To evaluate parameters associated with and the impact of advance information given in a regular outpatient setting on user satisfaction with the levonorgestrel-releasing intrauterine system.
A questionnaire was sent to 23,885 women in Finland who had had a levonorgestrel intrauterine system inserted between 1990 and 1993. The number of returned questionnaires was 17,914 (response rate 75%). Cumulative logistic regression analysis was based on the five-grade scale of satisfaction as a dependent variable.
Most users of the levonorgestrel-releasing intrauterine system (74%) were very or fairly satisfied with it, although over 70% of them had chosen it because of dissatisfaction with their previous method of contraception. User satisfaction increased with age and was associated with the amount of information about different symptoms (menstrual, greasiness of hair/skin, pregnancy, pelvic inflammatory disease, and missed periods) regardless of whether the symptom in question was actually experienced. The women who received information about the possibility of absence of menstruation were more satisfied than the less informed women (odds ratio 5.0, 95% confidence interval 4.1, 5.9).
Information received at the insertion visit is strongly associated with increased user satisfaction among the users of the levonorgestrel intrauterine system. The association between high user satisfaction and advance information was strongest regarding the possibility of missing periods.
An inverse association between body height and the incidence of coronary heart disease (CHD) has been observed. However, the mechanisms behind this association are still largely unknown. We will examine the role of genetic and familial factors behind the association in a large twin data set.
The data were derived from the Finnish Twin cohort including 2438 singletons, 4073 monozygotic (MZ) twins, and 9202 dizygotic (DZ) twins aged 25-69 years at baseline in 1976. Incident CHD cases were derived from hospital discharge data and cause of death data between 1977 and 1995. Cox regression analysis and conditional logistic regression analysis were used.
In population-level analyses no differences in the general risk of CHD between zygosity groups were found. The association between body height and CHD was similar between sexes and zygosity groups. When men and women in all zygosity groups were studied together an increased risk of CHD was found only among the shortest quartile (hazard ratio [HR] = 1.34, 95% CI: 1.14-1.57). Among the twin pairs discordant for CHD a suggestive increased risk for the shorter twin was seen among DZ twins (odds ratio [OR] = 1.19, 95% CI: 0.95-1.48) when men and women were studied together.
An inverse association between body height and CHD was broadly similar between sexes and twin zygosity groups and was associated with short stature. Among discordant twin pairs we found a weak association among DZ twins but not MZ twins. This may suggest the role of genetic liability behind the association between body height and CHD.
Reduced availability of tobacco outlets is hypothesized to reduce smoking, but longitudinal evidence on this issue is scarce.
To examine whether changes in distance from home to tobacco outlet are associated with changes in smoking behaviors.
The data from 2 prospective cohort studies included geocoded residential addresses, addresses of tobacco outlets, and responses to smoking surveys in 2008 and 2012 (the Finnish Public Sector [FPS] study, n?=?53?755) or 2003 and 2012 (the Health and Social Support [HeSSup] study, n?=?11?924). All participants were smokers or ex-smokers at baseline. We used logistic regression in between-individual analyses and conditional logistic regression in case-crossover design analyses to examine change in walking distance from home to the nearest tobacco outlet as a predictor of quitting smoking in smokers and smoking relapse in ex-smokers. Study-specific estimates were pooled using fixed-effect meta-analysis.
Walking distance from home to the nearest tobacco outlet.
Quitting smoking and smoking relapse as indicated by self-reported current and previous smoking at baseline and follow-up.
Overall, 20?729 men and women (age range 18-75 years) were recruited. Of the 6259 and 2090 baseline current smokers, 1744 (28%) and 818 (39%) quit, and of the 8959 and 3421 baseline ex-smokers, 617 (7%) and 205 (6%) relapsed in the FPS and HeSSup studies, respectively. Among the baseline smokers, a 500-m increase in distance from home to the nearest tobacco outlet was associated with a 16% increase in odds of quitting smoking in the between-individual analysis (pooled odds ratio, 1.16; 95% CI, 1.05-1.28) and 57% increase in within-individual analysis (pooled odds ratio, 1.57; 95% CI, 1.32-1.86), after adjusting for changes in self-reported marital and working status, substantial worsening of financial situation, illness in the family, and own health status. Increase in distance to the nearest tobacco outlet was not associated with smoking relapse among the ex-smokers.
