Age at the introduction of solid foods during the first year and allergic sensitization at age 5 years.

Objective: The goal was to examine the relationship between age at the introduction of solid foods during the first year of life and allergic sensitization in 5-year-old children.

Methods: We analyzed data from the Finnish Type 1 Diabetes Prediction and Prevention nutrition study, a prospective, birth cohort study. We studied 994 children with HLA-conferred susceptibility to type 1 diabetes mellitus for whom information on breastfeeding, age at the introduction of solid foods, and allergen-specific immunoglobulin E levels at 5 years was available.

Miscarriage and risk of cardiovascular disease.

In a nationally representative sample (the Health 2000 Survey) comprising 3,937 Finnish women aged 30-99 years, we examined the association of miscarriage (assessed by questionnaire) with risk of cardiovascular disease (assessed by physician's examination and linkages to hospital discharge and drug reimbursement registers). We considered age, smoking, body mass index, waist/hip ratio, physical activity, education, number of previous pregnancies, blood pressure, and fasting blood glucose and cholesterol as potentially confounding factors in the analysis. In women 50-74 years of age who had experienced pregnancy, history of miscarriage tended to be associated with a higher risk of myocardial infarction (age-adjusted odds ratio (OR): 2.

Encounters with unemployment in occupational health care: Nurses' constructions of clients without work.

This study explores occupational health nurses' encounters with unemployed clients in Finland. It involved setting up and evaluating a new service, Career Health Care, that resembled occupational health care, except that clients were recruited from among job seekers who were participating in one of three active labour market policy measures: vocational training, subsidised employment in the public sector, or participatory training for entering the labour market. Our main interest focused on nurses' perceptions of the unemployed and their professional practices in the context of Career Health Care.

Sociodemographic factors and a secular trend of adolescent overweight in Finland.

Background And Aim: The prevalence of overweight and obesity increased three-fold among Finnish adolescents during the past three decades. The aim of the present study was to evaluate whether this secular trend differed between sociodemographic subgroups of adolescents.

Methods: Mailed surveys were conducted among nationally representative samples of 12-18 year olds biennially in 1979-2005 (N=3,105-8,390 per year, response rates 88%-66%).

Psychiatrists' views of compulsory psychiatric care of minors.

Commitment to psychiatric care is in Finland allowed for minors in broader terms than for adults. Minors can be committed to and detained in involuntary psychiatric treatment if they suffer from severe mental disorder and fulfil the additional commitment criteria defined in the Mental Health Act. Adults can be committed to involuntary psychiatric care only if they are mentally ill (=psychotic), and fulfil the additional criteria.

An analysis of ophthalmology services in Finland - has the time come for a Public-Private Partnership?

Background: We studied the prerequisites for Public-Private Partnership (PPP) in the context of the Finnish health care system and more specifically in the field of ophthalmology. PPP can be defined as a more or less permanent cooperation between public and private actors, through which the joint products or services are developed and in which the risks, costs and profits are shared.The Finnish eye care services system is heterogeneous with several different providers and can be regarded as sub-optimal in terms of overall resource use.

Evaluation of breast cancer service screening programme with a Bayesian approach: mortality analysis in a Finnish region.

Evaluation of long-term effectiveness of population-based breast cancer service screening program in a small geographic area may suffer from self-selection bias and small samples. Under a prospective cohort design with exposed and non-exposed groups classified by whether women attended the screen upon invitation, we proposed a Bayesian acyclic graphic model for correcting self-selection bias with or without incorporation of prior information derived from previous studies with an identical screening program in Sweden by chronological order and applied it to an organized breast cancer service screening program in Pirkanmaa center of Finland. The relative mortality rate of breast cancer was 0.

Employment trajectories and changes in sense of coherence.

Background: Knowledge of the associations between labour market position and sense of coherence (SOC) comes mainly from cross-sectional studies. We investigated whether change in employment status is associated with change in SOC and whether such an association varies when young (<30 years) and older employees are compared.

