In the present study, pure-tone audiometry was used in 687 Finnish school children, aged 6-15 years, to determine the prevalence of a 6 kHz acoustic dip and related factors among three age groups. Trained audiometricians tested air conduction thresholds in a sound-proof room. A total of 57 children (8.3%) had a clear-cut dip of at least 20 dB at 6 kHz. This dip was more pronounced in older children and in boys. A thorough case history was obtained by questionnaire, with logistic regression analysis showing that low birth weight (
Adiponectin may be involved in the pathogenesis of atherosclerosis. We investigated the relation of adiponectin on early functional and structural markers of subclinical atherosclerosis in a large population-based cohort of young men and women.
We measured serum adiponectin using radioimmunoassay in 2,147 young adults (ages 24-39 years) participating in the Cardiovascular Risk in Young Finns Study. The subjects had ultrasound data on carotid intima-media thickness (IMT), carotid artery elasticity (n = 2,139) and brachial flow-mediated dilatation (FMD) (n = 1,996). In univariate analysis, adiponectin was inversely associated with IMT (r = -0.16, P
Copayments are common measures intended to control drug expenditures and promote rational prescribing. In Finland, new antiglaucoma drugs start with a high copayment, but once sufficient clinical experience is available, they are reevaluated and can receive a lower copayment status.
This study assessed the effect of changes in copayment level on the adoption of 2 antiglaucoma drugs.
A retrospective analysis was performed from 1997 to 2001 using the Finnish national register of reimbursed drug purchases, which covers approximately 98% of all antiglaucoma drug purchases in the country. There were 172,293 purchases of dorzolamide (plain or combined with timolol) and 281,377 purchases of latanoprost. An interrupted time-series design from approximately 30 months before and 20 months after the change in copayment was used in the analysis. The main outcome measures were the numbers of defined daily doses (DDDs) purchased and the monthly numbers of patients who purchased the study drugs for the first time before and after the change in copayment.
A substantial increase in consumption of both dorzolamide and latanoprost was seen immediately after the introduction of the lower copayment. The monthly consumption of dorzolamide was 60,713 DDDs higher and the monthly consumption of latanoprost was 49,330 DDDs higher than expected according to the utilization trend during the higher copayment period. Twelve months later, the observed consumption of dorzolamide was 109% higher and that of latanoprost was 21% higher than if the copayment had remained the same. The number of new patients using the study drugs peaked within 2 months of the lower copayment, but the amount consumed per patient per day remained quite stable.
Decreasing the copayment of a new antiglaucoma drug to the same level as the copayments of alternative drugs accelerated the adoption of these new products in Finland.
The first survey carried out in Finland specifically to study men's violence against women showed that partner violence is quite common in Finland and it is directed especially toward young women. The statistical findings don't support the idea that violence has become more widespread in Finland. Life situation factors that are usually viewed as making women vulnerable to spousal violence, such as having children, cohabiting, low educational level, and financial dependency on the male partner, failed to explain partnership violence against women in Finland as such, too. The author's objective is to find out whether meanings of violence have changed and whether this could be one reason why young women report in a survey such cases of violence that other women would not. This could explain why violence in partnerships is so common among young women in Finland.
To evaluate whether confounding by several known or suspected coronary heart disease risk factors are likely to explain the lower coronary heart disease risk among light alcohol drinkers compared with never-drinkers.
A population-based cross-sectional study.
Hypertension, body mass index (BMI), diabetes, depression, sleep disturbances, smoking, physical activity, life satisfaction, psychological distress, trait anxiety, independent and dependent life events, length of working hours, job control, job strain and effort-reward imbalance were compared between never-drinkers and light drinkers (
To discover whether the number of fatal alcohol peaks during festivities characterized by unrestrained drinking and relates to sales of alcoholic beverages.
Time-series and cross-sectional.
Fatal alcohol poisonings and retail alcohol sales in Finland in 1983-99.
Fatal alcohol poisonings were found to peak during weekends and in the May Day, Midsummer Day and Christmas celebrations. Regression analysis of quarterly series lead to a model showing that 1% increase in the sales of spirits increases the number of fatal alcohol poisonings by 0.4%.
