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The present study addresses the concern for the well-being of teachers and school personnel by examining the efficacy of a multicomponent positive psychology intervention aimed at enhancing emotional well-being in the school environment. The study design comprised a clustered randomized controlled trial, targeting teachers and school personnel working in Finnish basic education. Data collection encompassed the utilization of both the Experience Sampling Method (ESM, n = 241) to assess state-like emotions and questionnaires (n = 245) to evaluate trait-like emotions. The results showed a post-intervention increase in state-like distinct emotions of interest and a trend towards increased engagement in the intervention group, and conversely, increased stress in the control group. Positive trait-like emotions increased in the intervention group post intervention. The intervention further resulted in decreased stress and loneliness amongst teachers and school personnel when in the company of students, and decreased stress while working. The results indicate that positive psychology interventions may be efficacious in enhancing teachers' emotional well-being. Additionally, assessing both state- and trait-like emotions contributes to a broader understanding of this efficacy, whilst measuring teachers' experienced emotions can increase ecological validity.

Introduction: The Coronavirus 2019 Disease (COVID‐19) pandemic reached the Nordic countries in March 2020. Public health interventions to limit viral transmission varied across different countries both in timing and in magnitude. Interventions indicated by an Oxford Stringency Index ≥50 were implemented early (March 13–17, 2020) in Denmark, Finland, Norway and Iceland, and on March 26, 2020 in Sweden. The aim of the current study was to assess the incidence of COVID‐19‐related admissions of pregnant women in the Nordic countries in relation to the different national public health strategies during the first year of the pandemic. Material and methods: This is a meta‐analysis of population‐based cohort studies in the five Nordic countries with national or regional surveillance in the Nordic Obstetric Surveillance System (NOSS) collaboration: national data from Denmark, Finland, Iceland and Norway, and regional data covering 31% of births in Sweden. The source population consisted of women giving birth in the included areas March 1–December 31, 2020. Pregnant women with a positive SARS‐CoV‐2 PCR test ≤14 days before hospital admission were included, and admissions were stratified as either COVID‐19‐related or non‐COVID (other obstetric healthcare). Information about public health policies was retrieved retrospectively. Results: In total, 392 382 maternities were considered. Of these, 600 women were diagnosed with SARS‐CoV‐2 infection and 137 (22.8%) were admitted for COVID‐19 symptoms. The pooled incidence of COVID‐19 admissions per 1000 maternities was 0.5 (95% confidence interval [CI] 0.2 to 1.2, I2 = 77.6, tau2 = 0.68, P = 0.0), ranging from no admissions in Iceland to 1.9 admissions in the Swedish regions. Interventions to restrict viral transmission were less stringent in Sweden than in the other Nordic countries. Conclusions: There was a clear variation in pregnant women's risk of COVID‐19 admission across countries with similar healthcare systems but different public health interventions to limit viral transmission. The meta‐analysis indicates that early suppression policies protected pregnant women from severe COVID‐19 disease prior to the availability of individual protection with vaccines. [ABSTRACT FROM AUTHOR]

Much of the research on students' understanding of the greenhouse effect and global warming reports poor results. Students are claimed to hold misconceptions and naive beliefs, and the impact of teaching on their conceptions is also low. In the present study, these results are called into question, and it is argued that they may to a large extent be seen as artifacts of the research methods deployed, in particular when written questionnaires are used. When following students' project work in school over a long period, many of the misunderstandings reported in the literature do not appear. It is argued that the appropriation and use of scientific language when discussing complex socioscientific issues is a gradual process. When observing the language and mediational means students use over time, it is obvious that they are able to identify and use central distinctions in their interactions. They are also able to make productive use of texts and other materials that allow them to successively approximate scientific modes of reasoning. Thus, what students know emerges in communicative practices where they interact with others and with cultural tools in a focused activity. It is argued that students' knowledge of complex multidisciplinary phenomena of this kind may be particularly ill-suited to conventional questionnaire types of testing.

