Regional and age differences in the reliability and factor structure of the SDS among elderly (65-84 years) men who were living either in eastern or in southwestern Finland were investigated. The Cronbach alpha coefficient was .803 for the eastern and .809 for the southwestern cohort; these figures were reasonably high. The tendency found was for the coefficient to be somewhat higher for the old (75-84 years) than for the young-old (65-74 years) population. In investigating the factor structure, a principal components factor analysis was performed, and the remaining factors were rotated using the orthogonal Varimax rotation algorithm. Three factors emerged for young-old men in the East, for young-old men in the Southwest and for old men in the Southwest, and four factors for old men in the East. The factor patterns of the first two factors showed similarities in both regions, but their order was different. "Loss of self-esteem" accounted for more of the common variance in the East and "agitated mood" in the Southwest. The differences in the third factor between the two regions were evident.
The association between alcohol consumption and 10-year mortality by death cause was studied in 1112 men aged 55-74 years and living either in eastern or south-western Finland. After adjustment for age, blood pressure, smoking, serum cholesterol, and other variables, the relative odds ratio of 10-year total mortality associated with consuming 1-273 g of absolute alcohol per month was 0.9 (95% confidence interval of 0.6-1.2) and with consuming more than 273 g per month due to violence was small, 15, but relative odds of violent death associated with consuming 1-273 and 274 or more grams of alcohol per month were 3.4 and 16.2, respectively (95% confidence intervals of 0.4-31.9 and 1.9-141.2).
The aims were (1) to compare all cause mortality in population samples of different cultures; and (2) to cross predict fatal event by risk functions involving risk factors usually measured in cardiovascular epidemiology.
The study was a 25 year prospective cohort study. The prediction of all cause mortality was made using the multiple logistic equation as a function of 12 risk factors; the prediction of months lived after entry examination was made by the multiple linear regression using the same factors. POPULATION SAMPLES: There were five cohorts of men aged 40-59 years, from Finland (two cohorts, 1677 men), from The Netherlands (one cohort, 878 men), and from Italy (two cohorts, 1712 men).
The Finnish cohorts came from geographically defined rural areas, the Dutch cohort from a small town in central Holland, and the Italian cohorts from rural villages in northern and central Italy.
All cause mortality was highest in Finland (557 per 1000), and lower in The Netherlands (477) and in Italy (475). The solutions of the multiple logistic function showed the significant and almost universal predictive role of certain factors, with rare exceptions. These were age, blood pressure, cigarette smoking, and arm circumference (the latter with a negative relationship). Similar results were obtained when solving a multiple linear regression equation predicting the number of months lived after entry examination as a function of the same factors. The prediction of fatal events in each country, using the risk functions of the others, produced limited errors, the smallest one being -2% and the largest +11%. When solving the logistic model in the pool of all the cohorts with the addition of dummy variables for the identification of nationality, it also appeared that only a small part of the mortality differences between countries is not explained by 12 available risk factors.
A small set of risk factors seems to explain the intercohort differences of 25 year all cause mortality in population samples of three rather different cultures.
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In Finland's North Karelia region a community-based program for control of hypertension was administered for 5 years. Afterward, drug treatment and the impact of such treatment on control of blood pressure were studied in a cross-sectional survey. The study population (n = 10,199) consisted of a 6.6% random sample of people aged 30-64 years in North Karelia (program area) and Kuopio (reference area). Rate of participation was about 90%. The methods included questionnaire, personal interview, and clinical examination. In North Karelia, 24% of the men and 25% of the women were hypertensives (blood pressure greater than or equal to 175 mm Hg systolic and/or 100 mm Hg diastolic, or currently on antihypertensive drug therapy), compared with 33% of the men and 29% of the women in the reference area. In North Karelia, 48% of the male hypertensives and 67% of the female hypertensives were on drug therapy, compared with 32% and 54%, respectively, in the reference area. Of the total population in each area, 14% in North Karelia currently used drugs, compared with 13% in the reference area. Diuretics and beta-blockers were the drugs most commonly prescribed; men used beta-blockers more often than women did. In terms of quantity of medication, type of drugs, and compliance, the differences between the two areas were small. Control of blood pressure, however, was clearly better in North Karelia than in the reference area for hypertensives and drug users and for both men and women. Therefore, compared with the traditional system, organized hypertension care results in more successful treatment.
A nation-wide survey of the prevalence of antimicrobial resistance in Haemophilus influenzae was conducted on isolates collected in 1988-90 from middle ear fluid (MEF), blood, or cerebrospinal fluid (CSF) in infected children or throat samples of healthy children. Altogether 885 strains were examined regarding capsular type b, beta-lactamase production and the minimal inhibitory concentration (MIC) of ampicillin, cefaclor, erythromycin, tetracycline, chloramphenicol, trimethoprim and trimethoprim-sulfamethoxazole for these strains was determined by the agar dilution method. 99% (578/585) of MEF isolates, 93% (112/121) of throat isolates, but only 6% (10/179) of blood/CSF isolates were not of type b (Hib). The rate of beta-lactamase production was 11.4% among Hib strains, 8.0% among non-type b MEF isolates, and 4.5% among non-type b throat isolates. No increase in the prevalence of beta-lactamase production in H. influenzae has taken place in Finland since the early 1980s. Resistance to ampicillin among strains that lacked beta-lactamase activity was rare (0.2%). Of the non-type b MEF and throat isolates, 5.9% and 2.7%, respectively, were resistant to trimethoprim and 3.6% and 2.7%, respectively, to trimethoprim-sulfamethoxazole. Resistance to other drugs was rare (
A nationwide survey of the prevalence of antimicrobial resistance among Streptococcus pneumoniae isolates from the middle ear fluid of children with acute otitis media (639 strains) and from throat-swab samples of healthy children (149 strains) was conducted in Finland during 1987-1990. The MICs of penicillin, cephalothin, cefaclor, erythromycin, trimethoprim, and co-trimoxazole were determined by the agar dilution method. Low-level resistance to penicillin (MIC, 0.1-1 microgram/mL) was found in 1.7% of the otitis-related and 1.3% of the healthy-carrier strains. No highly penicillin-resistant strains (MIC, > or = 2 micrograms/mL) were found. Six multiresistant strains were detected, three of them possibly belonging to a previously identified clone present in Finland since 1985. Eighty-five percent of the resistant otitis-related strains, including 9 of the 11 moderately penicillin-resistant strains (4 of which were multiresistant), belonged to the three most common serogroups (6, 19, and 23).
An association between late-onset Alzheimer's disease, vascular dementia and the common polymorphic alleles of the gene coding for apolipoprotein E, epsilon 2, epsilon 3, and epsilon 4, was assessed in a population sample of 393 elderly Finnish men aged 70 to 89 years. Of them, 7% suffered Alzheimer's disease and 3% had vascular dementia. Among those who suffered Alzheimer's disease, there was a statistically significant excess of the epsilon 4 allele. No such an association was observed between the apolipoprotein E alleles and vascular dementia. We conclude that the apolipoprotein E polymorphism confers information about a risk of Alzheimer's disease in this population sample of elderly Finnish men.