63 results on '"Laanpere M"'
Search Results
2. 27. Folate and female infertility: folate-metabolizing pathway in folliculogenesis, infertility treatment, and implantation
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Altmäe, S., primary, Laanpere, M., additional, Campoy, C., additional, and Salumets, A., additional
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- 2014
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3. Contextualising Learning Analytics with Classroom Observations: a Case Study
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Maka Eradze, Rodríguez-Triana, M. J., Milikic, N., Laanpere, M., and Tammets, K.
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Human-Computer Interaction ,Architecture ,Media Technology ,Classroom Observations ,Learning Analytics ,Multimodal Learning Analytics ,Blended Learning ,Co-located Classrooms ,Contextualisation ,Learning Design ,Social Sciences (miscellaneous) ,Computer Science Applications ,Education - Abstract
Educational processes take place in physical and digital places. To analyse educational processes, Learning Analytics (LA) enable data collection from the digital learning context. At the same time, to gain more insights, the LA data can be complemented with the data coming from physical spaces enabling Multimodal Learning Analytics (MMLA). To interpret this data, theoretical grounding or contextual information is needed. Learning designs (LDs) can be used for contextualisation, however, in authentic scenarios the availability of machine-readable LD is scarce. We argue that Classroom Observations (COs), traditionally used to understand educational processes taking place in physical space, can provide the missing context and complement the data from the co-located classrooms. This paper reports on a co-design case study from an authentic scenario that used CO to make sense of the digital traces. In this paper we posit that the development of MMLA approaches can benefit from co-design methodologies; through the involvement of the end-users (project managers) in the loop, we illustrate how these data sources can be systematically integrated and analysed to better understand the use of digital resources. Results indicate that CO can drive sense-making of LA data where predefined LD is not available. Furthermore, CO can support layered contextualisation depending on research design, rigour and systematic documentation/data collection efforts.Also, co-designing the MMLA solution with the end-users proved to be a useful approach.
- Published
- 2020
4. Semantically annotated lesson observation data in learning analytics datasets: A reference model
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Eradze, M., María Jesús Rodríguez Triana, and Laanpere, M.
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learning analytics ,Human-Computer Interaction ,semantic annotations ,lesson observations ,Architecture ,Media Technology ,multimodal learning analytics ,Learning analytics ,Learning design ,Lesson observations ,Multimodal learning analytics ,Semantic annotations ,Social Sciences (miscellaneous) ,learning design ,Computer Science Applications ,Education - Abstract
Learning analytics (LA) and lesson observations are two approaches frequently used to study teaching and learning processes. In both cases, in order to extract meaningful data interpretations, there is a need for contextualization. Previous works propose to enrich LA datasets with observation data and to use the learning design as a framework to guide the data gathering and the later analysis. However, the majority of lesson observation tools collect data that is not compliant with LA datasets. Moreover, the connection between the learning design and the data gathered is not straightforward. This study reflects upon our research-based design towards an LA model for context-aware semantically annotated lesson observations that may be integrated in multimodal LA datasets. Six teachers (out of which 2 were also researchers) with previous experience in lesson observation were engaged in a focus group interview and participatory design session that helped us to evaluate the LA model through the conceptual design of Observata (a lesson observation tool that implements our model). The findings show the feasibility and usefulness of the proposal as well as the potential limitations in terms of adoption.
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- 2017
5. The Role of Formative Assessment in a Blended Learning Course
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Klinkenberg, S., Joosten-ten Brinke, D., Laanpere, M., Psychology Other Research (FMG), and FMG
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Medical education ,Higher education ,business.industry ,media_common.quotation_subject ,education ,A moderate amount ,Attendance ,Common sense ,Blended learning ,Formative assessment ,Pedagogy ,Remedial Teaching ,Psychology ,Grading (education) ,business ,media_common - Abstract
Assessing the effectiveness of a course design in higher education is an almost unfeasible task. The practical inability to conduct randomised controlled trials in a natural setting limits teachers who want to interpret their design choices to non causal evaluation. With at least a moderate amount of common sense these evaluations could be useful in gathering insight into what works and what does not work in education. In our blended learning course we wanted to assess the role of formative assessment while also taking lecture attendance into account. There are certainly many confounds for which we cannot control. We found no effect of lecture attendance but formative assessments did predict a substantial amount of course outcome. This was probably due to not including the formative performance in the final grading and our emphasis in the course that to err is to be student. The validity of the formative assessment paves the way for diagnostic use and remedial teaching.
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- 2017
6. Exploring a Solution for Secured High Stake Tests on Students’ Personal Devices
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van Meeuwen, L.W., Verhagen, F.P., den Brok, P.J., Joosten-ten Brinke, D., and Laanpere, M.
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Software ,business.industry ,Computer science ,Proof of concept ,Controlling students’ personal notebooks ,Bring your own device ,Security in digital tests ,Software engineering ,business ,Secure test environment protocol ,Test (assessment) - Abstract
Digital testing requires software and hardware. A hardware option is to establish dedicated test halls. As an alternative, this paper describes a setup and first experiences of a pilot run on a proof of concept, to answer the questions: which conditions are needed to create a secure solution for high stake assessments via students’ personal devices (e.g., notebook from students)?To answer this question, a proof of concept was run based on an outline of a Secure Test Environment Protocol (STEP). This STEP was based on three shells of security: Prevention, Detection and Reaction. Prevention concerns the technical solutions to prevent the use of unauthorized sources during tests. Detection concerns the risks (i.e., chance and impact) and the possibilities to detect unauthorized behavior and security issues. Reaction gives insight in requirements needed for an organization when students’ personal notebook are being used in taking high stake tests.The preliminary conclusion from the proof of concept is that it is possible to use students’ personal notebook in secured high stake tests if a STEP - comprising three shells of security - has been implemented. Suggestions for further development are given.
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- 2017
7. Constructivist teaching using the IVA course management
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Leijen, Ä., Hudson, B., Kiefer, S., Laanpere, M., Rugelj, J., Docent & Didactiek, Universiteit Utrecht, and Inst.v.Lerarenopl,Onderw.ontw.en Studiev
- Published
- 2004
8. Folate-metabolizing gene variants and pregnancy outcome of IVF
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Laanpere, M, Altmäe, Signe, Kaart, T, Stavreus-Evers, Anneli, Nilsson, T K, Salumets, A, Laanpere, M, Altmäe, Signe, Kaart, T, Stavreus-Evers, Anneli, Nilsson, T K, and Salumets, A
- Abstract
There is growing evidence that folate status and variation in folate-metabolizing genes are involved in female reproductive functions. This study evaluated the influence of maternal blood folate, vitamin B(12), homocysteine and 10 folate pathway gene variants on IVF outcome. Also, the prevalence of these polymorphisms was compared in 439 female IVF patients and 225 fertile controls. MTHFR 677 CT heterozygotes had a higher proportion of good-quality embryos and an increased chance of pregnancy. MTHFR 1793 GA heterozygosity was associated with a lower percentage of previously failed IVF treatments. Heterozygosity for FOLR1 1816 C/delC and 1841 G/A was associated with a raised risk of pregnancy loss. The CTH 1208 GT genotype was associated with an increased chance of pregnancy and a smaller number of previously failed IVF cycles and the genotype frequency was lower in IVF patients with three or more previously failed IVF treatments compared with fertile controls. SLC19A1 80 GA heterozygotes had a decreased number of previously failed IVF treatments and were more prevalent among fertile controls. In conclusion, polymorphisms in folate-metabolizing genes may affect ovarian stimulation and pregnancy outcome of IVF, and heterozygous individuals, rather than the wild-type homozygotes, appeared to have more favourable outcomes.
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- 2011
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9. HCI issues for web-based training course design
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Stanchev, I.S. and Laanpere, M.
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METIS-137572 - Abstract
Use of Internet in education and training has been growing rapidly during last two years, training companies has recognized it's usefulness much faster than every other new kind of training before that. The short experience shows that WWW can be used in education and training in different ways and levels: from additional resource bank in face-to-face learning activities to carefully designed virtual classroom. In this paper we address design of Web-based Training (WBT), which we define as a form of distance education delivered via WWW.WorldWideWeb has all characteristics of an exellent distance learning environment: it's available everywhere, it has fast access to huge amounts of information and good communication tools. Designing and updating Web-based courseware is easy and not too expensive. It has caused "gold rush" within education and training community - many training providers are in hurry to set up on-line versions of their courses, without reasoning specific issues of Web-based course design. It's not enough to have just well-prepared content of the course or nice graphical design with streaming multimedia to make a good Web-based course.HCI design of Web-based courses is dependent on instructional design principles and decisions in one hand and on current technological capabilities of WWW environment in the other hand. In this paper we are going to open discussion on HCI issues of Web-based course design, based on the catalogue of WBT instructional tools. This catalogue has been prepared to support Web-based course design by presenting sets of available alternative solutions for every instructional event or functionality. At the end the paper is discussing the results of some Web-based courseware evaluation with respect of the catalogue implementation.
