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Background Longitudinal studies demonstrate that physical activity (PA) declines on average from adolescence to early adulthood. However, some subgroups of adolescents increase activity while others decrease or maintain high or low activity. Determinants of change or maintenance of (in)activity may differ between subgroups and are valuable information for targeted health promotion. The purpose of this study was to identify PA patterns from adolescence to early adulthood, and also to explore how different activity domains and Sedentary Behaviour (SB) are associated with PA patterns. Methods The data of this observational cohort study (collected in 2013/2014 and 2017/2018) consisted of 254 Finns at age 15 and 19 participating the Health Promoting Sports Club study. K-means cluster analysis for longitudinal data was performed to identify participant clusters (patterns) based on their accelerometry-measured moderate-to-vigorous PA (MVPA). Associations of sports club participation (SC), active commuting (AC), and SB with PA patterns were examined by logistic regression analysis. Results (preliminary) Five MVPA patterns were identified: inactivity maintainers (n = 71), activity maintainers (n = 70), decreasers from moderate (to low) PA (n = 61), decreasers from high (to moderate) PA (n = 32), and increasers (n = 20). At age 15, SC participation (41-97%) and AC (47-75%) were common in all the patterns. By age 19, clear dropout from these activities was prevalent (SC participation mean 32%, AC 31-63%). Maintained SC participation was associated with a higher likelihood of belonging to the decreasers from high PA (OR = 11.2, CI = 1.4-90.0) and to the combined group of increasers and activity maintainers (OR = 3.6, CI = 1.8-7.4); also with a lower likelihood of being an inactivity maintainer (OR = 0.1, CI = 0.02-0.2). Dropout from SC was related to a higher likelihood of being a decreaser from high PA (OR = 10.9, CI = 1.3-90.7). Maintenance/adoption of AC was associated with a lower likelihood of being an inactivity maintainer (OR = 0.3, CI = 0.1-0.7). Decreased SB was related to a higher likelihood of belonging to the activity maintainers and increasers (OR = 0.96, CI = 0.93-0.98). Conclusions PA patterns diverge greatly over the transition to adulthood. Changes in SC participation, AC, and SB show different associations with diverging PA patterns. Hence, tailored PA promotion is recommended.

Background Low-trauma fractures of elderly women are a major public health concern. Methods We determined the current trend in the absolute number and incidence (per 100,000 persons) of fresh low-trauma fractures of the proximal humerus among 80-year-old or older Finnish women by taking into account all women who were admitted to Finnish hospitals for primary treatment of such a fracture between 1970 and 2015. Results The number of low-trauma fractures of the proximal humerus among 80-year-old or older Finnish women rose continuously between 1970 (32 fractures) and 2015 (568 fractures), whereas the age-adjusted fracture rate (showing a clear rise from 87 fractures per 100,000 persons in 1970 to 304 fractures in 1995) became stabilized between 1995 and 2015 (297 fractures per 100,000 persons in 2015). Conclusions The clear rise in the incidence of low-trauma proximal humeral fractures in Finnish elderly women from early 1970s until mid 1990s has been followed by stabilized fracture rates. Reasons for this are largely unknown, but a cohort effect toward a healthier aging population with improved functional ability, as well as measures to prevent falls and alleviate fall severity, could partly explain the phenomenon.

BACKGROUND: Fall-related injuries in older adults are a major public heath challenge. METHODS: we determined the current trends in the number and age-adjusted incidence of fall-induced severe cervical spine injuries among older adults in Finland by taking into account all persons in 50 years of age or older who were admitted to Finnish hospitals for primary treatment of these injuries between 1970 and 2011. Similar patients aged 20-49 years served as a reference group. RESULTS: the number of fall-induced cervical spine injuries among older Finns rose six-fold from 59 in 1970 to 372 in 2011. The age-adjusted incidence of injury (per 100 000 persons) was higher in men than in women throughout this period and showed a clear increase from 1970 to 2011: from 8.5 to 20.3 in men, and from 2.8 to 11.7 in women. In both sexes, the increase was most prominent in the oldest age group, persons aged 70 years or older. In the reference group, the injury incidence did not rise by time. CONCLUSIONS: the number and incidence of fall-induced severe cervical spine injuries among older Finns increased considerably between 1970 and 2011. An increase in the average risk of serious falls may partly explain the phenomenon. Wide-scale fall and injury prevention measures are urgently needed, because further ageing of the population is likely to worsen the problem in the near future. Language: en