Objective: To assess the incidence of lichen sclerosus (LS) in women and the all-cause and cause-specific mortality of women with LS.Design: Population-based descriptive study.Setting: Finland.Population: All Finnish women, including 7790 women diagnosed with LS during the period 1969-2012.Methods: Information gathered from the Finnish Hospital Discharge Register on women with LS was combined with dates and causes of death from Statistics Finland and the Finnish Cancer Registry. Population statistics are from Statistics Finland.Main Outcome Measures: Crude and age-adjusted incidence rates of LS and standardised mortality ratios (SMRs).Results: The incidence rate of LS adjusted for age (European Standard Population) increased from 14 per 100 000 woman-years in 2003 to 22 per 100 000 woman-years in 2010-2012. The age-specific incidence rate was highest in postmenopausal women (24-53 per 100 000) but was also elevated in girls aged 5-9 years (seven per 100 000). The all-cause mortality of women with LS was lower than in the general female population (SMR 0.84, 95% CI 0.78-0.90), mostly as a result of decreased mortality from circulatory diseases (SMR 0.80, 95% CI 0.72-0.89) and dementia and Alzheimer's disease (SMR 0.75, 95% CI 0.62-0.88). The cancer mortality equalled that of the population, but the vulvar cancer mortality was increased (SMR 28.1, 95% CI 19.3-39.4).Conclusions: Lichen sclerosus is a common disease of elderly women. The overall mortality is decreased whereas the mortality as a result of vulvar cancer is increased.Tweetable Abstract: The likelihood of getting LS by age 80 years is 1.6%. The mortality of women with LS is reduced compared with that of the population. [ABSTRACT FROM AUTHOR]

Objective: To compare the 1-year (previously published) and 3-year objective and subjective cure rates, and complications, related to the use of a collagen-coated transvaginal mesh for anterior vaginal wall prolapse against a conventional anterior repair.Design: Randomised controlled study.Setting: Six departments of obstetrics and gynaecology in Norway, Sweden, Finland, and Denmark.Population: A total of 138 women, of 55 years of age or older, admitted for stage ≥2 anterior vaginal wall prolapse.Methods: The women scheduled for primary anterior vaginal wall prolapse surgery were randomised between conventional anterior colporrhaphy and surgery with a collagen-coated prolene mesh. All patients were evaluated using the Pelvic Organ Prolapse Quantification (POP-Q) assessment before and after surgery. Symptoms related to pelvic organ prolapse were evaluated using the Pelvic Floor Impact Questionnaire (PFIQ-7) and the Pelvic Floor Distress Inventory (PFDI-20).Main Outcome Measures: Objective cure, defined as POP-Q stage <2 prolapse at the 1- and 3-year follow-ups. Furthermore, mesh exposure and dyspareunia were also recorded.Results: In total, 138 patients (70 from the mesh group versus 68 from the conventional anterior colporrhaphy group) out of 160 (86.3%) participated in the 3-year follow-up. POP-Q revealed an objective anatomic cure for 88.1 and 91.4%, respectively, in the mesh group at the 1- and 3-year follow-ups, compared with 39.9 and 41.2% in the colporrhaphy group. No difference between the groups was observed regarding PFIQ-7, PFDI-20, and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) scores. The number of mesh exposures did not change during the study period and all exposures were minor.Conclusion: Our study demonstrates that although the objective outcome was superior in the mesh group, the use of mesh had no impact on the subjective outcome.Tweetable Abstract: POP-Q deteriorates after anterior prolapse surgery but remains stable in women with mesh implantation. [ABSTRACT FROM AUTHOR]

