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Introduction: The skill domains of fundamental movement skills (FMS), emphasizing gross motor movements, including locomotor skills (LMS) and object control skills (OCS), along with process- and product-oriented measures of FMS, may predict cardiorespiratory fitness (CRF) and muscular fitness (MF) differently. This study investigates the longitudinal relationship from early childhood FMS, focusing on process-oriented LMS and OCS and product-oriented FMS, to CRF and MF in late childhood. Methods: The study involved 441 Finnish children (49.9% female; mean age at baseline, 5.5 yr) over a 6-yr period. FMS was evaluated using the Test of Gross Motor Development, third version, for process-oriented LMS and OCS, and the Körperkoordinationstest Für Kinder (KTK) was used to evaluate the product-oriented FMS. CRF was assessed through the total number of laps completed in the 20-m shuttle run test, whereas MF was measured via repetitions of curl-ups and push-ups. Employing a two-level cross-classified regression analysis and Cholesky decomposition, this study aimed to determine the contributions of product-oriented KTK and process-oriented LMS and OCS. Adjustments for variations in age, measurement intervals, and maturation were achieved through residualization. In addition, gender and body mass index were incorporated as covariates in the analysis. Results: The analysis revealed that process-oriented LMS (CRF: ΔR² = 0.016; MF: ΔR² = 0.014) significantly predicted later health-related fitness, whereas OCS did not. However, KTK exhibited a better ability to predict both CRF (ΔR² = 0.092) and MF (ΔR² = 0.032), overshadowing process-oriented measures. Conclusions: In conclusion, the findings suggest that KTK, which potentially encompasses a broader spectrum of fitness elements along with FMS, more effectively predicts health-related fitness components than process-oriented FMS. [ABSTRACT FROM AUTHOR]

Teachers' engagement in active learning from and within their professional community is highly dependent on the support they receive from their colleagues. In this study we examined teachers' sense of agency in the professional community and its relationship with received professional recognition over a five-year follow-up. The sample comprised 2310 Finnish comprehensive schoolteachers who responded to a survey in 2011 and 2016. The results showed that the teachers' sense of agency in the professional community in terms of the reported engagement in transformative practice, collective efficacy, positive interdependency, mutual agreement and active help seeking, was strong and somewhat stable over time. The professional recognition they received from colleagues contributed to the teacher's sense of professional agency in the professional community, enhancing their motivation, efficacy beliefs and skills to learn in the professional community. The study contributes to the research on teacher learning by showing that active learning within the professional community can be enhanced through professional recognition. [ABSTRACT FROM AUTHOR]

Technological environments change social interactions within local communities, potentially leading to the erosion of the sense of local community. In this study, we examined the social, psychological, environmental, and technological factors that predict a sense of local community. Employing a longitudinal approach, we analysed predictors of a sense of local community among Finnish adults aged 18–80 years (N = 1,226) at three time points (spring 2021, spring 2022, and spring 2023). Our results, based on hybrid multilevel regression models, showed that greater neighbourhood engagement and perceived residential environment pleasantness positively predicted a sense of local community over time. Neighbourhood engagement, perceived residential environment pleasantness, use of neighbourhood technology, and positive attitude towards neighbourhood technologies showed positive effects and perceived loneliness and perceived level of urbanization negative between‐person effects, on a sense of local community. The results shed light on the determinants of a sense of local community and carry implications for broader community engagement efforts. Enhancing perceived residential environment pleasantness and promoting more active engagement within neighbourhoods could help increase a sense of local community. Future initiatives may also focus on utilizing neighbourhood technology as a tool to help strengthen a sense of local community. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement. [ABSTRACT FROM AUTHOR]

Objectives: To examine with a population-based longitudinal survey design whether poor health, longstanding activity limitation, impaired cognitive functioning, mental distress, or loneliness predict poor access to healthcare and whether digital competence mediates these associations. Methods: The data were from the longitudinal FinHealth -survey gathered in Finland in 2017 and 2020 including 3,771 respondents (57.1% women). Linear regression analyses were used to examine the associations of factors affecting healthcare utilization with access to care adjusted for age, sex, and education. Counterfactual causal mediation framework was used to examine the mediating role of digital competence in the relationships among these factors and access to healthcare. Results: Factors affecting healthcare utilization were associated with poor access to care and these associations were partly mediated by low digital competence. Low digital competence mediated 12%, 9% and 8%, of the associations of impaired cognitive functioning, longstanding activity limitation, and loneliness with poor access to care, respectively. Conclusion: According to our results, one way to improve the access to healthcare among vulnerable groups could be to improve their digital competence. [ABSTRACT FROM AUTHOR]

Background: Compliance with a study protocol is central to meeting its research goals. In longitudinal research studies, data loss due to missed visits limit statistical power and introduce bias. The Environmental Determinants of Diabetes in the Young (TEDDY) study is a longitudinal multinational (US, Finland, Germany, and Sweden) investigation of children at risk for type 1 diabetes (T1D) that seeks to identify the environmental triggers of islet autoimmunity and T1D. The purpose of the current study was to identify sociodemographic variables and maternal characteristics assessed in the first year of TEDDY that were associated with study visit compliance in the subsequent 3 years. Methods: Sociodemographic variables, maternal life-style behaviors, post-partum depression, maternal reactions to the child's T1D risk, and study-related variables were collected at child-age 6 months and 15 months. Multiple linear regression was used to examine the association of these variables to study visit compliance in the subsequent 3 years. Results: Study visit compliance was highest in Sweden (p > 0.001), in children who were their mother's first child (p > 0.001), and whose mothers were older (p > 0.001) and more satisfied with the TEDDY study (p > 0.001). Father participation was also associated with better study visit compliance (p > 0.001). In contrast, children whose mothers smoked (p > 0.001), suffered from post-partum depression (p = 0.034), and were more anxious about their child's T1D risk (p = 0.002), completed fewer visits. Father's study satisfaction was also associated with study visit compliance (p = 0.029); however, it was not significant in models that included maternal study satisfaction. Conclusions: Sociodemographic variables, maternal characteristics—including study satisfaction—and fathers' participation in the first year of a longitudinal study were associated with subsequent study visit compliance in a sample of children genetically at-risk for T1D followed for 4 years. This information can inform future strategies designed to improve study visit compliance in longitudinal pediatric studies. Trial registration: NCT00279318, 06/09/2004. [ABSTRACT FROM AUTHOR]

Early positive bonding between parents and babies promotes the development of parenting skills and parents' sensitivity to their infant's needs. Positive bonding has been suggested to decrease the risk of maltreatment. There is less research into the differences between primiparae's and their spouses' bonding with their baby and changes in the parent-to-infant bonding during the first year of the baby's life. The aim of this study was to describe bonding with one's baby and related differences and changes within first-time parents. The data were collected from nine maternal health clinics in 2019–2021 in one city in Finland. The Mother-to-Infant Bonding Scale (MIBS) and the Edinburgh Postnatal Depression Scale (EPDS) were used. The data were collected during pregnancy (T1) and when the baby was aged 1–2 months (T2) and 6–8 months (T3). The questionnaire was completed separately by the primiparae (n = 81 at T1) and their spouses (n = 79 at T1). The findings demonstrated that both parents had positive feelings for their baby. The primiparae's and their spouses' MIBS scores were relatively low at T2 and T3. The change between time points or the difference in the parents' bonding was not statistically significant when examining MIBS total scores. The present study identified a positive weak-to-moderate correlation between the MIBS and EPDS. This association was highlighted in the group of primiparae. The results of this study can be used to develop maternity and child health clinic services, and to promote parents' equal growth in parenthood. [ABSTRACT FROM AUTHOR]

