Search

Background Leg cramps are painful sensations of tightening in the muscles of the legs that commonly appear during the night and are often associated with secondary insomnia. They are common especially in older age. There is no evidence that any method of prevention of nocturnal leg cramps is both safe and effective. There are no previous trials concerning cramp prevention by using compression stockings. The objective of this study is to assess in a prospective randomised controlled trial whether leg cramps can be prevented by the daily use of knee-length compression stockings or magnesium supplements. Methods The study will be set in Finland, and 50–84-year-old volunteers will be recruited through Google Ads, the Finnish health library website and Finnish primary health care centres. The participants must have a minimum of two episodes of leg cramps per week for the past 4 weeks to be included in the study. The participants (n = 225) will be allocated to three equal groups: the compression stocking arm, the magnesium supplement arm and the placebo arm. The participants will go through 4 weeks of follow-up without intervention and then another 4 weeks of follow-up with the assigned intervention. The material for the study will be collected through electronic questionnaires. Discussion This protocol describes a study that compares compression stockings, magnesium supplements and placebo for the prevention of leg cramps. The results of this study can significantly improve knowledge on the methods of preventing leg cramps. Trial registration ClinicalTrials.gov NCT04694417. Registered on Jan 4, 2021.

Consumers’ increasing fascination with recreational eating out has contributed to numerous transformations in the upmarket restaurant practice. This paper explores such changes in regard to the “social” aspects of eating out, focusing particularly on the “cultural phenomenon” and practice of eating publicly alone (solo dining). Specifically, the paper extends previous portrayals of solo dining as a bundle of aloneness and togetherness by exploring such interplay in the context of the aestheticization of eating and/or the aesthetic food(ie) movement. Based on the interviews of Finnish food/restaurant enthusiasts and exponents of solo dining, the paper firstly depicts solo dining as a practice in which eating publicly alone is celebrated for the sake of enhanced aesthetic immersion. Secondly, the paper argues that solo dining can indeed be interpreted as a form of eating together and depicts the myriad ways, both concrete and “anonymous”, through which solo restaurant meals are shared between like-minded enthusiasts. Thus, the aesthetically oriented slice of solo dining becomes not understood as a complete departure from the ideal of shared public meals but as an alternative manifestation of commensality within an enthusiasm-based consumer group characteristic of late modern consumer culture.

Background: Prediction tools that combine polygenic risk scores with clinical factors provide a new opportunity for improved prediction and prevention of atherosclerotic cardiovascular disease, but the clinical utility of polygenic risk score has remained unclear. Methods: We collected a prospective cohort of 7342 individuals (64% women, mean age 56 years) and estimated their 10-year risk for atherosclerotic cardiovascular disease both by a traditional risk score and a composite score combining the effect of a polygenic risk score and clinical risk factors. We then tested how returning the personal risk information with an interactive web-tool impacted on the participants’ health behavior. Results: When reassessed after 1.5 years by a clinical visit and questionnaires, 20.8% of individuals at high (>10%) 10-year atherosclerotic cardiovascular disease risk had seen a doctor, 12.4% reported weight loss, 14.2% of smokers had quit smoking, and 15.4% had signed up for health coaching online. Altogether, 42.6% of persons at high risk had made one or more health behavioral changes versus 33.5% of persons at low/average risk such that higher baseline risk predicted a favorable change (OR [CI], 1.53 [1.37–1.72] for persons at high risk versus the rest, P P P =0.003) contributing independently. Conclusions: Web-based communication of personal atherosclerotic cardiovascular disease risk-data including polygenic risk to middle-aged persons motivates positive changes in health behavior and the propensity to seek care. It supports integration of genomic information into clinical risk calculators as a feasible approach to enhance disease prevention.

BACKGROUND The COVID-19 pandemic has prevailed over a year, and log and register data on coronavirus have been utilized to establish models for detecting the pandemic. However, many sources contain unreliable health information on COVID-19 and its symptoms, and platforms cannot characterize the users performing searches. Prior studies have assessed symptom searches from general search engines (Google/Google Trends). Little is known about how modeling log data on smell/taste disorders and coronavirus from the dedicated internet databases used by citizens and health care professionals (HCPs) could enhance disease surveillance. Our material and method provide a novel approach to analyze web-based information seeking to detect infectious disease outbreaks. OBJECTIVE The aim of this study was (1) to assess whether citizens’ and professionals’ searches for smell/taste disorders and coronavirus relate to epidemiological data on COVID-19 cases, and (2) to test our negative binomial regression modeling (ie, whether the inclusion of the case count could improve the model). METHODS We collected weekly log data on searches related to COVID-19 (smell/taste disorders, coronavirus) between December 30, 2019, and November 30, 2020 (49 weeks). Two major medical internet databases in Finland were used: Health Library (HL), a free portal aimed at citizens, and Physician’s Database (PD), a database widely used among HCPs. Log data from databases were combined with register data on the numbers of COVID-19 cases reported in the Finnish National Infectious Diseases Register. We used negative binomial regression modeling to assess whether the case numbers could explain some of the dynamics of searches when plotting database logs. RESULTS We found that coronavirus searches drastically increased in HL (0 to 744,113) and PD (4 to 5375) prior to the first wave of COVID-19 cases between December 2019 and March 2020. Searches for smell disorders in HL doubled from the end of December 2019 to the end of March 2020 (2148 to 4195), and searches for taste disorders in HL increased from mid-May to the end of November (0 to 1980). Case numbers were significantly associated with smell disorders (PPP CONCLUSIONS Novel infodemiological approaches could be used in analyzing database logs. Modeling log data from web-based sources was seen to improve the model only occasionally. However, search behaviors among citizens and professionals could be used as a supplementary source of information for infectious disease surveillance. Further research is needed to apply statistical models to log data of the dedicated medical databases.