Introduction: Neonatal outcomes after the maternal obstetric near-miss complications of uterine rupture, abnormally invasive placenta, and emergency peripartum hysterectomy were assessed.Material and Methods: This case-control study was conducted as part of the Nordic Obstetric Surveillance Study (NOSS). Data on 211 newborns from 197 deliveries in which an obstetric near-miss complication was involved, were collected prospectively from April 2009 to August 2011 from all Finnish delivery units via questionnaires. Missing cases were obtained from national health registers and confirmed by the clinics. Control populations consisted of all other children born during the same period of time in the Finnish Medical Birth Register (n = 147 551).Results: The number of stillbirths in this cohort was high [n = 8, 3.8% vs. 0.3% among controls, odds ratio (OR) 12.5, 95% confidence interval (CI) 6.32-24.9]. In addition, there were two neonatal deaths. The majority of cases (n = 8, 80%) were connected to uterine rupture. The risk of severe birth asphyxia diagnosis was increased compared with controls (n = 17, 8.1% vs. 0.1%, OR 137, 95% CI 82.7-226). A low umbilical artery pH (<7.05) was also observed among these neonates (28.8% vs. 1.0%, OR 28.7, 95% CI 21.5-38.2). Post-term pregnancies were relatively common among the uterine rupture cases. Adverse neonatal outcomes in the AIP and emergency peripartum hysterectomy cases were associated with preterm deliveries.Conclusions: The prospective data collected from clinicians, combined with the information gathered from national health registers, provided valuable insights into rare maternal near-miss cases. These complications also predisposed stillbirth and neonatal death. In this study, 75% of fetal losses were associated with uterine rupture. [ABSTRACT FROM AUTHOR]

This article contributes to the literature on political gerontology by analysing the role that social capital plays in the political participation of older adults. More specifically, the aim is to test the importance of individual-level and contextual-level social capital for different types of political participation of older adults in a Scandinavian setting by using survey data from Finland and Sweden (N = 6838). The results show that even though membership in voluntary associations, intense social networks and high levels of interpersonal trust tend to be positively correlated with political participation of older adults as a whole, the explanative logic differs between them depending on the kind of political engagement. The only type of social capital with a robust positive impact on all dimensions of political participation was individual-level membership in voluntary associations. [ABSTRACT FROM AUTHOR]

Objective To study the differences in neonatal outcome and treatment measures in Finnish obstetric units. Design A registry study with Medical Birth Register data. Setting and population All births ( n = 2 94 726) in Finland from 2006 to 2010 with a focus on term, singleton non-university deliveries. Methods All 34 delivery units were grouped into small (below 1000), mid-sized (1000-2999) and large (3000 or more) units, and the adverse outcome rates in neonates were compared using logistic regression. Main outcome measures Early neonatal deaths, stillbirths, Apgar scores, arterial cord pH, Erb's paralysis, respirator treatment, the proportion of post-term deliveries (gestational age beyond 42 weeks) and the proportion of newborns still hospitalised 7 days after delivery. Results From an analysis of term, singleton non-university deliveries, the early neonatal mortality was significantly higher in the small relative to the mid-sized delivery units [odds ratio ( OR), 2.07; 95% confidence interval ( CI), 1.19-3.60]. The rate of Erb's paralysis was lowest in the large units ( OR, 0.65; 95% CI, 0.50-0.84). The use of a respirator was more than two-fold more common in large relative to mid-sized units ( OR, 2.38; 95% CI, 2.00-2.83). The proportion of post-term deliveries was highest in the large units ( OR, 1.36; 95% CI, 1.31-1.42), where a significantly higher percentage of post-term newborns were still hospitalised after 7 days ( OR, 1.50; 95% CI, 1.19-1.89). Conclusions There are significant differences in several neonatal indicators dependent on the hospital size. An international consensus is needed on which indicators should be used. [ABSTRACT FROM AUTHOR]

This article examines political participation among older adults in Ö sterbotten, Finland, and Västerbotten, Sweden. Two specific hypotheses are tested. First, we anticipate that older adults are loyal voters but less avid in engaging in politics between elections. Second, we expect individuallevel resources to explain why older people participate in politics. The article offers two contributions to the literature on political participation of older adults. First, it corroborates earlier findings by showing that older adults indeed have a higher inclination to vote than to engage in political activities between elections, but it also shows that the latter engagement is more diversified than one could expect. Second, although the findings largely support the resource model, they suggest that we need to consider also other factors such as the overall attitude towards older people. [ABSTRACT FROM AUTHOR]

