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This paper examines how signers make lists. One way is to use the fingers on the signer's nondominant hand to enumerate items on a list. The signer points to these list-fingers with the dominant hand. Previous analyses considered lists to be nondominant, one-handed signs, and thus were called list buoys because the nondominant hand often remains in place during the production of the list. The pointing hand was largely ignored as a nonlinguistic gesture. We take a constructional approach based on Cognitive Grammar. In our approach, we analyze lists as a type of pointing construction consisting of two meaningful components: a pointing device (the pointing hand) used to direct attention; and a Place, also consisting of form and a meaning. Using data from Brazilian Sign Language (Libras) and Finland–Swedish Sign Language (FinSSL), we examine the semantic role of each component, showing how the nondominant list-fingers identify and track discourse referents, and how the pointing hand is used to create higher-order entities by grouping list-fingers. We also examine the integration of list constructions and their components with other conventional constructions. [ABSTRACT FROM AUTHOR]

The validity of grocery purchase data as an indicator of food consumption is uncertain. This paper investigated (1) the associations between food consumption and grocery purchases using automatically accumulated purchase data and (2) whether the strength of the associations differed in certain sub-populations. The participants filled in a FFQ, and a major Finnish retailer issued us with their loyalty-card holders' grocery purchase data covering the 1- and 12-month periods preceding the FFQ. We used gamma statistics to study the association between thirds/quarters of FFQ and grocery purchase data (frequency/amount) separately for eighteen food groups among the 11 983 participants. Stratified analyses were conducted for subgroups based on sex, family structure, educational level, household income and self-estimated share of purchases from the retailer. We also examined the proportion of participants classified into the same, adjacent, subsequent and opposite categories using the FFQ and purchase data. The gammas ranged from 0·12 (cooked vegetables) to 0·75 (margarines). Single households had stronger gammas than two-adult families, and participants with > 60 % of purchases from the retailer had stronger gammas. For most food groups, the proportion of participants classified into the same or adjacent category was > 70 %. Most discrepancies were observed for fresh/cooked vegetables, berries and vegetable oils. Even though the two methods did not categorise all food groups similarly, we conclude that grocery purchase data are able to describe food consumption in an adult population, and future studies should consider purchase data as a resource-saving and moderately valid measure in large samples. [ABSTRACT FROM AUTHOR]

The debate about the differing philosophies of human-nature relationship is ongoing. Several studies discuss the need to develop and adopt a new environmental paradigm to replace the neoclassical economic paradigm predominant in Western societies. This issue has been discussed mainly at a societal level. Society or societies are, however, entities that consist of smaller particles. If a phenomenon is supposed to exist in an entity, signs of the phenomenon should also be found in its particles, business enterprises among others. This paper examines a shift of a managerial paradigm in a business organization, since not only the actions of individuals and governments but also those of business enterprises account for the preservation of the natural environment. It studies empirically how a managerial paradigm can shift from "traditional managerial thinking" to "environment-related management." Two frameworks will be developed for this purpose. [ABSTRACT FROM AUTHOR]

The ability to provide adequate nutrition is considered a key factor in evaluating the sustainability of foods and diets. Nutrient indices are used as functional units (FU) in life cycle assessment of foods to include nutritional performance in the environmental assessment of a product. Several general and food-group-specific nutrient indices exist but many lack validation, particularly when used as FU. In addition, the nutrient selection strategies and reference units for nutrient intake can vary considerably among studies. To validate intake-based product-group-specific nutrient indices previously developed for protein (NR-FIprot) and carbohydrate (NR-FIcarb) foods and for fruits and vegetables (NR-FIveg), we applied principal component analysis to investigate correlations between nutrients in foods and dishes representing a typical Finnish diet. The reference amounts for meal components were based on a plate model that reflected Finnish dietary recommendations. The portion sizes for the different food groups were anchored at 100 g, 135 g and 350 g for proteins, carbohydrates and fruits/vegetables, respectively. Statistical modelling largely validated the NR-FI indices, highlighting protein foods as sources of niacin, vitamin B12 and Se, carbohydrate foods as sources of Mg, Fe and phosphorous, and fruits/vegetables as sources of potassium, vitamin K, vitamin C, fibre and thiamine. However, in contrast to the intake-based approach applied in NR-FIprot, the dietary recommendation-based validation process suggested that fruits and vegetables should be favoured as sources of riboflavin and vitamin B6. [ABSTRACT FROM AUTHOR]

Background: The prevalence of type 2 diabetes has been increasing in Finland, in parallel with a gradual increase in overweight and obesity during the past decades. The expanding prevalence of type 2 diabetes brings along complications, most importantly CVD. Therefore, it is extremely important to implement activities to prevent type 2 diabetes. Objective: In the present paper, the clinical evidence for the prevention of type 2 diabetes is presented with the Finnish diabetes prevention study. In addition, the paper discusses the practical implementation of prevention of type 2 diabetes using three different types of prevention programmes as examples: FIN-D2D, including risk-screening and repeated consultation in primary health-care; FINNAIR, a workplace-targeted intervention project involving airline employees; and the good ageing in Lahti region (GOAL) programme, a community-based prevention programme. Conclusions: FIN-D2D, the FINNAIR project and the GOAL programme have shown that screening for type 2 diabetes risk and implementing large-scale lifestyle intervention in primary health-care are feasible. However, the crucial questions still are whether it is possible to replicate the results concerning effectiveness of lifestyle intervention in primary and occupational health-care systems. Furthermore, it remains to be shown whether it is possible to achieve the same results in different health-care settings, cultures, regions and age groups, especially in adolescents and young adults among whom the increase in the incidence has been the highest. In addition, the importance of co-operation among all sections of society, citizens' awareness of healthy lifestyles and the social inequalities in health must be emphasised because the diabetes epidemic cannot be solved only by concentrating on preventive actions carried out by health-care systems. [ABSTRACT FROM AUTHOR]

