, Helsinki, Finland;
- Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland;
| | - Päivi Korhonen
- Department of Family Medicine, Institute of Clinical Medicine, University of Turku and Turku University Hospital, Turku, Finland;
- Health Center of Harjavalta, Central Satakunta Health Federation of Municipalities, Harjavalta, Finland
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Hellwig K, Geissbuehler Y, Sabidó M, Popescu C, Adamo A, Klinger J, Huppke P, Ornoy A, Korhonen P, Myhr K, Montgomery S, Burkill S. Pregnancy and Infant Outcomes with Interferon Beta: Data from the European Interferon Beta Pregnancy Registry and Population Based Registries in Finland and Sweden. Mult Scler Relat Disord 2018. [DOI: 10.1016/j.msard.2018.10.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Loppi S, Kolosowska N, Kärkkäinen O, Korhonen P, Huuskonen M, Grubman A, Dhungana H, Wojciechowski S, Pomeshchik Y, Giordano M, Kagechika H, White A, Auriola S, Koistinaho J, Landreth G, Hanhineva K, Kanninen K, Malm T. HX600, a synthetic agonist for RXR-Nurr1 heterodimer complex, prevents ischemia-induced neuronal damage. Brain Behav Immun 2018; 73:670-681. [PMID: 30063972 PMCID: PMC8543705 DOI: 10.1016/j.bbi.2018.07.021] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 07/14/2018] [Accepted: 07/25/2018] [Indexed: 01/16/2023] Open
Abstract
Ischemic stroke is amongst the leading causes of death and disabilities. The available treatments are suitable for only a fraction of patients and thus novel therapies are urgently needed. Blockage of one of the cerebral arteries leads to massive and persisting inflammatory reaction contributing to the nearby neuronal damage. Targeting the detrimental pathways of neuroinflammation has been suggested to be beneficial in conditions of ischemic stroke. Nuclear receptor 4A-family (NR4A) member Nurr1 has been shown to be a potent modulator of harmful inflammatory reactions, yet the role of Nurr1 in cerebral stroke remains unknown. Here we show for the first time that an agonist for the dimeric transcription factor Nurr1/retinoid X receptor (RXR), HX600, reduces microglia expressed proinflammatory mediators and prevents inflammation induced neuronal death in in vitro co-culture model of neurons and microglia. Importantly, HX600 was protective in a mouse model of permanent middle cerebral artery occlusion and alleviated the stroke induced motor deficits. Along with the anti-inflammatory capacity of HX600 in vitro, treatment of ischemic mice with HX600 reduced ischemia induced Iba-1, p38 and TREM2 immunoreactivities, protected endogenous microglia from ischemia induced death and prevented leukocyte infiltration. These anti-inflammatory functions were associated with reduced levels of brain lysophosphatidylcholines (lysoPCs) and acylcarnitines, metabolites related to proinflammatory events. These data demonstrate that HX600 driven Nurr1 activation is beneficial in ischemic stroke and propose that targeting Nurr1 is a novel candidate for conditions involving neuroinflammatory component.
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Affiliation(s)
- S. Loppi
- A. I. Virtanen Institute for Molecular Sciences, Biocenter Kuopio, University of Eastern Finland, Kuopio, Finland
| | - N. Kolosowska
- A. I. Virtanen Institute for Molecular Sciences, Biocenter Kuopio, University of Eastern Finland, Kuopio, Finland
| | - O. Kärkkäinen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland
| | - P. Korhonen
- A. I. Virtanen Institute for Molecular Sciences, Biocenter Kuopio, University of Eastern Finland, Kuopio, Finland
| | - M. Huuskonen
- A. I. Virtanen Institute for Molecular Sciences, Biocenter Kuopio, University of Eastern Finland, Kuopio, Finland
| | - A. Grubman
- Department of Anatomy and Developmental Biology, Monash University, Clayton 3800, Australia
| | - H. Dhungana
- A. I. Virtanen Institute for Molecular Sciences, Biocenter Kuopio, University of Eastern Finland, Kuopio, Finland
| | - S. Wojciechowski
- A. I. Virtanen Institute for Molecular Sciences, Biocenter Kuopio, University of Eastern Finland, Kuopio, Finland
| | - Y. Pomeshchik
- A. I. Virtanen Institute for Molecular Sciences, Biocenter Kuopio, University of Eastern Finland, Kuopio, Finland
| | - M. Giordano
- A. I. Virtanen Institute for Molecular Sciences, Biocenter Kuopio, University of Eastern Finland, Kuopio, Finland
| | - H. Kagechika
- Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University, Tokyo, Japan
| | - A. White
- Cell and Molecular Biology, QIMR Berghofer Medical Research Institute, Herston, Qld 4006, Australia
| | - S. Auriola
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland
| | - J. Koistinaho