Objective. To examine the prevalence and risk factors for blood transfusion during delivery. Design. Register-based retrospective cohort study from Finland. Setting. National Medical Birth Register data during 2006-2008. Sample. A total of 171 731 women having singleton deliveries, of whom 3394 (1.98%) received blood transfusion. Methods. We calculated odds ratios (ORs) with 95% confidence intervals (CIs) by multivariate logistic regression to adjust for confounders related to maternal background and mode of delivery. Main outcome measures. Blood transfusion rates by risk factors. Results. Blood transfusion rate during labor increased slightly, from 1.83% in 2006 to 2.27% in 2008 ( p < 0.001), during the study period. The highest rate, almost 4%, was reported in central hospitals. Advanced maternal age and primiparity predisposed to blood transfusion. A previous cesarean section increased these rates also in subsequent vaginal delivery (2.64%) compared with women who had vaginal deliveries only (0.86%, OR 3.14, 95% CI 2.65-3.72). Induction of labor almost doubled the risk for blood transfusion (adjusted OR 1.74, 95% CI 1.60-1.89). All instrumental vaginal deliveries (adjusted OR 2.46, 95% CI 2.25-2.69) and any cesarean sections (adjusted OR 1.80, 95% CI 1.66-1.96) increased this risk. Delivery of a large-for-gestational age newborn increased the blood transfusion risk over twofold. Conclusions. As previous cesarean section includes an increased risk for blood transfusion, even in subsequent deliveries, it is essential to consider the mode of labor carefully. The blood transfusion rate was the highest in central hospitals, suggesting differences in blood transfusion practice. [ABSTRACT FROM AUTHOR]

The aim is to analyse political participation among senior citizens in the West-Finnish region Osterbotten/Pohjanmaa by using data from the 2005 GERDA (gerontological regional database) survey. The first research question related to patterns of political participation and the extent to which older people in this region engage in voting and non-institutionalised forms of participation. Secondly, the driving forces behind different dimensions of participation were assessed on an individual level by using a modified variant of the civic voluntarism model as suggested by Verba and colleagues. The results show a high propensity to vote among elders in this region, but they also suggest that so-called non-institutionalised participation is likely to become more common in the future. Moreover, even though the results support the so-called resource theory of political participation, the fit of the multivariate models were modest, which necessitates further research in order to understand fully the driving forces behind political participation of older people in this specific region. [ABSTRACT FROM AUTHOR]

Aim:To study the association between social participation, interpersonal trust, and self-rated health among 65- and 75-year-olds. Methods: The data originates from a cross-sectional postal questionnaire survey conducted among 1577 persons aged 65 and 75 years in western Finland (response rate 67%). Logistic regression analyses were performed in order to investigate the association between social capital – in terms social participation and interpersonal trust – and health while controlling for sociodemographic variables. Results: The results showed that the social participation indicator (“active membership in organisations”) was positively associated with health among 75-year-olds, but not among 65-year-olds. By contrast, interpersonal trust was positively associated with health in both age groups. Conclusions: The results imply that social participation and its association with health is moderated by age, whereas interpersonal trust is not. [ABSTRACT FROM PUBLISHER]