Later timing of eating has been associated with higher adiposity among adults and children in several studies, but not all. Moreover, studies in younger children are scarce. Hence, this study investigated the associations of the timing of evening eating with BMI Z -score and waist-to-height ratio (WHtR), and whether these associations were moderated by chronotype among 627 preschoolers (3–6-year-olds) from the cross-sectional DAGIS survey in Finland. Food intake was measured with 3-d food records, and sleep was measured with hip-worn actigraphy. Three variables were formed to describe the timing of evening eating: (1) clock time of the last eating occasion (EO); (2) time between the last EO and sleep onset; and (3) percentage of total daily energy intake (%TDEI) consumed 2 h before sleep onset or later. Chronotype was assessed as a sleep debt-corrected midpoint of sleep on the weekend (actigraphy data). The data were analysed with adjusted linear mixed effects models. After adjusting for several confounders, the last EO occurring closer to sleep onset (estimate = −0·006, 95 % CI (−0·010, −0·001)) and higher %TDEI consumed before sleep onset (estimate = 0·0004, 95 % CI (0·00003, 0·0007)) were associated with higher WHtR. No associations with BMI Z -score were found after adjustments. Clock time of the last EO was not significantly associated with the outcomes, and no interactions with chronotype emerged. The results highlight the importance of studying the timing of eating relative to sleep timing instead of only as clock time. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to (1) examine the clustering of energy balance-related behaviours (EBRB) and (2) investigate whether EBRB clusters, temperament and hair cortisol concentration (HCC) associate with overweight. Design: We assessed food consumption using food records, screen time (ST) using sedentary behaviour diaries, sleep consistency and temperament (negative affectivity, surgency, effortful control) using questionnaires and HCC using hair samples. Accelerometers were used to assess physical activity (PA) intensities, sleep duration and sleep efficiency. Researchers measured each child's weight and height. We used finite mixture models to identify EBRB clusters and multilevel logistic regression models to examine the associations between EBRB clusters, temperament, HCC and overweight. Setting: The cross-sectional DAGIS survey, data collected in 2015–2016. Participants: Finnish 3–6-year-olds (n 864) recruited through preschools. Results: One-third of the participants were categorised into the cluster labelled 'Unhealthy diet, excessive screen time', characterised by unhealthy dietary choices (e.g. greater consumption of high-fat, high-sugar dairy products) and longer ST. Two-thirds were categorised into the second cluster, labelled 'Healthy diet, moderate screen time'. PA and sleep were irrelevant for clustering. Higher negative affectivity and lower effortful control associated with the 'Unhealthy diet, excessive screen time' cluster. EBRB clusters and HCC did not associate with overweight, but surgency was positively associated with overweight (OR = 1·63, 95 % CI 1·17, 2·25). Conclusions: Of the EBRB, food consumption and ST seem to associate. As temperament associates with EBRB clusters and overweight, tailored support acknowledging the child's temperament could be profitable in maintaining a healthy weight. [ABSTRACT FROM AUTHOR]

A cross-sectional survey, FINDIET 2007, was carried out in Finland. Food intake data was collected by a 48 h recall interview. Additional food intake data was collected by a repeated 3 d food diary, a barcode-based product diary, a food frequency questionnaire and by a supplementary questionnaire on rarely eaten foods. The purpose of the present paper is to describe the methodology of the national dietary survey and to discuss the particular implications for the applications of food consumption data in risk assessment. The food consumption data of the FINDIET 2007 survey can be used in food risk assessment, due thanks to flexible data processing of individual food consumption, and a risk assessment point of view was taken into account. However, international standardisation projects are needed in order to estimate comparable food intakes. [ABSTRACT FROM AUTHOR]

Objective: The present study is to describe, on the basis of recent Finnish population surveys, (i) the frequencies of school and worksite canteen use, (ii) the determinants of having a hot lunch during school or working hours and (iii) the associations of lunch eating patterns with food habits. Setting: The study summarises mainly basic reports and studies concerning catering services conducted in Finland based on nationally representative population surveys. Design and subjects: Cross-sectional study. The most important surveys cited in this paper are the School Health Promotion Study, the Work and the Working Conditions survey, the National FINDIET 2002 Study, and the Health Behavior and Health among Finnish Adult Population survey. Results: School lunch is eaten by on average 70-90% of children aged 9-18 years. Of all employees, 30% eat at a worksite canteen daily, whereas 30% of men and 45% of women eat packed lunches. Nationally representative cross-sectional population surveys show that the use of catering services is associated with more healthy food habits; schoolchildren eating school meals and employees eating lunch at a worksite canteen tend to make food choices closer to nutritional recommendations as compared to those not using catering services to the same degree. Conclusions: Some evidence exists that catering services in schools and worksites contribute to healthy eating habits in the population. In order to verify the positive role of catering services more scientific research with prospective and intervention design studies will be needed. [ABSTRACT FROM AUTHOR]

The role of legumes in healthy and sustainable diets is increasingly of interest. Few studies have investigated the association between legume consumption and the consumption of other food groups and the intake of nutrients. This study examined how legume consumption is associated with the consumption of other foods and the intake of nutrients among Finnish adults. Our study used cross-sectional data from the population-based FinHealth 2017 Study consisting of 2250 men and 2875 women aged ≥18 years. The associations between legume consumption (quartile classification), food groups and nutrients were analysed using multivariable linear regression. The models were initially adjusted for energy intake and additionally for age, educational level, smoking status, leisure-time physical activity and BMI. Legume consumption had a positive association with age, education level and leisure-time physical activity. The consumption of legumes was positively associated with the consumption of fruits and berries, vegetables, nuts and seeds and fish and fish products and inversely associated with the consumption of red and processed meat, cereals and butter and butter-based fat spreads. Furthermore, legume consumption was positively associated with the intake of protein, fibre, folate, thiamine and salt in both sexes and inversely associated with the intake of saturated fatty acids and sucrose (sucrose, women only). Thus, legume consumption appears to reflect overall healthier food choices. An increase in legume consumption could accelerate the transition to more sustainable diets. The confounding role of other foods and nutrients should be considered when studying associations between legume consumption and health outcomes. [ABSTRACT FROM AUTHOR]

The response by Sonja Soininen and colleagues in response to the letter to the editor about their article "Determinants of serum 25-hydroxyvitamin D concentration in Finnish children: The Physical Activity and Nutrition in Children (PANIC) study," published in a previous issue is presented.

Aims. Although seasonality has been documented for mental disorders, it is unknown whether similar patterns can be observed in employee sickness absence from work due to a wide range of mental disorders with different severity level, and to what extent the rate of change in light exposure plays a role. To address these limitations, we used daily based sickness absence records to examine seasonal patterns in employee sickness absence due to mental disorders. Methods. We used nationwide diagnosis-specific psychiatric sickness absence claims data from 2006 to 2017 for adult individuals aged 16-67 (n = 636,543 sickness absence episodes) in Finland, a high-latitude country with a profound variation in daylength. The smoothed time-series of the ratio of observed and expected (O/E) daily counts of episodes were estimated, adjusted for variation in all-cause sickness absence rates during the year. Results. Unipolar depressive disorders peaked in October-November and dipped in July, with similar associations in all forms of depression. Also, anxiety and non-organic sleep disorders peaked in October-November. Anxiety disorders dipped in January-February and in July-August, while non-organic sleep disorders dipped in April-August. Manic episodes reached a peak from March to July and dipped in September-November and in January-February. Seasonality was not dependent on the severity of the depressive disorder. Conclusions. These results suggest a seasonal variation in sickness absence due to common mental disorders and bipolar disorder, with high peaks in depressive, anxiety and sleep disorders towards the end of the year and a peak in manic episodes starting in spring. Rapid changes in light exposure may contribute to sickness absence due to bipolar disorder. The findings can help clinicians and workplaces prepare for seasonal variations in healthcare needs. [ABSTRACT FROM AUTHOR]