Publisher Copyright: © Milla Mukka, Samuli Pesälä, Charlotte Hammer, Pekka Mustonen, Vesa Jormanainen, Hanna Pelttari, Minna Kaila, Otto Helve. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 07.12.2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Public Health and Surveillance, is properly cited. The complete bibliographic information, a link to the original publication on https://publichealth.jmir.org, as well as this copyright and license information must be included. Background: The COVID-19 pandemic has prevailed over a year, and log and register data on coronavirus have been utilized to establish models for detecting the pandemic. However, many sources contain unreliable health information on COVID-19 and its symptoms, and platforms cannot characterize the users performing searches. Prior studies have assessed symptom searches from general search engines (Google/Google Trends). Little is known about how modeling log data on smell/taste disorders and coronavirus from the dedicated internet databases used by citizens and health care professionals (HCPs) could enhance disease surveillance. Our material and method provide a novel approach to analyze web-based information seeking to detect infectious disease outbreaks. Objective: The aim of this study was (1) to assess whether citizens' and professionals' searches for smell/taste disorders and coronavirus relate to epidemiological data on COVID-19 cases, and (2) to test our negative binomial regression modeling (ie, whether the inclusion of the case count could improve the model). Methods: We collected weekly log data on searches related to COVID-19 (smell/taste disorders, coronavirus) between December 30, 2019, and November 30, 2020 (49 weeks). Two major medical internet databases in Finland were used: Health Library (HL), a free portal aimed at citizens, and Physician's Database (PD), a database widely used among HCPs. Log data from databases were combined with register data on the numbers of COVID-19 cases reported in the Finnish National Infectious Diseases Register. We used negative binomial regression modeling to assess whether the case numbers could explain some of the dynamics of searches when plotting database logs. Results: We found that coronavirus searches drastically increased in HL (0 to 744,113) and PD (4 to 5375) prior to the first wave of COVID-19 cases between December 2019 and March 2020. Searches for smell disorders in HL doubled from the end of December 2019 to the end of March 2020 (2148 to 4195), and searches for taste disorders in HL increased from mid-May to the end of November (0 to 1980). Case numbers were significantly associated with smell disorders (P

Background Healthcare professionals (HCPs) search medical information during their clinical work using Internet sources. In Finland, Physician's Databases (PD) serve as an Internet medical portal aimed at HCPs. Influenza epidemics appear seasonal outbreaks causing public health concern. Oseltamivir can be used to treat influenza. Little is known about HCPs' queries on oseltamivir and influenza from dedicated online medical portals and whether queries could be used as an additional source of information for disease surveillance when detecting influenza epidemics. Methods We compared HCPs' queries on oseltamivir and influenza from PD to influenza diagnoses from the primary healthcare register in Finland 2011-2016. The Moving Epidemic Method (MEM) calculated the starts of influenza epidemics. Laboratory reports of influenza A and influenza B were assessed. Paired differences compared queries, diagnoses, and laboratory reports by using starting weeks. Kendall's correlation test assessed the season-to-season similarity. Results We found that PD and the primary healthcare register showed visually similar patterns annually. Paired differences in the mean showed that influenza epidemics based on queries on oseltamivir started earlier than epidemics based on diagnoses by -0.80 weeks (95% CI: -1.0, 0.0) with high correlation (tau = 0.943). Queries on influenza preceded queries on oseltamivir by -0.80 weeks (95% CI: -1.2, 0.0) and diagnoses by -1.60 weeks (95% CI: -1.8, -1.0). Conclusions HCPs' queries on oseltamivir and influenza from Internet medical databases correlated with register diagnoses of influenza. Therefore, they should be considered as a supplementary source of information for disease surveillance when detecting influenza epidemics.

Perceiving various lifestyles as unpleasant is considered as an indicator of symbolic boundaries distinguishing between social groups. This article examines culinary dislikes covering various cuisine types. Using Finnish data collected among young urban adults (n = 1706), we find that disliking various cuisine types (19 in total) is particularly patterned and somewhat determined by socio-demographic factors. Dislikes are clustered according to legitimacy and exoticness in four components: ‘Culinary canon’, ‘Fast and Convenient’, ‘Ethnic’ and ‘Familiar’. Furthermore, a large group of categorical tolerant people is observed. As expected, socially more ‘well-to-do’ groups show less dislike towards various cuisines types. However, higher statuses are selective and very specific in terms of certain dislikes thus showing signs of patterned intolerance (à la Bryson). The highly educated dislike particularly less cuisine types belonging to ‘Culinary canon’, whereas ‘Fast and Convenient’ are clearly less tolerated. Categorical tolerance towards food is more a sign of cultural goodwill than new form of omnivorousness.

BackgroundAlgorithms including both traditional risk factors and polygenic risk scores (PRS) can significantly improve prediction of atherosclerotic cardiovascular disease (ASCVD). However, the clinical benefit of adding PRS to clinical risk evaluation remains unclear.ObjectivesThe study evaluated the attitudes of 7,342 individuals (64% women, mean age 56 yrs) upon receiving personal genome-enhanced ASCVD risk information, and prospectively assessed the impact on the participants’ health behavior.MethodsThe participant’s 10-year risk for ASCVD was estimated using both a traditional clinical risk score and a PRS-enhanced score, and both scores were communicated directly to study participants with an interactive web-tool.ResultsWhen reassessed after 1.5 years by a clinical visit and questionnaires, 20.8% of individuals at high (>10%) ASCVD risk had seen a doctor, 12.4% reported weight loss, 14.2% of smokers had quit smoking, and 15.4% had signed up for health coaching online. Altogether, 42.6% of individuals at high risk had made some health behavioral change compared to 33.5% of persons at low/average risk such that a higher baseline risk predicted a favorable change (pConclusionsWeb-based communication of personal ASCVD risk-data including polygenic risk to middle-aged persons can motivate positive changes in health behavior. It supports integration of genomic information into clinical risk calculators as a feasible approach to enhance disease prevention.Condensed AbstractPrediction tools that combine polygenic risk scores (PRS) with clinical factors provide a new opportunity for improved risk assessment and prevention of atherosclerotic cardiovascular disease (ASCVD), but the clinical impact of PRS has hitherto remained unclear. We evaluated the longitudinal effects of using a web-based tool to communicate genome-based ASCVD risk-information to 7,342 middle-aged individuals. 42% of persons at high risk improved their health behavior during follow-up which resulted in clinically significant improvement of lipid profiles and lower systolic blood pressure. This supports integration of PRS into clinical risk calculators as a feasible approach to enhance disease prevention.