Methods: Data were derived from two studies: a cohort of initially non-permanent employees (n = 1898) was followed up for four years, and a cohort representing the national workforce (n = 9623) was followed up for five years.

Associations of leisure-time physical activity with balance and lower extremity strength: a validation of the neuromuscular part of the Physical Activity Pie.

Background: The importance of neuromuscular-type exercise (NME) has been recognized in recent recommendations for public health. However, the knowledge on associations and dose response of different types of leisure-time physical activity (LTPA) with musculoskeletal fitness and health is incomplete. This study evaluated the validity of the NME recommendation for public health introduced by the Physical Activity Pie.

Missing values in longitudinal dietary data: a multiple imputation approach based on a fully conditional specification.

Multiple imputation (MI) has increasingly received attention as a flexible tool to resolve missing data problems both in observational and controlled studies. Our goal has been to develop a valid and efficient MI procedure for the Diabetes Prediction and Prevention Nutrition Study, in which the diet of a cohort of newborn children with HLA-DQB1-conferred susceptibility to type 1 diabetes is repeatedly measured by 3-day food records over early childhood. The estimation of risk is based on a nested case-control design setup within the cohort.

Knowledge sources affecting decision-making among social and health care managers.

Purpose: The purpose of this paper is to investigate how managers in social and health care evaluate the knowledge sources affecting their decision-making, and how the evaluations were associated with the managers' professional background, activity sector, gender, age and management experience.

Design/methodology/approach: The study data are gathered from a questionnaire survey to the middle-line doctor, nurse and social managers (n = 404) within the responsibility area of a Finnish university hospital. Assessed the proportions of individual knowledge sources in the complete data set and their associations with the subjects' background data.

Effect of family history on the incidence of varicose veins: a population-based follow-up study in Finland.

In the literature, the estimates of high risk of family history for varicose veins are based on prevalence rates from cross-sectional studies. The purpose of this study was to compare such prevalence rates with incidence rates from our longitudinal follow-up study to find out whether there is a difference due to the methodology. A validated questionnaire was used in 3 middle-aged cohorts (n = 6874) in Tampere, Finland.

Variation in use and costs of primary health and social services in mental health or drinking problems.

Background: Psychiatric inpatient hospital care was cut dramatically in Finland in recent last decades, and patients were assigned to care in the community. Consequently, the burden of care shifted from hospital districts to municipalities, which have considerable autonomy in organizing health and social services. These changes probably created locally differing service patterns in mental health care.

Test sensitivity in the European prostate cancer screening trial: results from Finland, Sweden, and the Netherlands.

Test sensitivity pertains to the ability of a test to identify subjects with the target disorder. In cancer screening, test sensitivity can be estimated using interval cancer incidence as an indicator of false-negative result. A randomized trial provides the optimal approach for estimating test sensitivity, as the control arm provides the expected rates.

Adolescent sexual behavior during periods of increase and decrease in the abortion rate.

Objective: To study changes in adolescent sexual behavior in periods of increase (1994-2000) and decrease (2001-2007) in the abortion rate.

Methods: School surveys with self-administered questionnaires were carried out annually among eighth graders (mean age 14.8 years) and ninth graders (mean age 15.

Effectiveness in political--administrative decision-making in specialized healthcare.

Aim: To investigate the occurrence of the word ;;effectiveness'' in the political-administrative decision-making minutes in specialized healthcare as presented to board and council meetings by top management teams.

Methods: The occurrence and intended use of ;;effectiveness'' were identified from all council and board meeting minutes (n = 190) of five Finnish university hospital districts in 2001 and 2006. Data were collected from the Internet pages of the hospital districts.

Unemployment, depressiveness and disability retirement: a follow-up study of the Finnish HeSSup population sample.

Background: Disability retirement because of depression is increasingly common in Finland. The rise of such retirement coincided with the rise of unemployment in the second half of the 1990s. In this study we sought potential connections between these two epidemics.

Home-based sourcing of tobacco among adolescents.

Objective: To study home-based sources of tobacco and associated family factors among Finnish adolescents.