Objective: Schools can be an effective arena for food education. The Tasty School is a tailored teacher-driven food education model that provides tools for implementing food education in primary schools. This study aimed to investigate the effects of the Tasty School model on pupils' eating patterns and experiences. We also aimed to assess the implementation strength of the Tasty School.Design: A quasi-experimental study was conducted during one school year 2019-2020 in fifteen intervention and ten control schools. The intervention schools implemented the Tasty School food education model. The pupils completed web-based baseline and follow-up questionnaires in class during a school day. The principals were interviewed after the intervention. The data were analysed using a mixed-effects model for repeated measures, accounting for the implementation strength and selected standardisation effects.Setting: A total of twenty-five general Finnish primary schools.Participants: 1480 pupils from grades 3-6 (age 8-12 years) from five municipalities in Finland.Results: Percentages of pupils eating a balanced school meal increased in schools where food education was actively implemented (P = 0·027). In addition, pupils' experience of social participation in school dining strengthened in schools where the Tasty School model was implemented (5-point scale mean from 2·41 to 2·61; P = 0·017).Conclusions: Healthy eating patterns can be promoted by the active implementation of food education in primary schools. The Tasty School model offers a promising tool for developing healthy eating patterns and increasing social participation among pupils not only in Finland, but also potentially in other countries as well. [ABSTRACT FROM AUTHOR]

Background: Research on the effectiveness of pharmacotherapies for schizophrenia and comorbid substance use disorder (SUD) is very sparse, and non-existent on the prevention of the development of SUDs in patients with schizophrenia.Aims: To compare the real-world effectiveness of antipsychotics in schizophrenia in decreasing risk of developing an initial SUD, and psychiatric hospital admission and SUD-related hospital admission among patients with an SUD.Method: Two independent national cohorts including all persons diagnosed with schizophrenia (N = 45 476) were followed up for 22 (Finland: 1996-2017) and 11 (Sweden: 2006-2016) years. Risk of developing an SUD was calculated with between-individual models, and risks of psychiatric and SUD-related hospital admission were calculated with within-individual models, using Cox regression and adjusted hazard ratios (aHRs) for using versus not using certain antipsychotics.Results: For patients with schizophrenia without an SUD, clozapine use (Finland: aHR 0.20, 95% CI 0.16-0.24, P < 0.001; Sweden: aHR 0.35, 95% CI 0.24-0.50, P < 0.001) was associated with lowest risk of developing an initial SUD in both countries. Antipsychotic polytherapy was associated with second lowest risk (aHR 0.54, 95% CI 0.44-0.66) in Sweden, and third lowest risk (aHR 0.47, 95% CI 0.42-0.53) in Finland. Risk of relapse (psychiatric hospital admission and SUD-related hospital admission) were lowest for clozapine, antipsychotic polytherapy and long-acting injectables in both countries. Results were consistent across both countries.Conclusions: Clozapine and antipsychotic polytherapy are most strongly associated with reduced risk of developing SUDs among patients with schizophrenia, and with lower relapse rates among patients with both diagnoses. [ABSTRACT FROM AUTHOR]

Added sugar intake has been associated with several health issues, but few studies have examined its association with overall diet quality. We aimed at examining the association between added sugar intake and overall diet quality in Finnish adults. Associations between added sugar intake and sociodemographic factors, lifestyle factors, and BMI were also explored. Our data comprised 5094 adults residing in Finland who participated in the National FinHealth 2017 Study. Dietary intake was assessed by a validated FFQ. Food consumption and nutrient intakes were calculated using the Finnish national food composition database. Added sugar intake was estimated based on food categorisation and identifying naturally occurring sugar sources. Overall diet quality was assessed by the modified Baltic Sea Diet Score. The average added sugar intake was 7·6 E % in women and 8·3 E % in men in this study population. Added sugar intake was inversely associated with education (P = 0·03 women; P = 0·001 men), physical activity (P < 0·0001), and BMI in men (P = 0·003), and directly with smoking (P = 0·002 women; P < 0·0001 men). Added sugar intake was inversely associated with overall diet quality in both sexes (P < 0·0001). No interactions were found except for men's physical activity subgroups, the inverse association being stronger among active men than moderately active or inactive men (Pfor interaction = 0·005). Our findings suggest that high added sugar intake is associated with several unhealthy dietary and lifestyle habits, including poor-quality diets, smoking and leisure-time inactivity in Finnish adults. Efforts to improve diet quality should consider added sugar intake equally in the whole population. [ABSTRACT FROM AUTHOR]

Objective: To identify food purchase patterns and to assess their carbon footprint and expenditure.Design: Cross-sectional.Setting: Purchase patterns were identified by factor analysis from the annual purchases of 3435 product groups. The associations between purchase patterns and the total purchases' carbon footprints (based on life-cycle assessment) and expenditure were analysed using linear regression and adjusted for nutritional energy content of the purchases.Participants: Loyalty card holders (n 22 860) of the largest food retailer in Finland.Results: Eight patterns explained 55 % of the variation in food purchases. The Animal-based pattern made the greatest contribution to the annual carbon footprint, followed by the Easy-cooking, and Ready-to-eat patterns. High-energy, Traditional and Plant-based patterns made the smallest contribution to the carbon footprint of the purchases. Animal-based, Ready-to-eat, Plant-based and High-energy patterns made the greatest contribution, whereas the Traditional and Easy-cooking patterns made the smallest contribution to food expenditure. Carbon footprint per euros spent increased with stronger adherence to the Traditional, Animal-based and Easy-cooking patterns.Conclusions: The Animal-based, Ready-to-eat and High-energy patterns were associated with relatively high expenditure on food, suggesting no economic barrier to a potential shift towards a plant-based diet for consumers adherent to those patterns. Strong adherence to the Traditional pattern resulted in a low energy-adjusted carbon footprint but high carbon footprint per euro. This suggests a preference for cheap nutritional energy rather than environment-conscious purchase behaviour. Whether a shift towards a plant-based pattern would be affordable for those with more traditional and cheaper purchase patterns requires more research. [ABSTRACT FROM AUTHOR]

