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Airway obstruction and the risk of myocardial infarction and death from coronary heart disease: a national health examination survey with a 33-year follow-up period.

https://arctichealth.org/en/permalink/ahliterature297762
Source
Eur J Epidemiol. 2018 01; 33(1):89-98
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
01-2018
Author
Tiina Mattila
Tuula Vasankari
Harri Rissanen
Paul Knekt
Pauli Puukka
Markku Heliövaara
Author Affiliation
Heart and Lung Center, Helsinki University Hospital, Meilahti Triangle Hospital, HUS, 6th Floor, PO Box 372, 00029, Helsinki, Finland. tiina.m.mattila@fimnet.fi.
Source
Eur J Epidemiol. 2018 01; 33(1):89-98
Date
01-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Aged
Airway Obstruction - epidemiology
Cause of Death
Coronary Disease - mortality
Female
Finland - epidemiology
Follow-Up Studies
Health Surveys
Hospitalization
Humans
Male
Middle Aged
Myocardial Infarction - mortality
Proportional Hazards Models
Risk factors
Abstract
Chronic obstructive pulmonary disease (COPD) has been associated with coronary mortality. Yet, data about the association between COPD and acute myocardial infarction (MI) remain scarce. We aimed to study airway obstruction as a predictor of MI and coronary mortality among 5576 Finnish adults who participated in a national health examination survey between 1978 and 1980. Subjects underwent spirometry, had all necessary data, showed no indications of cardiovascular disease at baseline, and were followed up through record linkage with national registers through 2011. The primary outcome consisted of a major coronary event-that is, hospitalization for MI or coronary death, whichever occurred first. We specified obstruction using the lower limit of normal categorization. Through multivariate analysis adjusted for potential confounding factors for coronary heart disease, hazard ratios (HRs) (with the 95% confidence intervals in parentheses) of a major coronary event, MI, and coronary death reached 1.06 (0.79-1.42), 0.84 (0.54-1.31), and 1.40 (1.04-1.88), respectively, in those with obstruction compared to others. However, in women aged 30-49 obstruction appeared to predict a major coronary event, where the adjusted HR reached 4.21 (1.73-10.28). In conclusion, obstruction appears to predict a major coronary event in younger women only, whereas obstruction closely associates with the risk of coronary death independent of sex and age.
PubMed ID
28688065 View in PubMed
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Albuminuria and Microalbuminuria as Predictors of Cognitive Performance in a General Population: An 11-Year Follow-Up Study.

https://arctichealth.org/en/permalink/ahliterature298098
Source
J Alzheimers Dis. 2018; 62(2):635-648
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
2018
Author
Laura L Ekblad
Sini Toppala
Jouni K Johansson
Seppo Koskinen
Jouko Sundvall
Juha O Rinne
Pauli Puukka
Matti Viitanen
Antti Jula
Author Affiliation
Turku PET Centre, University of Turku, c/o Turku University Hospital, Turku, Finland.
Source
J Alzheimers Dis. 2018; 62(2):635-648
Date
2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Aged
Albuminuria - epidemiology
Cognition
Cognitive Dysfunction - epidemiology
Creatinine - urine
Cross-Sectional Studies
Female
Finland - epidemiology
Follow-Up Studies
Humans
Kidney - physiopathology
Linear Models
Male
Middle Aged
Multivariate Analysis
Neuropsychological Tests
Risk factors
Abstract
Microalbuminuria, defined as urine albumin-to-creatinine ratio (UACR)>3.0?mg/mmol and = 30?mg/mmol, is an early marker of endothelial damage of the renal glomeruli. Recent research suggests an association among microalbuminuria, albuminuria (UACR?>?3.0?mg/mmol), and cognitive impairment. Previous studies on microalbuminuria, albuminuria, and cognition in the middle-aged have not provided repeated cognitive testing at different time-points. We hypothesized that albuminuria (micro- plus macroalbuminuria) and microalbuminuria would predict cognitive decline independently of previously reported risk factors for cognitive decline, including cardiovascular risk factors. In addition, we hypothesized that UACR levels even below the cut-off for microalbuminuria might be associated with cognitive functioning. These hypotheses were tested in the Finnish nationwide, population-based Health 2000 Survey (n?=?5,921, mean age 52.6, 55.0% women), and its follow-up, Health 2011 (n?=?3,687, mean age at baseline 49.3, 55.6% women). Linear regression analysis was used to determine the associations between measures of albuminuria and cognitive performance. Cognitive functions were assessed with verbal fluency, word-list learning, word-list delayed recall (at baseline and at follow-up), and with simple and visual choice reaction time tests (at baseline only). Here, we show that micro- plus macroalbuminuria associated with poorer word-list learning and a slower reaction time at baseline, with poorer word-list learning at follow-up, and with a steeper decline in word-list learning during 11 years after multivariate adjustments. Also, higher continuous UACR consistently associated with poorer verbal fluency at levels below microalbuminuria. These results suggest that UACR might have value in evaluating the risk for cognitive decline.