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- 1997
10. Intimate partner violence and sexual health outcomes: a population-based study among 16-44-year-old women in Estonia
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Laanpere, M., primary, Ringmets, I., additional, Part, K., additional, and Karro, H., additional
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- 2012
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11. Constructivist teaching using the IVA course management
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Docent & Didactiek, Universiteit Utrecht, Inst.v.Lerarenopl,Onderw.ontw.en Studiev, Leijen, Ä., Hudson, B., Kiefer, S., Laanpere, M., Rugelj, J., Docent & Didactiek, Universiteit Utrecht, Inst.v.Lerarenopl,Onderw.ontw.en Studiev, Leijen, Ä., Hudson, B., Kiefer, S., Laanpere, M., and Rugelj, J.
- Published
- 2004
12. P777 Contraceptive counselling in primary health care - what do young women prefer?
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Laanpere, M., primary, Rahu, K., additional, Part, K., additional, Haldre, K., additional, Rahu, M., additional, and Karro, H., additional
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- 2009
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13. Towards the Interoperability of Online Assessment Tools.
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Tomberg, V. and Laanpere, M.
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- 2007
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14. Supporting Cross-Institutional Knowledge-Building with Web 2.0 Enhanced Digital Portfolios.
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Pata, K. and Laanpere, M.
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- 2008
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15. The second thoughts about pedagogical neutrality of LMS.
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Laanpere, M., Poldoja, H., and Kikkas, K.
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- 2004
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16. Context-aware multimodal learning analytics taxonomy
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Maka Eradze, Rodríguez Triana, M. J., and Laanpere, M.
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Technology-enhanced classrooms ,Human-labelled observations ,Classroom observations ,Multimodal learning analytics ,Context ,Learning design ,Automated observations
17. Smart school multimodal dataset and challenges
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Prieto, L. P., María Jesús Rodríguez Triana, Kusmin, M., Laanpere, M., Prieto, Luis P., Martínez-Maldonado, Roberto, Spikol, Daniel, Hernández-Leo, Davinia, Rodriguez Triana, Maria Jesus, and Ochoa, Xavier
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Multimodal learning analytics ,multimodal teaching analytics ,STEM education ,smart school ,smart classroom ,sensors - Abstract
As part of a research project aiming to explore the notion of ‘smart school’ (especially for STEM education) in Estonia, we are developing classrooms and schools that incorporate data gathering not only from digital traces, but also physical ones (through a variety of sensors). This workshop contribution describes briefly the setting and our initial efforts in setting up a classroom that is able to generate such a multimodal dataset. The paper also describes some of the most important challenges that we are facing as we setup the project and attempt to build up such dataset, focusing on the specifics of doing it in an everyday, authentic school setting. We believe these challenges provide a nice sample of those that the multimodal learning analytics (MMLA) community will have to face as it transitions from an emergent to a mainstream community of research and practice.
18. Open courses: The next big thing in eLearning?
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Kaido Kikkas, Laanpere, M., and Põldoja, H.
19. Comparing children's e-safety strategies with guidelines offered by adults
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Birgy Lorenz, Kikkas, K., and Laanpere, M.
20. How to aggregate lesson observation data into learning analytics dataset?
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Maka Eradze, Jesús, M., and Laanpere, M.
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Classroom observation ,Learning sciences ,Multimodal learning analytics
21. What types of essay feedback influence implementation: Structure alone or structure and content?
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Joosten-ten Brinke, D., Laanpere, M., Whitelock, Denise, Twiner, Alison, Richardson, John T. E., Field, Debora, Pulman, Stephen, Joosten-ten Brinke, D., Laanpere, M., Whitelock, Denise, Twiner, Alison, Richardson, John T. E., Field, Debora, and Pulman, Stephen
- Abstract
Students approach educational courses with varying levels of experience and understanding, and so need appropriate support to inform them of expectations and to guide their learning efforts. Feedback is critical in this process, so that learners can gauge how their performance aligns with expectations, and how they can improve their efforts and attainments. This study focused on the effects of providing different types of feedback on participants’ written essays, as well as on participants’ motivations for learning using measures of motivation and self-efficacy. In terms of research questions, it was important to ascertain whether participants performed differently in subsequent essays after receiving feedback on structure alone or on structure and content; whether their self-reported levels of motivation and attitudes to learning were related to essay performance; and whether the difference in type of feedback affected their self-reported levels of motivation and attitudes to learning. Findings revealed no significant difference in marks between those receiving feedback on structure alone and those receiving feedback on structure and content, which is surprising and deserves further exploration. Even so, using feedback to highlight certain structural elements of essay writing can have a lasting positive impact on participants’ future essay performance.
22. What types of essay feedback influence implementation: Structure alone or structure and content?
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Joosten-ten Brinke, D., Laanpere, M., Whitelock, Denise, Twiner, Alison, Richardson, John T. E., Field, Debora, Pulman, Stephen, Joosten-ten Brinke, D., Laanpere, M., Whitelock, Denise, Twiner, Alison, Richardson, John T. E., Field, Debora, and Pulman, Stephen
- Abstract
Students approach educational courses with varying levels of experience and understanding, and so need appropriate support to inform them of expectations and to guide their learning efforts. Feedback is critical in this process, so that learners can gauge how their performance aligns with expectations, and how they can improve their efforts and attainments. This study focused on the effects of providing different types of feedback on participants’ written essays, as well as on participants’ motivations for learning using measures of motivation and self-efficacy. In terms of research questions, it was important to ascertain whether participants performed differently in subsequent essays after receiving feedback on structure alone or on structure and content; whether their self-reported levels of motivation and attitudes to learning were related to essay performance; and whether the difference in type of feedback affected their self-reported levels of motivation and attitudes to learning. Findings revealed no significant difference in marks between those receiving feedback on structure alone and those receiving feedback on structure and content, which is surprising and deserves further exploration. Even so, using feedback to highlight certain structural elements of essay writing can have a lasting positive impact on participants’ future essay performance.
23. The second thoughts about pedagogical neutrality of LMS
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Laanpere, M., primary, Poldoja, H., additional, and Kikkas, K., additional
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24. The socio-demographic patterning of sexual risk behaviour: a survey of young men in Finland and Estonia
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Kunnas Heikki, Laanpere Made, Jormanainen Vesa, Gissler Mika, Nikula Minna, Haavio-Mannila Elina, and Hemminki Elina
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Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Sexually transmitted infections (STIs) among the youth are an increasing challenge for public health in Europe. This study provided estimates of men's (18–25 years) sexual risk behaviour and self-reported STIs and their socio-demographic patterning in Finland and Estonia; two countries that are geographically close, but have very different STI epidemics. Method Nationally representative cross-sectional population surveys with comparable survey questions were used. Data from self-administered questionnaires for 1765 men aged 18–25 years in Finland (85% of the age cohort was included in the sampling frame, 95% of the sample responded) and 748 in Estonia, with a response rate of 43% respectively, were analysed. Socio-demographic patterning of multiple partners, condom use and self-reported STIs are presented was studied using multiple logistic regression analysis. Results The main findings focus on associations found within each country. In Finland, higher age, low education and to a lesser extent relationship with a non-steady partner increased the likelihood of reporting multiple lifetime-partners, while in Estonia only higher age and low education revealed this effect. In relation to unprotected intercourse, in Finland, higher age, low education and relationship status with a steady partner increased the likelihood of reporting unprotected intercourse. In Estonia, the same was observed only for relationship status. In Finland the likelihood of self-reported STIs increased by older age and lower education and decreased by being with a non-steady partner, while in Estonia, a non-significant increase in self-reported STIs was observed only in the older age group. Conclusion A clear socio-demographic patterning for sexual behaviour and self-reported STIs was revealed in Finland, but a less consistent trend was seen in Estonia. The findings of this study suggest that prevention strategies should focus in Finland on less educated singles and in Estonia on young men generally.
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- 2009
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25. What Types of Essay Feedback Influence Implementation: Structure Alone or Structure and Content?
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John T. E. Richardson, Alison Twiner, Stephen Pulman, Denise Whitelock, Debora Field, Joosten-ten Brinke, D., and Laanpere, M.