Objective: To examine the prevalence and determinants of food insecurity among private sector service workers in Finland and assess validity of the Household Food Insecurity Access Scale (HFIAS) tool.Design: In this cross-sectional study, food insecurity and background characteristics were collected from Finnish private service workers via electronic questionnaires (2019) and national register data (2018-2019). We conducted univariate and multivariate logistic regression analyses to determine the variables explaining food insecurity. Validity of HFIAS was assessed with rotated principal component analysis and Cronbach's α.Setting: Members of the trade union for private sector service workers, Service Union United (PAM), from all municipalities in Finland participated in the study in 2019.Participants: The subjects were 6435 private sector workers that were members of the Service Union United (PAM) in Finland. Mean age of participants was 44 years (sd 12·7 years).Results: Two-thirds of the participants (65 %) were food insecure with over a third (36 %) reporting severe food insecurity. Reporting great difficulties in covering household expenses and young age markedly increased the risk of severe food insecurity (OR 15·05; 95 % CI 10·60, 21·38 and OR 5·07; 95 % CI 3·94, 6·52, respectively). Not being married, low education, working in the hospitality industry, being male and living in rented housing also increased the probability of severe food insecurity. The HFIAS tool demonstrated acceptable construct and criterion validity.Conclusions: Severe food insecurity was widespread and associated with low socio-economic status, young age and being male among Finnish private sector service workers, emphasising the need for regular monitoring of food insecurity in Finland. [ABSTRACT FROM AUTHOR]

Background: Long-term 'not in education, employment or training' (NEET) status is an important indicator of youth marginalisation.Aims: To carry out a comprehensive overview of the associations between different psychiatric illnesses and long-term NEET status.Method: We used the register-based 1987 Finnish Birth Cohort study, which includes all live births in Finland during that year. The analyses comprised 55 273 individuals after exclusions for intellectual disability, death or emigration. We predicted that psychiatric disorders, diagnosed by specialist services between 1998 and 2007 when the cohort were 10-20 years of age, would be associated with subsequent long-term NEET (defined as NEET for at least 5 years between 2008 and 2015, when they were 20-28 years of age).Results: In total, 1438 individuals (2.6%) were long-term NEET during follow-up and the associations between long-term NEET and the 11 diagnostic categories we studied were statistically significant (P < 0.001). In multivariate models we included sociodemographic characteristics and upper secondary education as covariates, and the highest effect sizes, measured by odds ratios (OR) with 95% confidence intervals (CI), were found for psychosis (OR = 12.0, 95% CI 9.5-15.2) and autism spectrum disorder (OR = 17.3, 95% CI 11.5-26.0). If individuals had not successfully completed this education, 70.6% of those with autism spectrum disorder and 48.4% of those with psychosis were later long-term NEET.Conclusions: Adolescents who receive treatment for psychiatric disorders, particularly autism spectrum disorder or psychosis, need support to access education and employment. This could help to prevent marginalisation in early adulthood. [ABSTRACT FROM AUTHOR]

The article focuses on healthy Nordic diet score and risk of incident CHD among men the Kuopio Ischaemic Heart Disease Risk Factor Study.

We evaluated the effects of fish oil and/or probiotic supplementation in a randomised placebo-controlled intervention pilot trial on gestational weight gain (GWG) and body composition. Additionally, the influence of gestational diabetes (GDM) on GWG and body composition was assessed. We randomised 439 overweight women into intervention groups: fish oil + placebo, probiotics + placebo, fish oil + probiotics and placebo + placebo (fish oil: 1·9 g DHA and 0·22 g EPA and probiotics: Lactobacillus rhamnosus HN001 and Bifidobacterium animalis ssp. lactis 420, 1010 colony-forming units each). GDM was diagnosed with oral glucose tolerance test. Body composition was measured with air displacement plethysmography at randomisation (mean 13·9) and in late pregnancy (mean 35·2 gestational weeks). Intervention did not influence mean GWG or change in body fat mass/percentage (P > 0·17). Body composition in early pregnancy did not differ between the women who did or did not develop GDM (adjusted P > 0·23). Compared with the normoglycaemic women (n 278), women diagnosed with GDM (n 119) gained less weight (7·7 (sd 0·4) v. 9·3 (sd 0·4) kg, adjusted mean difference −1·66 (95 % CI −2·52, −0·80) and fat mass (0·4 (sd 0·4) v. 1·8 (sd 0·3) kg, adjusted mean difference −1·43 (95 % CI −2·19, −0·67) during the follow-up. In conclusion, adiposity of pregnant overweight women was not affected by supplementation with fish oil and/or probiotics, nor did it predict the development of GDM. However, adiposity was reduced in women with GDM compared with normoglycaemic women irrespective of the dietary intervention. [ABSTRACT FROM AUTHOR]

Objective: We investigated the determinants of serum 25-hydroxyvitamin D [S-25(OH)D] and dietary vitamin D sources among three immigrant groups in Finland and compared their S-25(OH)D to the general Finnish population.Design: Cross-sectional population-based Migrant Health and Wellbeing Study and the nationally representative Finnish Health 2011 Survey. S-25(OH)D was standardised according to the Vitamin D Standardisation Program. Vitamin D sources were assessed by interview.Setting: Six different municipalities in Finland (60°-63°N).Participants: Immigrants aged 18-64 years (446 Russians, 346 Somalis, 500 Kurds), 798 Finns aged 30-64 years.Results: The mean of S-25(OH)D was 64 (95 % CI 62, 66), 44 (95 % CI 41, 46), 35 (95 % CI 34, 37) and 64 (95 % CI 62, 66) nmol/l for Russians, Somalis, Kurds and Finns, respectively. S-25(OH)D among Somalis and Kurds was lower compared with Finns (P < 0·001). The prevalence of vitamin D deficiency (S-25(OH)D <30 nmol/l) and insufficiency (S-25(OH)D <50 nmol/l) was higher among immigrants than Finns (P < 0·001). Vitamin D-rich foods differed between the groups; vitamin D-fortified fat spread consumption was higher among Somalis (91 %) than among Russians (73 %) and Kurds (60 %); fish was less consumed among Kurds (17 %) than among Russians (43 %) and Somalis (38 %); and 57 % Russians, 56 % Kurds and 36 % Somalis consumed vitamin D-fortified dairy daily (P < 0·001 for all). Daily smoking, alcohol consumption and winter blood sampling were determinants of vitamin D insufficiency (P ≤ 0·03). Older age, physical activity, fish and vitamin D-fortified dairy consumption were associated with lower odds of insufficiency (P ≤ 0·04).Conclusions: Vitamin D status differed among immigrant groups and the determinants are, to some degree, associated with learned or existing cultural behaviours. [ABSTRACT FROM AUTHOR]

