To define a grade in the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) that would differentiate between esthetically acceptable and unacceptable occlusions and that would also be both subjectively and objectively meaningful.
Dental appearance and self-perceived orthodontic treatment need were analyzed in a group of Finnish young adults (171 males, 263 females, age range 16-25 years). Subjective data were gathered using a questionnaire, and the respondents were requested to score their dental appearance on a visual analog type 10-grade scale. Professional assessment of dental appearance was performed by two orthodontists using the AC of the IOTN. The cutoff value between esthetically acceptable and unacceptable occlusions was defined using receiver operating characteristic curves.
Sixty-six percent of orthodontically treated and 74% of the untreated respondents were satisfied with their own dental appearance. Every third respondent reported one or more disturbing traits in their dentition. The most frequently expressed reason for dissatisfaction was crowding; girls expressed dissatisfaction more often than boys did (P = .005). A self-perceived treatment need was reported infrequently by 8% of orthodontically treated and 6% of untreated respondents. In the logistic regression analysis, self-perceived need for orthodontic treatment was the only significant factor explaining dissatisfaction with own dental esthetics. On the applied scales, grades 1 and 2 fulfilled the criteria for satisfactory dental esthetics.
The results suggest that the AC grade 3 could serve as a cutoff value between esthetically acceptable and unacceptable occlusions.
Anxious parents have many concerns about the future health of their atopic infants. Paediatricians and primary care practitioners need to seek knowledge on long-term outcomes in order to cope with the increasing caseload of suspected allergy and the concerns of parents. The aim of the study was to assess suspected and diagnosed allergy in infancy as predictors of allergy and asthma in adolescence.
Families expecting their first baby and making their first visit to a maternity health care clinic in 1986 were selected as the study population in a random sample. There were 1278 eligible study families. The data were provided of the children at the ages of 9 and 18 months and 3, 5, 12, 15 and 18 years by health care professionals, parents, and adolescents (themselves).
At the age of 9 months, the prevalence of allergy suspicions was distinctly higher than that of allergy diagnoses. At the age of five years suspected allergy approaches were nil, and the prevalence of diagnosed allergy was about 9%. During the adolescence, the prevalence of self-reported allergy increases steadily up to the age of 18 years, and that of asthma remains at approximately 5%. Suspected allergy at the age of 9 or 18 months and at the 5 years of age does not predict allergy at adolescence. Compared with non-allergic children, children with definite allergy at the age of 5 were over 8 times more likely to have allergy and nearly 7 times more likely to have asthma in adolescence.
An early ascertained diagnosis of allergy, but not suspicions of allergy, predicts prevailing allergy in adolescence. Efforts need to be focused on accurate diagnosis of early childhood allergies.
A randomised controlled trial was used to evaluate elective ambulatory orthopaedic surgery patients' emotions during internet-based patient education or face-to-face education with a nurse. The internet-based patient education was designed for this study and patients used websites individually based on their needs. Patients in the control group participated individually in face-to-face patient education with a nurse in the ambulatory surgery unit. The theoretical basis for both types of education was the same. Ambulatory orthopaedic surgery patients scored their emotions rather low at intervals throughout the whole surgical process, though their scores also changed during the surgical process. Emotion scores did not decrease after patient education. No differences in patients' emotions were found to result from either of the two different patient education methods.
To compare serum lipids and their changes during a family-based health education in children aged 6-17 years with or without the epsilon4 allele of the gene encoding apolipoprotein E (apoE).
An intervention study.
A family-based prevention of risk factors of coronary heart disease in Eastern Finland. The programme consisted of two counselling meetings at children's schools and three at children's homes.
Four hundred and thirty-nine children with a family history of cardiovascular diseases (CVD) participated in a family-based health education. The children were divided into two groups according to apoE genotype. The risk group consisted of 143 children having apoE epsilon4 allele (genotype epsilon3/4 or epsilon4/4) and the non-risk group of 296 children without apoE epsilon4 allele (epsilon2/3 or epsilon3/3). The final sample of the follow-up study included 354 (81%) children (114 and 240, respectively).
Baseline differences were found in low-density lipoprotein cholesterol (LDL-C) (P=0.007) and LDL-C/high-density lipoprotein cholesterol (HDL-C) ratio (P=0.030) among boys and in total cholesterol (TC)/HDL-C (P=0.008) and LDL-C/HDL-C ratios (P=0.006) among girls. Differences between groups in changes during the follow-up were observed only for TC/HDL-C ratio (P-value adjusted for age=0.049) among boys.