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Structure (mathematical logic) ,Self-efficacy ,Process (engineering) ,4. Education ,05 social sciences ,Significant difference ,050301 education ,050109 social psychology ,Essay writing ,0501 psychology and cognitive sciences ,Content (Freudian dream analysis) ,Psychology ,0503 education ,Social psychology - Abstract
Students approach educational courses with varying levels of experience and understanding, and so need appropriate support to inform them of expectations and to guide their learning efforts. Feedback is critical in this process, so that learners can gauge how their performance aligns with expectations, and how they can improve their efforts and attainments. This study focused on the effects of providing different types of feedback on participants’ written essays, as well as on participants’ motivations for learning using measures of motivation and self-efficacy. In terms of research questions, it was important to ascertain whether participants performed differently in subsequent essays after receiving feedback on structure alone or on structure and content; whether their self-reported levels of motivation and attitudes to learning were related to essay performance; and whether the difference in type of feedback affected their self-reported levels of motivation and attitudes to learning. Findings revealed no significant difference in marks between those receiving feedback on structure alone and those receiving feedback on structure and content, which is surprising and deserves further exploration. Even so, using feedback to highlight certain structural elements of essay writing can have a lasting positive impact on participants’ future essay performance.
- Published
- 2017
26. An Analysis and Comparison of Adoption of E-learning Systems in Higher Education by Lecturers at Largest Universities in Estonia and Turkey
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Fatih Gullu, Rein Kuusik, Kazbulat Shogenov, Mart Laanpere, Yusuf Oysal, Omer Faruk Sozcu, Parlak, Zekeriya, Anadolu Üniversitesi, Shogenov, Kazbulat/0000-0002-0478-0281, Oysal, Yusuf, Gullu, F, Kuusik, R, Shogenov, K, Laanpere, M, Oysal, Y, Sozcu, OF, Parlak, Z, Sakarya Üniversitesi/Mühendislik Fakültesi/Makine Mühendisliği Bölümü, and Parlak, Zekeriya
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Estonia ,E-Learning ,Tam2 ,Technology Acceptance Model ,Turkey ,Computer Science ,Higher Education - Abstract
WOS: 000378084800004, In this study, for the first time, we analysed and compared adoption of e-learning by lecturers in three largest universities in Estonia and Turkey. Total number of students and academic staff in the Estonian universities is 39,259 and 3,991, respectively, and 1,194,735 and 9,076, respectively, in the Turkish universities. The extended Technology Acceptance Model (TAM2) was used to analyse results of acceptance and usage of e-learning by 923 lecturers (298 from Estonia and 625 from Turkey) or 22% from the sample subject, took part in the research from the studied universities. Total number of respondents subjected to the questionnaire distribution was 4,198 (1,423 in Estonia and 2,775 in Turkey). We found and analysed strong and weak sides of e-learning and main barriers, which hinder adoption of e-learning in Estonian and Turkish largest universities. Immediate measures to support development and improvement of e-learning system at higher education in these universities were suggested.
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- 2016
27. Improving Teacher Awareness Through Activity, Badge and Content Visualizations
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Erik Duval, Jose Luis Santos, Sven Charleer, Joris Klerkx, Cao, Y, Valjataga, T, Tang, JKT, Leung, H, and Laanpere, M
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learning analytics ,Reflection (computer programming) ,Computer science ,business.industry ,Dashboard (business) ,Learning analytics ,collaboration ,World Wide Web ,Information visualization ,learning dashboards ,open badges ,ComputingMilieux_COMPUTERSANDEDUCATION ,Mathematics education ,awareness ,information visualization ,Content (Freudian dream analysis) ,business ,reflection - Abstract
This paper introduces LARAe (Learning Analytics Reflection & Awareness environment), a teacher-oriented dashboard that visualizes learning traces from students, badges and course content. We also present an evaluation of the dashboard in a course on Human-Computer Interaction. The LARAe teacher dashboard provides a detailed overview of group and individual activities, achievements and course outcomes. To help visualize the abundance of traces, badges are used to abstract essential aspects of the course such as course goals and social activity. This paper reports our work on LARAe, presents the course in which we evaluated our approach with students and teachers, and analyses our first results that indicate that such an environment can help with teacher awareness. ispartof: pages:143-152 ispartof: Lecture Notes in Computer Science vol:8699 pages:143-152 ispartof: 1st International Workshop on Open Badges in Education location:Tallinn, Estonia date:14 Aug - 17 Aug 2014 status: published
- Published
- 2014
28. Social Network Analysis and Evaluation of Communities of Practice of Teachers: A Case Study
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Maria De Marsico, Andrea Sterbini, Filippo Sciarrone, Marco Temperini, Carla Limongelli, Valjataga T., Tang J.K.T., Cao Y., Laanpere M., Leung J.K.T., De Marsico, M, Limongelli, Carla, Sciarrone, F, Sterbini, A, and Temperini, M.
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community of practice ,Knowledge management ,Computer science ,business.industry ,Teacher ,Community of Practice ,Closeness ,Domain (software engineering) ,Social Network ,Teacher Education ,Community of practice ,Betweenness centrality ,Vocational education ,Learning ,Centrality ,business ,Social network analysis ,Educational program - Abstract
Communities of Practice (CoPs) may be interpreted as kinds of a vertical evolution of social networks, where members share common interests in a particular domain or area, and exchange practical experiences to increase their knowledge and skills with respect to that specific field. In this paper we present some evaluation aspects of an experiment conducted within the framework of the European project UnderstandIT. The experiment involved the use of a CoP providing an educational program on Web2.0 Technologies for education for Vocational Education and Training teachers. The CoP was designed on the basis of the foundational Wenger’s concepts of domain, community and practice. In particular, we present a study of some social aspects of the CoP dynamics, basing our study on some evaluation metrics coming from the Social Network Analysis research area, i.e., using metrics such as betweenness, centrality, and closeness, in order to elicit useful relationships information. The experimental results confirm the goodness of the use of such approach for the elicitation of hidden information in the communicative network processes.
- Published
- 2014
29. Using electronic health records to evaluate the adherence to cervical cancer prevention guidelines: A cross-sectional study.
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Mooses K, Šavrova A, Pajusalu M, Oja M, Tamm S, Haug M, Padrik L, Laanpere M, Uusküla A, and Kolde R
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- Humans, Female, Cross-Sectional Studies, Adult, Middle Aged, Estonia, Colposcopy, Papillomavirus Infections prevention & control, Mass Screening, Uterine Cervical Neoplasms prevention & control, Uterine Cervical Neoplasms diagnosis, Guideline Adherence statistics & numerical data, Electronic Health Records, Early Detection of Cancer, Papanicolaou Test, Vaginal Smears statistics & numerical data
- Abstract
Objective: The fight against cervical cancer requires effective screening together with optimal and on-time treatment along the care continuum. We examined the impact of cervical cancer testing and treatment guidelines on testing practices, and follow-up adherence to guidelines., Methods: Data from Estonian electronic health records and healthcare provision claims for 50,702 women was used. The annual rates of PAP tests, HPV tests and colposcopies during two guideline periods (2nd version 2012-2014 vs 3rd version 2016-2019) were compared. To assess the adherence to guidelines, the subjects were classified as adherent, over- or undertested based on the timing of the appropriate follow-up test., Results: The number of PAP tests decreased and HPV tests increased during the 3rd guideline period (p < 0.01). During the 3rd guideline period, among 21-29-year-old women, the adherence to guidelines ranged from 38.7% (44.4…50.1) for ASC-US to 73.4% (62.6…84.3) for HSIL and among 30-59-year-old from 49.0% (45.9…52.2) for ASC-US to 65.7% (58.8…72.7) for ASCH. The highest rate of undertested women was for ASC-US (21-29y: 25.7%; 30-59y: 21.9%). The rates of over-tested women remained below 12% for all cervical pathologies observed. There were 55.2% (95% CI 49.7…60.8) of 21-24-year-olds and 57.1% (95% CI 53.6…60.6) of 25-29-year-old women who received HPV test not adherent to guidelines., Conclusions: Our findings highlighted some shortcomings in guideline adherence, especially among women under 30. The insights gained from this study help to improve the quality of care and, thus, reduce cervical cancer incidence and mortality., 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. The author is an Editorial Board Member/Editor-in-Chief/Associate Editor/Guest Editor for [Journal name] and was not involved in the editorial review or the decision to publish this article., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
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- 2024
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30. Prevaccination Prevalence of Type-Specific Human Papillomavirus Infection by Grade of Cervical Cytology in Estonia.