- A. I. Virtanen Institute for Molecular Sciences, Biocenter Kuopio, University of Eastern Finland, Kuopio, Finland,Neuroscience Center, University of Helsinki, Helsinki, Finland
| | - G. Landreth
- Stark Neuroscience Research Institute, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - K. Hanhineva
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland
| | - K. Kanninen
- A. I. Virtanen Institute for Molecular Sciences, Biocenter Kuopio, University of Eastern Finland, Kuopio, Finland
| | - T. Malm
- A. I. Virtanen Institute for Molecular Sciences, Biocenter Kuopio, University of Eastern Finland, Kuopio, Finland,Corresponding author at: A. I. Virtanen Institute for Molecular Science, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland. (T. Malm)
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Hirvonen M, Ojala R, Korhonen P, Haataja P, Eriksson K, Gissler M, Luukkaala T, Tammela O. Visual and Hearing Impairments After Preterm Birth. Pediatrics 2018; 142:peds.2017-3888. [PMID: 30018154 DOI: 10.1542/peds.2017-3888] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/18/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Our aim was to determine and compare the incidences of sensory impairments among very preterm (VP) (<32 + 0/7 weeks), moderately preterm (MP) (32 + 0/7-33 + 6/7 weeks), late preterm (LP) (34 + 0/7-36 + 6/7 weeks), and term infants (≥37 weeks) and to establish risk factors of neurosensory disabilities. METHODS This national register study included all live-born infants in Finland between 1991 and 2008. Infants who died before the age of 1 year, who had any major congenital anomaly, or had missing data were excluded (n = 21 007; 2.0%). A total of 1 018 256 infants were analyzed. Incidences of hearing loss, visual disturbances or blindness, other ophthalmologic disorders, and retinopathy of prematurity were determined for gestational age (GA) groups. Risk factors of hearing loss and visual disturbances or blindness were analyzed. RESULTS The incidences of sensory impairments decreased with advancing GA at birth (P < .001). The most prominent factors associated with increased risks of hearing loss and visual impairment were intracranial hemorrhage and convulsions. VP (odds ratio [OR] 2.34; 95% confidence interval [CI] 1.75-3.14) and LP (OR 1.26; 95% CI 1.04-1.52) births were associated with an increased risk of hearing loss, and VP (OR 1.94; 95% CI 1.55-2.44), MP (OR 1.42; 95% CI 1.11-1.80), and LP (OR 1.31; 95% CI 1.16-1.49) births predicted an increased risk of visual impairment. CONCLUSIONS Incidences of sensory impairment decreased with increasing GA at birth. The most prominent risk factors predictive of sensory disabilities were intracranial hemorrhage and convulsions. VP and LP births were associated with an increased risk of hearing loss, and VP, MP, and LP births were associated with an increased risk of visual impairment.
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Affiliation(s)
- Mikko Hirvonen
- Department of Pediatrics, Central Finland Health Care District, Jyväskylä, Finland; .,Tampere Center for Child Health Research and
| | - Riitta Ojala
- Tampere Center for Child Health Research and.,Departments of Pediatrics and
| | - Päivi Korhonen
- Tampere Center for Child Health Research and.,Departments of Pediatrics and
| | - Paula Haataja
- Tampere Center for Child Health Research and.,Departments of Pediatrics and
| | - Kai Eriksson
- Tampere Center for Child Health Research and.,Pediatric Neurology, and
| | - Mika Gissler
- National Institute for Health and Welfare, Helsinki, Finland.,Research Centre for Child Psychiatry, University of Turku, Turku, Finland; and.,Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Tiina Luukkaala
- School of Health Sciences, Faculty of Social Sciences, University of Tampere, Tampere, Finland.,Research and Innovation Center, Tampere University Hospital, Tampere, Finland
| | - Outi Tammela
- Tampere Center for Child Health Research and.,Departments of Pediatrics and
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Korhonen P, Haataja P, Ojala R, Hirvonen M, Korppi M, Paassilta M, Uotila J, Gissler M, Luukkaala T, Tammela O. Asthma and atopic dermatitis after early-, late-, and post-term birth. Pediatr Pulmonol 2018; 53:269-277. [PMID: 29316371 DOI: 10.1002/ppul.23942] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 12/06/2017] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To assess the incidence and risk factors of asthma and atopic dermatitis by seven years of age after early-term (ET) (37+0 -38+6 weeks), full-term (FT) (39+0 -40+6 weeks), late-term (LT) (41+0 -41+6 weeks), and especially post-term (PT) (≥42 weeks) birth. METHODS Altogether, 965 203 infants born between 1991 and 2008 in Finland were investigated