PubMed ID
29480195 View in PubMed
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Are patient rights to information and self-determination in diagnostic genetic testing upheld? A comparison of patients' and providers' perceptions.

https://arctichealth.org/en/permalink/ahliterature154456
Source
J Genet Couns. 2009 Feb;18(1):72-81
Publication Type
Article
Date
Feb-2009
Author
Tarja Nyrhinen
Marja Hietala
Pauli Puukka
Helena Leino-Kilpi
Author Affiliation
TUCH LAB, Department of Clinical Chemistry, Turku University Hospital, PL 52, 20521, Turku, Finland. tarja.nyrhinen@utu.fi
Source
J Genet Couns. 2009 Feb;18(1):72-81
Date
Feb-2009
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Female
Finland
Freedom
Genetic Testing - psychology
Health Personnel - psychology
Humans
Male
Middle Aged
Patient Rights
Patients - psychology
Questionnaires
Abstract
This study assessed how the patient's right to receive information and the right to self-determination were followed during diagnostic testing, according to the perceptions of patients and parents of tested children (group 1, n = 106) and healthcare personnel (group 2, n = 162). Data were collected in three Finnish university hospitals using a questionnaire. Results revealed one between group difference: patients/parents agreed more strongly than did personnel that self-determination was followed before testing. Within groups included: patients/parents had stronger agreement that self-determination was followed before testing than after testing; personnel had stronger agreement about information received after testing than before testing, and they had weaker agreement about how well self-determination was followed before testing than after testing. Received information was experienced as similar both before and after testing and by patients/parents and by personnel. Providing adequate time to consider whether or not to be tested and giving more support to patients after testing would promote the rights of patients. Furthermore, assessment of personnel characteristics is needed to determine, for example, the kinds of value conflicts that exist between personnel's own values and patients' values.
PubMed ID
18979191 View in PubMed
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Association between all-cause and cause-specific mortality and the GOLD stages 1-4: A 30-year follow-up among Finnish adults.

https://arctichealth.org/en/permalink/ahliterature272552
Source
Respir Med. 2015 Aug;109(8):1012-8
Publication Type
Article
Date
Aug-2015
Author
Tiina Mattila
Tuula Vasankari
Merja Kanervisto
Tarja Laitinen
Olli Impivaara
Harri Rissanen
Paul Knekt
Pekka Jousilahti
Seppo Saarelainen
Pauli Puukka
Markku Heliövaara
Source
Respir Med. 2015 Aug;109(8):1012-8
Date
Aug-2015
Language
English
Publication Type
Article
Keywords
Adult
Cause of Death - trends
Female
Finland - epidemiology
Follow-Up Studies
Forced expiratory volume
Forecasting
Humans
Male
Population Surveillance - methods
Proportional Hazards Models
Pulmonary Disease, Chronic Obstructive - mortality - physiopathology
Retrospective Studies
Risk Assessment - methods
Risk factors
Severity of Illness Index
Survival Rate - trends
Vital Capacity
Abstract
Mortality correlates with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria of airway obstruction. Yet, little data exist concerning the long-term survival of patients presenting with different levels of obstruction.