Background Understanding the relationship between personal values, well-being, and health-related behavior could facilitate the development of engaging, effective digital interventions for promoting well-being and the healthy lifestyles of citizens. Although the associations between well-being and values have been quite extensively studied, the knowledge about the relationship between health behaviors and values is less comprehensive. Objective The aim of this study was to assess retrospectively the associations between self-reported values and commitment to values combined with self-reported well-being and health behaviors from a large cross-sectional dataset. Methods We analyzed 101,130 anonymous responses (mean age 44.78 years [SD 13.82]; 78.88%, 79,770/101,130 women) to a Finnish Web survey, which were collected as part of a national health promotion campaign. The data regarding personal values were unstructured, and the self-reported value items were classified into value types based on the Schwartz value theory and by applying principal component analysis. Logistic and multiple linear regression were used to explore the associations of value types and commitment to values with well-being factors (happiness, communal social activity, work, and family-related distress) and health behaviors (exercise, eating, smoking, alcohol consumption, and sleep). Results Commitment to personal values was positively related to happiness (part r2=0.28), communal social activity (part r2=0.09), and regular exercise (part r2=0.06; P Conclusions The findings suggest that commitment to values is positively associated with happiness and highlight various, also previously unexplored, associations between values and health behaviors.

Introduction With the exception of D-dimer, not much is known about the plasma levels of haemostatic factors during acute venous thromboembolism (VTE) compared to their basic levels in a stable phase. The goal of this study was to examine how plasma levels of factor V, VIII, XIIIa, von Willebrand factor antigen (vWF:Ag), fibrinogen, thrombomodulin evolve from the point of diagnosis of acute VTE to the end of standard treatment period. Methods Sixty-three consecutive patients (mean 57, range 18-86 years, 33 females) with acute pulmonary embolism (PE) were included. Laboratory samples were collected upon arrival (acute phase) and seven months later (stable phase). Fifteen similar aged individuals served as controls. Results Plasma levels of factor XIIIa (87.5% vs 117.7%, P

Background: People using the Internet to find information on health issues, such as specific diseases, usually start their search from a general search engine, for example, Google. Internet searches such as these may yield results and data of questionable quality and reliability. Health Library is a free-of-charge medical portal on the Internet providing medical information for the general public. Physician’s Databases, an Internet evidence-based medicine source, provides medical information for health care professionals (HCPs) to support their clinical practice. Both databases are available throughout Finland, but the latter is used only by health professionals and pharmacies. Little is known about how the general public seeks medical information from medical sources on the Internet, how this behavior differs from HCPs’ queries, and what causes possible differences in behavior. Objective: The aim of our study was to evaluate how the general public’s and HCPs’ information-seeking trends from Internet medical databases differ seasonally and temporally. In addition, we aimed to evaluate whether the general public’s information-seeking trends could be utilized for disease surveillance and whether media coverage could affect these seeking trends. Methods: Lyme disease, serving as a well-defined disease model with distinct seasonal variation, was chosen as a case study. Two Internet medical databases, Health Library and Physician’s Databases, were used. We compared the general public’s article openings on Lyme disease from Health Library to HCPs’ article openings on Lyme disease from Physician’s Databases seasonally across Finland from 2011 to 2015. Additionally, media publications related to Lyme disease were searched from the largest and most popular media websites in Finland. Results: Both databases, Health Library and Physician’s Databases, show visually similar patterns in temporal variations of article openings on Lyme disease in Finland from 2011 to 2015. However, Health Library openings show not only an increasing trend over time but also greater fluctuations, especially during peak opening seasons. Outside these seasons, publications in the media coincide with Health Library article openings only occasionally. Conclusions: Lyme disease–related information-seeking behaviors between the general public and HCPs from Internet medical portals share similar temporal variations, which is consistent with the trend seen in epidemiological data. Therefore, the general public’s article openings could be used as a supplementary source of information for disease surveillance. The fluctuations in article openings appeared stronger among the general public, thus, suggesting that different factors such as media coverage, affect the information-seeking behaviors of the public versus professionals. However, media coverage may also have an influence on HCPs. Not every publication was associated with an increase in openings, but the higher the media coverage by some publications, the higher the general public’s access to Health Library. [JMIR Public Health Surveill 2017;3(4):e86]

This study examines the determinants behind the perceived happiness of residents in the five cities of the Helsinki metropolitan area. A set of variables based on Maslow’s hierarchy was chosen in order to explain the subjective perception of happiness. Maslow’s hierarchy as a theoretical framework worked relatively well. A great deal of the results were in line with expectations and there are structures that clearly distinguish the cities from each other. Some of these structures seem to be connected to stereotypes concerning the examined cities and actually affect happiness in a way that is contrary to these stereotypes. It can even be said that something that is taken for granted, does not actually affect happiness; but despite this, people consider these issues very important.

