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Background Physical activity (PA) is known to be associated with lipid profiles and the risk of both cardiovascular diseases and cancer. The aim of this study was to evaluate the association of objectively measured PA, sedentary behaviour (SB), amount of breaks during SB and number of daily steps with serum lipids in a healthy, Finnish, middle-aged, female population. Methods The participants (571) were recruited at mammography screening, target group was women aged 50–60 years. A measurement of PA was done with accelerometer, blood lipid profile was assessed, and questionnaires of participants characteristics were sent to participants. Results The participants with the highest number of daily breaks during SB (≥ 41) had the highest mean concentration of HDL-cholesterol (high density lipoprotein cholesterol, HDL-c) (1.9 mmol/l, standard deviation (SD) 0.4) and the lowest mean concentration of triglycerides (1.0 mmol/l, SD 0.5). HDL-c level was 0.16 mmol/l higher (p p Those with the most daily steps (≥ 9100) had the highest mean HDL-c level (1.9 mmol/l). HDL-c level was 0.16 mmol/l higher (p p From wake-time, participants spent 60% in SB, 18% standing, 14% in light PA, and 9% in moderate-to-vigorous PA (MVPA). PA was associated with serum total cholesterol (TC), HDL-c and triglyceride levels. The mean HDL-c level was the highest in the lowest quartile of SB and in the highest quartile of MVPA. Conclusions To our knowledge, this is the first study showing a high number of objectively measured breaks during SB is associated with a favourable effect on the level of serum lipids, which may later translate into cardiovascular health among middle-aged women. Trial registration This study was registered and approved by the Regional Ethics Committee of Tampere University Hospital in Finland (approval code R15137).

An electrocardiography (ECG) monitoring can be used to detect heart-related abnormalities by recording cardiac activity over a period of time. The conventional 12-lead ECG measurement system is the standard practice for the evaluation of the heart's electrical activity. However, a recent trend is to develop patch-type measurement devices for unobtrusive ECG monitoring by reducing device size and number of electrodes on the skin. This development aims to minimize the discomfort for the user from the wearable recording devices. A printed, bandage-type hybrid system for continuous ECG monitoring to allow as much comfort as possible while maintaining the signal quality required for medical evaluation is proposed. Movement artifacts in recorded ECG signals are a challenge in long-term monitoring while the patients are engaged in their everyday activities. The movement artifacts from the printed skin-conformable electrode are compared to commercial exercise stress-test ECG electrodes during different physical activities and stationary periods. The results show that the signal quality obtained with the multilead patch ECG electrode, manufactured with printing technologies, is comparable to electrodes currently used in healthcare. acceptedVersion

The aim of this follow-up study was to explore the long-term effects of a 6-month trial of exercise training on hot flushes. The follow-up was 4 years after the exercise intervention ended.A cohort study after a randomised controlled trial. Ninety-five of the 159 randomised women (60%) participated in anthropometric measurements and performed a 2-km walk test. Participants completed a questionnaire and kept a one-week diary on physical activity, menopause symptoms and sleep quality. The frequency of 24-h hot flushes was multiplied by severity and the total sum for one week was defined as the Hot Flush Score (HFScore). Multilevel mixed regression models were analysed to compare the exercise and control groups.Hot Flush Score (HFScore) as assessed with the one-week symptom diary.The women in the exercise group had a higher probability of improved HFScore, i.e. a decrease in HFScore points, adjusted for hormone therapy (OR 0.95; 95% CI 0.90-1.00) than women in the control group at the 4-year follow-up. After additional adjustment for sleep quality, the result approached statistical significance at HFScore≥13 with women in the exercise group. Women who had the least amount of hot flushes, HFScore13, benefited most from exercise during the 4-year follow-up when compared with women in the control group.Women in the exercise group had positive effects on their HFScore 4 years after a 6-month exercise intervention.