At baseline, children with apoE epsilon4 allele had on average a more unfavourable lipid profile than those without apoE epsilon4 allele. However, the effect of about 33 months' family-based health education on plasma lipids did not depend on apoE genotype in children with a family history of CVD.
Comment In: Public Health Nutr. 2006 Oct;9(7):821-217010243
The positive influence of social support on psychological wellbeing is well documented but the research among young adults is scarce. Additionally, it is still unclear what type of social support explains the positive influence in this age group. Alexithymia has been linked to lacking social support and higher levels of psychological distress, but the underlying mechanisms are not well known. We aimed to assess the association of social support and alexithymia with psychological distress in a sample of young adults. The non-clinical sample comprised 316 young Finnish adults (mean age 23 years). Psychological distress was assessed using the 12-item General Health Questionnaire (GHQ-12), alexithymia was measured with the Toronto Alexithymia Scale (TAS-20) and social support with the Multidimensional Scale of Perceived Social Support (MSPSS). The associations were assessed using regression analyses. The TAS-20 (p = 0.002) and MSPSS (p =
Cystatin C is claimed to be superior to creatinine-based estimates of glomerular filtration rate (eGFRcr). The purpose of the study is to analyze whether cystatin C, creatinine, and/or estimated glomerular filtration rates (eGFR) predicted cardiovascular and/or non-cardiovascular deaths among Finnish elderly.
Hazard ratios (HR) of cystatin C, creatinine and eGFRs for cardiovascular and non-cardiovascular deaths.
During a 9-year follow-up, 275 died, 192 deaths were a result of cardiovascular disease. In age-adjusted analyses, cystatin C predicted the risk of non-cardiovascular and cardiovascular death in men (HR for 0.1-unit increase 1.12 [95% CI, 1.04-1.19] for non-CVD deaths and 1.18 [1.09-1.28] for CVD deaths) and women (1.14 [1.07-1.21] and 1.14 [1.06-1.22], respectively). CKD-EPIcr-cyc predicted the risk of CVD deaths in men (HR for 5-unit decrease 1.17 [1.09-1.25]) and women (1.09 [1.02-1.17]) and non-CVD deaths in women (1.07 [1.01-1.14]). Also, MDRD (HR for 5-unit decrease 1.16 [1.05-1.27]) and CKD-EPI (HR for 5-unit decrease 1.15 [1.05-1.25]) predicted CVD deaths among men. After additional adjustments, predictive value of cystatin C remained significant. Also, the predictive value of CKD-EPIcr-cys remained significant in non-CVD deaths among women.
Cystatin C was clearly the best predictor for cardiovascular and non-cardiovascular deaths among Finnish elderly. Serum cystatin C is more accurate for clinical decision making than creatinine-based eGFR equations or the combined CKD-EPIcr-cys equation in persons older than 64years.
From the Turku PET Centre (N.K., J. Johansson, J.T., J. Joutsa, J.R., E.R., J.P., J.O.R.), University of Turku; Division of Clinical Neurosciences (N.K., J. Joutsa, E.R., J.O.R.), Turku University Hospital; Department of Radiology (R.P.), Turku University Hospital and University of Turku, Finland; Athinoula A. Martinos Center for Biomedical Imaging (J. Joutsa), Massachusetts General Hospital and Harvard Medical School, Charlestown; Berenson-Allen Center for Noninvasive Brain Stimulation (J. Joutsa), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA; Department of Public Health Solutions (T.N., T.L., M.K.), Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland; Division of Clinical Geriatrics (T.N., A.S., M.K.), Center for Alzheimer Research, NVS, and Aging Research Center (A.S., M.K.), Karolinska Institutet, Stockholm, Sweden; Department of Neurology (A.S., R.S., Y.L., H.S., M.K.), Institute of Clinical Medicine, and Institute of Public Health and Clinical Nutrition (T.L.), University of Eastern Finland, Kuopio; Department of Neurology (T.H., H.S.), Kuopio University Hospital; Research and Service Centre for Occupational Health (T.P.), Finnish Institute of Occupational Health, Helsinki; Joint Municipal Authority for North Karelia Social and Health Services (T.L.), Joensuu; National Institute for Health and Welfare (A.J.); and Department of Biostatistics (T.V.), University of Turku and Turku University Hospital, Turku, Finland. firstname.lastname@example.org.