Background Web-based interventions provide a possibility to enhance well-being in large groups of people. Only a few studies have studied the effectiveness of the interventions and there is no information on the sustainability of the effects. Study aims were to investigate both the short (2-month) and long-term (2-year) effects of email-based training for mental health and lifestyle. Methods Persons who completed an ‘Electronic Health Check’, as advertised in a TV program, were offered a chance to participate in email-based interventions. The baseline questionnaire was completed by 73 054 people, with 42 761 starting interventions, and 16 499 people participating in at least one of the follow-ups. Persons who did not choose to start the interventions served as controls. Results At baseline, the intervention group had a higher level of stress and lower gratitude and confidence in the future than the control group. Both groups showed improvement in the level of stress, but improvement was more marked in the intervention group (P

PurposeThe paper aims to examine changes in household consumption behaviour through an empirical investigation of the decision to consume meat, to not consume meat or to consume only small amounts of meat. The goal is to find out if the decision not to consume meat is becoming more prevalent, and to understand in what social categories this is happening, if any. A further aim is to investigate whether meat consumption is strongly associated with gender on the household level.Design/methodology/approachExpenditure survey data gathered from Finland during the last 40 years was used to identify what kinds of changes were taking place in the consumption of meat and meat products. The independent measures include six variables: the gender of the highest earner in the household (HEH), the type of household, the type of municipality and the income quintile, educational level and age of the HEH. The size of the samples varied between 2,986 and 8,258 households.FindingsThe analysis revealed that the decision not to consume meat became prevalent in Finland at the end of the 1970s but the growth rate has somewhat stabilised during recent decades. The gender of the HEH affects the family meat consumption. As non‐meat consumption has become more widespread it has also more clearly become a middle‐class phenomenon.Originality/valueThere are no previous studies available on the development of non‐meat consumption from this long‐term perspective.

According to postmodern theories, social divisions are based on identity and lifestyle rather than on sociodemographic background. In this paper, the effects of these both were examined. Tourism consumption was divided into two dimensions, tourism consumption and desire to travel more. Empirical analysis were based on two nation-wide surveys, Finland 1999 and Finland 2004. Sociodemographic factors were assumed to influence more on tourism consumption than on desire to travel more. The results were somewhat parallel with the hypothesis. However, both demographics and lifestyle determinants should be taken into account. The effects have remained quite stable regardless of the finding that desire to travel more has decreased while tourism consumption has increased.

It has been said that altruism is the fundamental basis of social life. However, it has not been in the centre when consumption of tourism has been discussed. Aim of this study was to go deeper into the structures behind altruistic and egoistic motives behind volunteer tourism—a form of tourism to which altruistic motives are often connected. Motives of volunteer tourists fluctuate in the scales formed on one hand by altruism and egoism and on the other hand by individuality and sociality. Although it can be stated that tourism in general is more or less ego-centric activity it was noticed that the line between altruism and egoism is blurred. By interacting with the fellow tourists and the hosts vacation-minded tourists can become volunteer-minded tourists even though their motives in the beginning were egoistic. By reviewing the wide range of literature concerning the phenomenon in hand it was claimed that in volunteer tourism, altruism, ethical dilemmas, pursuit of individuality and sociality c...

Volunteer tourism is very close to modern backpacking tourism but when the motive basis is concerned, it can be considered a clearly separate form of tourism. Thus new viewpoints must be utilised. In this study the discussion was expanded towards premodern tourism and postmodern theories were utilised. To strengthen the theoretical ideas, two example destinations in Indian Himalayas were selected. The rise of so-called alternative tourism is one aspect of postmodernity in tourism. Volunteer tourism belongs to the group but it also differs remarkably from the other members. These differences are connected here with traditional pilgrimage, which represents probably the oldest type of tourism. While pilgrims are searching for enlightenment by conducting pilgrimages to particular sites, volunteer tourists follow their altruistic motives and reach their aspiration level in sacred liminoid. Altruistic tourism will most likely grow in the future. In addition to this, traditional pilgrimage has also been changing...

In this article the whole picture of tourism is viewed through the lens of individuals' choices and motives. Inglehart's (1977; 1997) idea of postmaterialism is used as a background as differences are sought between individuals who have considered environment as a major criterion for choosing a holiday destination and individuals who have not. The most remarkable result was that the political identity is related to a person's choice of destination. Those who identify themselves with the Left seem to consider environment to be an important criterion more often than those on the Right. This strengthens the theory of postmaterialists: those on the Left tend to be more environment friendly than those on the right. The great deal of other differences found, for example between countries, could be due to differences between other variables such as political attitudes or latent cultural and social features which are difficult to measure using statistics. More detailed examination of the postmaterial issues and t...

Background: Both health care professionals and nonprofessionals seek medical information on the Internet. Using Web-based search engine searches to detect epidemic diseases has, however, been problematic. Physician’s databases (PD) is a chargeable evidence-based medicine (EBM) portal on the Internet for health care professionals and is available throughout the entire health care system in Finland. Lyme borreliosis (LB), a well-defined disease model, shows temporal and regional variation in Finland. Little data exist on health care professionals’ searches from Internet-based EBM databases in public health surveillance. Objective: The aim of this study was to assess whether health care professionals’ use of Internet EBM databases could describe seasonal increases of the disease and supplement routine public health surveillance. Methods: Two registers, PD and the register of primary health care diagnoses (Avohilmo), were used to compare health care professionals’ Internet searches on LB from EBM databases and national register-based LB diagnoses in order to evaluate annual and regional variations of LB in the whole country and in three selected high-incidence LB regions in Finland during 2011-2015. Results: Both registers, PD and Avohilmo, show visually similar patterns in annual and regional variation of LB in Finland and in the three high-incidence LB regions during 2011-2015. Conclusions: Health care professionals’ Internet searches from EBM databases coincide with national register diagnoses of LB. PD searches showed a clear seasonal variation. In addition, notable regional differences were present in both registers. However, physicians’ Internet medical searches should be considered as a supplementary source of information for disease surveillance. [JMIR Public Health Surveill 2017;3(2):e19]