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Uusküla A, Oja M, Tamm S, Tisler A, Laanpere M, Padrik L, Nygard M, Reisberg S, Vilo J, and Kolde R
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- Adult, Female, Humans, Middle Aged, Cross-Sectional Studies, Estonia epidemiology, Human papillomavirus 16, Human Papillomavirus Viruses, Phylogeny, Prevalence, Papillomavirus Infections diagnosis, Papillomavirus Infections epidemiology, Papillomavirus Infections prevention & control, Uterine Cervical Neoplasms diagnosis, Uterine Cervical Neoplasms epidemiology, Uterine Cervical Neoplasms prevention & control
- Abstract
Importance: Large-scale data on type-specific human papillomavirus (HPV) prevalence and disease burden worldwide are needed to guide cervical cancer prevention efforts. Promoting the research and application of health care big data has become a key factor in modern medical research., Objective: To examine the prevaccination prevalence of high-risk HPV (hrHPV) and type distribution by cervical cytology grade in Estonia., Design, Setting, and Participants: This cross-sectional study used text mining and the linking of data from electronic health records and health care claims to examine type-specific hrHPV positivity in Estonia from 2012 to 2019. Participants were women aged at least 18 years. Statistical analysis was performed from September 2021 to August 2022., Main Outcomes and Measures: Type-specific hrHPV positivity rate by cervical cytological grade., Results: A total of 11 017 cases of cervical cytology complemented with data on hrHPV testing results between 2012 and 2019 from 66 451 women aged at least 18 years (mean [SD] age, 48.1 [21.0] years) were included. The most common hrHPV types were HPV16, 18, 31, 33, 51 and 52, which accounted for 73.8% of all hrHPV types detected. There was a marked decline in the positivity rate of hrHPV infection with increasing age, but the proportion did not vary significantly based on HPV type. Implementation of nonavalent prophylactic vaccination was estimated to reduce the number of women with high-grade cytology by 50.5% (95% CI, 47.4%-53.6%) and the number with low-grade cytology by 27.8% (95% CI, 26.3%-29.3%), giving an overall estimated reduction of 33.1% (95% CI, 31.7%-34.5%) in the number of women with precancerous cervical cytology findings., Conclusions and Relevance: In this cross-sectional study, text mining and natural language processing techniques allowed the detection of precursors to cervical cancer based on data stored by the nationwide health system. These findings contribute to the literature on type-specific HPV distribution by cervical cytology grade and document that α-9 phylogenetic group HPV types 16, 31, 33, 52 and α-7 phylogenetic group HPV 18 are the most frequently detected in normal-to-high-grade precancerous lesions in Estonia.
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- 2023
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31. Trends in the use of hormonal contraception in Estonia 2005-2019 and the risk of arterial and venous thromboembolism: a population-based study.
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Kurvits K, Laius O, Uusküla M, and Laanpere M
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- Adolescent, Adult, Contraceptives, Oral, Hormonal administration & dosage, Estonia epidemiology, Female, Hormonal Contraception statistics & numerical data, Humans, Middle Aged, Population Surveillance, Risk Factors, Thromboembolism epidemiology, Venous Thromboembolism epidemiology, Young Adult, Contraceptives, Oral, Combined adverse effects, Contraceptives, Oral, Hormonal adverse effects, Hormonal Contraception trends, Thromboembolism chemically induced, Venous Thromboembolism chemically induced
- Abstract
Purpose: To describe trends in hormonal contraceptive use, incidence of thromboembolism and presence of risk factors for thromboembolism among the users in Estonia., Material and Methods: Data of 223 312 female patients aged 15-49 years in 2005-2019 from national health insurance databases was derived. Annual prevalence rates of hormonal contraceptive users, incidence rates of thromboembolism and prevalence rates of risk factors were calculated., Results: Between 2005-2019 usage of progestogen-only contraceptives (POCs) increased steadily (from 24 to 135 users per 1000 population), whereas combined hormonal contraceptive (CHC) use declined (from 209 in 2012 to 161 users per 1000 population in 2019). During the study period, 390 cases of venous thromboembolism and 108 arterial thromboembolism coincided with hormonal contraceptive use. Incidence rate for venous thromboembolism was 5.0 (95% CI 4.5-5.5) and for arterial thromboembolism 1.4 per 10 000 person-years (95% CI 1.1-1.7) among hormonal contraceptive users. Age adjusted incidence of venous thromboembolism among CHC users was 5.8 (95% CI 4.1-8.2) times higher than in POC users. Among CHC users, 10.3% had more than one risk factor for thrombosis., Conclusions: In regards to the risk of thromboembolism, wider use of POCs and declining prevalence of CHCs in Estonia is positive trend. Still, women with history of thrombosis receiving CHC is a serious concern.
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- 2021
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32. Polyvictimization and the Associations Between Poor Self-Perceived Health, Dissatisfaction With Life, and Sexual Dysfunction Among Women in Estonia.
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Lippus H, Laanpere M, Part K, Ringmets I, and Karro H
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- Adult, Anxiety epidemiology, Cross-Sectional Studies, Estonia epidemiology, Female, Health Status, Humans, Sex Offenses
- Abstract
The severe impact of different forms of violence on health has been demonstrated in a substantial number of studies. At the same time, it has been acknowledged that different forms of violence tend to co-occur, such that many survivors of violence have been exposed to more than one violent event and/or more than one form of violence. Despite mounting evidence concerning the associations between polyvictimization and health, there are still important gaps in this knowledge concerning adult female population's sexual health, including both physical and mental aspects associated with it. The aim of this study was to evaluate the exposure to emotional, physical, and sexual violence among women and associations with poor self-perceived health, dissatisfaction with life, stress, and worry due to sex life and sexual dysfunction. The term polyvictimization is used in this article to express the exposure to more than one form of violence. We used data from a cross-sectional study carried out in Estonia in 2014 among women aged 16 to 44 years. Responses of 2,333 women were analyzed for this article. Of all the respondents, 27.9% were polyvictimized. Women who had been exposed to all three forms of violence had, after adjusting for confounding factors, the highest risk of reporting poor self-perceived health, limited daily activities due to chronic health problems, feelings of depression, dissatisfaction with life, stress, and worry due to sex life and sexual dysfunction. The results of this study demonstrate that exposure to violence is associated with poorer health outcomes and that the association is stronger among those who have been polyvictimized.
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- 2021
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33. What do we know about the impact of sexual violence on health and health behaviour of women in Estonia?
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Lippus H, Laanpere M, Part K, Ringmets I, and Karro H
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- Adolescent, Adult, Cross-Sectional Studies, Estonia epidemiology, Female, Health Behavior, Humans, Prevalence, Young Adult, Sex Offenses, Sexually Transmitted Diseases
- Abstract
Background: Sexual violence against women is a major public health issue and a breach of human rights. Although various consequences of sexual violence on health have been described in a large number of scientific publications, very little is known about this topic in Estonia. The aim of this study was to examine the prevalence of sexual violence and associations between exposure to sexual violence and risky health and sexual behaviours among women in Estonia., Methods: A population-based cross-sectional study was carried out in Estonia in 2014. Self-reported data regarding selected indicators of risky health and sexual behaviours were collected from 1670 women, aged 18-44 years, via a self-administered questionnaire. To measure the prevalence of sexual violence, questions from the NorVold Abuse Questionnaire were included. Chi-square and multivariate logistic regression were used to analyse the data., Results: Of the respondents, 22.7% (n = 379) reported being exposed to sexual violence during their lifetime, and over half of these women had had these experiences before the age of 18. Statistically significant associations were found between sexual violence and smoking (adjusted odds ratio (AOR) 1.32, 95% CI 1.03-1.70), alcohol consumption (AOR 1.52, 95% CI 1.18-1.95), illicit drug use (AOR 2.21, 95% CI 1.70-2.89), sexual intercourse for money or other material reward (AOR 3.51, 95% CI 1.62-7.61), concurrent sexual relationships (AOR 2.64; 95% CI 1.80-3.86), and being diagnosed with sexually transmitted infections (AOR 1.48, 95% CI 1.09-2.01)., Conclusions: In Estonia, sexual violence against women is widespread and is associated with several risky health and sexual behaviours. Efforts should be made, both among the general public and professionals, to raise awareness regarding the prevalence and negative impact of sexual violence. Women who have been exposed to sexual violence are in need of professional medical, legal and psychological help free from prejudice to help them recover from such traumatic events.
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- 2020
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34. Seroprevalence of SARS-CoV-2 antibodies among pregnant women in Estonia: A call for epidemiological studies.
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Veerus P, Salumets A, Naaber P, Krjutškov K, Tilk K, Laanpere M, and Uusküla A
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- Betacoronavirus, COVID-19, Estonia epidemiology, Female, Humans, Pregnancy, SARS-CoV-2, Seroepidemiologic Studies, Coronavirus Infections, Pandemics, Pneumonia, Viral, Pregnancy Complications, Infectious epidemiology
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- 2020
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35. The prevalence and patterns of exposure to interpersonal violence among men and women in Estonia.