Background: Knowledge of the continuity of sleep problems and the associations between sleep and psychiatric symptoms in child psychiatric patients is scarce. Objectives: To investigate the persistency of sleep problems and how sleep at preschool age predicts sleep problems and psychiatric symptoms at school age in child psychiatric patients. Methods: Participants (n = 68) were child psychiatry outpatients at Helsinki University Hospital in 2015–2017. Caregivers evaluated sleep with the Sleep Disturbance Scale for Children (SDSC) and psychiatric symptoms with the Child Behavior Checklist (CBCL) at baseline (age 4–7 years) and again at follow-up (age 8–13 years). Family background information was collected at both time points. Results: Sleep problems at preschool age predicted sleep problems at school age (R2Adjusted =.48, p <.001). Persistent sleep problems associated strongly with the intensity of psychiatric symptoms (p =.001). Internalizing symptoms were predicted by sleep problems (p =.038) even after controlling for age, sex, and psychiatric symptoms at preschool age. Conclusion: Sleep problems are prevalent and persistent and relate to psychiatric symptoms in children treated at child psychiatry clinics. These results emphasize the need for identification and treatment of sleep problems in these children. [ABSTRACT FROM AUTHOR]

The article examines media consumption and compliance with health-protective measures during the COVID-19 pandemic. Two-wave, longitudinal surveys were conducted in Finland and the United States in April 2020 and October 2020, with a total of 1,380 participants (N = 1,380). The variables analyzed included daily consumption of different media channels (broadcast, print, and social media), health-protective behavior, and COVID-19 self-efficacy. The results indicated that individuals who consumed more than one media channel on a daily basis exhibited increased health-protective behavior and COVID-19 self-efficacy in both countries. One-sided and social media-based media consumption showed a negative association with health-protective behavior and COVID-19 self-efficacy in both countries. Finally, COVID-19 self-efficacy was found to mediate the relationship between media consumption and health-protective behavior in both countries, with a stronger effect observed in the United States. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine the prevalence of loneliness among older people and to identify risk factors for loneliness in a Nordic regional context over a six-year period. Longitudinal data from the Gerontological Regional Database (GERDA) study of 4,269 older adults living in northern Sweden and western Finland, aged 65, 70, 75 and 80 at baseline in 2010, were analysed. Logistic regressions were used to analyse socio-demographic, social and health-related risk factors at baseline and changes in these for experiences of loneliness at follow-up. The results showed that most older adults (85%) did not experience loneliness at baseline or at follow-up in our study region. However, 3 per cent of the sample reported loneliness in both study years, indicating enduring and chronic loneliness. Analyses revealed that being widowed and becoming a widow/er as well as poor self-rated health at baseline and the onset of depression were risk factors for loneliness. Finally, the risk of loneliness was higher in older people living in Sweden. Further work is needed to explore changes and stability in loneliness as well as to increase our understanding of between-country differences in loneliness. [ABSTRACT FROM AUTHOR]

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Background: Return-to-work (RTW) process often includes many phases. Still, multi-state analyses that follow relevant labour market states after a long-term sickness absence (LTSA), and include a comprehensive set of covariates, are scarce. The goal of this study was to follow employment, unemployment, sickness absence, rehabilitation, and disability pension spells using sequence analysis among all-cause LTSA absentees. Methods: Register data covered full-time and partial sickness allowance, rehabilitation, employment, unemployment benefits, and permanent and temporary disability pension (DP), retrieved for a 30% representative random sample of Finnish 18–59 years old persons with a LTSA in 2016 (N = 25,194). LTSA was defined as a ≥ 30-day-long full-time sickness absence spell. Eight mutually exclusive states were constructed for each person and for 36 months after the LTSA. Sequence analysis and clustering were used to identify groups with different labour market pathways. In addition, demographic, socioeconomic, and disability-related covariates of these clusters were examined using multinomial regressions. Results: We identified five clusters with emphases on the different states: (1) rapid RTW cluster (62% of the sample); (2) rapid unemployment cluster (9%); (3) DP after a prolonged sickness absence cluster (11%); (4) immediate or late rehabilitation cluster (6%); (5) other states cluster (6%). Persons with a rapid RTW (cluster 1) had a more advantaged background than other clusters, such as a higher frequency of employment and less chronic diseases before LTSA. Cluster 2 associated especially with pre-LTSA unemployment and lower pre-LTSA earnings. Cluster 3 was associated especially with having a chronic illness before LTSA. Those in cluster 4 were on average younger and had a higher educational level than others. Especially clusters 3 and 4 were associated with a LTSA based on mental disorders. Conclusions: Among long-term sickness absentees, clear groups can be identified with both differing labour market pathways after LTSA and differing backgrounds. Lower socioeconomic background, pre-LTSA chronic diseases and LTSA caused by mental disorders increase the likelihood for pathways dominated by long-term unemployment, disability pensioning and rehabilitation rather than rapid RTW. LTSA based on a mental disorder can especially increase the likelihood for entering rehabilitation or disability pension. [ABSTRACT FROM AUTHOR]

This longitudinal study analyses gender and the blurring boundaries of work during prolonged telework, utilising data gathered during the different phases of the COVID‐19 pandemic. The pandemic caused a major change in the knowledge work sector, which has characteristically been more prone to work leaking into other parts of life. The study examines the blurring boundaries of telework: between time and place, care and housework, and emotional, social, spiritual and aesthetic labour. The experiences of different genders regarding the blurring boundaries of work during long‐term telework are scrutinised using a mixed methods approach, analysing two surveys (Autumn 2020: N = 87, and Autumn 2021: N = 94) conducted longitudinally in a consulting company operating in Finland. There were several gendered differences in the reported forms of labour, which contribute to the blurring boundaries of work. Some boundary blurring remained the same during the study, while some fluctuated. The study also showed how the gendered practices around the blurring boundaries of work transformed during prolonged telework. Blurring boundaries of work and attempts to establish boundaries became partially gendered, as gender and life situation were reflected in knowledge workers' experiences of teleworking. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine the relationship between socio-demographic factors, gambling behaviour, and the level of gambling expenditure. The data were drawn from the population-based Gambling Harms Survey 2016 and 2017 conducted in Finland. The data were linked to register-based variables. Past-year gamblers were included (Wave 1; n = 5 805, both Waves; n = 2 165). The study showed that of the 4.2 % of gamblers that produced 50.0 % of the total GE in 2016, 33.1 % of the GE was produced by those with a gambling problem and 43.3 % by those with at-risk gambling pattern. Compared to gamblers in the lowest GE group, those in the highest GE group were more likely to be men, aged 25 or older, with upper secondary education, have a high income, be on disability pension or sickness allowance, be frequent gamblers, gambling at least six game types, and showing at-risk and problem gambling patterns. Cumulative weekly GE by income tertiles remained fairly stable between the years. The results suggest that GE is highly concentrated. Among the small group of high-intensity consumers, the majority of the revenue comes from at-risk and problem gambling. Participants in the low GE group differ from those in the intermediate and high GE groups in terms of socio-demographics and gambling behaviour. [ABSTRACT FROM AUTHOR]

Aims: To investigate women's childbirth experiences and their relation to self‐esteem development in the postpartum year. Design: A mixed methods study. Methods: Women (N = 125) completed survey questionnaires regarding their self‐esteem and childbirth experiences at three time points in 2020–2021: third trimester of pregnancy (T1), 4–8 weeks postpartum (T2) and 1 year postpartum (T3). The survey results were analysed using qualitative thematic and quantitative path analyses with latent change factors. The open‐ended answers of the women who demonstrated a change in self‐esteem between T2 and T3 were then compared. The STROBE checklist was used as the reporting guideline. Results: The quantitatively measured childbirth experiences predicted statistically significantly and positively the changes in self‐esteem in the following year. The women described their childbirth stories through three main themes: childbirth as a lived experience, childbirth as a relational event and childbirth as a medical event. On the basis of the thematic analysis, we propose that the relationship between childbirth experience and self‐esteem development might only hold for women with extremely positive or negative childbirth experiences. There were mixed results for those women who had mixed experiences, indicating that other factors probably contributed to the changes in self‐esteem. Conclusion: Childbirth is a pivotal event that may have lasting effects on the mother's self‐esteem after childbirth. Especially women with traumatic experiences deserve attention because they are at risk of the most negative consequences. Impact Perinatal services and policy makers must recognize the importance of childbirth experiences in women's well‐being and improve their practices. Different cultural models of childbirth should be recognized and supported to facilitate good experiences and prevent traumatic ones. Patient or Public Contribution: Service users recruited in Finnish Child Health Centers responded to surveys that were used as data for this study. [ABSTRACT FROM AUTHOR]