Aim: To explore what thoughts, feelings, and learning processes were involved in obese participants' lifestyle change during an acceptance and commitment therapy (ACT) lifestyle intervention delivered in primary health care. Background: Previous studies have revealed that lifestyle interventions are effective at promoting initial weight loss, but reduced weight is often difficult to sustain because of the failure to maintain healthy lifestyle changes. Achieving and maintaining lifestyle changes requires to learn self-regulation skills. ACT-based lifestyle interventions combine many self-regulatory skill factors, and the results from previous studies are promising. Research on the individual learning processes of lifestyle change is still needed. Methods: This study investigated a subset of data from a larger web-based lifestyle intervention. This subset consisted of online logbooks written by 17 obese participants (n = 17, body mass index mean 41.26 kg/m2) during the six-week online module. The logbooks were analyzed via data-driven content analysis. Findings: Four groups were identified based on the participants being at different phases in their lifestyle changes: stuck with barriers, slowly forward, reflective and hardworking, and convincingly forward with the help of concrete goals. Differences between the groups were manifested in personal barriers, goal setting, training of mindfulness and acceptance, and achieving healthy actions. The ACT-based lifestyle intervention offered participants an opportunity to reflect on how their thoughts and feelings may hinder healthy lifestyle changes and provided tools for learning psychological flexibility. [ABSTRACT FROM AUTHOR]

Objective: We aimed to examine associations between early educators' feeding practices and opinions and children's dietary intake at pre-school, in a context where uniform meals are served and pre-schools are highly regulated.Design: Cross-sectional study. Food consumption data of the children consisted of two-day food records from pre-school kept by early educators. Early educators also reported their feeding practices and opinions on pre-school food. Serving style was observed.Setting: Municipal pre-schools in Southern and Western Finland.ParticipantsPre-schoolers (n 586) aged 3-6 years and early educators (n 378).Results: Early educators' positive opinion of the food served at pre-school and the opinion that sufficient vegetables were available for the children were positively associated with children's vegetable consumption. Early educators' role modelling and a positive opinion of the food were negatively associated with children's energy intake. Encouragement to eat fruit and vegetables was associated with higher fibre intake. Intake of added sugar was low (4·4 % of energy).Conclusions: Some of the feeding practices and opinions of early educators were related to healthier dietary intake (higher vegetable consumption and fibre intake) among the children. However, in some respects, the results contradicted previous findings. Overall, early educators' feeding practices and opinions contribute to children's dietary intake and should be taken into account when promoting healthy food intake among pre-school children. [ABSTRACT FROM AUTHOR]

ObjectiveTo study the associations between home food availability and dietary patterns among pre-school children.DesignCross-sectional study in which parents of the participating children filled in an FFQ and reported how often they had certain foods in their homes. We derived dietary pattern scores using principal component analysis, and composite scores describing the availability of fruits and vegetables as well as sugar-enriched foods in the home were created for each participant. We used multilevel models to investigate the associations between availability and dietary pattern scores.SettingThe DAGIS study, Finland.SubjectsThe participants were 864 Finnish 3–6-year-old children recruited from sixty-six pre-schools. The analyses included 711 children with sufficient data.ResultsWe identified three dietary patterns explaining 16·7 % of the variance. The patterns were named ‘sweets-and-treats’ (high loadings of e.g. sweet biscuits, chocolate, ice cream), ‘health-conscious’ (high loadings of e.g. nuts, natural yoghurt, berries) and ‘vegetables-and-processed meats’ (high loadings of e.g. vegetables, cold cuts, fruit). In multivariate models, the availability of fruits and vegetables was inversely associated with the sweets-and-treats pattern (β=−0·05, P<0·01) and positively associated with the health-conscious (β=0·07, P<0·01) and vegetables-and-processed meats patterns (β=0·06, P<0·01). The availability of sugar-enriched foods was positively associated with the sweets-and-treats pattern (β=0·10, P<0·01) and inversely associated with the health-conscious pattern (β=−0·03, P<0·01).ConclusionsConsidering dietary patterns, the availability of sugar-enriched foods in the home seems to have a stronger role than that of fruits and vegetables. Parents should restrict the availability of unhealthy foods in the home. [ABSTRACT FROM PUBLISHER]

This article examines the case files of patients diagnosed with Transvestitismus [transvestism] in the Psychiatric Clinic of the Helsinki University Central Hospital in the years 1954-68. These individuals did not only want to cross-dress, but also had a strong feeling of being of a different sex from their assigned one. The scientific concept of transsexuality had begun to take form, and this knowledge reached Finland in phases. The case files of the transvestism patients show that they were highly aware of their condition and were very capable of describing it, even if they had no medical name for it. Psychiatrists were willing to engage in dialogue with the patients, and did not treat them as passive objects of study. Although some patients felt that they had been helped, many left the institution as frustrated, angered or desperate as before. They had sought medical help in the hope of having their bodies altered to correspond to their identity, but the Clinic psychiatrists insisted on seeing the problem in psychiatric terms and did not recommend surgical or hormonal treatments in most cases. This attitude would gradually change over the course of the 1970s and 1980s. [ABSTRACT FROM AUTHOR]

Objective: Dietary quality in relation to bone health has been analysed in relatively few studies. The current study aimed to assess the association of the Baltic Sea diet (BSD) and the Mediterranean diet (MD) with bone mineral density (BMD) among elderly women.Design: Lumbar, femoral and total body BMD were measured by dual-energy X-ray absorptiometry at baseline and year 3. Dietary intake was measured by 3 d food record at baseline. BSD and MD scores were calculated from food and alcohol consumption and nutrient intake. Information on lifestyle, diseases and medications was collected by questionnaires. Longitudinal associations of BSD and MD scores with BMD were analysed using linear mixed models.Setting: Interventional prospective Kuopio Osteoporosis Risk Factor and Fracture Prevention study including women aged 65-71 years and residing in Kuopio province, Finland.Subjects: Women (n 554) with mean age of 67·9 (sd 1·9) years and mean BMI of 28·8 (sd 4·7) kg/m2.Results: Higher BSD scores were associated with higher intakes of fruit and berries, vegetables, fish and low-fat dairy products, and lower intake of sausage. Higher MD scores were associated with higher consumption of fruit and berries and vegetables. BSD and MD scores were associated with higher PUFA:SFA and higher fibre intake. Femoral, lumbar or total body BMD was not significantly different among the quartiles of BSD or MD score.Conclusion: The lack of associations suggest that Baltic Sea and Mediterranean dietary patterns may not adequately reflect dietary factors relevant to bone health. [ABSTRACT FROM AUTHOR]

The aim was to analyse whether changes in the Healthy Food Intake Index (HFII) during pregnancy are related to gestational diabetes (GDM) risk. The 251 pregnant women participating had a pre-pregnancy BMI≥30 kg/m2 and/or a history of GDM. A 75 g oral glucose tolerance test (OGTT) was performed during the first and second trimesters of pregnancy for assessment of GDM. A normal OGTT result at first trimester was an inclusion criterion for the study. FFQ collected at first and second trimesters served for calculating the HFII. A higher HFII score reflects higher adherence to the Nordic Nutrition Recommendations (NNR) (score range 0–17). Statistical methods included Student’s t test, Mann–Whitney U test, Fisher’s exact test and linear and logistic regression analyses. The mean HFII at first trimester was 10·1 (95 % CI 9·7, 10·4) points, and the mean change from the first to the second trimester was 0·35 (95 % CI 0·09, 0·62) points. The range of the HFII changes varied from –7 to 7. The odds for GDM decreased with higher HFII change (adjusted OR 0·83 per one unit increase in HFII; 95 % CI 0·69, 0·99; P=0·043). In the analysis of the association between HFII-sub-indices and GDM, odds for GDM decreased with higher HFII-Fat change (fat percentage of milk and cheese, type of spread and cooking fats) but it was not significant in a fully adjusted model (P=0·058). Dietary changes towards the NNR during pregnancy seem to be related to a lower risk for GDM. [ABSTRACT FROM PUBLISHER]