in ET, FT, LT, and PT groups. Data on asthma medication reimbursement and hospital visits for atopic dermatitis were retrieved from national health databases. RESULTS The frequencies of asthma medication reimbursement in the ET, FT, LT, and PT groups were 4.5%, 3.7%, 3.3%, and 3.2%, respectively. Hospital visits due to atopic dermatitis were most common after PT birth. Compared with FT births, ET births were associated with an increased risk of asthma (adjusted odds ratio (aOR), 95% confidence interval (CI) 1.20, 1.17-1.23), while LT (aOR, 95%CI 0.91, 0.89-0.93) births and PT (aOR, 95%CI 0.87, 0.83-0.92) births decreased this risk. PT birth (aOR, 95%CI 1.06, 1.01-1.10) predicted atopic dermatitis. From a population point of view, the most relevant risk factors for asthma were male sex, ET birth, smoking during pregnancy and birth by elective cesarean section, and for atopic dermatitis male sex, first delivery, birth in a level II hospital and birth by cesarean section. CONCLUSIONS Early-term birth was a predictor of asthma, and PT birth was associated with atopic dermatitis. Counseling against smoking and following strict indications for planned ET deliveries and cesarean sections may be means to reduce the risk of later asthma.
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Affiliation(s)
- Päivi Korhonen
- Department of Pediatrics, Tampere University Hospital, Finland.,Tampere Center for Child Health Research, University of Tampere, Finland
| | - Paula Haataja
- Department of Pediatrics, Tampere University Hospital, Finland.,Tampere Center for Child Health Research, University of Tampere, Finland
| | - Riitta Ojala
- Department of Pediatrics, Tampere University Hospital, Finland.,Tampere Center for Child Health Research, University of Tampere, Finland
| | - Mikko Hirvonen
- Department of Pediatrics, Tampere University Hospital, Finland.,Tampere Center for Child Health Research, University of Tampere, Finland.,Central Finland Health Care District, Jyväskylä, Finland
| | - Matti Korppi
- Department of Pediatrics, Tampere University Hospital, Finland.,Tampere Center for Child Health Research, University of Tampere, Finland
| | | | - Jukka Uotila
- Department of Obstetrics and Gynecology, Tampere University Hospital, Finland
| | - Mika Gissler
- National Institute for Health and Welfare, Helsinki, Finland.,Research Centre for Child Psychiatry, University of Turku, Turku, Finland.,Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Tiina Luukkaala
- Health Sciences, Faculty of Social Sciences, University of Tampere, Tampere, Finland.,Research and Innovation Center, Tampere University Hospital and Faculty of Social Sciences, University of Tampere, Finland
| | - Outi Tammela
- Department of Pediatrics, Tampere University Hospital, Finland.,Tampere Center for Child Health Research, University of Tampere, Finland
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Åttman E, Korhonen P, Tammela O, Vuento R, Aittoniemi J, Syrjänen J, Mattila E, Österblad M, Huttunen R. A Serratia marcescens outbreak in a neonatal intensive care unit was successfully managed by rapid hospital hygiene interventions and screening. Acta Paediatr 2018; 107:425-429. [PMID: 29068091 DOI: 10.1111/apa.14132] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 08/14/2017] [Accepted: 10/19/2017] [Indexed: 12/17/2022]
Abstract
AIM Serratia marcescens is a rare, but important, pathogen in hospital-acquired infections, especially in neonatal units. Outbreaks may cause significant mortality among neonates. This study describes how an outbreak of S. marcescens was handled in a neonatal intensive care unit in Finland in June 2015. METHODS Tampere University Hospital is the only hospital that offers intensive care for preterm neonates in the Pirkanmaa health district area in Finland. Between June 9, 2015 and June 29, 2015, seven neonates were screened positive for S. marcescens in the hospital. We examined the management and outcomes, including environmental sampling. RESULTS Two of the seven neonates developed a bloodstream infection, and one with S. marcescens sepsis died after six days of antibiotic treatment. The outbreak was rapidly managed with active hospital hygiene interventions, including strict hand hygiene, cleaning, patient screening, contact precautions and education. Environmental sampling was limited to one water tap and a ventilator, and the results were negative. The outbreak was contained within three weeks, and no further cases appeared. The screening of healthcare workers was not necessary. CONCLUSION A S. marcescens outbreak caused significant morbidity in neonates and one death. Rapid hospital hygiene interventions and patient screening effectively contained the outbreak.