These data suggest that increase in distance from home to the nearest tobacco outlet may increase quitting among smokers. No effect of change in distance on relapse in ex-smokers was observed.
Education is associated with health related lifestyle choices including leisure-time physical inactivity. However, the longitudinal associations between education and inactivity merit further studies. We investigated the association between education and leisure-time physical inactivity over a 35-year follow-up with four time points controlling for multiple covariates including familial confounding.
This study of the population-based Finnish Twin Cohort consisted of 5254 twin individuals born in 1945-1957 (59 % women), of which 1604 were complete same-sexed twin pairs. Data on leisure-time physical activity and multiple covariates was available from four surveys conducted in 1975, 1981, 1990 and 2011 (response rates 72 to 89 %). The association between years of education and leisure-time physical inactivity (
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An inverse association between height and risk of coronary heart disease (CHD) is well demonstrated, but it is not known whether this association is because of genetic factors, socioeconomic background, or other environmental factors. Four population-based twin cohorts with register-based follow-up data on CHD mortality from Denmark (1966-1996), Finland (1975-2001), and Sweden (1963-2001 and 1972-2001) were used to investigate this question; response rates varied between 65% and 86%. Together, the cohorts included 74,704 twin individuals (35,042 complete twin pairs) with 5,943 CHD deaths during 1.99 million person-years of follow-up. Cox and conditional logistic regression models were used. Per 1-standard deviation decrease in height, height was inversely associated with CHD mortality in men (hazard ratio = 1.08, 95% confidence interval (CI): 1.04, 1.12) and in women (hazard ratio = 1.06, 95% CI: 1.01, 1.10). A twin who had died from CHD was on average shorter than the co-twin within monozygotic pairs (odds ratio = 1.27, 95% CI: 1.12, 1.44, with no sex difference), whereas a weaker association was found within dizygotic pairs in men (odds ratio = 1.01, 95% CI: 0.91, 1.13) and in women (odds ratio = 1.14, 95% CI: 1.01, 1.28). The inverse association between height and CHD mortality found within monozygotic discordant twin pairs suggests that this association is because of environmental factors that directly affect height and CHD risk.
The association of coronary heart and cardiovascular mortality with noise sensitivity was studied. We also investigated how this association is affected by self-reported lifetime noise exposure. In 1988 a case-control study, based on the Finnish Twin Cohort, was carried out to investigate the relationship between noise and hypertension (n=1495). Potential confounders were obtained from questionnaire in 1981 for the same individuals. Data on deaths and causes of death were obtained from record linkage to the nationwide register of death certificates. All deaths that occurred among the study population during the 15 years of follow-up were classified as being due to all causes (n=382), to cardiovascular diseases (n=193), including the number of deaths due to coronary heart diseases (n=111) and to other causes than cardiovascular diseases (n=189). Cardiovascular mortality (Hazard ratio 1.80, 95% CI 1.07-3.04) was significantly increased among noise-sensitive women. Among men, there were no statistically significant effects. Noise sensitivity may be a risk factor for cardiovascular mortality in women.
The present study characterized the associations of three sex life issues (importance of, satisfaction with, and ease in talking about sex life) with social support and reciprocity. We utilised survey data of working-aged men and women (n = 21,101) from the population-based random sample of the Health and Social Support (HeSSup) Study (40% response). The respondents with abundant social support considered sex life important, were satisfied with it, and found it easy to talk about sex life more often than those with less social support. Social support in sex life offered by one's own spouse/partner was important particularly to women, not available from the other sources to the same extent. Friends functioned as significant positive sources of support in sex life particularly among women, but relatives did not. Mutual reciprocity was associated with favourable perceptions of sex life. Persons lacking established primary social support should have easy access to services.