Aims: This study aims to measure any changes in the marital relationship during the first year after a diagnosis of prostate cancer, identify the demographic characteristics that influenced such changes, and measure changes related to health‐related quality of life (HRQoL). Background: Knowledge is limited on the impact of a diagnosis of prostate cancer on the marital relationship and HRQoL of patients and their spouses. Design: A 1‐year longitudinal study. Methods: Data were collected from five Finnish hospitals between October 2013 and January 2017. Of the 350 recruited couples (N = 700), 179 patients and 166 spouses completed the Marital Questionnaire and the RAND 36‐Item Health Survey 1 year after diagnosis. Results: No major changes were found in the marital relationship during the follow‐up period. The spouses reported statistically significant changes in their marital relationships, but the patients did not. Furthermore, changes in the marital relationship were not associated with the patients' HRQoL. Among spouses, emotional well‐being was associated with changes in the marital relationship. Conclusion: The marital relationship was relevant in terms of the spouses' HRQoL during the first year after a diagnosis of prostate cancer. Nurses and other healthcare providers should assess counselling and support provided to spouses individually. Summary statement: What is already known about this topic? Prostate cancer affects not only the individual but also the whole family's structure and hierarchy.Prostate cancer patients' quality of life is better if their spouses have positive beliefs about the disease's duration and treatment control. What does this paper add? Spouses reported statistically significant changes in the marital relationship, but the patients did not.Among spouses, emotional well‐being was associated with changes in the marital relationship. This paper's implications: By individually assessing counselling and support to spouses during prostate cancer care, nurses and other healthcare providers have the opportunity to use these findings. [ABSTRACT FROM AUTHOR]

Background: Mental distress among retirees and older people is a severe public health challenge, and information on new risk groups is needed. This study aims to identify subgroups of old-age retirees with varying associations between low social support and mental distress by applying model-based recursive partitioning (MOB)., Methods: We used the Helsinki Health Study follow-up survey data of old-age retired former municipal sector employees of the City of Helsinki, Finland. Phase 1 data were collected in 2000-2002, when all participants were employed, Phase 2 in 2007, Phase 3 in 2012, Phase 4 in 2017, and Phase 5 in 2022 (n = 4,466, 81% women). Social support and covariates were measured at each Phase 1-5 and the outcome, mental distress (Depression Anxiety Stress Scales [DASS-21]) was measured at a single occasion, during Phase 5. The three subscales and the common factor of general distress were analysed separately. An approach rooted in computational statistics was used to investigate risk factor heterogeneity in the association of low social support and mental distress. MOB combines decision trees with regression analysis to identify subgroups with the most significant heterogeneity among risk factors., Results: Median (IQR) general distress score from DASS-21 was 5.7 (3.0, 9.0), while Social Support Questionnaire number-score (SSQN) was 1.5 (1.15, 2.05). The primary effect modifier for the association between social support and general distress was education (p < 0.001). Those with high education had a different association of low social support and general distress than those with low or medium education. Additionally, the subgroup with low and medium education had a significant effect modification for age (p = 0.01). For the association between low social support and depressive symptoms, the moderating effect of education was dependent on gender, as men with medium-high education had the weakest association, while for women with medium-high education the association was strongest., Conclusions: Our results suggest that stratification by sociodemographic variables is justifiable when investigating risk factors of mental distress in old-age retirees. The incongruent association of low social support and depressive symptoms in men with medium-high education compared to women with medium-high education is a promising target for confirmatory research., (© 2024. The Author(s).)

This article observes how developments in politics, society, the media, and journalistic ethos impact political journalism content in Finland between 1995 and 2015. The focus is on three newspapers: the dailies Helsingin Sanomat and Aamulehti, and the tabloid Iltalehti. Using a coding scheme developed by Benson and Hallin (2007) and utilizing earlier findings by Kunelius and Väliverronen (2012), the analysis indicates two different approaches to politics at story level: a neutral and policy-oriented style in the two dailies, and a more diverse take by Iltalehti. Within stories, journalistic interventionism increases in all papers until 2010 and then diminishes. Differences emerge between the dailies and Iltalehti in journalistic presence, reporting patterns and sources used. Notably, in recent years, Iltalehti's approach has become more reminiscent of the dailies both at story level and within stories. The findings highlight the impact of the general journalistic ethos and the differing market considerations on the journalistic content. [ABSTRACT FROM AUTHOR]

Poor mental health among the unemployed—the long-term unemployed in particular—is established, but these associations may be driven by confounding from unobserved, time-invariant characteristics such as past experiences and personality. Using longitudinal register data on 2,720,431 residents aged 30–60 years, we assessed how current unemployment and unemployment history predict visits to specialized care due to psychiatric conditions and self-harm in Finland in 2008–2018. We used linear ordinary-least-squares and fixed-effects models. Prior to adjusting for time-invariant characteristics, current unemployment was associated with poor mental health, and the risk increased with longer unemployment histories. Accounting for all time-invariant characteristics with the fixed-effects models, these associations attenuated by approximately 70%, yet current unemployment was still associated with a 0.51 (95% confidence interval: 0.48, 0.53) percentage-point increase in the probability of poor mental health among men and women. Longer unemployment histories increased the probability among men in their 30s but not among older men or among women. The results indicate that selection by stable characteristics may explain a major part of the worse mental health among the unemployed and especially the long-term unemployed. However, even when controlling for this selection, current unemployment remains associated with mental health. [ABSTRACT FROM AUTHOR]

Background: Participants' study satisfaction is important for both compliance with study protocols and retention, but research on parent study satisfaction is rare. This study sought to identify factors associated with parent study satisfaction in The Environmental Determinants of Diabetes in the Young (TEDDY) study, a longitudinal, multinational (US, Finland, Germany, Sweden) study of children at risk for type 1 diabetes. The role of staff consistency to parent study satisfaction was a particular focus. Methods: Parent study satisfaction was measured by questionnaire at child-age 15 months (5579 mothers, 4942 fathers) and child-age four years (4010 mothers, 3411 fathers). Multiple linear regression analyses were used to identify sociodemographic factors, parental characteristics, and study variables associated with parent study satisfaction at both time points. Results: Parent study satisfaction was highest in Sweden and the US, compared to Finland. Parents who had an accurate perception of their child's type 1 diabetes risk and those who believed they can do something to prevent type 1 diabetes were more satisfied. More educated parents and those with higher depression scores had lower study satisfaction scores. After adjusting for these factors, greater study staff change frequency was associated with lower study satisfaction in European parents (mothers at child-age 15 months: − 0.30,95% Cl − 0.36, − 0.24, p < 0.001; mothers at child-age four years: -0.41, 95% Cl − 0.53, − 0.29, p < 0.001; fathers at child-age 15 months: -0.28, 95% Cl − 0.34, − 0.21, p < 0.001; fathers at child-age four years: -0.35, 95% Cl − 0.48, − 0.21, p < 0.001). Staff consistency was not associated with parent study satisfaction in the US. However, the number of staff changes was markedly higher in the US compared to Europe. Conclusions: Sociodemographic factors, parental characteristics, and study-related variables were all related to parent study satisfaction. Those that are potentially modifiable are of particular interest as possible targets of future efforts to improve parent study satisfaction. Three such factors were identified: parent accuracy about the child's type 1 diabetes risk, parent beliefs that something can be done to reduce the child's risk, and study staff consistency. However, staff consistency was important only for European parents. Trial registration: NCT00279318. [ABSTRACT FROM AUTHOR]