We studied the association between all-cause and cause-specific mortality and GOLD stages 1-4 in a 30-year follow-up among 6636 Finnish men and women aged 30 or older participating in the Mini-Finland Health Study between 1978 and 1980.
After adjusting for age, sex, and smoking history, the GOLD stage of the subject showed a strong direct relationship with all-cause mortality, mortality from cardiovascular and respiratory diseases, and cancer. The adjusted hazard ratios of death were 1.27 (95% confidence interval (CI) 1.06-1.51), 1.40 (1.21-1.63), 1.55 (1.21-1.97) and 2.85 (1.65-4.94) for GOLD stages 1-4, respectively, with FEV1/FVC =70% as the reference. The association between GOLD stages 2-4 and mortality was strongest among subjects under 50 years of age at the baseline measurement. Cardiovascular mortality increased consistently for all GOLD stages.
Airway obstruction indicates an increased risk for all-cause mortality according to the severity of the GOLD stage. We found that even stage 1 carries a risk for cardiovascular death independently of smoking history and other known risk factors.
PubMed ID
26108990 View in PubMed
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Association between thyroid-stimulating hormone and blood pressure in adults: an 11-year longitudinal study.

https://arctichealth.org/en/permalink/ahliterature278181
Source
Clin Endocrinol (Oxf). 2016 May;84(5):741-7
Publication Type
Article
Date
May-2016
Author
Ville L Langén
Teemu J Niiranen
Pauli Puukka
Jouko Sundvall
Antti M Jula
Source
Clin Endocrinol (Oxf). 2016 May;84(5):741-7
Date
May-2016
Language
English
Publication Type
Article
Keywords
Adult
Aged
Blood Pressure - physiology
Cross-Sectional Studies
Diastole - physiology
Female
Finland - epidemiology
Humans
Hypertension - blood - diagnosis - physiopathology
Incidence
Linear Models
Logistic Models
Longitudinal Studies
Male
Middle Aged
Prevalence
Prospective Studies
Thyrotropin - blood
Abstract
The results of longitudinal studies on the association between thyroid function and blood pressure (BP) are divided. This study aimed to investigate this association in cross-sectional and longitudinal settings in a nationwide, random sample representative of the Finnish adult population aged 30 and over.
The study sample was randomly drawn from the population register. A total of 5655 participants were included in the baseline analyses and 3453 in the 11-year prospective analyses. The associations between baseline TSH and (i) BP and BP change over time; and (ii) prevalent and incident hypertension were assessed using linear and logistic models, adjusted for age, gender, smoking and body mass index.
A positive association (ß ± standard error) was observed between TSH and diastolic (0·36 ± 0·12, P = 0·003) but not systolic BP (0·16 ± 0·21, P = 0·45) at baseline. TSH was negatively associated with 11-year BP change in men (systolic: -0·92 ± 0·41, P = 0·03; diastolic: -0·66 ± 0·26, P = 0·01) but not in women (P = 0·09 for systolic and diastolic BP change). Participants in the highest TSH tertile within the TSH reference interval (0·4-3·4 mU/L), as compared with the lowest, had increased odds of prevalent (odds ratio 1·22, 95% confidence interval 1·05-1·43, P = 0·01) but not incident hypertension (odds ratio 0·93, 95% confidence interval 0·73-1·19, P = 0·58).
A modest association was found between increasing TSH and prevalent but not incident hypertension. TSH was inversely associated with BP change in men in our study. These findings contest an independent role of thyroid function at normal to near-normal levels in the pathogenesis of hypertension.
PubMed ID
26261034 View in PubMed
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The association of social support at work and in private life with mental health and antidepressant use: the Health 2000 Study.