Diet is a major modifiable lifestyle factor that may affect the components of the metabolic syndrome. We aimed to investigate the association between relative proportions of macronutrients and the components of the metabolic syndrome in a population of individuals with type 1 diabetes. In all, 791 individuals without nephropathy, with plausible energy intake and known metabolic syndrome status, taking part in the Finnish Diabetic Nephropathy Study were included in the analyses. Dietary data were collected with a diet record. The association between the relative macronutrient intake and the outcome variables were analysed using multivariable nutrient density substitution models. The relative proportions of dietary macronutrients or fatty acids were not associated with the presence of the metabolic syndrome. In men, however, favouring carbohydrates over fats was associated with lower odds of the waist component, whereas favouring either carbohydrates or fats over proteins was associated with lower odds of the blood pressure component of the metabolic syndrome. In women, substituting carbohydrates for fats was associated with lower HDL-cholesterol concentration. Substituting carbohydrates or fats for alcohol or protein was, in men, associated with lower systolic blood pressure. To conclude, the relative distribution of macronutrients may have some relevance for the metabolic syndrome. [ABSTRACT FROM PUBLISHER]

Long-chain n-3 PUFA from fish and exercise capacity are associated with CVD risk. Fish, especially large and old predatory fish, may contain Hg, which may attenuate the inverse association of long-chain n-3 PUFA with CVD. However, the associations of long-chain n-3 PUFA or Hg exposure with exercise capacity are not well known. We aimed to evaluate the associations of serum long-chain n-3 PUFA EPA, docosapentaenoic acid (DPA) and DHA and hair Hg with exercise cardiac power (ECP, a ratio of VO2max:maximal systolic blood pressure (SBP) during an exercise test), a measure for exercise capacity. For this, data from the population-based Kuopio Ischaemic Heart Disease Risk Factor Study were analysed cross-sectionally in order to determine the associations between serum long-chain n-3 PUFA, hair Hg and ECP in 1672 men without CVD, aged 42–60 years. After multivariate adjustments, serum total long-chain n-3 PUFA concentration was associated with higher ECP and VO2max (Ptrend across quartiles=0·04 and Ptrend=0·02, respectively), but not with maximal SBP (Ptrend=0·69). Associations were generally similar when EPA, DPA and DHA were evaluated individually. Hair Hg was not associated with ECP, VO2max or maximal SBP. However, the associations of total long-chain n-3 PUFA (Pinteraction=0·03) and EPA (Pinteraction=0·02) with higher VO2max were stronger among men with lower hair Hg. Higher serum long-chain n-3 PUFA concentration, mainly a marker for fish consumption in this study population, was associated with higher ECP and VO2max in middle-aged men from eastern Finland. [ABSTRACT FROM AUTHOR]

Objective: Non-compliance with food record submission can induce bias in nutritional epidemiological analysis and make it difficult to draw inference from study findings. We examined the impact of demographic, lifestyle and psychosocial factors on such non-compliance during the first 3 years of participation in a multidisciplinary prospective paediatric study.Design: The Environmental Determinants of Diabetes in the Young (TEDDY) study collects a 3 d food record quarterly during the first year of life and semi-annually thereafter. High compliance with food record completion was defined as the participating families submitting one or more days of food record at every scheduled clinic visit.Setting: Three centres in the USA (Colorado, Georgia/Florida and Washington) and three in Europe (Finland, Germany and Sweden).Subjects: Families who finished the first 3 years of TEDDY participation (n 8096).Results: High compliance was associated with having a single child, older maternal age, higher maternal education and father responding to study questionnaires. Families showing poor compliance were more likely to be living far from the study centres, from ethnic minority groups, living in a crowded household and not attending clinic visits regularly. Postpartum depression, maternal smoking behaviour and mother working outside the home were also independently associated with poor compliance.Conclusions: These findings identified specific groups for targeted strategies to encourage completion of food records, thereby reducing potential bias in multidisciplinary collaborative research. [ABSTRACT FROM AUTHOR]

Increased vitamin D fortification of dairy products has increased the supply of vitamin D-containing products with different vitamin D contents on the market in Finland. The authors developed a ninety-eight-item FFQ with eight food groups and with a question on supplementation to assess dietary and supplemental vitamin D and Ca intakes in Finnish women (60ºN). The FFQ was validated in subgroups with different habitual vitamin D supplement use (0–57·5 µg/d) against the biomarker serum 25-hydroxyvitamin D (S-25(OH)D) and against 3-d food records (FR) (n 29–67). Median total vitamin D intake among participants was 9·4 (range 1·6–30·5) µg/d. Spearman’s correlations for vitamin D and Ca ranged from 0·28 (P 0·146, FFQ v. S-25(OH)D, persons not using supplements) to 0·75 (P<0·001, FFQ v. FR, supplement use included). The correlations between the FFQ and S-25(OH)D concentrations improved within increasing supplement intake. The Bland–Altman analysis showed wide limits of agreement between FFQ and FR: for vitamin D between −7·8 and 8·8 µg/d and for Ca between −938 and 934 mg/d, with mean differences being 0·5 µg/d and 2 mg/d, respectively. The triads method was used to calculate the validity coefficients of the FFQ for vitamin D, resulting in a mean of 1·00 (95 % CI 0·59, 1·00) and a range from 0·33 to 1·00. The perceived variation in the estimates could have been avoided with a longer FR period and larger number of participants. The results are comparable with earlier studies, and the FFQ provides a reasonable estimation of vitamin D and Ca intakes. [ABSTRACT FROM PUBLISHER]

We examined whether there are sex differences in children’s fruit and vegetable (FV) intake and in descriptive norms (i.e. perceived FV intake) related to parents and friends. We also studied whether friends’ impact is as important as that of parents on children’s FV intake. Data from the PRO GREENS project in Finland were obtained from 424 children at the age 11 years at baseline. At baseline, 2009 children filled in a questionnaire about descriptive norms conceptualised as perceived FV intake of their parents and friends. They also filled in a validated FFQ that assessed their FV intake both at baseline and in the follow-up in 2010. The associations were examined with multi-level regression analyses with multi-group comparisons. Girls reported higher perceived FV intake of friends and higher own fruit intake at baseline, compared with boys, and higher vegetable intake both at baseline and in the follow-up. Perceived FV intake of parents and friends was positively associated with both girls’ and boys’ FV intake in both study years. The impact of perceived fruit intake of the mother was stronger among boys. The change in children’s FV intake was affected only by perceived FV intake of father and friends. No large sex differences in descriptive norms were found, but the impact of friends on children’s FV intake can generally be considered as important as that of parents. Future interventions could benefit from taking into account friends’ impact as role models on children’s FV intake. [ABSTRACT FROM AUTHOR]