Study Objectives: Poor sleep is one of the multiple health issues associated with heavy alcohol consumption. While acute effects of alcohol intake on sleep have been widely investigated, the longitudinal associations remain relatively underexplored. The objective of our research was to shed light on cross-sectional and longitudinal associations between alcohol use and poor sleep quality over time, and to elucidate the role of familial confounding factors in such associations. Methods: Using self-report questionnaire data from the Older Finnish Twin Cohort (N = 13 851), we examined how alcohol consumption and binge drinking are associated with sleep quality during a period of 36 years. Results: Cross-sectional logistic regression analyses revealed significant associations between poor sleep and alcohol misuse, including heavy and binge drinking, at all four time points (OR range = 1.61-3.37, p < .05), suggesting that higher alcohol intake is associated with poor sleep quality over the years. Longitudinal cross-lagged analyses indicated that moderate, heavy and binge drinking predict poor sleep quality (OR range = 1.25-1.76, p < .05), but not the reverse. Withinpair analyses suggested that the associations between heavy drinking and poor sleep quality were not fully explained by genetic and environmental influences shared by the co-twins. Conclusions: In conclusion, our findings support previous literature in that alcohol use is associated with poor sleep quality, such that alcohol use predicts poor sleep quality later in life, but not vice versa, and that the association is not fully explained by familial factors. [ABSTRACT FROM AUTHOR]

Social networks are associated with individual's health and well-being. Working life offers opportunities to create and maintain social networks, while retirement may change these networks. This study examined how the number of ties in social network changes across the retirement transition. The study population consisted of 2319 participants (84% women, mean age 63.2 years) from the Finnish Retirement and Aging study. Information about social network ties, including the number of ties in the inner, middle and outer circles of the social convoy model, was gathered using annual postal surveys before and after retirement. Three repeat surveys per participant covered the retirement transition and the post-retirement periods. Mean number of network ties was 21.6 before retirement, of which 5.6 were situated in the inner, 6.9 in the middle and 9.1 in the outer circle. The number of ties in the outer circle decreased by 0.67 (95% CI − 0.92, − 0.42) during the retirement transition period, but not during the post-retirement period (0.11, 95% CI − 0.33, 0.12) (interaction period * time, p = 0.006). The pattern of change in these ties did not differ by gender, occupational status, marital status, number of chronic diseases and mental health during the retirement transition period. The number of ties in the inner and middle circles overall did not decrease during these periods. The number of peripheral relationships decreased during the retirement transition but not after that, suggesting that the observed reduction is more likely to be associated with retirement rather than aging. [ABSTRACT FROM AUTHOR]

Loneliness and social isolation both increase mortality and are likely to affect health via several pathways. However, information on the potential pathways remains scarce. We investigated the associations between loneliness, social isolation, and mortality, and possible mechanisms underlying these connections. The analyzed data comprised a prospective population-based cohort of Finnish men (42–61 years at baseline, n = 2588) who were followed up for an average of 23.2 years. Mortality data were obtained from the national population register in 2012. Cox proportional hazards analysis with adjustments for possible confounding factors was used to examine the associations between loneliness and social isolation at baseline and all-cause, injury, cancer, and cardiovascular disease (CVD) mortality. Mediation analysis was conducted to investigate the mechanisms underlying the associations of loneliness and social isolation with mortality. Loneliness predicted all-cause mortality, even after adjustments for all covariates. Loneliness predicted cancer mortality, except after adjustments for lifestyle variables or Human Population Laboratory (HPL) depression scores, and also predicted CVD mortality, except after adjustments for HPL depression scores. Social isolation predicted all-cause mortality and injury mortality. The effect of social isolation on all-cause mortality was mediated by loneliness and HPL depression scores. Our findings suggest that both loneliness and social isolation increase the risk of all-cause mortality, while they have differing effects on different causes of death. Loneliness and depressive symptoms may mediate the effect of social isolation on increased mortality. [ABSTRACT FROM AUTHOR]

Small or large birth weight for gestational age has been linked with later cardiovascular disease risk. However, cardiovascular risk markers from childhood to adulthood according to birth weight in diverse longitudinal settings globally have not been extensively studied. To examine the relationship between birth weight and cardiovascular risk profile from childhood until young adulthood in two geographically and socioeconomically distinct cohorts. Data were derived from two longitudinal birth cohort studies; one from southern Finland (Special Turku Coronary Risk Factor Intervention Project, STRIP) and one from northern Australia comprising Indigenous Australians (Aboriginal Birth Cohort, ABC). The sample included 747 Finnish participants and 541 Indigenous Australians with data on birth weight, gestational age and cardiovascular risk factors (body mass index [BMI]), waist-to-height ratio [WHtR], lipid profile, blood pressure) collected at ages 11, 18 and 25 or 26 years. Carotid intima-media thickness (cIMT) was assessed at age 18 or 19 years. Participants were categorised according to birth weight for gestational age (small [SGA], appropriate [AGA] or large [LGA]). Associations between birth weight category and cardiovascular risk markers were studied using a repeated measures ANOVA. Higher birth weight category was associated with higher BMI later in life in both cohorts (p=.003 for STRIP and p<.0001 for ABC). In the ABC, higher birth weight category was also associated with higher WHtR (p=.004). In the ABC, SGA participants had lower systolic and diastolic blood pressure than AGA participants (p=.028 for systolic, p=.027 for diastolic) and lower systolic blood pressure than LGA participants (p=.046) at age 25. In the STRIP cohort, SGA participants had lower cIMT than LGA participants (p=.024). Birth weight can predict future cardiovascular risk profile in diverse populations. Thus, it needs to be included in targeted public health interventions for tackling the obesity pandemic and improving cardiovascular health worldwide. The strongest association between birth weight and later cardiovascular risk profile was manifested as differences in body mass index in two culturally and geographically distinct cohorts. Foetal growth is a determinant for later cardiovascular health in diverse populations, indicating a need to focus on maternal and foetal health to improve cardiovascular health worldwide. [ABSTRACT FROM AUTHOR]

Objective: Sex, age, and education are associated with the level of cognitive performance. We investigated whether these factors modulate the change in cognitive performance in midlife by leveraging the longitudinal data from the Cardiovascular Risk in Young Finns Study (YFS)., Methods: Participants of the YFS cohort performed a computer-based Cambridge Neuropsychological Test Automated Battery (CANTAB) in 2011 and 2018 (n = 1671, age 41-56 years in 2018). Overall cognitive performance and domains representing learning and memory, working memory, reaction time, and information processing were extracted by common principal component analysis from the longitudinal cognitive data. Linear models adjusted for baseline cognitive performance were used to study the association of sex, age, and education with changes in overall cognitive performance and in the cognitive domains., Results: Cognitive performance decreased in all domains (overall cognition -0.56 SD, p < 0.001; working memory -0.81 SD, p < 0.001; learning and memory -0.70 SD, p < 0.001; reaction time -0.06 SD, p = 0.019; information processing -0.03 SD, p = 0.016). The decrease in working memory and information processing was greater in females compared to males. Cognitive performance decreased more in older participants in all domains. Education alleviated the decrease in cognitive performance in all domains except reaction time. The beneficial effect of education was greater for males., Conclusions: This study describes the natural course of aging-related changes in cognitive performance in midlife, the critical time window for early prevention of clinical cognitive decline. These findings provide a reference for studies focusing on determinants of pathological cognitive decline deviating from normal changes in cognitive performance., (© 2024. The Author(s).)