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Affiliation(s)
- Emilia Åttman
- Tampere Medical School; University of Tampere; Tampere Finland
| | - Päivi Korhonen
- Tampere Center for Child Health Research; Tampere University Hospital and University of Tampere; Tampere Finland
| | - Outi Tammela
- Tampere Center for Child Health Research; Tampere University Hospital and University of Tampere; Tampere Finland
| | | | | | - Jaana Syrjänen
- Department of Internal Medicine; Tampere University Hospital; Tampere Finland
| | - Erja Mattila
- Department of Internal Medicine; Tampere University Hospital; Tampere Finland
| | - Monica Österblad
- Bacterial Infections Unit; National Institute for Health and Welfare; Turku Finland
| | - Reetta Huttunen
- Department of Internal Medicine; Tampere University Hospital; Tampere Finland
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43
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Haataja P, Korhonen P, Ojala R, Hirvonen M, Korppi M, Gissler M, Luukkaala T, Tammela O. Hospital admissions for lower respiratory tract infections in children born moderately/late preterm. Pediatr Pulmonol 2018; 53:209-217. [PMID: 29193814 DOI: 10.1002/ppul.23908] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 10/17/2017] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To evaluate the frequency and predictors of hospital admissions for lower respiratory tract infections (LRTIs) in moderately preterm (MP, 32+0 to 33+6 weeks) and late preterm (LP, 34+0 to 36+6 weeks) infants compared to term (T ≥37 weeks) and very preterm (VP, <32+0 weeks) infants. STUDY DESIGN This national register-based study covered all infants born in Finland in 1991-2008. Data on 1 018 256 infants were analyzed in four gestational age-based groups: VP (n = 6329), MP (n = 6796), LP (n = 39 928), and T (n = 965 203) groups. Data on hospital admissions due to bronchiolitis/bronchitis and pneumonia were collected up to the age of 7 years. RESULTS Hospital admissions for LRTIs were more common in the MP and LP groups than in the T group but less frequent than in the VP group: bronchiolitis/bronchitis (VP 24.4%, MP 13.9%, LP 9.5%, and T 5.6%) and pneumonia (VP 8.8%, MP 4.5%, LP 3.3%, and T 2.4%). Compared to the term group, MP and LP birth predicted bronchiolitis/bronchitis (MP OR 1.89; 95%CI 1.75-2.03, LP 1.51; 1.45-1.56) and pneumonia (MP 1.49; 1.32-1.67, LP 1.25; 1.18-1.33) admissions. Statistically significant risk factors for LRTIs included maternal smoking, cesarean section, male sex, admission to a neonatal unit and ventilator therapy. In addition, being first-born, being born SGA and neonatal antibiotic therapy were associated with bronchiolitis/bronchitis. CONCLUSIONS MP and LP births, in addition to VP birth, have a significant impact on respiratory infectious morbidity and the need of hospital admissions for LRTIs.