ObjectiveThe aim was to explore how the behaviour of consumers changed while they selected food in a supermarket environment after they were reminded about weight management. This investigation was carried out from the perspective of selection criteria, reading of package labels, nutritional quality of the products selected and time taken to select a product.DesignThe subjects, who were actively watching their weight, participated in two consecutive tasks in a supermarket. They were given a shopping list of eleven food categories and asked to think aloud while selecting from each category a product they usually buy and a product they would use for weight management. The data (n 792 selections) were collected through interviews and a verbal analysis protocol combined with wireless audio-visual observation.SubjectsThirty-six consumers were recruited from a sample of 367 supermarket customers.SettingKuopio, Finland.ResultsThe subjects’ behaviour changed radically after they were reminded about weight management. In the first selection, taste and familiarity were the main food selection criteria while in the latter selection the energy/fat content predominated. Consequently, the nutritional quality of products improved greatly because subjects read package labels twice as much in the latter selection. The time taken to select a product increased significantly, on average, from 23 (sd 10) to 60 (sd 51) s/product (P = 0·000).ConclusionsOnly by reminding consumers about weight management was there a significant impact on their food selection behaviour. Marketing communication should be developed which quickly and easily promotes consumers’ awareness of healthy food in supermarkets. [ABSTRACT FROM PUBLISHER]

Fatty acids (FA) are known to have a number of immunological effects and, accordingly, may play a role in the development of allergic diseases. We investigated the effect of maternal intake of FA during pregnancy on the risk of allergic rhinitis, wheeze and atopic eczema in children aged 5 years. The present study analysed data from the Finnish Type 1 Diabetes Prediction and Prevention Nutrition Study, a population-based birth cohort study with a 5-year follow-up. Complete information on maternal diet (assessed by a validated FFQ) and International Study of Asthma and Allergies in Childhood-based allergic outcomes was available for 2441 children. Cox proportional regression and logistic regression were used for the analyses. After adjusting for potential confounding variables, high maternal consumption of butter and butter spreads (hazard ratio (HR) 1·33; 95 % CI 1·03, 1·71) and higher ratio of n-6:n-3 FA (HR 1·37; 95 % CI 1·07, 1·77) during pregnancy were associated with an increased risk of allergic rhinitis in the offspring by 5 years of age. High maternal intakes of total PUFA (HR 0·71; 95 % CI 0·52, 0·96) and α-linolenic FA (HR 0·73; 95 % CI 0·54, 0·98) were associated with a decreased risk of allergic rhinitis. However, these results lost their significance after adjustment for multiple comparisons. Overall, our data suggest that maternal consumption of butter, the ratio of n-6:n-3 FA and intake of PUFA and α-linolenic FA during pregnancy may be potential determinants of allergic rhinitis in the offspring. [ABSTRACT FROM PUBLISHER]

FFQ require validation as part of epidemiological research of diet–disease relationships. Studies exploring associations between carbohydrate type and chronic diseases are rapidly increasing, but information on the validity of carbohydrate fractions, dietary glycaemic index (GI) and the glycaemic load (GL) estimated by FFQ is scarce. Likewise, the effects of subject characteristics on FFQ validity have been poorly documented. The present study evaluates the relative validity of an 131-item FFQ in relation to two 3 d food records (FR) performed 6 months apart focusing on the intake of carbohydrate fractions, dietary GI and the GL. Furthermore, we assessed the extent to which subjects' age, education and BMI explain differences between these methods. The study sample comprised 218 men and 292 women aged 25–74 years participating in a large population-based survey in Finland. Energy-adjusted Spearman's rank correlations ranged from 0·27 (sugars) to 0·70 (lactose) for men and from 0·37 (sugars) to 0·69 (lactose) for women. On average, 73 % of the subjects were categorised into the same or adjacent distribution quintile based on the two methods. In general, the FFQ overestimated the intakes compared with FR. Especially in women, FFQ validity for some nutrients was associated with the level of intake, subjects' age and, to a lesser extent, education but not BMI. In conclusion, the FFQ appears to be reasonably valid in the assessment of carbohydrate exposure variables, but the findings show a need for adjustment of diet–disease relationships for subjects' age and education. [ABSTRACT FROM PUBLISHER]

An essay is presented on 20th-century Finnish architect Alvar Aalto. The author describes Aalto's status as Finnish figure and discusses how his style differs from the Modern Movement of architecture. Other topics addressed include architectural critic Sigfried Giedion's views on Aalto, how Finnish architecture is unique from other architecture, the role of play in Aalto's designs, and how Aalto's work is related to artist Johann Wolfgang von Goethe.

The present study describes the main actions in Finnish nutrition policy during the past decades. The main actor is the National Nutrition Council, which provides nutritional recommendations and action programmes, and sets up expert groups to solve nutritional problems in the population. The main fortification programmes have been the iodization of table salt, supplementation of selenium to fertilizers and the vitamin D fortification programme. As an example of national legislation, labelling the salt content of foods is described. Finnish nutrition policy is based on a good monitoring system of nutrition and risk factors of chronic diseases, as well as active epidemiological research. However, the authorities have not often taken proposed fiscal measures seriously but have instead considered agricultural and economic policies more important than health policy. [ABSTRACT FROM AUTHOR]

Objective: Eating habits of Finns have improved dramatically in 40 years. The proportion of fat in the diet has decreased and vegetable and fruit consumption increased. Knowledge of Finnish young men's dietary habits is limited. The aim was to assess food choices and quality of diet among young men and to analyse how background and health behaviour factors explain it. Design: In 2007, data on eating habits, sociodemographic background factors and health behaviours of 17-21-year-old men (n 2905) entering military service were collected by self-administrated questionnaire. Two indexes - core food index (CFI) and extra food index (EFI) - were formed to describe daily and redundant snacking-type eating, respectively. Associations of background factors and health behaviours on the indexes were analysed by general linear modelling. Results: In all, 13% consumed fruits and berries daily and 8% consumed vegetables, whereas 24% consumed pizza and 19% consumed hamburgers more than once a week. CFI increased with educational level (P < 0·001) and was explained by background and health behaviour (smoking, physical activity and eating breakfast). EFI was inversely associated with BMI (P < 0·001) and explained by health behaviour: (smoking, physical activity, drinking beer and eating breakfast). Conclusions: These results indicate that in early adulthood, eating habits cluster with other health behaviours among men. In this age group, education is associated with core food but not with extra food eating habits. Furthermore, seasonal variation is seen in both types of eating. When promoting healthy eating, a distinction between core foods and extra foods by using feasible indexes will be helpful in targeting the efforts. [ABSTRACT FROM AUTHOR]