Methods: Nationwide surveys (1999, 2003, 2007) of 14-16-year-old daily (n=2355), occasional (n=708), and experimental (n=2763) smokers. The main outcome measure was home-based sourcing of tobacco (parents, siblings, taking from home) during the past month.

Age and closeness of death as determinants of health and social care utilization: a case-control study.

Background: We used case-control design to compare utilization of health and social services between older decedents and survivors, and to identify the respective impact of age and closeness of death on the utilization of services.

Methods: Data were derived from multiple national registers. The sample consisted of 56,001 persons, who died during years 1998-2000 at the age of > or = 70, and their pairs matched on age, gender and municipality of residence, who were alive at least 2 years after their counterpart's death.

Genetic and environmental effects on isometric muscle strength and leg extensor power followed up for three years among older female twins.

The purpose of this study was to examine changes in the contribution of genetic and environmental effects to isometric knee extensor strength and leg extensor power among 63- to 76-year-old female twins over a 3-yr follow-up. At baseline in 2000 the sample comprised 206 monozygotic (MZ) and 228 dizygotic (DZ) twin individuals, and at follow-up in 2003 the sample comprised 149 MZ and 164 DZ twin individuals. Genetic modeling showed that genetic effects explained 58% (95% CI: 46-68%) of the variance in muscle strength at baseline and 56% (95% CI: 41-68%) at follow-up, with no occasion-specific genetic effect.

Alexithymia and health-related quality of life in a general population.

Background: Alexithymia is thought to reflect a deficit in the cognitive processing of emotion, and, therefore, it may predispose individuals to both psychological and somatic symptoms.

Objective: The authors investigated the relationship between alexithymia and health-related quality of life (HRQoL) in a nationally representative population sample of 5,418 subjects, age 30 to 97 years.

Method: Alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20) and HRQoL measured with the 15D, a generic HRQoL measure.

Social phobia in Finnish general adolescent population: prevalence, comorbidity, individual and family correlates, and service use.

Background: Few studies have investigated the epidemiology of social phobia (SP) among early to middle adolescents, at the time of suggested mean onset of the disorder. The objective of this study was to investigate the prevalence, comorbidity, individual and familial correlates, and service use associated with SP among Finnish 12-17-year-old adolescents in general population.

Methods: A sample of 784 adolescents was screened with the Social Phobia Inventory, and a sub-sample (n=350) was interviewed with a semi-structured clinical interview to identify SP, sub-clinical SP (SSP), and a range of other axis I DSM-IV disorders.

Efficacy of pneumococcal conjugate vaccine against PCR-positive acute otitis media.

We aimed to assess the efficacy of a pneumococcal conjugate vaccine against acute otitis media (AOM) positive by pneumolysin-PCR (Ply-PCR). 1662 infants vaccinated with PncCRM or control vaccine using random allocation were followed for AOM up to 24 months of age. When AOM was diagnosed a middle ear fluid sample was obtained for etiological assays.

"Effectiveness'' in Finnish healthcare studies.

Aims: Evaluation of effectiveness is connected with prevailing paradigms, and the breadth and perspective applied therein exhibit differences. Effectiveness refers to the extent to which a given intervention or service produces health outcomes in individuals to whom it is offered. The aim of this paper is to clarify the concept of effectiveness evaluation in health care and present the ways in which Finnish healthcare studies use the concept of effectiveness.

Six-year follow-up and predictors of urgency-associated urinary incontinence and bowel symptoms among the oldest old: a population-based study.

Urinary urgency with incontinence, and fecal incontinence and constipation were followed up over a 6-year period in 398 subjects aged 70 years and over at baseline. Age- and gender-adjusted and multivariate Cox proportional hazard models were used to examine the associations of urinary urgency and fecal incontinence and constipation with mortality, and logistic regression models to determine predictors of incident symptoms among the survivors. The proportion of incident cases of urinary urgency with incontinence, fecal incontinence and constipation in the 252 survivors were 17% (n=46), 9% (n=34) and 13% (n=36), respectively.