The aim of the research was to study the association between engagement in the recommended level of physical activity and quality of life (QoL) among middle-aged women. In total, 2606 Finnish women aged 49 years responded to a postal questionnaire on lifestyle, quality of life, and health, wherein QoL was assessed with a shorter version of the menopause-specific Women's Health Questionnaire (WHQ). Proportional odds ratios (PORs) from ordered logistic regression models were used to test the association between the physical-activity and WHQ domains or three quality-of-life variables. Physically inactive women had an increased probability of anxiety/depressed mood (POR 1.44; 95% confidence interval (CI) 1.26-1.65), of decreased well-being (POR 1.96; 95% CI 1.71-2.25), of somatic symptoms (POR 1.61; 95% CI 1.40-1.85), of memory/concentration problems (POR 1.48; 95% CI 1.29-1.70), and of vasomotor symptoms (POR 1.19; 95% CI 1.03-1.36) as compared to physically active women. Women with the recommended level of physical activity had a higher self-perceived health level, better relative health, and better global quality of life in relation to other women their age. Physically active women showed higher quality of life in four menopause-specific WHQ dimensions and in global quality of life when compared to inactive women.

Background: Physical exercise during leisure time is known to increase physical capacity; however, the long-term effects on work ability and work strain are inconclusive. The aim of this study was to investigate the effects of a 6-month physical exercise program on work ability and work strain after 6 months and 30 months, among women with menopausal symptoms at baseline. Methods: A questionnaire including questions on work ability and work strain was mailed in the beginning, at 6 months and after 30 months after the intervention to occupationally active women participating in a randomized controlled study on physical exercise and quality of life. The intervention included aerobic exercise training 4 times per week, 50 minutes per session. Work ability was measured with the Work Ability Index (WAI) and with questions about physical and mental work strain. Results: Women aged 47–62 years (N = 89) who were occupationally active at baseline were included in the analyses. The increase in WAI from baseline to the end of the exercise intervention (6 months) was statistically significantly greater among the intervention group than among the control group (regression coefficient 2.08; 95% confidence interval 0.71–3.46). The difference between the groups persisted for 30 months. No significant short- or long-term effects on physical and mental work strain were found. Conclusion: A 6-month physical exercise intervention among symptomatic menopausal women had positive short-term as well as long-term effects on work ability.

We studied dietary patterns, physical activity (PA), and monthly goal setting in a weight reduction intervention in long-distance professional drivers. The study was conducted in Finland in 2009–2012. Male drivers with waist circumference > 100 cm were randomized to a lifestyle counseling (LIFE, N = 55) and a reference (REF, N = 58) group. During 12 months, LIFE participated in 6 face-to-face and 7 telephone counseling sessions on diet and PA. Dietary patterns were assessed using an index combining food diary and counselor interview, and PA with the number of daily steps using a pedometer. Monthly lifestyle goals, perceived facilitators and barriers, and adverse effects of PA in the LIFE participants were monitored using counselors' log books. Forty-seven (85%) LIFE participants completed the 12-month program. After 12 months, the mean dietary index score improved by 12% (p = 0.002, N = 24), and the number of daily steps increased by 1811 steps (median; p = 0.01, N = 22). The most frequent dietary goals dealt with meal frequency, plate model, and intake of vegetables, fruits, and berries. The most common PA mode was walking. Typical facilitators to reach monthly lifestyle goals were support from family and friends and ailment prevention; typical barriers were working schedules and ailments. Adverse effects, most commonly musculoskeletal pain, occurred among 83% of the LIFE participants. Positive changes in lifestyle habits were observed during counseling. Monthly lifestyle counseling combining face-to-face and phone contacts seemed appropriate to long-distance drivers. Barriers for reaching lifestyle changes, and adverse effects of PA were common and need to be addressed when planning counseling. Trial registration: Clinical Trials NCT00893646, Highlights • Our study is one of the few lifestyle counseling RCTs in truck and bus drivers. • Dietary habits improved during 12-month program. • Habitual walking and daily step count increased during 12-month program. • Improved dietary habits were associated with weight reduction. • Perceived barriers related to working schedules and ailments were common.