Objective: To study food consumption and nutrient intake in Finnish children aged 1-6 years and to assess the effect of age and sex on food consumption and nutrient intake. Design: Cross-sectional samples of children participating in the Type 1 Diabetes Prediction and Prevention (DIPP) birth cohort study in Finland. Subjects: The study population comprised healthy children recruited in the nutrition study within the DIPP study in 1998-2003. Three-day food records (2535 in total) from 1-, 2-, 3-, 4- and 6-year-old children were kept between the years 2003 and 2005. Results: The energy-adjusted consumption of fruits and berries, cereal products, infant formulas and meat dishes was higher and the consumption of vegetables, salads, breads, dairy products, fat spreads, drinks, sweets and sugar was lower among 1-year-old children than older age groups (P for all <0·05). The mean daily energy intake increased with age and was higher among boys than girls in all age groups, except among the 2-year-olds (P for all <0·05). The diet of the 2-6-year-old children contained too much saturated fat and sucrose, and too little PUFA compared with the current Nordic Nutrition Recommendations. The intakes of most vitamins and minerals met the recommendations. However, the intakes of vitamin D, E and iron fell below the recommended levels. The nutrient density of the diet decreased after the age of 1 year at the time that the children adapted to the regular family diet. Conclusions: In order to improve the diet of young children, it is essential to evaluate the diet of the whole family. [ABSTRACT FROM AUTHOR]

AbstractObjectivesTo determine the prevalence and sociodemographic factors related to vegetarians according to different definitions in Finland and to compare the consumption of selected foodstuffs and nutritional intakes among vegetarians and omnivores.DesignInformation about subjects? identification as vegetarians in a survey was used as a basis for self-defined vegetarianism. Foodstuffs consumed and their frequencies of consumption were obtained, and the reported consumption frequencies of meat, fish, milk and eggs or food portions containing these foodstuffs were used as a basis for an operationalized definition of different types of vegetarianism. Reported consumption was used to estimate foodstuff and nutritional intakes.SettingThree large nationwide surveys in Finland.SubjectsIn total, 24 393 participants aged between 18 and 79 years were included.ResultsThe proportion of self-identified vegetarians was 3?3 % of the total population in Finland. According to responses to questions on consumption frequency, 1?4 % of the population were pesco-lacto-ovo-vegetarians, 0?43 % were vegans, lacto-vegetarians or lacto-ovo-vegetarians, and 0?18 % were vegans or lacto-vegetarians. Eighty per cent of the self-identified vegetarians did not follow a vegetarian diet according to the operationalized definition, but they consumed fewer meat products (P< 0?01).ConclusionSome self-defined vegetarians do consume red meat, poultry or fish, but they follow a healthier diet than self-defined omnivores. In the same sample self-identification indicated more than double the incidence of vegetarianism than the operationalized definition. Therefore self-identification is not a good method for observing the prevalence of vegetarianism. [ABSTRACT FROM AUTHOR]

At the level of micro-intonation, singing provides an object for intimate corporeal identification for the listener. In fact, the listener can, by way of vocal identification, achieve a direct corporeal relationship with the vocal performance. Similarly, the researcher can use his/her own purposeful identification and imitation as a means of observation. 'Once in a century' is a description often attached to the legendary singer Olavi Virta (1915-1972), who had a significant impact on Finnish popular music during the 1950s and is considered a cultural icon by many Finns. In this article, the vocal performance on the novelty recording 'Luonasi jos oisin ('If I were there with you')/Isn't it Romantic?' is studied in order to map out its gestural content. Olavi Virta was in possession of a rich arsenal of vocal gestures. The gestures shared a relationship with the semantic content of the lyrics - not always mimetic but often contrapuntal, polarising, or estranging. [ABSTRACT FROM AUTHOR]

Examines the characterization of place in the music of folk instrument players in Finland. Representation of pelimanni music in the waltz `Memories of Perikyla'; Connection of the musical piece to the Tradition Village of pelimanni musicians; Construction of the musicians' identity in pelimmani music; Definition of pelimanni as folk instrument players.

The article examines the post-war conditions, the political system and policy of Finland after 1939. The author asserts that the political conditions in the country after 1939 offers little hope, in which the question as to the future of freedom and independence arises. He argues that the country's independence depends entirely upon its consistency with Russian security and interest in world affairs.

A global health transition is currently underway. The burden of non-communicable diseases (NCDs) is increasing rapidly in the developing world, very much as a result of changes in lifestyles. In addition to changes in tobacco use and physical activity, major changes are taking place in diets, contributing greatly to the growing epidemic of NCD. Thus, a huge global public health challenge is how to influence the trends in diet and nutrition for effective global NCD prevention. The health transition took place rapidly in Finland after World War II and mortality from cardiovascular disease (CVD) was exceptionally high. The North Karelia Project was launched in 1972 as a community-based, and later as a national, programme to influence diet and other lifestyles that are crucial in the prevention of CVD. The intervention had a strong theory base and it employed comprehensive strategies. Broad community organisation and the strong participation of people were the key elements. Evaluation has shown how the diet (particularly fat consumption) has changed and how these changes have led to a major reduction in population serum cholesterol and blood pressure levels. It has also shown how ischaemic heart disease mortality in a working-age population has declined by 73% in North Karelia and by 65% in the whole country from 1971 to 1995. Although Finland is an industrialised country, North Karelia was rural, of rather low socio-economic level and with many social problems in the 1970s and 1980s. The project was based on low-cost intervention activities, where people's participation and community organisations played a key role. Comprehensive interventions in the community were eventually supported by national activities--from expert guidelines and media activities to industry collaboration and policy. Similar principles for nutrition intervention programmes could be used in developing countries, obviously tailored to the local conditions. This paper discusses the experiences of the North Karelia Project in the light of needs from the less-industrialised countries and makes some general recommendations.

This paper describes 2 outbreaks of hepatitis A infection in Finland, a very low endemic area of hepatitis A infection, where a large proportion of the population is now susceptible to infection by hepatitis A virus (HAV). The first outbreak involved people attending several schools and day-care centres; the second employees of several bank branches in a different city. The initial investigation revealed that both were related to food distributed widely from separate central kitchens. Two separate case-control studies implicated imported salad food items as the most likely vehicle of infection. HAV was detected in the stool of cases from both outbreaks using reverse-transcriptase polymerase chain reaction; however, comparison of viral genome sequences proved that the viruses were of different origin and hence the outbreaks, although occurring simultaneously, were not linked. Foodborne outbreaks of HAV may represent an increasing problem in populations not immune to HAV.