Objective: Rigorous research in the last decade has demonstrated the efficacy of specific techniques in positive psychology that enhance psychological well-being. Online positive psychology interventions have the potential to enhance positive well-being in large audiences, including hard-to-reach target groups. There is lack of data on the effect of positive psychology exercises on happiness and on depressive symptoms in comparison with physical activity exercises and a placebo group. Methods: The Finnish Happiness-Flourishing Study (FHFS) included a TV-program on happiness interventions, a happiness website and an email-based happiness exercise intervention. A three-armed randomized controlled trial was conducted on 3274 Finnish adults in 2011. The participants were assigned to receive happiness exercises, tailored physical activity exercises or reading exercises on happiness (i.e. placebo). The statistical analyses were based on the intention-to-treat principle and linear random effects models. Results: The overall happiness scores increased (X 2 =7.83, df=3, p=0.05) and depressive symptoms decreased (X 2 =5.5, df=1, p=0.02) during the intervention, with more pronounced changes among women. The order of the four different happiness exercises did not have a systematic effect on the happiness score. The exercise on good deeds had the strongest effect on the improvement of the happiness score (change =4.50, 95% CI=2.47-6.52) whereas for the optimism exercise there was no improvement (change=0.46, 95% CI=-1.55-2.48). In the physical exercise group, there was an increase in the proportion of physically active subjects as compared with the placebo reading-group (X 2 =8.4, df=1, p=0.004). Conclusions: This study produced further evidence on the effectiveness of web-based happiness exercises. The results amplify the need for tailored online interventions for reducing well-being disparities. Further studies also need to increase the current understanding of the relative importance of variety in the application of positive interventions. Online positive psychology interventions are a potential tool in helping reduce well-being disparities, particularly among populations with little access to other services.

The membrane-spanning glycoprotein gp210 is a major component of the nuclear pore complex. This nucleoporin contains a large cisternal N-terminal domain, a short C-terminal cytoplasmic tail, and a single transmembrane segment. We show here that dimers of native gp210 can be isolated from cell extracts by immunoprecipitation, and from purified rat liver nuclear envelopes by velocity sedimentation and gel filtration. Cross-linking of proteins in isolated membranes prior to solubilization dramatically increases the proportion of dimers. The dimers are SDS-resistant, as previously observed for some integral membrane proteins of cis-Golgi and plasma membrane proteins, including glycophorin A. Larger oligomers of gp210 can also be obtained by gel filtration and denaturing electrophoresis, but unlike the dimers are dissociated by reduction and heating in the presence of SDS. We propose that gp210 is organized into the pore membrane as a large array of gp210 dimers that may constitute a luminal submembranous protein skeleton.

Binding of quinacrine to phospholipids and porcine pancreatic phospholipase A2 (PLA2) was investigated using fluorescence resonance energy transfer, Langmuir films, assay for the enzymatic activity, and molecular modeling. No significant binding of this drug to the zwitterionic phosphatidylcholine was observed whereas a high affinity for acidic phospholipids was revealed by quenching of pyrene-labeled phospholipid analogues. Partial reversal of this binding was observed due to the addition of 4 mM CaCl2. Quinacrine efficiently and independently of the lipid surface pressure penetrated into monolayers of phosphatidylglycerol while only a weak penetration into phosphatidylcholine films was evident. Quinacrine also bound to eosin-labeled PLA2, and the addition of 4 mM CaCl2 reversed this interaction almost completely. In the presence of acidic phospholipids both the drug and the enzyme were attached to the lipid surface. Studies on the influence of quinacrine on the activity of PLA2 toward pyrene-labeled phospholipid analogues revealed that the hydrolysis of phosphatidylcholine was progressively reduced as a function of increasing [quinacrine]. At low [CaCl2] and low quinacrine:lipid molar ratios (1:5) quinacrine enhanced slightly the rate of hydrolysis of acidic phospholipids whereas at higher drug:lipid molar ratios (1:2) an inhibition was observed. In the presence of 1 mM CaCl2 quinacrine inhibited PLA2-catalyzed hydrolysis of phosphatidylglycerol only when the drug:lipid molar ratio exceeded 1:1. The presence of 4 mM CaCl2 abolished nearly completely the inhibition with all the substrate analogues used. Our data suggest that the inhibition of PLA2 by quinacrine is due to its binding to the enzyme. This is supported also by molecular modeling which suggested a binding site for quinacrine close to the active site and Ca2+ binding site of the enzyme. Importantly, our data indicate that quinacrine binds avidly to acidic phospholipids and their presence may influence the drug-enzyme interaction and the inhibition of the enzyme action. Accordingly, presence of quinacrine may interfere also with other processes that require the presence of acidic lipids and/or Ca2+, such as the function of the nicotinic acetylcholine receptor.

Binding of DNA and RNA to sphingosine-containing dimyristoylphosphatidylcholine (DMPC) liposomes was characterized by differential scanning calorimetry. The thermal phase behaviour of neat DMPC liposomes was unaffected by the presence of the nucleic acids. However, significant alterations in the melting profiles of the DMPC/sphingosine composite membranes were produced by DNA and RNA, thus revealing their binding to the liposomes. For example, for 79:21 (molar ratio) DMPC/sphingosine liposomes a single endotherm at 29.1 degrees C with an enthalpy of 6.3 kcal/mol lipid was observed. In the presence of DNA at the nucleotide/sphingosine ratio of 0.6 this endotherm separated into three distinct peaks at 28.0, 31.4 and 35.1 degrees C, together with an approximately 22% reduction in the total enthalpy. Further increase in DNA concentration up to 1.5 nucleotides per sphingosine led to complete loss of the original heat absorption peak of the DMPC/sphingosine liposomes, while an endotherm at 34.3 degrees C with delta H of 2.7 kcal/mol developed. By visual inspection, rapid and extensive aggregation of the liposomes due to DNA was evident. Evidence for DNA-induced phase separation was also provided by compression isotherms of sphingosine containing DMPC monolayers recorded over an aqueous buffer both in the presence and absence of DNA. The effects of RNA on the thermal phase behaviour of the composite liposomes were qualitatively similar to those described above for DNA. Notably, the presence of eggPA abolished the nucleic acid induced heat capacity changes for DMPC/sphingosine liposomes probably because of neutralization of the positive charge of sphingosine. The binding of DNA to DMPC/sphingosine liposomes occurred both below and above the lipid phase transition temperature, as shown by fluorescence resonance energy transfer utilizing adriamycin-labelled DNA as a quencher and membrane incorporated pyrene-labelled phospholipid as a donor. However, the apparent binding to liquid crystalline liposomes was slightly more effective.