Background: Previous studies have shown positive association between health behavior and life satisfaction, but the studies have mostly been cross-sectional, had follow-up times up to 5 years or focused on only one health behavior domain. The aim of the study was to explore how principal health behavior domains predict life satisfaction as a composite score in a previously unexplored longitudinal setting.Methods: The present study tested whether a health behavior sum score (range 0-4) comprising of dietary habits, smoking, alcohol consumption, and physical activity predicted subsequent composite score of life satisfaction (range 4-20). Data included responses from 11,000 working-age Finns who participated in the Health and Social Support (HeSSup) prospective population-based postal survey.Results: Protective health behavior in 2003 predicted (p < .001) better life satisfaction 9 years later when sex, age, education, major diseases, and baseline life satisfaction were controlled for. The β in the linear regression model was - 0.24 (p < .001) corresponding to a difference of 0.96 points in life satisfaction between individuals having the best and worst health behavior.Conclusion: Good health behavior has a long-term beneficial impact on subsequent life satisfaction. This knowledge could strengthen the motivation for improvement of health behavior particularly on an individual level but also on a policy level. [ABSTRACT FROM AUTHOR]

Background: The positive association of health with education level and socioeconomic status (SES) is well-established. Two theoretical frameworks have been delineated to understand main mechanisms leading to socioeconomic health inequalities: social causation and health selection but how these work in adolescence is poorly known. We studied if adolescent health and health behaviours predict higher education and higher SES in adulthood and if family background and school performance in adolescence explain these associations., Methods: Surveys on health and health behaviours were sent to representative samples of 12-18-year-old Finns in 1981-1997 every second year (response rate 77.8%, N = 55,682). The survey data were linked with the respondents' and their parents' socioeconomic data from the Finnish national registries. Both latent variables, namely, health (perceived health, health complaints, chronic disease), health-compromising behaviours (smoking status, drunkenness frequency), and family background (parents' occupation-based SES, education, family type) and variables directly measuring health-enhancing behaviours (toothbrushing, physical activity) and school performance were used to predict higher education and higher occupation-based SES at age 34. Logistic regression analysis and structural equation models (SEM) were used., Results: In logistic regression analyses, good health, health-enhancing behaviours, and lack of health-compromising behaviours were related to higher education and SES, also after controlling for family background and school performance. In the SEM analyses, good health, health-enhancing behaviours, and lack of health-compromising behaviours directly predicted higher SES and higher education, although the standardised coefficients were low (from 0.034 to 0.12). In all models, health, lack of health-compromising behaviours, and health-enhancing behaviours predicted school performance, which in turn, predicted the outcomes, suggesting indirect routes to these. Good socioeconomic prospects in terms of family background predicted good health, healthy behaviours, and good school performance in adolescence and higher SES and higher education in adulthood., Conclusion: Health and health behaviours in adolescence predicted education and SES in adulthood. Even though the relationships were modest, they support the health selection hypotheses and emphasise the importance of adolescence for health inequalities during the life-course. Health and health behaviours were strongly associated with school performance and family background which together modified the paths from health and health behaviours to the outcomes., (© 2024. The Author(s).)

Workplace downsizing and closure have been considered natural experiments that strengthen causal inference when assessing the association between unemployment and health. Selection into unemployment plays a lesser role among those exposed to severe workplace downsizing. This study compared mortality for individuals unemployed from stable, downsized, and closed workplaces with a reference group unexposed to unemployment. We examined nationally representative register data of residents of Finland aged 25–63 years in 1990–2009 (n  = 275,738). Compared with the control group, the hazard ratio for substance use–related mortality among men unemployed from stable workplaces was 2.43 (95% confidence interval (CI): 2.22, 2.67), from downsized workplaces 1.85 (CI: 1.65, 2.08), and from closed workplaces 2.16 (CI: 1.84, 2.53). Among women, the corresponding estimates were 3.01 (CI: 2.42, 3.74), 2.39 (CI: 1.75, 3.27), and 1.47 (CI: 1.09, 1.99). Unemployment from stable workplaces was associated with mortality from psychiatric and self-harm–related conditions. However, mortality due to ischemic heart disease and other somatic diseases decreased for those unemployed following closure. The results indicate that selection mechanisms partially explain the excess mortality among the unemployed. However, substance-use outcomes among men and women, and fatal accidents and violence among men, might be causally associated with unemployment. [ABSTRACT FROM AUTHOR]

Background: The longitudinal pattern of medication use among family caregivers of people with dementia is not well understood, despite the potential for medication over- or under-use. Objectives: To investigate caregiver medication use over a five-year follow-up using data obtained via self-report and from a national prescription register, and compare agreement between medication data obtained from the two sources. Methods: Medication data for 222 family caregivers of people with Alzheimer's disease were obtained via self-report and from the Finnish Social Insurance Institution. Generalised estimating equations, Kappa statistics and related samples Wilcoxon signed rank test were used to analyse medication use over time. Results: The mean number of medications used by caregivers increased from 3.4 to 4.1 (self-reported current regular medications) and 2.4 to 2.8 (reimbursed prescription medications during the past 90 days) over five years (p < 0.001). Significantly, more medications were identified via self-report (mean 3.6, SD = 3.3) than the national prescription register (mean 2.6, SD = 2.4, Z= –12.300, p < 0.001). Agreement between the two data sources was good for cardiovascular medications and anti-hypertensives (Kappa = 0.883–0.967, p < 0.001) and medications for acid-related disorders (Kappa = 0.508–0.092, p < 0.001). Agreement was moderate for analgesics (Kappa = 0.281–0.477, p < 0.001) and psychotropics (Kappa = 0.281–0.562, p < 0.002). The proportion of caregivers using five or more medications increased from 27.5% to 44.6% (self-report), and 16.7% to 27.7% (register) (p < 0.001). Conclusion: Caregivers use an increasing number of medications in the first five years of caring for persons with dementia, and self-report using a higher number of medications than data from the national prescription register suggest. [ABSTRACT FROM AUTHOR]

Objectives Shift work is a risk factor for chronic diseases, and physical inactivity can have an influence on this association. We examined whether intra-individual changes in working time characteristics were associated with changes in physical inactivity and examined the risk factors for physical inactivity among shift workers in a 17-year longitudinal study cohort. Methods Study participants were 95 177 employees from the Finnish public sector. Work schedule information was based on questionnaire responses and additional register-based working time characteristics for 26 042 employees. The associations between working time characteristics and physical inactivity were examined using a fixed-effects logistic model. To investigate the risk factors for physical inactivity among shift workers, the odds ratios (OR) of worktime control and having small children were calculated. Results Compared with day work, shift work without night shifts was associated with physical inactivity among men [OR 1.38, 95% confidence interval (CI) 1.09-1.74], whereas shift work with night shifts was negatively associated with physical inactivity among women (OR 0.85, 95% CI 0.76-0.96). Register-based working time data confirmed that workers with a higher percentage of night shifts had a lower risk of physical inactivity. Having small children was associated with physical inactivity among shift workers (OR 1.47, 95% CI 1.32-1.65). Conclusions Both survey and objective working hour data revealed that workers having work schedules with night shifts were more likely to be physically active. Having small children was a risk factor for physical inactivity among shift workers. [ABSTRACT FROM AUTHOR]

Background: Depression is associated with metabolic abnormalities linked to metabolic syndrome and tissue inflammation, but the interplay between metabolic markers and their association with subsequent depression is unknown. Therefore, we aimed to describe the network of metabolites and their prospective association with depressive symptoms., Methods: The Finnish Depression and Metabolic Syndrome in Adults (FDMSA) cohort, originally a prospective case-control study, comprised a group with Beck Depression Inventory (BDI)-I scores ≥10 at baseline, and controls (n = 319, BDI-I < 10); mean (sd) follow-up time: 7.4 (0.7) years. Serum metabolic biomarkers were determined by proton nuclear magnetic resonance (NMR), and depressive symptoms sum-score by using the BDI-I. We examined the prospective associations between metabolites at baseline and BDI score at follow-up utilizing multivariate linear regression, parsimonious predictions models and network analysis., Results: Some metabolites tended to be either negatively (e.g. histidine) or positively associated (e.g. glycoprotein acetylation, creatinine and triglycerides in very large high density lipoproteins [XL-HDL-TG]) with depressive symptoms. None of the associations were significant after correction for multiple testing. The network analysis suggested high correlation among the metabolites, but that none of the metabolites directly influenced subsequent depressive symptoms., Limitations: Although the sample size may be considered satisfactory in a prospective context, we cannot exclude the possibility that our study was underpowered., Conclusions: Our results suggest that the investigated metabolic biomarkers are not a driving force in the development of depressive symptoms. These findings should be confirmed in studies with larger samples and studies that account for the heterogeneity of depressive disorders., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Objectives: The aim of this longitudinal study was to investigate causal pathways among as well as interrelationships between changes in dental fear and dental attendance in a nationally representative sample of adult Finns aged 19 years or older in 2000, with 11 years of follow‐up. Methods: Data from the Health 2000 and 2011 Surveys (BRIF8901) in Finland were used. The Health 2000 survey used a stratified two‐stage cluster sampling design (N=9742). Of the participants in 2000, 7964 were eligible and invited to participate in 2011. Of the participants in 2011 (n=5806), 3,631 (63%) responded to both dental fear and attendance questions in both years. Both fear and attendance were assessed using single questions and dichotomized. The background variables included were age, gender and education. Path analysis and logistic regression models were used. Results: Dental fear led to nonhabitual use of dental services rather than vice versa (−0.07 to 0.04 vs. 0.00). When confounders were considered, in both age groups (29‐39 years and 40+ years) an increase in fear predicted nonhabitual dental attendance. This association was stronger among the younger age group (OR = 4.91) than among those aged 40 years and older (OR = 2.88). Among the younger age group, improved dental fear decreased the risk of nonhabitual dental attendance (OR = 0.16), while among older age group, stable fear increased the risk of nonhabitual dental attendance (OR = 2.33). Conclusions: Dental fear causes nonhabitual dental attendance, and decreasing dental fear increases habitual attendance. Oral health personnel should adapt measures to prevent and treat dental fear. [ABSTRACT FROM AUTHOR]