https://arctichealth.org/en/permalink/ahliterature155538
Source
J Affect Disord. 2009 May;115(1-2):36-45
Publication Type
Article
Date
May-2009
Author
Marjo Sinokki
Katariina Hinkka
Kirsi Ahola
Seppo Koskinen
Mika Kivimäki
Teija Honkonen
Pauli Puukka
Timo Klaukka
Jouko Lönnqvist
Marianna Virtanen
Author Affiliation
Finnish Institute of Occupational Health, Lemminkäisenkatu 14-18 B, FI-20520 Turku, Finland. marjo.sinokki@utu.fi
Source
J Affect Disord. 2009 May;115(1-2):36-45
Date
May-2009
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Adult
Antidepressive Agents - therapeutic use
Anxiety Disorders - diagnosis - drug therapy - epidemiology
Cohort Studies
Comorbidity
Cross-Sectional Studies
Depressive Disorder - diagnosis - drug therapy - epidemiology
Drug Utilization - statistics & numerical data
Female
Finland
Health Surveys
Humans
Job Satisfaction
Male
Middle Aged
Risk factors
Sex Factors
Social Adjustment
Social Support
Socioeconomic Factors
Statistics as Topic
Abstract
Social support is assumed to protect mental health, but it is not known whether low social support at work increases the risk of common mental disorders or antidepressant medication. This study, carried out in Finland 2000-2003, examined the associations of low social support at work and in private life with DSM-IV depressive and anxiety disorders and subsequent antidepressant medication.
Social support was measured with self-assessment scales in a cohort of 3429 employees from a population-based health survey. A 12-month prevalence of depressive or anxiety disorders was examined with the Composite International Diagnostic Interview (CIDI), which encompasses operationalized criteria for DSM-IV diagnoses and allows the estimation of DSM-IV diagnoses for major mental disorders. Purchases of antidepressants in a 3-year follow-up were collected from the nationwide pharmaceutical register of the Social Insurance Institution.
Low social support at work and in private life was associated with a 12-month prevalence of depressive or anxiety disorders (adjusted odds ratio 2.02, 95% CI 1.48-2.82 for supervisory support, 1.65, 95% CI 1.05-2.59 for colleague support, and 1.62, 95% CI 1.12-2.36 for private life support). Work-related social support was also associated with subsequent antidepressant use.
This study used a cross-sectional analysis of DSM-IV mental disorders. The use of purchases of antidepressant as an indicator of depressive and anxiety disorders can result in an underestimation of the actual mental disorders.
Low social support, both at work and in private life, is associated with DSM-IV mental disorders, and low social support at work is also a risk factor for mental disorders treated with antidepressant medication.
PubMed ID
18722019 View in PubMed
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The association of social support at work and in private life with sleeping problems in the Finnish health 2000 study.

https://arctichealth.org/en/permalink/ahliterature146346
Source
J Occup Environ Med. 2010 Jan;52(1):54-61
Publication Type
Article
Date
Jan-2010
Author
Marjo Sinokki
Kirsi Ahola
Katariina Hinkka
Mikael Sallinen
Mikko Härmä
Pauli Puukka
Timo Klaukka
Jouko Lönnqvist
Marianna Virtanen
Author Affiliation
Turku Centre for Occupational Health, Turku, Finland. marjo.sinokki@utu.fi
Source
J Occup Environ Med. 2010 Jan;52(1):54-61
Date
Jan-2010
Language
English
Publication Type
Article
Keywords
Adult
Dyssomnias - drug therapy - etiology
Female
Finland
Health Surveys
Humans
Hypnotics and Sedatives - therapeutic use
Male
Middle Aged
Organizational Culture
Social Support
Stress, Psychological - complications - etiology
Workplace - psychology
Abstract
To investigate the associations of social support at work and in private life with sleeping problems and use of sleep medication.
In the nationwide Health 2000 Study, with a cohort of 3430 employees, social support at work and in private life, and sleep-related issues were assessed with self-assessment scales. Purchases of sleep medication over a 3-year period were collected from the nationwide pharmaceutical register of the Social Insurance Institution.