This study investigates physicians’ willingness to adopt a professional medical SMS news service in the Finnish healthcare sector. A concise survey using SMS mobile technology was conducted on March 5, 2003. Two hundred and fifty-nine out of 685 responded within 24 hours, and 90% of these answers were received within 6 hours after the survey was sent out. The response rate was 38%. Findings from this simple SMS survey showed that physicians had positive perceptions of the SMS news service. Nearly 60% of the respondents have used it. Some of the answers included spontaneous feedback about the SMS news service, which revealed valuable comments and suggestions regarding further improvements to it. The SMS survey as a new data collection technique needs academic attention. Implications and future research are briefly discussed.

This study investigates physicians’ willingness to adopt a professional medical SMS news service in the Finnish healthcare sector. A concise survey using SMS mobile technology was conducted on March 5, 2003. Two hundred and fifty-nine out of 685 responded within 24 hours, and 90% of these answers were received within 6 hours after the survey was sent out. The response rate was 38%. Findings from this simple SMS survey showed that physicians had positive perceptions of the SMS news service. Nearly 60% of the respondents have used it. Some of the answers included spontaneous feedback about the SMS news service, which revealed valuable comments and suggestions regarding further improvements to it. The SMS survey as a new data collection technique needs academic attention. Implications and future research are briefly discussed.

Resonance energy transfer was measured between egg phosphatidylcholine liposomes containing the intramolecular excimer forming pyrene-labelled phospholipid analogue 1,2-bis[pyren-1-(-yl)]decanoyl-sn-glycero-3-phosphocholine (bisPDPC) as a donor and DNA-bound adriamycin as an acceptor. Membrane association of DNA turned out to be critically dependent on the presence of sphingosine in the liposomes. Identical result was obtained by measuring the extent of quenching of the fluorescent DNA-bound dye Hoechst 33258 due to energy transfer to the lipophilic stain Nile Red incorporated in egg phosphatidylcholine liposomes containing varying amounts of sphingosine. The attachment of DNA to sphingosine-containing membranes could be reversed by the further inclusion of the negatively charged phosphatidic acid up to approximately 1:2 PA/sphingosine molar ratio in the liposomes, thus suggesting the involvement of electrostatic interactions. Differential scanning calorimetry measurements confirmed a lack of association between DNA and dimyristoylphosphatidylcholine liposomes. Instead drastic changes were produced by DNA in the heat capacity scans measured for liposomes also incorporating sphingosine. Fluorescence microscopy revealed an extensive aggregation of sphingosine containing pyrene-phosphatidylcholine-labelled egg phosphatidylcholine liposomes in the presence of DNA. Together with other available data on the effects of sphingosine, the present findings suggest that sphingosine could directly alter the chromatin structure. Accordingly, such alterations may contribute to the control of replication and gene expression.

The binding of the cytotoxin adriamycin (doxorubicin) to phospholipids, DNA, and RNA was investigated using (i) fluorescence quenching by this drug of liposomes containing pyrene-labeled phospholipids and (ii) monomolecular cardiolipin films on an air/water interface. In accordance with previous studies, our fluorescence experiments revealed that the acidic phospholipids, phosphatidylglycerol, phosphatidylmethanol, and phosphatidic acid all have high and comparable affinities to adriamycin mainly due to electrostatic interactions whereas binding to phosphatidylcholine was much weaker. Highest affinity, however, was possessed by cardiolipin. Addition of 4 mM CaCl2 reduced the binding of adriamycin to the above lipids. Moreover, in the presence of calcium the affinity of the drug to the different lipids was similar. Ca2+ concentrations > 100 microM began to reverse the binding of adriamycin to cardiolipin-containing liposomes whereas lower concentrations had only an insignificant effect. The association of adriamycin with DNA, RNA, and cardiolipin was then compared by observing the reversal of the cytotoxin-cardiolipin association by nucleic acids. The affinity of adriamycin was found to decrease in the sequence DNA > cardiolipin > RNA with relative affinities of 7.8, 2.3, and 1, respectively. Penetration of the drug into cardiolipin monolayers spread on an air/water interface resulted in an increase in surface pressure pi whereas only a very weak increase was observed using dimyristoylphosphatidylcholine films. Removal of adriamycin from lipid monolayers was achieved by adding DNA into the aqueous subphase. Similar to the fluorescence quenching studies increase in pi after the inclusion of adriamycin into the aqueous subphase was significantly reduced in the presence of Ca2+ concentrations > 100 microM, whereas lower concentrations had only an insignificant effect. Residual drug-phospholipid interactions in the lipid monolayer observed in the presence of Ca2+ were also reversed by DNA.