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Affiliation(s)
- Paula Haataja
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland.,Tampere Center for Child Health Research, University of Tampere, Tampere, Finland
| | - Päivi Korhonen
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland.,Tampere Center for Child Health Research, University of Tampere, Tampere, Finland
| | - Riitta Ojala
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland.,Tampere Center for Child Health Research, University of Tampere, Tampere, Finland
| | - Mikko Hirvonen
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland.,Tampere Center for Child Health Research, University of Tampere, Tampere, Finland.,Central Finland Health Care District, Jyväskylä, Finland
| | - Matti Korppi
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland.,Tampere Center for Child Health Research, University of Tampere, Tampere, Finland
| | - Mika Gissler
- Information Services Department, THL National Institute for Health and Welfare, Helsinki, Finland.,Research Centre for Child Psychiatry, University of Turku, Turku, Finland.,Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Division of Family Medicine, Stockholm, Sweden
| | - Tiina Luukkaala
- Health Sciences, Faculty of Social Sciences, University of Tampere, Tampere, Finland.,Research and Innovation Centre, Tampere University Hospital, Tampere, Finland
| | - Outi Tammela
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland.,Tampere Center for Child Health Research, University of Tampere, Tampere, Finland
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Välimäki M, Jansson E, Korhonen P, Peltoniemi A, Rousu S. Custom-Shaped Organic Photovoltaic Modules-Freedom of Design by Printing. Nanoscale Res Lett 2017; 12:117. [PMID: 28228002 PMCID: PMC5309187 DOI: 10.1186/s11671-017-1871-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Accepted: 01/28/2017] [Indexed: 05/08/2023]
Abstract
Freedom of design that was introduced as organic photovoltaic (OPV) modules were fabricated by printing. As proof-of-concept, we show OPV leaf fabrication in A5 size using gravure and rotary screen printing processes for the main active layers of the OPV structure. These printing methods allow direct printing of any kind of arbitrary, two-dimensional shapes including patterning of the electric contacts thus post-patterning stages are not needed. Fabrication of custom-shaped OPV modules requires detailed information about the technical boundaries set by the manufacturing process and materials which in turn influence the layout design and R2R upscaling. In this paper, we show custom-shaped OPV modules, patterned directly in a shape of a tree leaf with an overall size of 110 cm2 and an active area of 50 cm2 providing a power conversion efficiency of 2.0% and maximum power of 98 mW.
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Affiliation(s)
- M Välimäki
- VTT Technical Research Centre of Finland Ltd, Oulu, Finland.
| | - E Jansson
- VTT Technical Research Centre of Finland Ltd, Oulu, Finland
| | - P Korhonen
- VTT Technical Research Centre of Finland Ltd, Oulu, Finland
| | - A Peltoniemi
- VTT Technical Research Centre of Finland Ltd, Oulu, Finland
| | - S Rousu
- VTT Technical Research Centre of Finland Ltd, Oulu, Finland
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Hirvonen M, Ojala R, Korhonen P, Haataja P, Eriksson K, Rantanen K, Gissler M, Luukkaala T, Tammela O. Intellectual disability in children aged less than seven years born moderately and late preterm compared with very preterm and term-born children - a nationwide birth cohort study. J Intellect Disabil Res 2017; 61:1034-1054. [PMID: 28699168 DOI: 10.1111/jir.12394] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 06/12/2017] [Accepted: 06/16/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Prematurity has been shown to be associated with an increased risk of intellectual disability (ID). METHOD The aim was to establish whether the prevalence of ID, defined as significant limitations in both intellectual (intelligence quotient below 70) and adaptive functioning among moderately preterm (MP; 32+0 -33+6 weeks) and late preterm (LP; 34+0 -36+6 weeks) infants, is increased compared with that in term infants (≥37+0 weeks). Antenatal and neonatal risk factors for ID among gestational age groups were sought. The national register study included all live-born infants in Finland in 1991-2008, excluding those who died before one year age, or had any major congenital anomaly or missing data. A total of 1 018 256 infants (98.0%) were analysed: very preterm (VP; <32+0 weeks, n = 6329), MP (n = 6796), LP (n = 39 928) and term (n = 965 203). RESULTS By the age of seven years, the prevalence of ID was 2.48% in the VP group, 0.81% in the MP group, 0.55% in the LP group and 0.35% in the term group. Intracranial haemorrhage increased the ID risk in all groups. Male sex and born small for gestational age predicted an increased risk in all but the MP group. CONCLUSIONS The prevalence of ID decreased with increasing gestational age. Prevention of intracranial haemorrhages may have a beneficial effect on the neurodevelopmental outcomes of neonates.