Background and objective. To estimate whether aerobic training has an effect on frequency of hot flushes or quality of life. Design. A randomized controlled trial. Participants and setting. Symptomatic, sedentary women (n = 176), 43–63 years, no current use of hormone therapy. Intervention. Unsupervised aerobic training for 50 minutes four times per week during 6 months. Outcomes. Hot flushes as measured with Women's Health Questionnaire (WHQ) and Health-Related Quality of Life (HRQoL, SF-36), daily reported hot flushes on phone-based diary, cardiorespiratory fitness (CRF), and body composition. Results. Intervention group had larger decrease in the frequency of night-time hot flushes based on phone diary (P for month X group = 0.012), but not on WHQ scale. Intervention group had less depressed mood (P= 0.01) than control women according to change in WHQ score. Changes in WHQ score in depressed mood (P = 0.03) and menstrual symptoms (P=0.01) in the intervention group were significantly dependent on frequency of training sessions. HRQoL was improved among the intervention group women in physical functioning (P= 0.049) and physical role limitation (P= 0.017). CRF improved (P= 0.008), and lean muscle mass increased (P= 0.046) significantly in the intervention group as compared to controls. Conclusions. Aerobic training may decrease the frequency of hot flushes and improve quality of life among slightly overweight women.

Objectives The aim of the study was to explore the long-term effects of physical activity intervention on quality of life (QoL) 4 years after an original randomised controlled trial (RCT). Design Cohort study after an RCT. Setting 95 of the 159 women from the original RCT participated in weight, height and waist circumference measurements, performed the UKK 2 km Walk Test and completed the SF-36 Health Survey questionnaire. Multilevel mixed regression models were performed in order to compare the original and current group in an RCT setting. Participants There were 159 participants in the original RCT; 2.5 years later, 102 of the women responded to a questionnaire and 4-year after the trial, there were 95 respondents. The inclusion criteria in the original RCT were: being symptomatic, experiencing daily hot flushes, age between 40 and 63 years, not using hormone therapy now or in the past 3 months, sedentary lifestyle and having last menstruated 3–36 months earlier. Main outcome measure Health-related QoL as measured with the SF-36 instrument. Results Women in the intervention group had a significantly higher probability of improved physical functioning (OR 1.41; 95% CI 1.00 to 1.99) as compared with women in the control group. In addition, women in the intervention group had higher odds of good role functioning (OR 1.21; 95% CI 0.88 to 1.67), physical health (OR 1.33; 95% CI 0.96 to 1.84) and general health (OR 1.14; 95% CI 0.81 to 1.62), relative to women in the control group, although the differences did not reach statistical significance. Conclusions Women in the intervention group showed positive long-term effects on physical and mental dimensions of QoL after 4 years. Trial registration number ISRCTN54690027.

Menopausal transition is associated with a variety of symptoms and complaints among majority of women. It is difficult to separate whether symptoms prevalent among menopausal women are due to aging or menopause itself. However, quality of life is an important issue when health of the middle-aged menopausal women is considered. Quality of life measurements include several aspects such as physical and mental health, vitality, depression, vasomotor symptoms, and other symptoms. Physical activity has been shown to be associated with overall better subjective health and also with quality of life among menopausal women. In this chapter, we discuss prevalence menopausal of symptoms, quality of life scales, and mechanisms of physical activity related to menopausal symptoms. Experimental evidence concerning physical activity, menopausal symptoms, and quality of life is not large; only few studies have been performed. Large cohort studies have shown that physical activity is associated with fewer menopausal symptoms. To summarize, the studies have parallel results independent of their design; increasing as well as greater levels of physical activity are associated with better quality of life. Thus, physical activity can be recommended for menopausal women suffering from vasomotor and other menopausal symptoms.

Background Menopause is associated with poor sleep quality and daytime sleepiness, which may lead to impaired quality of life and impaired functioning in daily activities. Objective To study whether exercise training improves sleep quality or decreases the amount of night time hot flushes among menopausal women with vasomotor symptoms. Study design A randomized controlled trial. Sedentary women (N = 176) aged 43–63 years with menopausal symptoms were randomized to a six-month unsupervised aerobic training intervention (50 min 4 times per week) or a control group. Both groups attended lectures on physical activity and health once a month. Main outcome measures Sleep quality and the amount of hot flushes disturbing sleep. The women reported daily via mobile phone whether hot flushes had disturbed their sleep and how they had slept (scale 1–5). Responses received by mobile phone over the 6-month period totaled on average 125 (5.2 per week) responses per participant. Results At baseline there was no difference between the groups in the demographic variables. Sleep quality improved significantly more in the intervention group than in the control group (OR 1.02; 95% CI = 1.0–1.05, p = 0.043). The odds for sleep improvement were 2% per week in the intervention group and a decrease of 0.5% per week in the control group. The amount of hot flushes related to sleep diminished (p = 0.004) by the end of the intervention. Conclusions Aerobic training for 6 months may improve sleep quality and reduce hot flushes among symptomatic menopausal women.