Membrane association of cytochrome c (cyt c) was monitored by the efficiency of resonance energy transfer from a pyrene-fatty acid containing phospholipid derivative (1-palmitoyl-2[6-(pyren-1-yl)]hexanoyl-sn-glycero-3-phosphocholine (PPHPC)) to the heme of cyt c. Liposomes consisted of 85 mol% egg phosphatidylcholine (egg PC), 10 mol% cardiolipin, and 5 mol% PPHPC. Cardiolipin was necessary for the membrane binding of cyt c over the pH range studied, from 4 to 7. In accordance with the electrostatic nature of the membrane association of cyt c at neutral pH both 2 mM MgCl2 and 80 mM NaCl dissociated cyt c from the vesicles completely. At neutral pH also adenine nucleotides in millimolar concentrations were able to displace cyt c from liposomes, their efficiency decreasing in the sequence ATP > ADP > AMP. In addition, both CTP and GTP were equally effective as ATP. The detachment of cyt c from liposomes by nucleotides is likely to result from a competition between cardiolipin and the nucleotides for a common binding site in cyt c. When pH was decreased to 4 there was a small yet significant increase in the apparent affinity of cyt c to cardiolipin containing liposomes. Notably, at pH 4 the above nucleotides as well as NaCl and MgCl2 were no longer able to dissociate cyt c and, on the contrary, they slightly enhanced the quenching of pyrene fluorescence by cyt c. The above results do suggest that the membrane association of cyt c at acidic pH was non-ionic and presumably due to hydrogen bonding. The pH-dependent binding of cyt c to membranes was fully reversible. Accordingly, in the presence of sufficient concentrations of either nucleotides or salts rapid detachment and membrane association of cyt c could be induced by varying pH between neutral and acidic values, respectively.

The action of porcine pancreatic phospholipase A2 towards fluorescent phospholipid analogs is either enhanced or suppressed by 4 beta-12-O-tetradecanoylphorbol-13- acetate (TPA), depending on the chemical structure of the substrate and the concentration of Ca2+. In the presence of nmolar Ca2+ concentrations increasing [TPA] enhanced by approx. 5-fold the rate of hydrolysis of the pyrene-labelled acidic alkyl-acyl phospholipid, 1-octacosanyl-2-[6- (pyrene-1-yl)] hexanoyl-sn-glycero-3-phosphatidylmethanol. Maximal effect was obtained at high TPA/substrate molar ratios approaching 1:2. In the presence of 4 mM CaCl2 maximal activation was reduced to approximately 1.5-fold. With the corresponding phosphatidylcholine derivative as a substrate increasing [TPA] reduced fatty acid release maximally by 90% both at low [Ca2+] as well as in the presence of 4 mM CaCl2. Essentially identical results were obtained using 4 alpha-TPA, a stereoisomer which does not activate protein kinase C.

To probe adriamycin-phospholipid interactions, the effects of this cytotoxin on the hydrolysis of a pyrene-labeled acidic alkyl-acyl phospholipid analog 1-octa-cosanyl-2-(6-pyren-1-yl)hexanoyl-sn-glycero-3-phos p hatidylmethanol (C28-O-PHPM) by porcine pancreatic phospholipase A2 (PLA2) were studied. In the absence of added Ca2+ adriamycin caused a 3-4-fold activation of hydrolysis of this pyrenelipid whereas an inhibition of action of PLA2 on the corresponding phosphatidylcholine derivative C28-O-PHPC was observed. Under similar conditions adriamycin also enhanced the rate of hydrolysis of the pyrene-labeled diacyl lipid 1-palmitoyl-2-(pyren-1-yl)hexanoyl-sn-glycero-3-phosphatidylgly cer ol and inhibited the hydrolysis of PLA2 on the phosphatidylcholine derivative. Increasing calcium concentrations abolished the activating and most of the inhibitory effects of adriamycin with the above phospholipid substrates. Quenching of pyrene excimer fluorescence by adriamycin revealed efficient binding of the drug to acidic lipids. Addition of 1 mM calcium reduced fluorescence quenching by adriamycin maximally by approximately 90%. In comparison, quenching by adriamycin of pyrene-labeled phosphatidylcholine was much weaker and calcium had only an insignificant effect. Monolayer experiments at an air/water interface showed a rapid and surface pressure-dependent penetration of the drug into a film of C28-O-PHPM. Increase in surface pressure was reversed by 80% by the inclusion of 1 mM Ca2+ into the subphase. Penetration of adriamycin into a monolayer of C28-O-PHPC was much weaker. In agreement with earlier studies two types of binding of adriamycin to C28-O-PHPM are proposed.

This paper sets out to investigate physicians' perceptions and usage regarding a new mobile medical information system in a pilot trial in the Finnish healthcare sector. Two sets of data were gathered in June and October 2003 by telephone interviews. The physicians interviewed had positive perceptions of the mobile system, and started to use it frequently in their work. They showed few negative experiences of using a Nokia Communicator. They favoured using mobile technology as a way to improve spreading medical knowledge. The main contents of the system, the Evidence-Based Medical Guidelines and the Pharmaca Fennica (the pharmacopoeia), were crucial for using the system. Some differences in physicians' behaviour across time were also found. Implications for system improvement are discussed.

Objectives To investigate the role of socioeconomic status and psychological stress to potential associations between confidence in the future and a wide range of health-related behaviours. Design Web-based cross-sectional study including an ‘Electronic Health Check’ at the Finnish Happiness-Flourishing Study website linked to a TV programme on happiness and depression. Setting The Finnish population with access to the internet. Participants 101 257 Finns aged 18 and above (21 365 men; 79 892 women). Participants who were under the age of 18 and who did not provide information about their gender were excluded. Primary outcome measures As planned, we assessed smoking, weekly alcohol consumption and binge drinking, daily intake of fruits and vegetables and regular exercise. Results Compared with participants with low confidence in the future, those with high confidence were less likely to be daily smokers (men OR 0.58, 95% CI 0.52 to 0.65; women 0.57, 95% CI 0.53 to 0.61) and binge drinkers (men 0.57; 0.52 to 0.63; women 0.54; 0.50 to 0.57). Participants with high confidence in the future were more likely to exercise regularly (men OR 2.82, 95% CI 2.55 to 3.13; women 2.57, 95% CI 2.44 to 2.71) and consume vegetables (men OR 2.48, 95% CI 2.25 to 2.74; women 2.13, 95% CI 2.03 to 2.24) and fruits (men OR 2.09, 95% CI 1.86 to 2.35; women 1.83, 95% CI 1.74 to 1.93) daily. Adjustment for current psychological distress and satisfaction for income attenuated the results. Conclusions Having confidence in the future is strongly associated with a healthy lifestyle, as assessed by a healthy diet, physical exercise and substance abuse. Health-related interventions may benefit from tailoring interventions according to the target population9s level of confidence in the future as well as their level of psychological distress.