The aim of this study was to conduct a prospective analysis of the association between negative life events (NLEs) and respiratory infections in children genetically at risk for islet autoimmunity (IA) and type 1 diabetes (T1D). Long‐ and short‐term temporal associations between NLEs and rate of respiratory infection episodes (RIEs) in 5,618 children in The Environmental Determinants of Diabetes in the Young study for at least 1 up to 4 years were analysed. All models were adjusted for demographic, day care, season of infection, and psychosocial factors associated with the rate of child RIEs between study visits. The rate of child RIEs was 26% higher in Europe (Sweden, Finland, Germany) than in the United States (rate ratio [RR] = 1.26, p < 0.001). However, the percentage of child NLEs (odds ratio [OR] = 1.18, p < 0.001) and mother NLEs (OR = 1.83, p < 0.001) was higher in the United States compared with Europe. In both continents (Europe, RR = 1.12, p < 0.001; United States, RR = 1.07, p = 0.006), high child cumulative NLEs (>1 NLE per year since study inception) was significantly associated with an increased rate of child RIEs. This large‐scale prospective study confirms observations that stress may increase the susceptibility for infections in paediatric populations and suggests at least one mechanism by which stress could increase risk for IA and T1D in genetically at risk children. [ABSTRACT FROM AUTHOR]

Aims: In 2007, Finnish authorities gave a national recommendation that schools should not sell sweet products. This study aimed to determine the effects of the national recommendation on school-level intermediary determinants (factors related to oral health inequalities) and if the changes were different according to school-level socio-economic position (SEP). Methods : This ecological and longitudinal study combined school-level data from two independent studies from Finnish upper comprehensive schools (N = 970): the School Health Promotion study (SHPS) and the School Sweet Selling survey (SSSS). The baseline data (SHPS from 2006–2007 and SSSS from 2007) and the post-intervention data (SHPS and SSSS from 2008–2009) were combined into a longitudinal school-level data set (n = 360 and response rate = 37%). The intermediary determinants were: attitudes and access to intoxicants, school health services, school environment, home environment, schools' health-promoting actions (including sweet product selling) and pupils' eating habits. Three equal-sized school-level SEP group — slow, middle and high — were formed. The changes in the intermediary determinants were analysed using Wilcoxon Signed Ranks test. Differences between school SEP groups were analysed the using Kruskal–Wallis test. Longitudinal linear mixed modelling was used to determine the contribution of intermediary determinants to the changes in pupils' eating habits. Results : The national recommendation was effective in decreasing sweet product selling at schools and the effect was equal in each school-level SEP group. Intermediary determinants contributed differently to eating habits in the three SEP groups. Conclusions : A national recommendation seems to be an effective tool in making the school environment healthier without increasing inequalities. [ABSTRACT FROM AUTHOR]

This study examined changes in pupils' agency beliefs and control expectancy from grade four to grade six, and whether they were associated with studying in a class with a special emphasis on a subject as compared to studying in a class without emphasis. After controlling for the effects of mother's education, prior school achievement, and gender, we found that the average pattern of change varied for different action-control beliefs, and that class membership did not moderate these changes. Mother's education, pupils' prior school achievement, and gender all predicted class membership, but their effects on action-control beliefs varied depending on the type of belief. Implications for educational policy will be discussed. [ABSTRACT FROM AUTHOR]

Physical inactivity has been associated with both insomnia symptoms and smoking. Further, they are all independently associated with increased sickness absence (SA) from work. However, joint contribution of either physical activity (PA) with insomnia symptoms or with smoking to SA and, especially, their direct cost for the employer is poorly understood. Therefore, we aimed to examine these joint associations with short‐term (<15 days) SA cost. The Helsinki Health Study is a cohort of midlife employees of the City of Helsinki, Finland (baseline n = 8960, response rate 67%). During 2000‐2002, the participants were mailed a survey questionnaire that gathered information on health behavior and sociodemographic characteristics. SA, salary, and time of employment were followed up through the employer's personnel register between 2002 and 2016 for those with a written consent to the use of their register data (78% of the participants). Individual salary data were used to calculate the direct cost of short‐term SA. Data were analyzed with a two‐part model. Inactive participants with frequent insomnia symptoms had 2526€ (95% CI 1736€‐3915€) higher cost of short‐term SA than vigorously active participants without insomnia symptoms. Furthermore, inactive smokers had 4166€ (95% CI 2737€‐5595€) higher cost for the employer over the follow‐up than vigorously active non‐smokers. In conclusion, this study showed that PA and insomnia symptoms as well as PA and smoking are jointly associated with short‐term SA cost. The results emphasize encouraging employers to improve work environments so that they promote active lifestyle, good sleep, and non‐smoking in order to reduce the cost of SA. [ABSTRACT FROM AUTHOR]

In this 3-year longitudinal study, we examined the interplay of children's motivational orientations, spontaneous focusing on numerosity (SFON) and number sequence and arithmetical skills from kindergarten (at age 6) to grade 1 (at age 7). We also examined the direct and indirect contributions of motivation and SFON to the acquisition of arithmetical skills from grades 1 to 2 (at age 8). The study involved 136 Finnish-speaking, typically developing children. Teacher ratings were used to assess the children's motivational orientations (i.e., task orientation, task avoidance orientation and social dependence orientation) in kindergarten and grade 1. Number sequence skills and SFON were evaluated in kindergarten, and arithmetical skills were assessed in kindergarten, grade 1 and grade 2. A theoretical model of the relationships among the variables was proposed, and the associations were analysed using path analysis. The results showed that task orientation, social dependence orientation and task avoidance orientation were each unique predictors of later arithmetical achievement. Furthermore, together with arithmetical skills in grade 1 and counting abilities in kindergarten, they helped to predict arithmetical achievement in grade 2. Motivational orientations did not explain the significant contributions of SFON to later arithmetical skills. The study suggests that both motivational orientations and SFON require attention and scaffolding in educational contexts, such as assessment and teacher-child interaction from early on. [ABSTRACT FROM AUTHOR]

Aim: To evaluate whether tooth loss is associated with cognitive decline and incident dementia., Materials and Methods: We analysed data from the Finnish population-based Health 2000 and follow-up Health 2011 surveys (participants aged ≥30 years and without dementia at baseline; N = 5506 at baseline and 3426 at 11-year follow-up). Dementia diagnoses until 2015 were ascertained from national registers (N = 5542). Tooth count was dichotomized as adequate (≥20) versus tooth loss (<20). Tooth loss was further stratified into 10-19 teeth, 1-9 teeth and edentulism. Upper and lower jaws were also considered separately. Baseline cognitive test scores were dichotomized by median as high versus low, and 11-year change as decline versus no decline., Results: Tooth loss (<20) was associated with lower baseline overall cognition (odds ratio [OR] = 1.21, 95% confidence interval [CI] = 1.03-1.43), 11-year cognitive decline (OR = 1.30, 95% CI = 1.05-1.70) and higher 15-year dementia risk (hazard ratio = 1.52, 95% CI = 1.15-2.02) after adjusting for multiple confounders. After adjustment for dentures, associations became non-significant, except for 10-19 teeth remaining and dementia. Results were similar after considering reverse causality bias; however, 10-19 teeth remaining was significantly associated with 11-year cognitive decline even after adjustment for dentures. No jaw-specific differences were observed., Conclusions: Tooth loss adversely impacts the risk of cognitive decline and dementia. The role of dentures should be further explored., (© 2023 The Authors. Journal of Clinical Periodontology published by John Wiley & Sons Ltd.)