To investigate brain amyloid pathology in a dementia-risk population defined as cardiovascular risk factors, aging, and dementia risk (CAIDE) score of at least 6 but with normal cognition and to examine associations between brain amyloid load and cognitive performance and vascular risk factors.
A subgroup of 48 individuals from the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) main study participated in brain 11C-Pittsburgh compound B (PiB)-PET imaging, brain MRI, and neuropsychological assessment at the beginning of the study. Lifestyle/vascular risk factors were determined as body mass index, blood pressure, total and low-density lipoprotein cholesterol, and glucose homeostasis model assessment. White matter lesions were visually rated from MRIs by a semiquantitative Fazekas score.
Twenty participants (42%) had a positive PiB-PET on visual analysis. The PiB-positive group performed worse in executive functioning tests, included more participants with APOE e4 allele (50%), and showed slightly better glucose homeostasis compared to PiB-negative participants. PiB-positive and -negative participants did not differ significantly in other cognitive domain scores or other vascular risk factors. There was no significant difference in Fazekas score between the PiB groups.
The high percentage of PiB-positive participants provides evidence of a successful recruitment process of the at-risk population in the main FINGER intervention trial. The results suggest a possible association between early brain amyloid accumulation and decline in executive functions. APOE e4 was clearly associated with amyloid positivity, but no other risk factor was found to be associated with positive PiB-PET.
Lepidopterists use substantial volumes of solvents, such as chloroform, 1,1,2,2-tetrachloroethane and xylene, in their traps when collecting faunistic and phenological data. A majority of them are citizen scientists and thus in part not identified by occupational healthcare as being at risk due to solvent handling. We surveyed the extent of solvent use, the frequency and extent of potential exposure and the safety precautions taken in trapping and catch handling by Finnish lepidopterists. Chloroform and 1,1,2,2-tetrachloroethane were the most frequently used anaesthetics. Potential for exposure prevailed during trap maintenance and exploration and catch sorting. Adequate protection against vapours or spills was worn by 17% during trap exploration. Subjects completed a median of 100 trap explorations per season. Dermal or mucosal spills were recorded at a median rate of one spill per ten (chloroform) to 20 (1,1,2,2-tetrachloroethane and xylene) trap explorations. Median annual cumulative durations of 8 and 20 h of exposure to chloroform and 1,1,2,2-tetrachloroethane at levels above odour detection threshold were reported. Subjective adverse findings possibly related solvents had been noticed by 24 (9.8%) lepidopterists. All the events had been mild to moderate. No factor predicting unsafe procedures or adverse reactions was recorded despite thorough statistical testing.
Cultural competence is an essential component in nursing. The purpose of this study was to evaluate the level of cultural competence of graduating nursing students, to identify associated background factors to cultural competence, and furthermore to establish whether teaching multicultural nursing was implemented in nursing education.
A structured Cultural Competence Assessment Tool was used in a correlational design with a sample of 295 nursing students in southern Finland.
The level of cultural competence was moderate, and the majority of students had studied multicultural nursing. Minority background (p = .001), frequency of interacting with different cultures (p = .002), linguistic skills (p = .002), and exchange studies (p = .024) were positively associated to higher cultural competence.
To improve cultural competence in students, nursing education should provide continuous opportunities for students to interact with different cultures, develop linguistic skills, and provide possibilities for internationalization both at home and abroad.
To compare medication use in patients suffering from cardiovascular disease with and without dementia.
All inhabitants aged 75 and older in Lieto, Finland (n = 462, participation rate 82%).
Direct standardised assessments of dementia and cardiovascular diseases. Quantification of drug use by self-report and by prescription and drug container checks.
In multivariate analyses, the odds ratio for demented cardiovascular patients receiving any cardiovascular medication (use vs. non-use) was 0.31 (95% confidence interval 0.12-0.82). Compared to the non-demented, demented stroke patients were treated less often with antithrombotic agents (p = 0.041) and demented hypertensive patients less often with beta-blockers (p = 0.045).
Demented cardiovascular patients, even mildly to moderately demented, were prescribed fewer evidence-based cardiovascular medications than non-demented patients.