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Lippus H, Soo K, Laanpere M, Yount KM, Part K, Ringmets I, Ainsaar M, and Karro H
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- Adolescent, Adult, Child, Cross-Sectional Studies, Estonia epidemiology, Female, Humans, Male, Prevalence, Self Report, Sex Characteristics, Socioeconomic Factors, Young Adult, Crime Victims psychology, Violence classification, Violence statistics & numerical data
- Abstract
Background: To understand better the total burden of interpersonal violence on society, it is useful to assess the prevalence of interpersonal violence among both, men and women. Exposure to multiple forms of interpersonal violence, referred to as polyvictimization, has been associated with more severe health consequences than exposure to any form separately. The aims of this study were to assess the prevalence of emotional, physical and sexual interpersonal violence in childhood, adulthood and at both childhood and adulthood among men and women in Estonia, analyze the patterns of interpersonal violence and socio-demographic correlates of polyvictimization in adulthood by gender., Methods: The analysis was based on two population-based, cross-sectional, self-administered surveys carried out among men and women in Estonia in 2014. In both surveys, the NorVold Abuse questionnaire was used to measure exposure to interpersonal violence. Men and women aged 18-44 were included to the analysis., Results: Among men 66.6% and among women 54.2% had been exposed to at least one form of interpersonal violence during lifetime. Men had been more often exposed to isolated physical interpersonal violence, among women the distribution of different forms of interpersonal violence was more even and exposure to sexual violence was more common. The prevalence of polyvictimization in adulthood was two times higher among women compared to men and more socio-demographic correlates, were associated with it. Exposure to violence in childhood was associated with polyvictimization in adulthood across gender., Conclusions: The prevalence of interpersonal violence in Estonia is high among men and women. The most prevalent forms and patterns of interpersonal violence, however, differ by gender, as do the socio-demographic correlates. Screening for interpersonal violence, in childhood and adulthood, and gender-specific interventions are needed, especially for high-risk groups identified in this study. Primary prevention of childhood violence should be a priority, as it was associated with higher risk for exposure to violence later in life across gender., Competing Interests: The authors have declared that no competing interests exist.
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- 2020
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36. Compliance with Pregnancy Prevention Recommendations for Isotretinoin in Estonia in 2012-2016.
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Uusküla A, Pisarev H, Kurvits K, Laius O, Laanpere M, and Uusküla M
- Abstract
Background: Isotretinoin is an effective treatment for severe acne; no alternative treatment has an equal therapeutic effect. The teratogenic effects of isotretinoin can be avoided, and numerous recommendations and regulations are in force to minimize the risk of pregnancy during treatment., Objectives: To describe isotretinoin prescription patterns for women aged 15-45 years, assess the concomitancy of isotretinoin and contraceptive use, and determine the rate of potential isotretinoin-exposed pregnancies in Estonia., Methods: This retrospective, nationwide, population-based, cohort study derived data from national health insurance databases and included female patients aged 15-45 years in Estonia for whom one or more prescriptions for isotretinoin were dispensed between 2012 and 2016. The main outcome was the proportion of women who used systemic isotretinoin and had a concomitant record of (hormonal or intrauterine) contraception use covering the isotretinoin treatment period when pregnancy is contraindicated., Results: Of the 2792 women aged 15-45 years filling an isotretinoin prescription, 15.7% (95% CI 14.4-17.1) had full and 13.9% (95% CI 12.7-15.3) partial (not covering the whole period during which pregnancy is contraindicated) contraceptive coverage. The risk for potential isotretinoin-exposed pregnancy was 3.6 (95% CI 2.0-7.0) per 1000 treated women over the 5-year observation period. The odds for full coverage with effective contraception increased with the age of the patient, with the duration of isotretinoin treatment and over the period of observation., Conclusion: Our study adds to the existing literature documenting limited compliance with pregnancy prevention programs for isotretinoin-containing products, and calls for program assessment to identify whether new measures should be taken or whether weaknesses in policy or implementation can be corrected.
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- 2018
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37. Combination with antimicrobial peptide lyses improves loop-mediated isothermal amplification based method for Chlamydia trachomatis detection directly in urine sample.
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Jevtuševskaja J, Uusna J, Andresen L, Krõlov K, Laanpere M, Grellier T, Tulp I, and Langel Ü
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- Chlamydia trachomatis drug effects, Chlamydia trachomatis isolation & purification, DNA, Bacterial isolation & purification, DNA, Bacterial metabolism, Female, Humans, Limit of Detection, Male, Point-of-Care Systems, Pregnancy, Sensitivity and Specificity, Anti-Infective Agents pharmacology, Antimicrobial Cationic Peptides pharmacology, Chlamydia Infections diagnosis, Chlamydia trachomatis genetics, DNA, Bacterial urine, Nucleic Acid Amplification Techniques methods
- Abstract
Background: Chlamydia trachomatis is an obligate intracellular human pathogen and is the most common cause of sexually transmitted diseases affecting both men and women. The pathogen can cause prostatitis and epididymitis in men. In women, cervicitis, pelvic inflammatory disease, ectopic pregnancy and acute or chronic pelvic pain are frequent complications. More than half of C. trachomatis-positive patients have minimal or no symptoms, providing an ongoing reservoir for the infection. The lack of sensitive large-scale applicable point- of- care (POC) tests for C. trachomatis detection makes it difficult to diagnose chlamydia infection efficiently in resource-limited environments., Methods: A rapid and sensitive assay based on loop-mediated isothermal amplification method (LAMP) was combined with antimicrobial peptide lysis, which is able to detect at least 7 C. trachomatis pathogens per reaction directly from urine samples., Results: Our study comprising 91 first-void urine samples showed that specificity of the assay is 100 % and sensitivity 73 % when using antimicrobial peptide lysis mix. Additionally we demonstrate that our assay does not give any cross-reactivity with 30 pathogen's DNA potentially present in the urine samples. Furthermore, the assay's novel approach does not require purification or extraction of DNA from clinical sample prior to amplification, so the need for specialized equipment is eliminated., Conclusions: The whole procedure is significantly less laborious, less time-consuming and consequently less expensive for early detection and identification of infectious disease. C. trachomatis specific LAMP assay is relatively simple to perform and could therefore be applied in numerous POC settings.
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- 2016
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38. Contraceptive use among young women in Estonia: Association with contraceptive services.
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Part K, Ringmets I, Laanpere M, Rahu M, and Karro H
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- Adolescent, Cross-Sectional Studies, Estonia, Family Practice, Female, Gynecology, Humans, Logistic Models, Multivariate Analysis, Odds Ratio, Surveys and Questionnaires, Young Adult, Condoms statistics & numerical data, Contraception Behavior, Contraceptives, Oral, Hormonal therapeutic use, Family Planning Services, Health Services Accessibility, Intrauterine Devices statistics & numerical data, Sex Education statistics & numerical data
- Abstract
Objectives: Our study aimed to explore the association between the use of effective contraceptive methods and access to different contraceptive services, as well as to describe accessibility-related obstacles when using contraceptive services and satisfaction with those services., Methods: From a population-based cross-sectional study carried out in 2004 (response rate 53.8%), the data of 16- to 24-year-old women requiring contraception (N = 868) were analysed. Factors associated with the use of effective contraceptive methods and, specifically, hormonal methods, were explored using multiple logistic regression analysis., Results: Effective contraception was used by 75.1% of the respondents. The use of effective contraceptive methods was associated with school-based sexuality education (adjusted prevalence odds ratio 2.69; 95% confidence interval 1.32 - 5.50), visiting a youth-friendly clinic (YFC) (1.82; 1.03-3.23) or a private gynaecologist (2.08; 1.11-3.92). The use of hormonal methods was additionally associated with being a native Estonian speaker and visiting a family doctor. More than half of the respondents reported some obstacle in accessing contraceptive services. The highest satisfaction ratings were given to YFCs., Conclusions: Steps to promote the use of services that are youth-friendly and associated with better uptake of effective contraceptive methods are needed among all 16- to 24-year-old women.
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- 2016
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39. Pregnancy intendedness and the association with physical, sexual and emotional abuse - a European multi-country cross-sectional study.