The aim of this study was to establish whether a combination of high-risk human papillomavirus (hrHPV) testing and cervical cytology could reduce colposcopy referral among women with atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion cytology. We randomized 598 women in the Helsinki area, Finland into three study groups. Different strategies of hrHPV testing, cytology and colposcopy with biopsy were used; subsequent hrHPV test results and cytological findings were compared with histology. The rates of hrHPV positivity and CIN2+ were compared. In total, 62.5% of all samples were hrHPV-positive. Altogether 45 (12.7%) CIN2 or worse (CIN2+) lesions were found in study groups A and B. Among hrHPV-positive women the rate of CIN2+ was 19.0% (n = 43), in contrast with 1.6% (n = 2) among hrHPV-negative women (relative risk = 12.2, 95% confidence interval [CI] 3.6-81.1, P, 0.001). Among all hrHPV-negative women whose cytological findings were normal or ASCUS, dysplastic lesions were uncommon (n = 4/119, 3.4%), and all were CIN1. If these women had not been referred to colposcopy, the number of colposcopies would have been reduced by 33.6%. We conclude that hrHPV testing combined with repeat cervical cytology had a high negative predictive value in patients with recurrent low-grade cervical cytology. This could reduce the referral rate to colposcopy without jeopardizing patient safety. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study exploring possible external and inner sources of the sense of security felt by older people aged 65 and 75. Background. The concept of 'security' has been parsimoniously defined and explored, especially as pertains to older people, and previous research has primarily focused on risks in relation to individuals' declining health and functional ability. Methods. In 2005, population-based cross-sectional surveys were carried out in 15 municipalities in Våsterbotten, Sweden and 18 municipalities in Ostrobothnia, Finland. A 15-page questionnaire (84 questions) was distributed, with the final total response rate reaching 68⋅4% (n = 3370): 1825 Swedish-speaking Swedes, 926 Swedish-speaking Finns and 621 Finnish-speaking Finns. The statistical analysis was three-stage, including nominal stepwise regressions. Results. Older people who indicate that they are 'very secure' are more likely to consider life meaningful and are able to master various life crises. Moreover, they possess confidence in economic institutions and are more likely to feel economically secure. Weak trust in family and friends or neighbours and decreased functional ability seem to indicate a subjective feeling of 'insecurity'. Conclusion. Caregivers in health care should focus more on supporting older persons' meaningfulness in life and how their feelings of security can be strengthened by trusting relationships and activities. In nursing, there should be more focus on developing knowledge of inner health resources, including positive life orientation and meaningfulness in life. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study conducted to compare service users', nursing students' and Registered Nurses' evaluations of the usability of a patient education website intended for individuals with severe mental health problems. Background. There is an obvious need for reliable mental health information on the Internet. When evaluating the usability of Internet-based patient education methods, the opinions of all parties need to be ascertained. Methods. An explorative descriptive design was used. Twenty-one service users, 20 nursing students and 35 Registered Nurses were recruited for the study in 2003 and 2004. Data were collected using a self-developed questionnaire on the content, structure and visual appearance of the website. Results. Service users had positive attitudes towards computer and Internet use but they needed support when using the computer and Internet. According to the evaluations, the content, structure and visual appearance of the website were good and it could be adopted for clinical practise after minor revisions. There were some differences in the evaluations between participant groups. Nurses were the most critical group, and the service user group was the most satisfied, although they were less experienced with using both computers and the Internet. Conclusion. It is especially important to include service users' evaluations at the early stages of the development process of Web-based patient education systems. It is possible to produce an information technology-based patient education system for individuals with severe mental health problems. Nurses working in psychiatric services need to pay more attention to supporting service users in computer and Internet use. [ABSTRACT FROM AUTHOR]

The article presents the findings of a study on whether loop electrosurgical excision procedure (LEEP) conization is linked with preterm birth as well as study the effect of cone size on preterm birth. The findings of the cohort study from Southern Finland conducted from 1997 to 2003 revealed that LEEP conization increases the risk of preterm birth notably among women without previous preterm birth. The findings disclosed that rates were maximum after repeat procedures.

Objective The objective of this study was to study whether women surgically treated for cervical intraepithelial neoplasia (CIN) have increased mortality later in life. We also wanted to study whether pregnancy beyond 22 weeks post-treatment affects the risk. Design Register-based retrospective cohort study from Finland. Setting National data of the Hospital Discharge Register and the Cause-of-Death Register during 1986–2003. Population A total of 25 827 women who had surgical treatment for CIN during 1986–2003. Methods We calculated standardised mortality ratios (SMRs) by dividing the numbers of observed deaths (until 31 December 2006) by the numbers of expected deaths. Main outcome measures SMRs for different causes-of-death groups. Results The overall mortality increased by 17% after treatment for CIN, including increased risk of dying from all diseases and medical conditions (SMR 1.13, 95% CI 1.01–1.26), cancers (SMR 1.09, 95% CI 0.91–1.27) and injury deaths (SMR 1.31, 95% CI 1.03–1.58). As expected, the mortality from cervical cancer was high (SMR 7.69, 95% CI 4.23–11.15). Women who had delivered post-treatment tended to have decreased overall mortality (SMR 0.78, 95% CI 0.52–1.04) and decreased disease mortality (SMR 0.63, 95% CI 0.37–0.90). However, the mortality rate was significantly increased for women who had subsequent preterm delivery (SMR 2.51, 95% CI 1.24–3.78). In this subgroup, there was a tendency of increased mortality from diseases of the circulatory system, alcohol-related causes and injury deaths. Conclusions Mortality rate was increased after surgical treatment for CIN. However, women who had delivered post-treatment had decreased overall disease mortality rate. Subsequent preterm delivery may be a risk marker for increased long-term mortality. [ABSTRACT FROM AUTHOR]