In a cluster-randomized trial, Riitta Luoto and colleagues find that counseling on diet and activity can reduce the birthweight of babies born to women at risk of developing gestational diabetes mellitus (GDM), but fail to find an effect on GDM., Background Our objective was to examine whether gestational diabetes mellitus (GDM) or newborns' high birthweight can be prevented by lifestyle counseling in pregnant women at high risk of GDM. Method and Findings We conducted a cluster-randomized trial, the NELLI study, in 14 municipalities in Finland, where 2,271 women were screened by oral glucose tolerance test (OGTT) at 8–12 wk gestation. Euglycemic (n = 399) women with at least one GDM risk factor (body mass index [BMI] ≥25 kg/m2, glucose intolerance or newborn's macrosomia (≥4,500 g) in any earlier pregnancy, family history of diabetes, age ≥40 y) were included. The intervention included individual intensified counseling on physical activity and diet and weight gain at five antenatal visits. Primary outcomes were incidence of GDM as assessed by OGTT (maternal outcome) and newborns' birthweight adjusted for gestational age (neonatal outcome). Secondary outcomes were maternal weight gain and the need for insulin treatment during pregnancy. Adherence to the intervention was evaluated on the basis of changes in physical activity (weekly metabolic equivalent task (MET) minutes) and diet (intake of total fat, saturated and polyunsaturated fatty acids, saccharose, and fiber). Multilevel analyses took into account cluster, maternity clinic, and nurse level influences in addition to age, education, parity, and prepregnancy BMI. 15.8% (34/216) of women in the intervention group and 12.4% (22/179) in the usual care group developed GDM (absolute effect size 1.36, 95% confidence interval [CI] 0.71–2.62, p = 0.36). Neonatal birthweight was lower in the intervention than in the usual care group (absolute effect size −133 g, 95% CI −231 to −35, p = 0.008) as was proportion of large-for-gestational-age (LGA) newborns (26/216, 12.1% versus 34/179, 19.7%, p = 0.042). Women in the intervention group increased their intake of dietary fiber (adjusted coefficient 1.83, 95% CI 0.30–3.25, p = 0.023) and polyunsaturated fatty acids (adjusted coefficient 0.37, 95% CI 0.16–0.57, p, Editors' Summary Background Gestational diabetes mellitus (GDM) is diabetes that is first diagnosed during pregnancy. Like other types of diabetes, it is characterized by high levels of sugar (glucose) in the blood. Blood-sugar levels are normally controlled by insulin, a hormone that the pancreas releases when blood-sugar levels rise after meals. Hormonal changes during pregnancy and the baby's growth demands increase a pregnant woman's insulin needs and, if her pancreas cannot make enough insulin, GDM develops. Risk factors for GDM, which occurs in 2%–14% of pregnant women, include a high body-mass index (a measure of body fat), excessive weight gain or low physical activity during pregnancy, high dietary intake of polyunsaturated fats, glucose intolerance (an indicator of diabetes) or the birth of a large baby in a previous pregnancy, and a family history of diabetes. GDM is associated with an increased rate of cesarean sections, induced deliveries, birth complications, and large-for-gestational-age (LGA) babies (gestation is the time during which the baby develops within the mother). GDM, which can often be controlled by diet and exercise, usually disappears after pregnancy but increases a woman's subsequent risk of developing diabetes. Why Was This Study Done? Although lifestyle changes can be used to control GDM, it is not known whether similar changes can prevent GDM developing (“primary prevention”). In this cluster-randomized controlled trial, the researchers investigate whether individual intensified counseling on physical activity, diet, and weight gain integrated into routine maternity care visits can prevent the development of GDM and the occurrence of LGA babies among newborns. In a cluster-randomized controlled trial, groups of patients rather than individual patients are randomly assigned to receive alternative interventions, and the outcomes in different “clusters” are compared. In this trial, each cluster is a municipality in the Pirkanmaa region of Finland. What Did the Researchers Do and Find? The researchers enrolled 399 women, each of whom had a normal blood glucose level at 8–12 weeks gestation but at least one risk factor for GDM. Women in the intervention municipalities received intensified counseling on physical activity at 8–12 weeks' gestation, dietary counseling at 16–18 weeks' gestation, and further physical activity and dietary counseling at each subsequent antenatal visits. Women in the control municipalities received some dietary but little physical activity counseling as part of their usual care. 23.3% and 20.2% of women in the intervention and usual care groups, respectively, developed GDM, a nonstatistically significant difference (that is, a difference that could have occurred by chance). However, the average birthweight and the proportion of LGA babies were both significantly lower in the intervention group than in the usual care group. Food frequency questionnaires completed by the women indicated that, on average, those in the intervention group increased their intake of dietary fiber and polyunsaturated fatty acids and decreased their intake of saturated fatty acids and sucrose as instructed during counseling, The amount of moderate physical activity also tended to decrease less as pregnancy proceeded in the intervention group than in usual care group. Finally, compared to the usual care group, significantly fewer of the 24% of women in the intervention group who actually met dietary and physical activity targets (“adherent” women) developed GDM. What Do These Findings Mean? These findings indicate that intensified counseling on diet and physical activity is effective in controlling the birthweight of babies born to women at risk of developing GDM and encourages at least some of them to alter their lifestyle. However, the findings fail to show that the intervention reduces the risk of GDM because of the limited power of the study. The power of a study—the probability that it will achieve a statistically significant result—depends on the study's size and on the likely effect size of the intervention. Before starting this study, the researchers calculated that they would need 420 participants to see a statistically significant difference between the groups if their intervention reduced GDM incidence by 40%. This estimated effect size was probably optimistic and therefore the study lacked power. Nevertheless, the analyses performed among adherent women suggest that lifestyle changes might be a way to prevent GDM and so larger studies should now be undertaken to test this potential primary prevention intervention. Additional Information Please access these Web sites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.1001036. The US National Institute of Diabetes and Digestive and Kidney Diseases provides information for patients on diabetes and on gestational diabetes (in English and Spanish) The UK National Health Service Choices website also provides information for patients on diabetes and on gestational diabetes, including links to other useful resources The MedlinePlus Encyclopedia has pages on diabetes and on gestational diabetes; MedlinePlus provides links to additional resources on diabetes and on gestational diabetes (in English and Spanish) More information on this trial of primary prevention of GDM is available