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Lukasse M, Laanpere M, Karro H, Kristjansdottir H, Schroll AM, Van Parys AS, Wangel AM, and Schei B
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- Adult, Belgium epidemiology, Chi-Square Distribution, Cohort Studies, Cross-Sectional Studies, Estonia epidemiology, Female, Humans, Logistic Models, Parturition psychology, Pregnancy, Prenatal Care psychology, Prenatal Care statistics & numerical data, Prevalence, Prospective Studies, Risk Factors, Scandinavian and Nordic Countries epidemiology, Sexual Partners, Stress, Psychological complications, Surveys and Questionnaires, Physical Abuse statistics & numerical data, Pregnancy, Unplanned psychology, Pregnancy, Unwanted psychology, Sex Offenses statistics & numerical data, Stress, Psychological epidemiology
- Abstract
Background: Unintended pregnancies are common and when not resulting in a termination of pregnancy may lead to unintended childbirth. Unintended pregnancies are associated with increased health risks, also for women for whom pregnancy continues to childbirth. Our objective was to present the prevalence of unintended pregnancy in six European countries among pregnant women attending routine antenatal care, and to investigate the association with a history of physical, sexual and emotional abuse., Methods: A prospective cross-sectional study, of 7102 pregnant women who filled out a questionnaire during pregnancy as part of a multi-country cohort study (Bidens) with the participating countries: Belgium, Iceland, Denmark, Estonia, Norway and Sweden. A validated instrument, the Norvold Abuse Questionnaire (NorAq) consisting of 10 descriptive questions measured abuse. Pregnancy intendedness was assessed using a single question asking women if this pregnancy was planned. Cross-tabulation, Chi-square tests and binary logistic regression analysis were used., Results: Approximately one-fifth (19.2 %) of all women reported their current pregnancy to be unintended. Women with an unintended pregnancy were significantly younger, had less education, suffered economic hardship, had a different ethnic background from the regional majority and more frequently were not living with their partner. The prevalence of an unintended pregnancy among women reporting any lifetime abuse was 24.5 %, and 38.5 % among women reporting recent abuse. Women with a history of any lifetime abuse had significantly higher odds of unintended pregnancy, also after adjusting for confounding factors, AOR for any lifetime abuse 1.41 (95 % CI 1.23-1.60) and for recent abuse AOR 2.03 (95 % CI 1.54-2.68)., Conclusion: Women who have experienced any lifetime abuse are significantly more likely to have an unintended pregnancy. This is particularly true for women reporting recent abuse, suggesting that women living in a violent relationship have less control over their fertility.
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- 2015
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40. Abortion trends from 1996 to 2011 in Estonia: special emphasis on repeat abortion.
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Laanpere M, Ringmets I, Part K, Allvee K, Veerus P, and Karro H
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- Abortion, Induced statistics & numerical data, Adolescent, Adult, Age Distribution, Condoms statistics & numerical data, Contraceptives, Oral therapeutic use, Educational Status, Employment statistics & numerical data, Estonia, Female, Humans, Intrauterine Devices statistics & numerical data, Marital Status statistics & numerical data, Middle Aged, Parity, Pregnancy, Young Adult, Abortion, Induced trends, Contraception trends, Contraception Behavior trends
- Abstract
Background: The study aimed to describe the overall and age-specific trends of induced abortions from 1996 to 2011 with an emphasis on socio-demographic characteristics and contraceptive use of women having had repeat abortions in Estonia., Methods: Data were retrieved from the Estonian Medical Birth and Abortion Registry and Statistics Estonia. Total induced abortion numbers, rates, ratios and age-specific rates are presented for 1996-2011. The percentage change in the number of repeat abortions within selected socio-demographic subgroups, contraception use and distribution of induced abortions among Estonians and non-Estonians for the first, second, third, fourth and subsequent abortions were calculated for the periods 1996-2003 and 2004-2011., Results: Observed trends over the 16-year study period indicated a considerable decline in induced abortions with a reduction in abortion rate of 57.1%, which was mainly attributed to younger cohorts. The percentage of women undergoing repeat abortions fell steadily from 63.8% during 1996-2003 to 58.0% during 2004-2011. The percentage of women undergoing repeat abortions significantly decreased over the 16 years within all selected socio-demographic subgroups except among women with low educational attainment and students. Within each time period, a greater percentage of non-Estonians than Estonians underwent repeat abortions and obtained third and subsequent abortions. Most women did not use any contraceptive method prior to their first or subsequent abortion., Conclusion: A high percentage of women obtaining repeat abortions reflects a high historical abortion rate. If current trends continue, a rapid decline in repeat abortions may be predicted. To decrease the burden of sexual ill health, routine contraceptive counselling, as standard care in the abortion process, should be seriously addressed with an emphasis on those groups--non-Estonians, women with lower educational attainment, students and women with children--vulnerable with respect to repeat abortion.
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- 2014
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41. Prevalence of emotional, physical and sexual abuse among pregnant women in six European countries.
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Lukasse M, Schroll AM, Ryding EL, Campbell J, Karro H, Kristjansdottir H, Laanpere M, Steingrimsdottir T, Tabor A, Temmerman M, Van Parys AS, Wangel AM, and Schei B
- Subjects
- Adult, Belgium epidemiology, Child, Cohort Studies, Estonia epidemiology, Female, Humans, Logistic Models, Pregnancy, Pregnant Women, Prenatal Care, Prevalence, Scandinavian and Nordic Countries epidemiology, Surveys and Questionnaires, Child Abuse statistics & numerical data, Sex Offenses statistics & numerical data, Spouse Abuse statistics & numerical data
- Abstract
Objectives: The primary objective was to investigate the prevalence of a history of abuse among women attending routine antenatal care in six northern European countries. Second, we explored current suffering from reported abuse., Design: A prospective cohort study., Setting: Routine antenatal care in Belgium, Iceland, Denmark, Estonia, Norway, and Sweden between March 2008 and August 2010., Population: A total of 7174 pregnant women., Methods: A questionnaire including a validated instrument measuring emotional, physical and sexual abuse., Main Outcome Measure: Proportion of women reporting emotional, physical and sexual abuse. Severe current suffering defined as a Visual Analogue Scale score of ≥6., Results: An overall lifetime prevalence of any abuse was reported by 34.8% of the pregnant women. The ranges across the six countries of lifetime prevalence were 9.7-30.8% for physical abuse, 16.2-27.7% for emotional abuse, and 8.3-21.1% for sexual abuse. Few women reported current sexual abuse, 0.4% compared with 2.2% current physical abuse and 2.7% current emotional abuse. Current severe suffering was reported by 6.8% of the women who reported physical abuse, 9.8% of those who reported sexual abuse and 13.5% for emotional abuse., Conclusion: A high proportion of pregnant women attending routine antenatal care report a history of abuse. About one in ten of them experiences severe current suffering from the reported abuse. In particular, these women might benefit from being identified in the antenatal care setting and being offered specialized care., (© 2014 Nordic Federation of Societies of Obstetrics and Gynecology.)
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- 2014
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42. Socioeconomic differences in self-rated health among women: a comparison of St. Petersburg to Estonia and Finland.
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Dubikaytis T, Härkänen T, Regushevskaya E, Hemminki E, Haavio-Mannila E, Laanpere M, Kuznetsova O, and Koskinen S
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- Adolescent, Adult, Estonia, Female, Finland, Health Surveys, Humans, Poverty, Russia, Self Report, Young Adult, Educational Status, Employment, Health Status Disparities, Income, Women's Health economics
- Abstract
Introduction: Social determinants of health have not been intensively studied in Russia, even though the health divide has been clearly demonstrated by an increased mortality rate among those with low education. A comparative analysis of social health determinants in countries with different historical and economic backgrounds may provide useful evidence for addressing health inequalities. We aimed to assess socioeconomic determinants of self-rated health in St. Petersburg as compared to Estonia and Finland., Methods: Data for women aged 18-44 were extracted from existing population-based surveys and analysed. In St. Petersburg the data were originally collected in 2003 (response rate 68%), in Estonia in 2004-2005 (54%), and in Finland in 2000-2001 (86%). The study samples comprised 865 women in St. Petersburg, 2141 in Estonia and 1897 in Finland., Results: Self-rated health was much poorer in St. Petersburg than in Estonia or Finland. High education was negatively associated with poor self-rated health in all the studied populations; it was (partially) mediated via health behaviour and limiting long-term illness only in Estonia and Finland, but not in St. Petersburg. High personal income and employment did not associate with poor self-rated health among St. Petersburg women, as it did in Estonia and Finland. In St. Petersburg housewives rather than employed women had better self-rated health, unlike the two other areas., Conclusion: Women's self-rated health in St. Petersburg varied similarly by education but differently by income and employment as compared to Estonia and Finland. Education is likely the most meaningful dimension of women's socioeconomic position in St. Petersburg. More research is needed to further clarify the pathways between socioeconomic position and health in Russia.
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- 2014
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43. A history of abuse and operative delivery--results from a European multi-country cohort study.