Parental unemployment is associated with worse adolescent mental health, but prior evidence has primarily been based on cross-sectional studies subject to reverse causality and confounding. We assessed the association between parental unemployment and changes in adolescent psychotropic medication purchases, with longitudinal individual-level fixed-effects models that controlled for time-invariant confounding. We used data from a large, register-based panel of Finnish adolescents aged 13–20 years in 1987–2012 (n = 138,644) that included annual measurements of mothers’ and fathers’ employment and offspring psychotropic medication purchases. We assessed changes in the probability of adolescent psychotropic medication purchases in the years before, during, and after the first episode of parental unemployment. There was no association between mother’s unemployment and offspring psychotropic purchases in the fixed-effects models, suggesting this association is largely driven by unmeasured confounding and selection. By contrast, father’s unemployment led to a significant 15%–20% increase in the probability of purchasing psychotropic medication among adolescents even after extensive controls for observed and unobserved confounding. This change takes at least 1 year to emerge, but it is long-lasting; thus, policies are needed that mitigate the harm of father’s unemployment on offspring’s mental well-being. [ABSTRACT FROM AUTHOR]

Objective Regular screening and follow-up is an important key to cervical cancer prevention; however, screening inevitably detects mild or borderline abnormalities that would never progress to a more severe stage. We analysed the cumulative probability and recurrence of cervical abnormalities in the Finnish organized screening programme during a 22-year follow-up. Methods Screening histories were collected for 364,487 women born between 1950 and 1965. Data consisted of 1 207,017 routine screens and 88,143 follow-up screens between 1991 and 2012. Probabilities of cervical abnormalities by age were estimated using logistic regression and generalized estimating equations methodology. Results The probability of experiencing any abnormality at least once at ages 30–64 was 34.0% (95% confidence interval [CI]: 33.3–34.6%). Probability was 5.4% (95% CI: 5.0–5.8%) for results warranting referral and 2.2% (95% CI: 2.0–2.4%) for results with histologically confirmed findings. Previous occurrences were associated with an increased risk of detecting new ones, specifically in older women. Conclusion A considerable proportion of women experience at least one abnormal screening result during their lifetime, and yet very few eventually develop an actual precancerous lesion. Re-evaluation of diagnostic criteria concerning mild abnormalities might improve the balance of harms and benefits of screening. Special monitoring of women with recurrent abnormalities especially at older ages may also be needed. [ABSTRACT FROM AUTHOR]

Most freshmen enter universities with high expectations and with good motivation, but too many are driven into performing instead of true learning. The issues are not only related to the challenge of comprehending the substance, social and other factors have an impact as well. All these multifaceted needs should be accounted for to facilitate student learning. Learning is an individual process and remarkable improvement in the learning practices is possible, if proper actions are addressed early enough. We motivate and describe a study of the experience obtained from a set of tailor-made courses that were given alongside standard curriculum. The courses aimed to provide a ‘safe community’ to address the multifaceted needs. Such support was integrated into regular coursework where active learning techniques, e.g. interactive small groups were incorporated. To assess impact of the courses we employ the feedback obtained during the courses and longitudinal statistical data about students' success. [ABSTRACT FROM PUBLISHER]

The aim of this study was to evaluate the effect of cynical distrust on mortality in middle-aged and aging men. The analysis is based on Kuopio Ischemic Heart Disease study, follow-up from 1984 to 2011. Sample consisted of 2682 men, aged 42-61 years at baseline. Data on mortality was provided by the National Death Registry, causes of death were classified by the National Center of Statistics of Finland. Cynical distrust was measured at baseline using Cynical Distrust Scale. Survival analyses were conducted using Cox regression models. In crude estimates after 28 years of follow-up, high cynical distrust was associated with 1.5-1.7 higher hazards for earlier death compared to low cynical distrust. Adjusted for conventional risk factors, high cynical distrust was significantly associated regarding CVD-free men and CVD mortality, while non-CVD mortality in study sample was consistently but not significantly associated. The risk effects were more expressed after 12-20 years rather than in earlier or later follow-up. To conclude, high cynical distrust associates with increased risk of CVD mortality in CVD-free men. The associations with non-CVD mortality are weaker and not reach statistical significance. [ABSTRACT FROM AUTHOR]

Background: Retirement is a key life event, which is associated with changes in physical activity, however, there is limited evidence with regard to changes in physical activity that take place in post-retirement years. The aim of this study was to examine how leisure-time physical activity changes shortly after the transition to retirement and during the post-retirement years.Methods: The phase 1 data were collected in 2000-2002 (n = 8960, response rate 67%) among 40-60-year-old employees of the City of Helsinki, Finland. Phase 2 was carried out in 2007 (n = 7332, response rate 83%) and phase 3 in 2012 (n = 6814, response rate 79%). Disability retirees and those under the age of 50 at baseline were excluded. This yielded 2902 participants. Most of the participants (79%) were women. The mean age of the participants was 54.4 in phase 1. Negative binomial models for repeated measurements with generalized estimating equations (GEE) were used to calculate the incidence rate ratios (IRR) and 95% confidence intervals (CI). These indicated the changes in time spent in self-reported leisure-time physical activity among the retired compared with the continuously employed.Results: Of the participants, 851 retired on the grounds of old age during the first period (phases 1-2), and 948 during the second period (phases 2-3). Change in physical activity was positive among those who retired during the first (IRR = 1.10, 95% CI 1.04-1.17) and second (IRR = 1.10, 95% CI 1.04-1.16) periods compared to the continuously employed. During the second period, there was little difference between those who had retired during the first one (IRR = 0.96, 95% CI 0.91-1.02) and the continuously employed.Conclusions: The transition to statutory retirement was associated with an immediate increase in leisure-time physical activity, which nevertheless diminished during post-retirement years. [ABSTRACT FROM AUTHOR]

Objective: We investigated if alexithymia, a personality construct with difficulties in emotional processing, is stable in the general population.Methods: Altogether 3083 unselected subjects aged 30 and older in Finland completed the 20-item Toronto Alexithymia Scale (TAS-20) in the longitudinal Health 2000 and Health 2011 general population surveys (BRIF8901). The stability of alexithymia at the 11-year follow-up was assessed with t-tests, correlations, and separate linear regression models with base-line and follow-up age, gender, marital status, education, and 12-month depressive and anxiety disorders as confounders.Results: The mean score (SD) of the TAS-20 for the whole sample was 44.2 (10.4) in 2000 and 44.2 (10.9) in 2011 (p=0.731). The mean score of the TAS-20 subscale Difficulty Identifying Feelings increased by 0.3 points, Difficulty Describing Feelings decreased by 0.6 points and Externally Oriented Thinking increased by 0.3 points. The effect sizes of the changes varied from negligible to small. Age had little effect except for the group of the oldest subjects (75-97years): the TAS-20 mean (SD) score was 49.1 (10.1) in 2000 and 53.1 (10.3) in 2011 (p<0.001), the effect size for the increase was medium. TAS-20 score in 2000 explained a significant proportion of variance in TAS-20 score in 2011. Controlling for all baseline confounders improved the model incrementally; the same applied to controlling for confounders at follow-up. Baseline depression or anxiety disorders were not associated with the TAS-20 scores in 2011, whereas current diagnoses were.Conclusions: According to our large longitudinal study both the absolute and relative stability of alexithymia assessed with the TAS-20 are high in the adult general population. [ABSTRACT FROM AUTHOR]