Background Annual prevalence of gestational diabetes mellitus (GDM) is 12.5% among Finnish pregnant women. The prevalence is expected to rise with the increasing overweight among women before pregnancy. Physical activity and diet are both known to have favourable effects on insulin resistance and possibly on the risk of GDM. We aimed to investigate, whether GDM can be prevented by counseling on diet, physical activity and gestational weight gain during pregnancy. Methods/Design A cluster-randomized controlled trial was conducted in 14 municipalities in the southern part of Finland. Pairwise randomization was performed in order to take into account socioeconomic differences. Recruited women were at 8-12 weeks' gestation and fulfilled at least one of the following criteria: body mass index ≥ 25 kg/m2, history of earlier gestational glucose intolerance or macrosomic newborn (> 4500 g), age ≥ 40 years, first or second degree relative with history of type 1 or 2 diabetes. Main exclusion criterion was pathological oral glucose tolerance test (OGTT) at 8-12 weeks' gestation. The trial included one counseling session on physical activity at 8-12 weeks' gestation and one for diet at 16-18 weeks' gestation, and three to four booster sessions during other routine visits. In the control clinics women received usual care. Information on height, weight gain and other gestational factors was obtained from maternity cards. Physical activity, dietary intake and quality of life were followed by questionnaires during pregnancy and at 1-year postpartum. Blood samples for lipid status, hormones, insulin and OGTT were taken at 8-12 and 26-28 weeks' gestation and 1 year postpartum. Workability and return to work were elicited by a questionnaire at 1- year postpartum. Linkage to the national birth register of years 2007-2009 will provide information on perinatal complications and GDM incidence among the non-participants of the study. Cost-effectiveness evaluation will be based on quality-adjusted life years. This study has received ethical approval from the Ethical board of Pirkanmaa Hospital District. Discussion The study will provide information on the effectiveness and cost-effectiveness of gestational physical activity and dietary counseling on prevention of GDM in a risk group of women. Also information on the prevalence of GDM and postpartum metabolic syndrome will be gained. Results on maintaining the possible health behaviour changes are important in order to prevent chronic diseases such as cardiovascular disease and diabetes. Trial registration The trial is registered ISRCTN 33885819