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Affiliation(s)
- M Hirvonen
- Department of Pediatrics, Central Finland Central Hospital, Jyväskylä, Finland
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland
- Tampere Center for Child Health Research, University of Tampere, Tampere, Finland
| | - R Ojala
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland
- Tampere Center for Child Health Research, University of Tampere, Tampere, Finland
| | - P Korhonen
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland
- Tampere Center for Child Health Research, University of Tampere, Tampere, Finland
| | - P Haataja
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland
- Tampere Center for Child Health Research, University of Tampere, Tampere, Finland
| | - K Eriksson
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland
- Tampere Center for Child Health Research, University of Tampere, Tampere, Finland
| | - K Rantanen
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland
- School of Social Sciences and Humanities, Psychology Clinic, University of Tampere, Tampere, Finland
| | - M Gissler
- Information Services Department, National Institute for Health and Welfare, Helsinki, Finland
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- Department of Neurobiology, Care Sciences and Society, Division of Family Medicine, Karolinska Institute, Stockholm, Sweden
| | - T Luukkaala
- Science Center, Pirkanmaa Hospital District, Tampere, Finland
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - O Tammela
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland
- Tampere Center for Child Health Research, University of Tampere, Tampere, Finland
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Heikkilä A, Kaipia A, Venermo M, Kautiainen H, Korhonen P. Relationship of Blood Pressure and Erectile Dysfunction in Men Without Previously Diagnosed Hypertension. J Sex Med 2017; 14:1336-1341. [PMID: 28993149 DOI: 10.1016/j.jsxm.2017.09.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 09/04/2017] [Accepted: 09/10/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Erectile dysfunction (ED) is the most common male sexual disorder that affects all age groups and has a close association with essential hypertension. AIM To characterize the relation of blood pressure and ED in detail. METHODS A cross-sectional population-based study of 45- to 70-year-old men without previously diagnosed hypertension, cardiovascular diseases, renal disease, or diabetes was conducted from 2005 to 2007 in southwestern Finland. A total of 665 men with at least one cardiovascular risk factor were studied. ED was defined by the five-item International Index of Erectile Function. OUTCOMES We found a U-shaped association between diastolic blood pressure (DBP) and prevalence of ED. RESULTS The average age of the study subjects was 56 ± 6 years and 52% had ED. After adjustment for age, cohabitation status, education, fasting plasma glucose level, waist circumference, and prevalence of depressive symptoms, the curve relating DBP to the prevalence of ED was U-shaped with a nadir of DBP 90 mm Hg. CLINICAL IMPLICATIONS Our findings emphasize the importance of blood pressure measurement in the physical examination of men with ED. STRENGTHS AND LIMITATIONS This was a cross-sectional study, which prevents the evaluation of causality between ED and hypertension. However, this community-based study population is well defined and the anthropologic measurements were made by trained medical staff. CONCLUSION We found a U-shaped correlation between ED and DBP, which confirms the link between ED and hypertension. Heikkilä A, Kaipia A, Venermo M, et al. Relationship of Blood Pressure and Erectile Dysfunction in Men Without Previously Diagnosed Hypertension. J Sex Med 2017;14:1336-1341.
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Affiliation(s)
- Arto Heikkilä
- Department of General Practice, Turku University and Turku University Hospital, Turku University, Turku, Finland.
| | - Antti Kaipia
- Department of Surgery, Satakunta Hospital District, Pori, Finland
| | - Maarit Venermo
- Department of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Hannu Kautiainen
- Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland; Folkhälsan Research Centre, Helsinki, University of Helsinki, Helsinki, Finland
| | - Päivi Korhonen
- Department of General Practice, Turku University and Turku University Hospital, Turku University, Turku, Finland; Central Satakunta Health Federation of Municipalities, Harjavalta, Finland
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Lehtinen A, Korhonen P, Hyödynmaa E, Koivisto AM, Peltola T, Hämäläinen M, Moilanen E, Tammela O. Adipokines played a limited role in predicting temporary growth differences between very low birthweight infants with and without bronchopulmonary dysplasia. Acta Paediatr 2017. [PMID: 28639282 DOI: 10.1111/apa.13942] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS This study explored whether growth was poorer among very low birthweight (VLBW) infants with bronchopulmonary dysplasia (BPD) and assessed adipokine levels as predictors of early growth. METHODS We studied 53 VLBW infants born in Tampere University Hospital up to 12 months of corrected age (CA). The median gestational age of the 21 infants with BPD and 32 infants without BPD was 29 weeks, and the median birthweights were 930 (635-1470) and 1185 (650-1470) grams. Growth parameters, macronutrients intake and plasma levels of adipokines were measured. RESULTS Bronchopulmonary dysplasia infants were lighter than controls until 36 weeks of CA, with catch-up growth achieved by three months of CA. Adipsin levels were lower in BPD infants at 28 days of postnatal age. High leptin levels seemed protective for low weight for height at nine months of CA. The duration of ventilator therapy predicted low weight for height, length for age and body mass index and BPD predicted low length for age at 12 months of CA. CONCLUSIONS Catch-up growth in VLBW infants with BPD was achieved by three months of CA, but adipokines played a limited role in predicting growth. Shortening ventilator therapy could help growth in VLBW infants.