Aims To study the predictive associations between maternal smoking and the impact of quitting smoking during pregnancy and offspring daily smoking at age 15-16 years. Design The Northern Finland Birth Cohort 1986 (NFBC86) includes 99% of all births in the region and has an ongoing follow-up. Data were collected using questionnaires at 24th gestational week during pregnancy and after delivery, and at follow-up in 2001-02, when the offspring were aged 15-16 years. Setting Northern Finland. Participants NFBC86 included 9432 live born children. Data regarding maternal smoking during pregnancy and offspring smoking at age 15-16 years were available for 4462 subjects (47.3% of the original sample). Measurements The outcome was offspring's self-reported daily smoking. Maternal smoking during pregnancy was considered using a four-class variable: (1) no smoking, (2) mother had smoked, but had quit smoking before becoming pregnant, (3) mother quit smoking during the 1st trimester and (4) mother quit smoking after the 1st trimester or continued smoking throughout the pregnancy. Information regarding paternal smoking during pregnancy, maternal and paternal smoking and education level, family structure and dwelling at offspring's age 15-16 years were considered potential confounding variables. Findings Continuing smoking after the 1st trimester increased the odds of daily smoking among offspring, independently of confounding factors [odds ratio (OR) = 1.8, 95% confidence interval (CI) = 1.3-2.5]. Continuing to smoke after the 1st trimester was associated with higher odds compared with quitting smoking during the 1st trimester. Also, parental smoking at offspring age 15-16 years increased the odds of offspring daily smoking, independently of prenatal smoking exposure. Conclusions Prenatal smoking exposure increases the risk for offspring adolescent daily smoking. Quitting smoking during the early stages of pregnancy may decrease the odds for offspring smoking. [ABSTRACT FROM AUTHOR]

Background: Telomere length and telomere shortening are associated with age-related health outcomes. Only a few studies have been able to longitudinally report on factors that are associated with changes in telomere length in an aging population. Objective: We studied the longitudinal relation between telomere length, the change in telomere length, and circulating amino acids. Design: A total of 812 subjects from the Helsinki Birth Cohort Study (born from 1934 to 1944), who underwent 3 clinical visits during a 10-y interval that included measurements of cardiometabolic risk factors, were included in the study. Leukocyte telomere length (LTL) was measured with the use of quantitative real-time polymerase chain reaction. Circulating branched-chain and aromatic amino acids (alanine, glycine, histidine, phenylalanine, leucine, isoleucine, valine, and tyrosine) were assessed with the use of high-throughput nuclear magnetic resonance spectroscopy. Results: The relative ± SD LTL at a mean age of 71 y was 0.79 ± 0.27 in men and 0.89 ± 0.35 in women (P < 0.001). Of the studied amino acids, the strongest inverse association was observed between the phenylalanine concentration that was measured 5 y earlier and the LTL. This finding was significant in men (P = 0.021) and remained significant after adjustment for multiple comparisons, but it was not significant in women (P = 0.39). Longitudinally, the change in LTL over 10 y was inversely associated with the phenylalanine concentration in men (P = 0.007) but not in women (P = 0.58) after adjustment for baseline LTL, age, smoking, and percentage of body fat. Conclusions: The serum phenylalanine concentration is associated with telomere length and, therefore, potentially with the aging process. Because the associations reported are observational, no conclusions can be made regarding causality. Our findings support the hypothesis that cellular pathways that regulate aging are sex specific. [ABSTRACT FROM AUTHOR]

The UK Biobank study on chronotype and mortality suggested small increases of all-cause and cardiovascular mortality in a 6.5-year follow-up. Our aim was to constructively replicate findings from it in a longer follow-up. A questionnaire was administered to the population-based adult Finnish Twin Cohort in 1981 (response rate 84%). The study population included 23 854 participants who replied to the question: "Try to assess to what extent you are a morning person or an evening person," with four response alternatives (anchored from "clearly a morning person" to "clearly an evening person"). Vital status and cause of death data were provided by nationwide registers up to the end of 2018. Hazard ratios for mortality were computed based on 8728 deaths. Adjustments were made for education, alcohol, smoking, BMI, and sleep duration. The covariate adjusted model showed a 9% increase of all-cause mortality for the evening-type group (HR = 1.09, 95% CI 1.01-1.18), with attenuation mainly due to smoking and alcohol. Their importance was highlighted by observing no increased mortality among non-smokers who were at most light drinkers. There was no increase in any cause-specific mortality. Our results suggest that there is little or no independent contribution of chronotype to mortality.

There have been calls to know more about vulnerability factors that may predispose to adverse health outcomes at work. We examined if childhood adverse experiences would affect vulnerability to psychosocial stress factors at work. A nationally representative sample of 1546 Finnish men and women was followed up from childhood to adulthood. Childhood adverse experiences consisted of socioeconomic and emotional factors. Job demands and job control were measured 21 years later, and depressive symptoms were measured 21 and 27 years after the childhood measurements. Job demands predicted depressive symptoms over 6 years, and the association was modified by childhood emotional adversity. Participants with three or more emotional adversities in childhood had more depressive symptoms in response to high job demands compared with participants with zero or one emotional adversities in childhood (Betas = −1.40 and −2.01, ps < 0.05 and <0.01). No such moderating effect by childhood adverse experiences was found for the association between job control and depressive symptoms. Although modest in effect size, these findings provide a developmental viewpoint for understanding the role of childhood experiences in work‐related stress factors. Such knowledge can enhance understanding of individual differences in vulnerability to the demands of working life. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Aim To examine the relationship between nurse staffing and patient length of stay in an acute-care hospital over a 1-year period. Background Although there has been prior research on the relationship between nurse staffing and length of stay in acute-care hospitals, there is a need for more information on how nurse staffing is related to length of stay longitudinally. Methods Retrospective time-series registry data from 20 acute-care inpatient units of a Finnish university hospital as a monthly time series in 2008 were analysed by linear mixed models. Results The ratio of registered nurses to all nurses was 72.4%. Nurses worked mainly (96%) full time, and 63% had permanent employment contracts. Statistically significant variation was found in time series of five variables. Statistically significant relationships were found between length of stay and patient acuity, diagnosis-related group-volume, census and nursing hours per patient day at the unit level. Nursing hours per patient day had the strongest correlation with length of stay. Conclusion and implications for nursing management A rational response to the variations in patient care needs and intensity in the complex care environment is flexible nurse staffing. Increasing nursing hours per patient day to achieve shorter length of stays is not the only solution, well-functioning care processes are also essential. [ABSTRACT FROM AUTHOR]

Objectives The aim of this study was to evaluate changes in dental fear among adult Finns aged 19 years and over at the beginning of the study in 2000-2011 in a nationally representative sample. Methods The study was based on Health 2000 and 2011 Surveys by the National Institute for Health and Welfare in Finland. The Health 2000 Survey used a stratified two-stage cluster sampling design ( N = 9 922). Those who participated in 2000 ( n = 7 964) were invited to participate in 2011. The number of participants was 3 961. Dental fear was assessed by a single question: 'How afraid are you of visiting a dentist?' (not at all, somewhat, very much). Background variables included were age (categories 30-34, 35-39, 40-44, 45-54, 55-64, 65-74, 75+ years), gender, marital status (nonsingle, single), and education (basic, secondary, higher). To match the population sizes in different areas and thus forming a nationally representative data, the data were weighted based on age, gender, and area. General linear modeling for repeated measures was used to evaluate changes in dental fear and associations with background variables. Results Between 2000 and 2011, dental fear decreased more often than increased among adults in Finland. Change from being very afraid to not at all afraid of visiting a dentist was most common in the oldest group. For most participants, dental fear remained stable; being very afraid of visiting a dentist was more stable among participants from 35 to 54 years of age than among younger or older participants. Conclusions Dental fear is still common among adult Finns and it seems to depend on age. As the most obvious consequence of dental fear is avoidance of dental care, reducing dental fear should be taken into account when planning and reorienting oral healthcare services. [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]