Background Excessive gestational weight gain and postpartum weight retention may predispose women to long-term overweight and other health problems. Intervention studies aiming at preventing excessive pregnancy-related weight gain are needed. The feasibility of implementing such a study protocol in primary health care setting was evaluated in this pilot study. Methods A non-randomized controlled trial was conducted in three intervention and three control maternity and child health clinics in primary health care in Finland. Altogether, 132 pregnant and 92 postpartum women and 23 public health nurses (PHN) participated in the study. The intervention consisted of individual counselling on physical activity and diet at five routine visits to a PHN and of an option for supervised group exercise until 37 weeks' gestation or ten months postpartum. The control clinics continued their usual care. The components of the feasibility evaluation were 1) recruitment and participation, 2) completion of data collection, 3) realization of the intervention and 4) the public health nurses' experiences. Results 1) The recruitment rate was slower than expected and the recruitment period had to be prolonged from the initially planned three months to six months. The average participation rate of eligible women at study enrolment was 77% and the drop-out rate 15%. 2) In total, 99% of the data on weight, physical activity and diet and 96% of the blood samples were obtained. 3) In the intervention clinics, 98% of the counselling sessions were realized, their contents and average durations were as intended, 87% of participants regularly completed the weekly records for physical activity and diet, and the average participation percentage in the group exercise sessions was 45%. 4) The PHNs regarded the extra training as a major advantage and the high additional workload as a disadvantage of the study. Conclusion The study protocol was mostly feasible to implement, which encourages conducting large trials in comparable settings. Trial registration Current Controlled Trials ISRCTN21512277

The formation of inhibitive benzotriazole films on copper and copper alloyed with silver has been studied with scanning electrochemical microscopy SECM and X-ray photoelectron spectroscopy XPS. The SECM measurements showed that the film grows rapidly on oxygen-free dehydrated copper OF-HC and that the rate depends on the substrate potential. The benzotriazole films were also observed on silver alloyed copper; however, electropolishing prevents film growth by enriching the surface with silver. XPS results show that the film consisted of CuI–BTA on both materials. No evidence of AgI–BTA was found.

The inhibition of copper corrosion by benzotriazole (BTAH) has been studied by scanning electrochemical microscopy as a function of time and oxygen content. Under normal atmospheric conditions the inhibiting [Cu(I)-BTA] film was formed in approximately 1 h. When the oxygen content was lowered below 15 ppm, an insulating film could not be obtained in 4 h, clearly showing that the formation of the inhibiting [Cu(I)-BTA] requires oxygen.

The inhibitive effect of benzotriazole on a commercial copper surface phosphorus-deoxidized copper was studied by a scanning electrochemical microscope SECM in an aqueous sodium sulfate solution using ferrocenemethanol FcMeOH as the redox mediator. The formation of the inhibitive film was followed as a function of time and as a function of the potential of the copper substrate. The results were analyzed using the existing models in the literature. The results show that the potential has a crucial effect on the growth of the CuI-BTA film. At a potential close to the dissolution range of copper, the surface changes gradually from almost ideally conductive to almost ideally insulating surface in the presence of benzotriazole, but at more negative potentials the effect is diminished and finally deceased. Quartz crystal microbalance experiments showed that the mass of an adsorbed layer must correspond to a multilayer.