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Affiliation(s)
- A Lehtinen
- Faculty of Medicine; University of Tampere; Tampere Finland
| | - P Korhonen
- Department of Paediatrics; Tampere University Hospital; Tampere Finland
- Tampere Center for Child Health Research; Tampere University Hospital and University of Tampere; Tampere Finland
| | - E Hyödynmaa
- Department of Paediatrics; Central Finland Central Hospital; Jyväskylä Finland
| | - AM Koivisto
- School of Health Sciences; University of Tampere; Tampere Finland
| | - T Peltola
- Medical Nutrition Unit; Tampere University Hospital; Tampere Finland
| | - M Hämäläinen
- The Immunopharmacology Research Group; University of Tampere School of Medicine and Tampere University Hospital; Tampere Finland
| | - E Moilanen
- The Immunopharmacology Research Group; University of Tampere School of Medicine and Tampere University Hospital; Tampere Finland
| | - O Tammela
- Department of Paediatrics; Tampere University Hospital; Tampere Finland
- Tampere Center for Child Health Research; Tampere University Hospital and University of Tampere; Tampere Finland
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48
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Suursalmi P, Ojala T, Poutanen T, Eerola A, Korhonen P, Kopeli T, Tammela O. Velocity vector imaging shows normal cardiac systolic function in survivors of severe bronchopulmonary dysplasia at six to 16 years of age. Acta Paediatr 2017; 106:1136-1141. [PMID: 28370347 DOI: 10.1111/apa.13860] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 03/07/2017] [Accepted: 03/28/2017] [Indexed: 01/02/2023]
Abstract
AIM This study evaluated global myocardial function and associations between cardiac function and lung function in very low birth weight (VLBW) children, with and without severe radiographic bronchopulmonary dysplasia (BPD), at six to 14 years of age. METHODS We studied 34 VLBW and 19 term-born controls, and the VLBW group was further divided into a BPD group with severe radiographic BPD and those without radiographic BPD in infancy. Detailed right and left ventricular myocardial functions were analysed by velocity vector imaging, and the left ventricular mass was calculated. The associations between cardiac function and lung function were assessed by impulse oscillometry. RESULTS The right and left ventricular myocardial systolic functions and the left ventricular mass were similar in the three groups. Lung function was not associated with cardiac systolic function. Neonatal exposure to dexamethasone treatment was negatively associated with right ventricular function, as measured by the automated fractional area change, with an odds ratio of 7.9 and 95% confidence interval of 1.9-33.5 (p = 0.005). CONCLUSION Lung function measurements were not associated with cardiac systolic function in preterm infants at six to 14 years of age. Neonatal exposure to dexamethasone, used for weaning from the ventilator, was negatively associated with right ventricular function.
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Affiliation(s)
- Piia Suursalmi
- Department of Pediatrics; Tampere University Hospital; Tampere Finland
- Tampere Center for Child Health Research; Tampere University Hospital and University of Tampere; Tampere Finland
| | - Tiina Ojala
- Department of Pediatric Cardiology; Children's Hospital; University Hospital of Helsinki and University of Helsinki; Helsinki Finland
| | - Tuija Poutanen
- Department of Pediatrics; Tampere University Hospital; Tampere Finland
| | - Anneli Eerola
- Department of Pediatrics; Tampere University Hospital; Tampere Finland
| | - Päivi Korhonen
- Department of Pediatrics; Tampere University Hospital; Tampere Finland
- Tampere Center for Child Health Research; Tampere University Hospital and University of Tampere; Tampere Finland
| | - Tarja Kopeli
- Department of Pediatrics; Tampere University Hospital; Tampere Finland
- Department of Pediatrics; Päijät-Häme Central Hospital; Lahti Finland
| | - Outi Tammela
- Department of Pediatrics; Tampere University Hospital; Tampere Finland
- Tampere Center for Child Health Research; Tampere University Hospital and University of Tampere; Tampere Finland
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49
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Suursalmi P, Eerola A, Poutanen T, Korhonen P, Kopeli T, Tammela O. Very low birthweight bronchopulmonary dysplasia survivors had similar cardiac outcomes to controls at six years to 14 years of age. Acta Paediatr 2017; 106:261-267. [PMID: 27792267 DOI: 10.1111/apa.13647] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 10/16/2016] [Accepted: 10/25/2016] [Indexed: 01/04/2023]
Abstract
AIM This study evaluated cardiac function and its associations with lung function and neonatal pulmonary morbidity in very low birthweight (VLBW) children, with and without severe radiographic bronchopulmonary dysplasia (radBPD), at school age. METHODS We examined 18 VLBW children with radBPD, 17 VLBW children without radBPD and 18 healthy term-born children using conventional echocardiography, tissue Doppler imaging, speckle tracking echocardiography and real-time three-dimensional echocardiography at six years to 14 years of age. Lung function was studied by impulse oscillometry. Plasma N-terminal-proBNP concentrations were measured. RESULTS Cardiac function and N-terminal-proBNP concentrations did not differ between the groups. No associations were found between cardiac function and neonatal dexamethasone, oxygen or ventilator therapies. In VLBW children, poorer reactance correlated with larger left ventricle (LV) end-systolic (Spearman's ρ = -0.45) and end-diastolic (ρ = -0.50) volumes and higher resistance correlated with higher LV dyssynchrony indexes, with ρ ranging from 0.37 to 0.48. Greater bronchodilation responses correlated with lower early diastolic myocardial relaxation velocities, with ρ ranging from 0.39 to 0.42. CONCLUSION BPD survivors had normal cardiac function at the age of six years to 14 years. No associations were found between neonatal pulmonary morbidity and cardiac parameters. Poorer lung function correlated modestly with LV echocardiographic parameters in VLBW children.