A large body of evidence strongly indicates biomembranes to be organized into compositionally and functionally specialized domains, supramolecular assemblies, existing on different time and length scales. For these domains and intimate coupling between their chemical composition, physical state, organization, and functions has been postulated. One important constituent of biomembranes are peripheral proteins whose activity can be controlled by non-covalent binding to lipids. Importantly, the physical chemistry of the lipid interface allows for a rapid and reversible control of peripheral interactions. In this review examples are provided on how membrane lipid (i) composition (i.e., specific lipid structures), (ii) organization, and (iii) physical state can each regulate peripheral binding of proteins to the lipid surface. In addition, a novel and efficient mechanism for the control of the lipid surface association of peripheral proteins by [Ca2+], lipid composition, and phase state is proposed. The phase state is, in turn, also dependent on factors such as temperature, lateral packing, presence of ions, metabolites and drugs. Confining reactions to interfaces allows for facile and cooperative large scale integration and control of metabolic pathways due to mechanisms which are not possible in bulk systems.

As revealed by resonance energy transfer utilizing pyrene-labeled phosphatidylcholine donor, the mainly electrostatically controlled binding of adriamycin (Adr) and cytochrome c (cyt c) to mixed egg yolk phosphatidic acid/phosphatidylcholine (eggPA/eggPC, 15:85 molar ratio) liposomes was reversed upon the inclusion of increasing contents of sphingosine. At a [sphingosine]/[eggPA] molar ratio of approximately 2:1, the degree of fluorescence quenching by cyt c and Adr was approximately the same as when using liposomes lacking eggPA. Similarly, the increase in the surface pressure of sphingosine/eggPA monolayers on an air/water interface due to the membrane penetration of either cyt c or Adr was progressively reduced by increasing the content of sphingosine in the monolayers. The above critical [sphingosine]/[acidic phospholipid] stoichiometry yielding dissociation of the positively charged ligands Adr or cyt c from membrane acidic phospholipids was shifted from 2:1 to 1:1 upon substituting egg phosphatidylglycerol (eggPG) for eggPA. Accordingly, charge neutralization of the acidic phospholipids by sphingosine could be involved. One eggPA (having maximally two negative charges) appears to require two molecules of sphingosine whereas the maximally singly charged eggPG is neutralized by one sphingosine. For comparison we also studied the effects of sphingosine on the phospholipase A2 catalyzed hydrolysis of the pyrene-labeled acidic alkylacyl phospholipid analog 1-octacosanyl-2-[6-(pyren-1-yl)]hexanoyl-sn-glycero-3- phosphatidylmethanol (C28-O-PHPM) and the corresponding phosphatidylcholine (C28-O-PHPC). In the presence of low Ca2+ concentrations (approximately 50 nM) limiting the rate of the enzymatic reaction, sphingosine gradually inhibited the hydrolysis of phosphatidylcholine, and at 1:6 sphingosine/C28-O-PHPC a nearly complete lack of hydrolysis was evident.(ABSTRACT TRUNCATED AT 250 WORDS)

The immense progress in the understanding of the functions of proteins and nucleic acids in living cells is still contrasted by the limited comprehension of the significance of lipids and their structural diversity in the self-assembly and functionalization of biological membranes. Nevertheless, taking into account the costly maintenance of the specific tissue, cell, and cell organelle lipid compositions and their alterations it is obvious that the individual lipid classes do serve more important roles than what is at present commonly accepted [1].

The study aims to contribute to the research on technology acceptance behaviour of professional physicians by extending its theoretical validity and empirical applicability in a new mobile communication technology context. We propose and empirically examine a research model using data collected from 151 physicians working in the healthcare sector in Finland; with the aid from previous research into the adoption of information systems, mainly TAM, UTAUT and PIIT. The results suggest that our proposed model could provide adequate explanations for physicians' intentions to use the mobile system (Nagelkerke R² = 0.654). The important determinants of physicians' behavioural intentions in early exposure to the mobile system are: perceived usefulness, the interaction effects of PIIT and age on ease of use, and of age on compatibility. Gender and hands-on experience of the system have different effect on physicians' perceptions of the system.

Resonance energy transfer from pyrene-fatty acid containing phospholipid derivatives to the heme of cytochrome c (cyt c) was used to observe the binding of this protein to liposomal membranes. Liposomes were formed of egg yolk phosphatidic acid (PA) and either egg yolk phosphatidylcholine or dipalmitoylphosphatidylcholine with 1 mol % of the fluorescent lipid. Binding of cyt c to liposomes was monitored by measuring the decrease either in the fluorescence intensity or in the lifetime of pyrene emission. The requirement for the presence of the acidic phospholipid in the membrane for the binding of cyt c could be reconfirmed. Below 5 mol % of phosphatidic acid in the membrane, no significant attachment of cyt c to liquid-crystalline bilayers was evident whereas upon increasing the concentration of PA further the association of cyt c progressively increased until a saturation was reached at about 30 mol % of phosphatidic acid. Addition of NaCl caused the fluorescence intensity and lifetimes to return to values observed in the absence of cyt c, thus revealing the dissociation of the protein from the membrane. The pyrene-labeled phosphatidic acid derivatives PPHPA and PPDPA were quenched more effectively than the corresponding phosphatidylcholines, apparently due to the direct involvement of the acidic head group in binding cyt c. When dipalmitoylphosphatidylcholine (DPPC) with 5 mol % of phosphatidic acid was used, no binding of cyt c to the liposomes above the phase transition temperature of the former lipid could be demonstrated whereas below the transition temperature (Tm) binding did take place.(ABSTRACT TRUNCATED AT 250 WORDS)