Low social support from supervisor was associated with tiredness (odds ratio [OR] 1.68, 95% confidence interval [CI] = 1.26 to 2.23) and sleeping difficulties within the previous month (OR 1.74, 95% CI = 1.41 to 1.92). Low support from coworkers was associated with tiredness (OR 1.55, 95% CI = 1.41 to 1.92), sleeping difficulties within the previous month (OR 1.77, 95% CI = 1.32 to 2.36), and only among women, with short sleep duration (OR 2.06, 95% CI = 1.22 to 3.47). Low private life support was associated with short sleep duration (OR 1.49, 95% CI = 1.13 to 1.98) and among women, with sleeping difficulties (OR 1.46, 95% CI = 1.08 to 1.33).
Low social support, especially at work, is associated with sleeping-related problems.
PubMed ID
20042884 View in PubMed
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Being respected by nurses: Measuring older patients' perceptions.

https://arctichealth.org/en/permalink/ahliterature297918
Source
Int J Older People Nurs. 2018 Sep; 13(3):e12197
Publication Type
Journal Article
Date
Sep-2018
Author
Jaana Koskenniemi
Helena Leino-Kilpi
Pauli Puukka
Minna Stolt
Riitta Suhonen
Author Affiliation
Department of Nursing Science, University of Turku, Turku, Finland.
Source
Int J Older People Nurs. 2018 Sep; 13(3):e12197
Date
Sep-2018
Language
English
Publication Type
Journal Article
Keywords
Aged
Aged, 80 and over
Cross-Sectional Studies
Female
Finland
Humans
Male
Nurse-Patient Relations
Nursing Staff, Hospital
Psychometrics
Respect
Surveys and Questionnaires
Abstract
To investigate older patients' perceptions of respect in hospital nursing care and to test a newly developed instrument measuring the phenomenon.
Respect manifests itself in the older patient-nurse relationship in terms of nurses being with and doing for the patient. Empirical studies investigating respect from the older patients' perspective are rare. There is a need to maintain respectful behaviours and attitudes within hospital-based nursing practice. Furthermore, there is a lack of instruments measuring respect in the care provided by nurses.
A descriptive, cross-sectional explorative survey design was used. Data were collected between February and May 2016 by interviewing face-to-face 196 older patients in two hospitals in Finland. Respect was measured using the ReSpect scale (Parts A and B) developed for this study. Respect is based on the two dimensions of respect, nurses' Being with and Doing for patients. Data were analysed using descriptive and inferential statistical methods including the psychometric testing of the new instrument.
Older patients perceived respect in their care frequently and to a great extent, although there were also shortcomings. The findings highlight the need to improve respect to patients in care delivery by showing an interest in their views, acknowledging them positively and supporting their individual capacities. A two-factor structure of the ReSpect scale Part A and a four-factor structure of the Part B were confirmed.
Findings from this study suggest that older hospital patients perceived respect by nurses overall, but the area where there is the most room for improvement is that of listening and encouraging. The psychometric analysis demonstrated that the ReSpect scale shows promise in measuring respect.
The ReSpect scale could be a useful tool to measure respect, an important element of value-based health care.
PubMed ID
29701287 View in PubMed
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Binge drinking and the risk of liver events: A population-based cohort study.

https://arctichealth.org/en/permalink/ahliterature292016
Source
Liver Int. 2017 Sep; 37(9):1373-1381
Publication Type
Journal Article
Date
Sep-2017
Author
Fredrik Åberg
Jaana Helenius-Hietala
Pauli Puukka
Antti Jula
Author Affiliation
Transplantation and Liver Surgery Clinic, Helsinki University Hospital, Helsinki University, Helsinki, Finland.