Objective We examined the trends and risk factors of preterm delivery. Design Register-based retrospective cohort study from Finland. Setting National Medical Birth Register data during 1987–2005. Population The study population consisted of 1 137 515 deliveries, of which 59 025 were preterm (5.2%). Methods We calculated the population attributable risks for using the risk factor prevalence rates in the population. We further calculated odds ratios with 95% CI by multivariate logistic regression to adjust for confounders. Main outcome measures Preterm delivery rate subclassified into moderately preterm (32–36 weeks), very preterm (28–31 weeks) and extremely preterm (less than 28 weeks). Results Preterm delivery rates increased from 5.1% in the late 1980s to 5.4% in the late 1990s but then decreased to 5.2% for 2001–05. The proportion of extremely preterm deliveries decreased substantially by 12% ( P < 0.01). The greatest risk factors were multiplicity (OR 13.72, 95% CI 13.26–14.19), followed by elective delivery (OR 1.86, 95% CI 1.82–1.89), primiparity (OR 1.47, 95% CI 1.45–1.50), in vitro fertilisation treatment (OR 1.39, 95% CI 1.31–1.47), maternal smoking (OR 1.31, 95% CI 1.29–1.34) and advanced maternal age (OR 1.02, 95% CI 1.02–1.03 for each additional year of age). Prematurity rates decreased by 1.8% after adjusting for risk variables. Conclusions The rate of preterm delivery has not increased from 1987 to 2005 in Finland, while the risk for extremely preterm delivery has decreased. This finding is in contrast with recent trends in other countries. [ABSTRACT FROM AUTHOR]

The gold standard of cervical intraepithelial neoplasia (CIN) treatment is large loop excision of the transformation zone (LLETZ) after histopathological diagnosis from punch biopsies. In addition, treatment may be appropriate at initial colposcopy. Our objective was to study the applicability of immediate treatment strategy according to clinical parameters. We conducted a prospective cohort study among patients referred to colposcopy at Helsinki University Hospital, Finland, between January 2014, and September 2018 (ISRCTN10933736). Patients treated with LLETZ, either after biopsies or immediately at initial colposcopy, were included. The main outcome measure was overtreatment (OT) rate defined as normal or low-grade histopathological findings in LLETZ specimen within both treatment groups. A total of 572 patients treated with LLETZ were included: 360 treated after biopsies and 212 treated immediately at initial colposcopy. When LLETZ was performed immediately after high-grade referral cytology and with colposcopic impression of high-grade disease, the overtreatment (OT) rate was 10.0% (95% CI 9.10 to 17.2), whereas when LLETZ was done after biopsy-confirmed high-grade lesions, the OT rate was 18.9% (95% CI 14.7 to 23.7), resulting in risk difference (RD) −8.91% (95% CI −16.0 to −1.82). Among HPV16/18 positive patients the OT rate was 8.22% (95% CI 3.08 to 17.0) for immediate treatment, resulting in RD of −10.7% (95% CI −18.3 to −3.04) compared to LLETZ after biopsies. Immediate LLETZ does not result in overtreatment when applied on selected cases, especially after high-grade referral cytology and when high-grade lesion is also colposcopically suspected. • Select-and-treat resulted in lower overtreatment rate than LLETZ after HSIL biopsy. • Immediate treatment of CIN does not increase overtreatment rate if current care guidelines are followed. • If HPV 16/18 was positive, the overtreatment rate was lower after immediate treatment than treatment after HSIL biopsy. • The overtreatment rate was rather high in both treatment groups for patients with type 3 transformation zone. [ABSTRACT FROM AUTHOR]