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Affiliation(s)
- Piia Suursalmi
- Department of Pediatrics Tampere University Hospital Tampere Finland
- Tampere Center for Child Health Research Tampere University Hospital and University of Tampere Tampere Finland
| | - Anneli Eerola
- Department of Pediatrics Tampere University Hospital Tampere Finland
| | - Tuija Poutanen
- Department of Pediatrics Tampere University Hospital Tampere Finland
| | - Päivi Korhonen
- Department of Pediatrics Tampere University Hospital Tampere Finland
- Tampere Center for Child Health Research Tampere University Hospital and University of Tampere Tampere Finland
| | - Tarja Kopeli
- Department of Pediatrics Tampere University Hospital Tampere Finland
- Department of Pediatrics Päijät‐Häme Central Hospital Lahti Finland
| | - Outi Tammela
- Department of Pediatrics Tampere University Hospital Tampere Finland
- Tampere Center for Child Health Research Tampere University Hospital and University of Tampere Tampere Finland
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50
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Heikkilä A, Venermo M, Kautiainen H, Aarnio P, Korhonen P. Short stature in men is associated with subclinical peripheral arterial disease. VASA 2016; 45:486-490. [PMID: 27598046 DOI: 10.1024/0301-1526/a000566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Peripheral arterial disease (PAD) affects approximately 202 million individuals around the world and is associated with a high risk of myocardial infarction, stroke and death. Although there is a clear inverse association between adult height and the risk of cardiovascular disease, little is known about the relationship between height and PAD. The aim of our study was to assess the relationship between subclinical PAD and height. PATIENTS AND METHODS In a cross-sectional cardiovascular risk factor study in southwestern Finland, ankle brachial index (ABI) and other risk factors were measured from a total of 972 cardiovascular risk subjects derived from the general population. None of them had previously diagnosed diabetes, cardiovascular or renal disease or intermittent claudication. Subjects with an ABI ≤ 0.90 were categorized as having subclinical PAD. RESULTS The average age of the study subjects was 58.1 ± 6.7 years for men and 58.8 ± 6.9 years for women. The prevalence of subclinical PAD was 5 % (95 % CI 3 % - 7 %) (23/455) among men and 5 % (95 % CI 3 %-7 %) (26/517) among women. The mean ABI among men and women was 1.09 ± 0.12 and 1.08 ± 0.12, respectively. In men, there was an inverse association between height and the prevalence of subclinical PAD (p < 0.001) along with a positive association between height and ABI values (p < 0.001). In a multivariate model, height, age and current smoking status remained independent factors that were associated with subclinical PAD in men, whereas in women, only pulse pressure was associated with subclinical PAD. CONCLUSIONS Short stature in men is associated with subclinical PAD and lower ABI values.
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Affiliation(s)
- Arto Heikkilä
- 1 Department of General Practice, University of Turku, Turku, Finland.,2 Department of Surgery, Satakunta Hospital District, Pori, Finland
| | - Maarit Venermo
- 3 Department of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Hannu Kautiainen
- 4 Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - Pertti Aarnio
- 2 Department of Surgery, Satakunta Hospital District, Pori, Finland
| | - Päivi Korhonen
- 1 Department of General Practice, University of Turku, Turku, Finland.,5 Department of Primary Care, Central Satakunta Health Federation of Municipalities, Harjavalta, Finland
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