Source
Liver Int. 2017 Sep; 37(9):1373-1381
Date
Sep-2017
Language
English
Publication Type
Journal Article
Keywords
Adult
Aged
Aged, 80 and over
Binge Drinking - epidemiology
Cause of Death
Cohort Studies
Female
Finland - epidemiology
Humans
Liver Diseases - epidemiology
Male
Metabolic Syndrome - epidemiology
Middle Aged
Multivariate Analysis
Proportional Hazards Models
Risk factors
Sex Factors
Time Factors
Abstract
Binge drinking or heavy episodic drinking is increasingly prevalent, but the health effects are incompletely understood. We investigated whether binge drinking increases the risk for liver disease above and beyond the risk due to average alcohol consumption.
6366 subjects without baseline liver disease who participated in the Finnish population-based Health 2000 Study (2000-2001), a nationally representative cohort. Follow-up data from national registers until 2013 were analysed for liver-related admissions, mortality and liver cancer. Binge drinking (=5 drinks per occasion, standard drink 12 g ethanol) was categorised as weekly, monthly, or as less often or none. Multiple confounders were considered.
Eighty-four subjects developed decompensated liver disease. Binge drinking frequency showed a direct association with liver-disease risk after adjustment for average daily alcohol intake and age. After adjustment, the hazard ratios (HRs) for weekly and monthly binge drinking were 3.45 (P=.001) and 2.26 (P=.007) and were higher after excluding regular heavy drinkers. The HR for weekly binging was 6.82 (P=.02) in women; 2.34 (P=.03) in men; and 4.29 (P=.001) in subjects with the metabolic syndrome. Weekly binge drinking and the metabolic syndrome produced supra-additive increases in the risk of decompensated liver disease. Weekly, and to a lesser extent monthly, binging retained significance in sequential multivariate models that additionally adjusted for beverage preference and lifestyle, metabolic, and socioeconomic factors.
Binge drinking is associated with an increased risk for liver disease independently of average alcohol intake and confounders. The rising prevalence of binge drinking and the metabolic syndrome is particularly concerning.
PubMed ID
28276137 View in PubMed
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The content of advocacy in procedural pain care - patients' and nurses' perspectives.

https://arctichealth.org/en/permalink/ahliterature153139
Source
J Adv Nurs. 2008 Dec;64(5):504-13
Publication Type
Article
Date
Dec-2008
Author
Heli Vaartio
Helena Leino-Kilpi
Tarja Suominen
Pauli Puukka
Author Affiliation
Department of Nursing Science, University of Turku, Finland. heli.vaartio@sydvast.fi
Source
J Adv Nurs. 2008 Dec;64(5):504-13
Date
Dec-2008
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Attitude of Health Personnel
Communication
Cross-Sectional Studies
Empathy
Female
Finland
Humans
Male
Nurse's Role - psychology
Nurse-Patient Relations - ethics
Outcome Assessment (Health Care) - standards
Pain - nursing - psychology
Patient Advocacy - psychology
Patient satisfaction
Questionnaires
Statistics as Topic
Young Adult
Abstract
This paper is a report of an exploration of the content of nursing advocacy from the point of view of patients and nurses in the context of procedural pain care.
Nursing advocacy is every nurse's professional duty, grounded in patients' legal and moral rights. Nevertheless, earlier research has approached advocacy as a whistle-blowing event from the nurse's perspective.
This cross-sectional study was conducted with a cluster sample of otolaryngology patients (n = 405) and nurses (n = 118) in 11 hospital units in Finland during 2007. The data were collected using an instrument measuring the content of advocacy and analysed statistically.
Advocacy in procedural pain care is a process which takes place in the patient-nurse relationship through role identification in decision-making about pain care. This prompts counselling and responding activities, which in turn lead to some degree of empowerment on the part of both patient and nurse. However, advocacy is partly dependent on the nurse's own role identification: in the context of pain care it seems that the nurse's pain care skills and influence over pain care plans are important factors in the decision to advocate or not. At best, patients have some role in decision-making about their care; at worst, they are subjected to paternalism.
Advocacy is an integral part of the nursing care process. It is important that this key ethical aspect of professional nursing is discussed in nursing education and systematically applied in nursing practice through on-the-job training, feedback and collaboration.
PubMed ID
19146519 View in PubMed
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39 records – page 1 of 4.