BACKGROUND: elderly people's fall-induced injuries are a major public health challenge.Methods: we determined the current trends in the number and age-adjusted incidence (per 100,000 persons) of fall-induced injuries among older adults in Finland by taking into account all persons 80 years of age or older who were admitted to Finnish hospitals for primary treatment of a first fall injury over the period 1970-2009. RESULTS: the number of fall-induced injuries in elderly Finns increased considerably during the study period: for women and men separately, these numbers were from 927 to 10,333 (an 11-fold rise), and from 212 to 3,258 (a 15-fold rise), respectively. In both genders, the age-adjusted incidence (per 100,000 persons) of fall-induced injuries increased till the late 1990s but decreased thereafter, the incidence being 2,729 (women) and 1,455 (men) in 1970, and 5,930 (women) and 4,240 (men) in 2009. Even with the current injury incidence the number of these injuries is expected to more than double by the year 2030. CONCLUSION: the rise in the age-adjusted incidence of hospital-treated fall injuries of 80 year old and older Finns from the 1970s to the late 1990s has been followed by declining injury rates. Despite this we have to effectively continue implementation of fall prevention actions. Language: en

Background. Although various low-trauma fractures among older adults are said to be a major public health concern in contemporary societies with aging populations, reliable epidemiologic information on their secular trends is scarce. Methods. We assessed the current trend in the number and incidence (per 100,000 persons) of low-trauma fractures of the calcaneus and foot of older adults in Finland, a European Union country with a well-defined white population of 5.2 million, by taking into account all persons 50 years old or older who were admitted to Finnish hospitals for primary treatment of such injury in 1970-2005. Results. The number and raw incidence of low-trauma fractures of the calcaneus and foot among Finns 50 years old or older rose considerably between the years 1970 and 2005, from 64 (number) and 5.6 (incidence) in 1970 to 294 and 15.2 in 2005. For the study period, the age-adjusted incidence of fracture was higher in men than women and showed a clear increase in both sexes in 1970-2005, from 7.3 to 17.4 in men (138% increase), and from 4.3 to 12.5 in women (191% increase). A similar finding was observed in the age-specific incidences. Assuming that the observed increase in the age-specific fracture incidence continues in the 50-year-old or older group and the size of this population increases as predicted, the annual number of low-trauma fractures of the calcaneus and foot in this population will be two times higher in the year 2030 (approximately 550 fractures annually) than it was during 2001-2005. Conclusions. In Finnish persons aged 50 years or older, the number of low-trauma fractures of the calcaneus and foot has risen considerably in 1970-2005 with a rate that cannot be explained merely by demographic changes. Further studies are needed to explore the exact reasons for the rise and possibilities for fracture prevention.

BACKGROUND: This study examined the recent nationwide trends for the absolute number and the age- and sex-specific incidence rates of the fatal and serious non-fatal injuries among 0-14 year old children in Finland in 1971-1995. METHODS: We selected from Official Cause-of-Death Statistics and National Hospital Discharge Register children aged 0-14 years who died or required treatment at a hospital department because of an injury in 1971-1995. The number of Finnish children was 1.1 million in 1971, and 1.0 million in 1995. RESULTS: During the entire study period injuries were the leading cause of death in children aged 1-14 years, but not in infants. However, in these years the incidence (per 100 000 people) of fatal injuries in Finnish children decreased considerably in all age groups and both sexes, in girls from 20.1 in 1971 to 4.6 in 1995, and in boys from 36.7 in 1971 to 9.3 in 1995. In 1995, 41% of all the injurious deaths among 0-14 year old Finnish children were motor vehicle accidents, 12% were drownings, and 24% intentional injuries. The overall number and incidence of serious non-fatal injuries among Finnish children showed no clear trend change in 1971-1995. The mean hospitalization time of injured children shortened between 1971 and 1995, from 7.4 days to 2.7 days. CONCLUSIONS: We conclude that the number and incidence of fatal childhood injuries have decreased dramatically in Finland between 1971 and 1995. The reasons for this positive development are multifactorial, but improved traffic safety and trauma care are probably very important. In children's serious non-fatal injuries the development has not been so encouraging and therefore children's injury prevention should receive continuous intense attention. Language: en

Objectives: to assess the acceptability and compliance with use of an energy-shunting hip protector in institutionalized elderly people. Design and setting: a 6-month prospective follow-up in a Finnish nursing home. Participants: 19 ambulatory nursing home residents with a high risk of hip fracture. Main outcome measures: the proportion of the residents who were willing to use the device, the number of hours of wearing the protector and the attitudes of the study subjects and the caregivers towards the appearance, comfort, fit, efficacy and laundering of the protector. Results: 12 of the 19 ambulatory residents (63%) agreed to use the protector. During the study period, these subjects wore the protector on average for more than 90% of their active days, i.e. the days they were mobile. Two subjects wore the protectors at night time; the rest only during waking hours. Mean wearing time during waking hours exceeded 90%. Conclusion: external hip joint protectors are a feasible strategy to prevent hip fractures in institutionalized elderly people. The attitude, education and motivation of the staff may be a factor in achieving good user compliance. Further community-based studies on acceptability and compliance in wearing external hip joint protectors are needed for verification of benefits to the general population of older people.