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Schei B, Lukasse M, Ryding EL, Campbell J, Karro H, Kristjansdottir H, Laanpere M, Schroll AM, Tabor A, Temmerman M, Van Parys AS, Wangel AM, and Steingrimsdottir T
- Subjects
- Adult, European Union, Female, Humans, Pregnancy, Risk Factors, Cesarean Section, Emergency Medical Services, Medical Records, Sex Offenses
- Abstract
Objective: The main aim of this study was to assess whether a history of abuse, reported during pregnancy, was associated with an operative delivery. Secondly, we assessed if the association varied according to the type of abuse and if the reported abuse had been experienced as a child or an adult., Design: The Bidens study, a cohort study in six European countries (Belgium, Iceland, Denmark, Estonia, Norway, and Sweden) recruited 6724 pregnant women attending routine antenatal care. History of abuse was assessed through questionnaire and linked to obstetric information from hospital records. The main outcome measure was operative delivery as a dichotomous variable, and categorized as an elective caesarean section (CS), or an operative vaginal birth, or an emergency CS. Non-obstetrically indicated were CSs performed on request or for psychological reasons without another medical reason. Binary and multinomial regression analysis were used to assess the associations., Results: Among 3308 primiparous women, sexual abuse as an adult (≥ 18 years) increased the risk of an elective CS, Adjusted Odds Ratio 2.12 (1.28-3.49), and the likelihood for a non-obstetrically indicated CS, OR 3.74 (1.24-11.24). Women expressing current suffering from the reported adult sexual abuse had the highest risk for an elective CS, AOR 4.07 (1.46-11.3). Neither physical abuse (in adulthood or childhood <18 years), nor sexual abuse in childhood increased the risk of any operative delivery among primiparous women. Among 3416 multiparous women, neither sexual, nor emotional abuse was significantly associated with any kind of operative delivery, while physical abuse had an increased AOR for emergency CS of 1.51 (1.05-2.19)., Conclusion: Sexual abuse as an adult increases the risk of an elective CS among women with no prior birth experience, in particular for non-obstetrical reasons. Among multiparous women, a history of physical abuse increases the risk of an emergency CS.
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- 2014
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44. Sensitive and rapid detection of Chlamydia trachomatis by recombinase polymerase amplification directly from urine samples.
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Krõlov K, Frolova J, Tudoran O, Suhorutsenko J, Lehto T, Sibul H, Mäger I, Laanpere M, Tulp I, and Langel Ü
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- Chlamydia Infections genetics, Chlamydia trachomatis enzymology, DNA, Bacterial analysis, DNA-Directed DNA Polymerase chemistry, Diacylglycerol Cholinephosphotransferase genetics, Female, Glyceraldehyde-3-Phosphate Dehydrogenase (Phosphorylating) genetics, Humans, Molecular Diagnostic Techniques methods, Nucleic Acid Amplification Techniques, Polymerase Chain Reaction, Recombinases chemistry, Sensitivity and Specificity, Sexually Transmitted Diseases, Bacterial genetics, Chlamydia Infections diagnosis, Chlamydia Infections urine, Chlamydia trachomatis genetics, Sexually Transmitted Diseases, Bacterial diagnosis, Sexually Transmitted Diseases, Bacterial urine
- Abstract
Chlamydia trachomatis is the most common sexually transmitted human pathogen. Infection results in minimal to no symptoms in approximately two-thirds of women and therefore often goes undiagnosed. C. trachomatis infections are a major public health concern because of the potential severe long-term consequences, including an increased risk of ectopic pregnancy, chronic pelvic pain, and infertility. To date, several point-of-care tests have been developed for C. trachomatis diagnostics. Although many of them are fast and specific, they lack the required sensitivity for large-scale application. We describe a rapid and sensitive form of detection directly from urine samples. The assay uses recombinase polymerase amplification and has a minimum detection limit of 5 to 12 pathogens per test. Furthermore, it enables detection within 20 minutes directly from urine samples without DNA purification before the amplification reaction. Initial analysis of the assay from clinical patient samples had a specificity of 100% (95% CI, 92%-100%) and a sensitivity of 83% (95% CI, 51%-97%). The whole procedure is fairly simple and does not require specific machinery, making it potentially applicable in point-of-care settings., (Copyright © 2014 American Society for Investigative Pathology and the Association for Molecular Pathology. Published by Elsevier Inc. All rights reserved.)
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- 2014
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45. Intimate partner violence and sexual health outcomes: a population-based study among 16-44-year-old women in Estonia.
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Laanpere M, Ringmets I, Part K, and Karro H
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- Adolescent, Adult, Cross-Sectional Studies, Estonia epidemiology, Female, Humans, Pregnancy, Reproductive Health education, Risk-Taking, Sexual Partners, Women's Health ethnology, Young Adult, Reproductive Health trends, Violence classification
- Abstract
Background: Violence against women as a public issue and health burden has only recently been acknowledged in Estonia. The aim of this study was to outline the prevalence and to explore the associations of intimate partner violence (IPV) and selected sexual health outcomes., Methods: Data from the population based cross-sectional survey among representative sample of 16-44-year-old non-pregnant women (n = 1966) were analysed using multivariate logistic regression., Results: Of 1966 respondents, 362 (18.4%) reported IPV during 12 months preceding the survey. Physical IPV was reported by 339 (17.2%), sexual by 80 (4.1%) and both physical and sexual by 35 (1.8%) of respondents. After controlling for significant confounding socio-demographic factors, exposure to IPV was found to be associated with contraception non-use [adjusted odds ratio (AOR) = 2.02, 95% confidence interval (CI) 1.44-2.82] or the use of unreliable contraceptive methods (AOR = 1.54, CI 1.16-2.04) during the most recent sexual intercourse, having never used a condom (AOR = 1.53, CI 1.12-2.10), repeat induced abortion (AOR = 1.72, CI 1.24-2.37), lifetime sexually transmitted infections (AOR = 2.05, CI 1.56-2.68) and dyspareunia (AOR = 2.14, CI 1.65-2.77)., Conclusion: The exposure of IPV was an important contributor to sexual risk behaviour and adverse sexual health outcomes among women of reproductive age in Estonia. Any strategy to promote sexual health should include prevention of IPV and other forms of violence against women with the strengthening of women's sexual and reproductive rights.
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- 2013
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46. Ethnic differences in factors associated with the use of contraception among 20- to 44-year-old women in Estonia and St. Petersburg, Russia.
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Laanpere M, Rahu K, Part K, Dubikaytis T, and Karro H
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- Abortion, Induced psychology, Adolescent, Adult, Age Factors, Cross-Sectional Studies, Estonia, Female, Health Surveys, Humans, Language, Multivariate Analysis, Needs Assessment, Parity, Pregnancy, Risk Factors, Russia, Socioeconomic Factors, Young Adult, Contraception Behavior ethnology, Safe Sex ethnology
- Abstract
Background: The aim of this study was to explore factors associated with contraception among 20- to 44-year-old women in different ethnic groups in two Eastern European countries., Study Design: Data on sexually experienced women in need of contraception taken from population-based cross-sectional surveys, conducted in Estonia (n=1680) and in St. Petersburg (n=798), were analyzed. Factors associated with contraception nonuse or the use of unreliable contraceptive methods were explored using multivariate logistic regression analysis., Results: The age-standardized prevalence rate of contraception nonuse or the use of unreliable contraceptive methods was high (27.3% among Estonian-speaking women in Estonia, 39.9% and 42.5% among Russian-speaking women in Estonia and in St. Petersburg, respectively). Age, economic subsistence, high-risk sexual behavior and smoking did not correlate with contraception nonuse or the use of unreliable contraceptive methods among Russian-speaking women in Estonia and in St. Petersburg; this was in contrast to Estonian-speaking women in Estonia. Previous childbirth and abortion reduced the risk of contraception nonuse or the use of unreliable contraceptive methods among Estonian-speaking women in Estonia (adjusted odds ratio, 0.50; 95% confidence interval [CI], 0.31-0.81) but elevated the risk among Russian-speaking women in St. Petersburg (1.99; 1.17-3.40). Abortion, not previous childbirth, was associated with an increased risk among Russian-speaking women in Estonia (2.94; 1.25-6.95)., Conclusions: The importance of different risk factors associated with contraceptive use varies between different ethnic groups. Cross-national comparisons are essential for the design of public health policies that decrease the burden of sexual ill health., (Copyright © 2012 Elsevier Inc. All rights reserved.)
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- 2012
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47. A folate receptor alpha double-mutated haplotype 1816delC-1841A is distributed throughout Eurasia and associated with lower erythrocyte folate levels.