Risk factors for the different human papillomavirus (HPV) genotypes are not well understood, although the risk of cancer is known to vary among them. Our aim was to evaluate the association of diverse behavioral and reproductive factors with genotype-specific HPV prevalence among 879 unvaccinated women aged 18–75 years referred to the colposcopy clinic at Helsinki University Hospital in Finland. Cervical swabs for HPV genotyping were collected in the first visit and assessed for 34 high-risk (hr) and low-risk (lr) HPV genotypes. Participants completed a questionnaire on behavioral, reproductive, and lifestyle factors. Differences in genotype-specific HPV prevalence were analyzed overall and in age groups using binary logistic regression. Smoking was associated with higher prevalence in HPV16 compared with other hrHPV genotypes together with decreasing age, being highest among younger women <30 years old, odds ratio (OR) 3.74 (95% CI 1.42–9.88). The later the sexual debut, the more it seemed to protect from HPV16 infection. The best protection was achieved when the sexual debut took place at >20 years of age, with an OR of 0.43 (95% CI 0.23–0.83). This association was not seen with other hrHPV genotypes. Methods of contraception seemed not to have an effect on hrHPV positivity, regardless of the HPV genotype. The genotype specific hrHPV prevalence differs, depending on behavioral factors, especially among younger women referred to colposcopy. [ABSTRACT FROM AUTHOR]

Abstract: A new plunger device has been designed and built to measure the lifetimes of unbound states in exotic nuclei beyond the proton drip-line. The device has been designed to work in both vacuum and dilute-gas environments made possible through the introduction of a low-voltage stepping motor. DPUNS will be used in conjunction with the gas-filled separator RITU and the vacuum separator MARA at the accelerator laboratory of the University of Jyväskylä, Finland, to measure the lifetimes of excited states with low population cross-sections. This is achieved by eliminating the need for a carbon foil to isolate the helium gas of RITU from the beam line thus reducing the background from beam-foil reactions. The inclusion of a high-sampling rate data acquisition card increases further the sensitivity of the device. The plunger will be used to address many key facets of nuclear structure physics with particular emphasis on the effect of deformation on proton emission rates. [Copyright &y& Elsevier]

Background: Urinary tract infection (UTI) is the most common diagnosis made in prescribing antimicrobials in long-term care facilities (LTCF). The diagnostic criteria for UTI vary among institutions and prescribers. Our aim was to reduce the inappropriate use of antimicrobials in LTCFs., Methods: A team comprising infectious disease consultant, infection control nurse, and geriatrician visited all LTCFs for older persons (2,321 patients in 25 primary care hospitals and 39 nursing homes and dementia units) in the Central Finland Healthcare District (population 267,000) during 2004-2005. The site visits consisted of a structured interview concerning patients, ongoing systematic antimicrobials, and diagnostic practices for UTI. Following the visits, regional guidelines for prudent use of antimicrobials in LTCFs were published, and the use of antimicrobials was followed up by an annual questionnaire., Results: The proportions of patients receiving antimicrobials in 2005, 2006, 2007, and 2008 were 19.9%, 16.9%, 16.2%, and 15.4%, respectively. Most of the antibiotics were used for UTI (range by year, 66.6%-81.1%). From 2005 through 2008, the proportion of patients on antibiotic prophylaxis for UTI decreased from 13% to 6%. The decrease was statistically significant in both types of settings., Conclusion: The visits and guidelines were associated with a reduction in the usage of antimicrobials. To sustain this, UTI surveillance and close collaboration between infection control experts and LTCFs are crucial., (Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.)

A multidisciplinary team visited all long-term care facilities (n = 123) for elderly persons in the Central Finland health care district (population, 265,000) during 2004-2005. Use of alcohol-based hand rubs and ongoing systematic antimicrobials were assessed. Thereafter, regional guidelines for prudent use of antimicrobials were published. One year after the visits, a significant increase in the mean amount of alcohol-based hand rubs used was detected while usage of antimicrobials for the prevention of urinary tract reinfections had decreased.