Only few prospective population studies have been able so far to investigate depression and drinking patterns in detail. Therefore, little is known about what aspect of alcohol consumption best predicts symptoms of depression in the general population.
In this prospective population-based two-wave cohort study, a cohort of alcohol-drinking men and women (n = 15 926) were followed-up after 5 years. A postal questionnaire was sent in 1998 (response proportion 40%) and again in 2003 (response proportion 80% of the baseline participants) to Finnish adults aged 20-54 years at baseline.
Alcohol consumption was measured by average intake (g/week) and by measures of binge drinking (intoxications, hangovers and alcohol-induced pass-outs). Depressive symptoms were assessed with the 21-item Beck Depression Inventory. In addition, information from hospital discharge register for depression and alcohol abuse were linked to the data.
This study found a positive association between baseline binge drinking and depressive symptoms 5 years later. Adjustment for several possible confounders attenuated the observed relationships only slightly, suggesting that binge drinking contributes independently to the occurrence of depressive symptoms. Binge drinking was related to symptoms of depression independently of average intake.
This study supports the hypothesis that heavy drinking, and in particular a binge pattern involving intoxications, hangovers or pass-outs, produces depressive symptoms in the general population. The frequency of hangovers was the best predictor for depressive symptoms.
Studies examining the long-term effects of alcohol consumption on cognitive functioning have produced conflicting results. Our goal was to determine whether a long follow-up period combined with information about drinking patterns, in addition to total alcohol consumption, would provide new insights about the relationship of alcohol use with dementia risk.
A population-based cohort of 554 Finnish twins, who had provided data on alcohol consumption in questionnaires in 1975 and 1981, was followed for 25 years. Subjects were age 65 years or older at the time of dementia assessment in 1999-2001. Dementia risk was analyzed with respect to varying patterns of alcohol use by log-linear modeling, adjusted for age, sex, and education.
By the end of follow-up, 103 participants had developed dementia. Binge drinking (ie, alcohol exceeding the amount of 5 bottles of beer or a bottle of wine on 1 occasion at least monthly), as reported in 1975, was associated with a relative risk of 3.2 (95% confidence interval=1.2-8.6) for dementia. Passing out at least twice as a result of excessive alcohol use during the previous year, as reported in 1981, was associated with a relative risk of 10.5 (2.4-46) for dementia in drinkers.
Binge drinking in midlife is associated with an increased risk of dementia.
Obesity has been shown to increase the risk of asthma and wheezing. Conditioning exercise might decrease the asthma risk, and that could partly explain the association. The relation between obesity and allergic diseases is quite conflicting.
The association between body mass index (BMI) and physician-diagnosed asthma, allergic rhinitis or conjunctivitis, atopic dermatitis, and self-reported wheezing was investigated in a questionnaire study among 10,667 Finnish first-year university students aged 18-25 years. Logistic regression was used to evaluate possible confounding by parental education, passive smoking at age 0-2, childhood residential environment, current and past smoking and leisure time physical activity index.
In men, there was a greater risk of asthma, but not wheezing with increasing BMI. Compared to those with BMI below 20, OR for male asthma was 1.98 (95% CI 1.11-3.52) in BMI category 20.0-22.4, 1.90 (95% CI 1.05-3.41) in BMI 22.5-24.9, and 3.5 (95% CI 1.63-7.64) in BMI > or = 27.5. Among women, the risks of asthma and wheezing were about two-fold among the overweight-obese subjects. Moderate leisure time physical activity was associated with lower risk of asthma in men (OR 0.62, 95% CI 0.62 (0.42-0.92), but not among women. The risk of allergic rhinoconjunctivitis and atopic dermatitis increased quite linearly with BMI among women but not men.
Low leisure time physical activity seems not to explain the greater risk of asthma among obese men and women. The quite linear association between BMI and both allergic rhinoconjunctivitis and wheezing among women suggests the independent effect of body fat on atopic diseases.