- Author
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Nilsson TK, Laanpere M, Altmäe S, Serra-Majem L, and Salumets A
- Subjects
- Adult, Alleles, Asia, Base Pairing genetics, Europe, Female, Homocysteine blood, Humans, Male, Polymerase Chain Reaction, Prevalence, Vitamin B 12 blood, Erythrocytes metabolism, Folate Receptor 1 genetics, Folic Acid blood, Haplotypes genetics, Mutation genetics
- Abstract
Folate is crucial for various cellular functions. Several transport mechanisms allow folate to enter the intracellular compartment with folate receptor-α being the major high-affinity receptor. Rare genetic variations in exons of the FR-α gene, FOLR1, were recently shown to cause severe folate deficiency accompanied by neurological and other disturbances. So far, similar effects by genetic variation in noncoding parts of the FOLR1 gene have not been identified. The aim of our study was to determine biochemically the haplotype structure of two linked polymorphisms in the FOLR1 gene, 1816delC and 1841G>A, the prevalences of the mutated alleles across Eurasia, and their possible effects on physiological folate levels in vivo. For this purpose we employed allele-specific PCR and Pyrosequencing technology and performed genotyping in 738 subjects from Spain, 387 from Sweden, 952 from Estonia, and 47 from Korea. We demonstrate the presence of an ancient double-mutated haplotype 1816delC-1841A in the FOLR1 gene, with the prevalence of the mutated allele being highest among Koreans (q = 0.074), lower in Estonians (q = 0.017), Spaniards (q = 0.0061), and the lowest among Swedes (q = 0.0026). Erythrocyte folate levels were studied in the Spanish population sample, where subjects carrying the double-mutated FOLR1 haplotype had significantly reduced levels by 27% (P = 0.039), adjusted for serum vitamin B(12) levels and MTHFR 677C>T genotype, while the mean serum folate levels were only 20% lower among the carriers (P = 0.11). Plasma homocysteine and cobalamin levels did not differ. Thus, we have demonstrated by molecular haplotyping an ancient double-mutated haplotype 1816delC-1841A in the FOLR1 gene, spread over the whole Eurasian continent, which may be of functional importance for uptake of folate in red blood cells.
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- 2012
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48. The determinants of sexually transmitted infections among reproductive age women in St. Petersburg, Estonia and Finland.
- Author
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Regushevskaya E, Dubikaytis T, Laanpere M, Nikula M, Kuznetsova O, Karro H, Haavio-Mannila E, and Hemminki E
- Subjects
- Adolescent, Adult, Condoms statistics & numerical data, Estonia epidemiology, Female, Finland epidemiology, Health Surveys, Humans, Interviews as Topic, Russia epidemiology, Sexual Behavior, Sexually Transmitted Diseases, Bacterial etiology, Sexually Transmitted Diseases, Bacterial transmission, Social Class, Young Adult, Risk-Taking, Sexually Transmitted Diseases, Bacterial epidemiology
- Abstract
Objectives: Sexually transmitted infections' (STIs) rate vary in St. Petersburg, Estonia and Finland; the aim was to compare the determinants of self-reported sexually transmitted infections in these areas., Methods: Data from four population-based questionnaire surveys were used (Finland in 1992 and 1999; St. Petersburg in 2003; Estonia in 2004). With the exception of the 1992 Finnish survey (interview) all were postal surveys, with 1,070 respondents in Finland (78 and 52% response rates), 1,147 (68%) in St. Petersburg, and 5,190 (54%) in Estonia., Results: Risky sexual behaviours were equally common in the three areas and the determinants were the same. Women with an STIs history more often had had their first sexual intercourse when aged under 18, had not used condom during first intercourse, had a high number of lifetime or previous year sexual partners. However, marital status and education were not similar determinants. Cohabiting and well-educated women in Finland were more likely to have STIs while in other areas the associations found were not statistically significant., Conclusions: Risky behaviour predicts STIs, but does not explain the varying rates of STIs between areas.
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- 2010
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49. Androgen receptor epigenetic variations influence early follicular phase gonadotropin levels.
- Author
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Laisk T, Haller-Kikkatalo K, Laanpere M, Jakovlev U, Peters M, Karro H, and Salumets A
- Subjects
- Adult, Alleles, Case-Control Studies, Female, Gene Expression Regulation, Genetic Predisposition to Disease, Genetic Variation, Gonadotropins genetics, Humans, Luteinizing Hormone blood, Luteinizing Hormone genetics, Microsatellite Repeats, Phenotype, Polycystic Ovary Syndrome blood, Polymerase Chain Reaction methods, Polymorphism, Genetic, Primary Ovarian Insufficiency blood, Reference Values, Risk Assessment, Epigenesis, Genetic, Follicular Phase genetics, Gonadotropins blood, Polycystic Ovary Syndrome genetics, Primary Ovarian Insufficiency genetics, Receptors, Androgen genetics, X Chromosome Inactivation genetics
- Abstract
Objective: we examined the influence of the androgen receptor gene (AR) CAG microsatellite (AR-CAG) repeat polymorphism and X-chromosome inactivation (XCI) pattern on ovarian reserve markers (follicle stimulating hormone (FSH) and antral follicle count on menstrual cycle day 3-5) and disease etiology in patients with polycystic ovarian syndrome (PCOS) or premature ovarian failure (POF)., Design: case-control study. Population. In all, 32 women with PCOS, 26 women with POF and 79 controls were investigated., Methods: AR-CAG and XCI were analyzed using polymerase chain reaction-based assays following DNA digestion with the methylation-sensitive restrictase HpaII., Main Outcome Measures: distribution of AR-CAG alleles and XCI patterns., Results: POF patients had shorter AR-CAG microsatellites than controls. AR-CAG microsatellite length was negatively associated with serum dehydroepiandrosterone sulfate level. The magnitude of XCI skewing was negatively and positively correlated with luteinizing hormone (LH) and FSH serum levels, respectively, during the early follicular phase, but showed no correlation with the number of early antral follicles., Conclusions: our results suggest that AR-CAG variations and XCI pattern exert an effect on FSH and LH values, and also have the potential to influence the etiopathogenesis of POF.
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- 2010
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50. Variations in folate pathway genes are associated with unexplained female infertility.
- Author
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Altmäe S, Stavreus-Evers A, Ruiz JR, Laanpere M, Syvänen T, Yngve A, Salumets A, and Nilsson TK
- Subjects
- Adult, Carrier Proteins genetics, Carrier Proteins metabolism, Carrier Proteins physiology, Cross-Sectional Studies, Cystathionine gamma-Lyase genetics, Cystathionine gamma-Lyase physiology, Female, Folate Receptor 1, Folate Receptors, GPI-Anchored, Folic Acid blood, Folic Acid physiology, Homocysteine blood, Humans, Infertility, Female enzymology, Membrane Transport Proteins genetics, Methylenetetrahydrofolate Reductase (NADPH2) genetics, Methylenetetrahydrofolate Reductase (NADPH2) physiology, Polymorphism, Genetic genetics, Receptors, Cell Surface genetics, Receptors, Cell Surface metabolism, Receptors, Cell Surface physiology, Reduced Folate Carrier Protein, Transcobalamins genetics, Transcobalamins physiology, Vitamin B 12 blood, Folic Acid genetics, Genetic Association Studies, Genetic Variation genetics, Infertility, Female diagnosis, Infertility, Female genetics, Signal Transduction genetics
- Abstract
Objective: To investigate associations between folate-metabolizing gene variations, folate status, and unexplained female infertility., Design: An association study., Setting: Hospital-based IVF unit and university-affiliated reproductive research laboratories., Patient(s): Seventy-one female patients with unexplained infertility., Intervention(s): Blood samples for polymorphism genotyping and homocysteine, vitamin B12, and folate measurements., Main Outcome Measure(s): Allele and genotype frequencies of the following polymorphisms: 5,10-methylenetetrahydrofolate reductase (MTHFR) 677C/T, 1298A/C, and 1793G/A, folate receptor 1 (FOLR1) 1314G/A, 1816delC, 1841G/A, and 1928C/T, transcobalamin II (TCN2) 776C/G, cystathionase (CTH) 1208G/T and solute carrier family 19, member 1 (SLC19A1) 80G/A, and concentrations of plasma homocysteine, vitamin B12, and serum folate., Result(s): MTHFR genotypes 677CT and 1793GA, as well as 1793 allele A were significantly more frequent among controls than in patients. The common MTHFR wild-type haplotype (677, 1298, 1793) CAG was less prevalent, whereas the rare haplotype CCA was more frequent in the general population than among infertility patients. The frequency of SLC19A1 80G/A genotypes differed significantly between controls and patients and the A allele was more common in the general population than in infertile women. Plasma homocysteine concentrations were influenced by CTH 1208G/T polymorphism among infertile women., Conclusion(s): Polymorphisms in folate pathway genes could be one reason for fertility complications in some women with unexplained infertility., (Copyright (c) 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)
- Published
- 2010
- Full Text
- View/download PDF
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