At the population level, increases in the sales of spirits and periods of hard drinking seem to increase deaths from alcohol poisoning. The findings could be of use in efforts to decrease hard drinking.
Self-reported angina symptoms are collected in epidemiological surveys. We aimed at validating the angina symptoms assessed by the Rose Questionnaire against registry data on coronary heart disease. A further aim was to examine the sex paradox in angina implying that women report more symptoms, whereas men have more coronary events.
Angina symptoms of 6601 employees of the City of Helsinki were examined using the postal questionnaire survey data combined with coronary heart disease registries.
The self-reported angina was classified as no symptoms, atypical pain, exertional chest pain, and stable angina symptoms. Reimbursed medications and hospital admissions were available from registries 10 years before the survey. Binomial regression analysis was used.
Stable angina symptoms were associated with hospital admissions and reimbursed medications [prevalence ratio (PR), 6.75; 95% confidence interval (CI), 4.56-9.99]. In addition, exertional chest pain (PR, 5.31; 95% CI, 3.45-8.18) was associated with coronary events. All events were more prevalent among men than women (PR, 2.36; 95% CI, 1.72-3.25).
The Rose Questionnaire remains a valid tool to distinguish healthy people from those with coronary heart disease. However, a notable part of those reporting symptoms have no confirmation of coronary heart disease in the registries. The female excess of symptoms and male excess of events may reflect inequality or delay in access to treatment, problems in identification and diagnosis, or more complex issues related to self-reported angina symptoms.
During the 1980s and early 1990s New Zealand experienced major social and economic change, decreasing all-cause mortality rates for the majority ethnic group, and high (but falling) cardiovascular disease (CVD) mortality rates. This paper explores whether inequalities in mortality by education were greater, and increased more, in New Zealand than in Nordic countries (Denmark, Finland, Norway), and determines the contribution of CVD to these differences and trends. METHODS: We used mortality rates for 30-59 year olds by education, and slope (SII) and relative (RII) indices of inequality, calculated from comparable linked census mortality data. RESULTS: Mortality inequalities in New Zealand were at the high end of the Nordic range when standardised by age only, but were mid-range when also standardised by ethnicity. Over time, relative inequalities in all-cause mortality increased similarly in all countries. In New Zealand a large increase in inequality for cardiovascular disease (CVD) mortality was the major contributor. In contrast both CVD and other causes of death were important drivers of increasing inequalities in Nordic countries. Absolute inequalities in all-cause mortality were stable over time among males across all countries, and increased modestly among females. The contribution of CVD to absolute inequality was stable or decreasing over time in all countries. CONCLUSION: Overall, inequalities in mortality in New Zealand did not widen more rapidly than in northern European countries. However, rapid social and economic change may have affected trends in CVD mortality among low educated men and women, and especially the ethnic minority groups.
Duration of untreated psychosis (DUP) has been linked with poor prognosis and changes in the brain structure in schizophrenia at least at the beginning of the disease, but it is still unknown whether DUP relates to brain morphometry in the longer term. Our aim was to analyze the relation between DUP and the brain structure in schizophrenia in the general population, after several years of illness.
Brains of subjects with psychosis from the Northern Finland 1966 Birth Cohort (NFBC 1966) were scanned with MRI during 1999-2001 after an 11-year follow-up. DUP was assessed from medical records and regressed against global and local tissue density measurements. The brain morphometric and the DUP information were available for 46 subjects with DSM-III-R schizophrenia.
The DUP did not correlate with volumes of the total gray or white matter or the cerebrospinal fluid. The length of DUP associated positively with reduced densities of the right limbic area and the right hippocampus.
Long DUP was slightly associated with reductions of gray matter densities in the limbic area and especially the hippocampus after several years follow-up, supporting the hypothesis that, compared to short DUP, long DUP might be a marker of different disease trajectories including subtle morphometric changes.
To evaluate whether mid-life marital status is related to cognitive function in later life.
Prospective population based study with an average follow-up of 21 years.
Kuopio and Joensuu regions in eastern Finland.
Participants were derived from random, population based samples previously investigated in 1972, 1977, 1982, or 1987; 1449 individuals (73%), aged 65-79, underwent re-examination in 1998.
Alzheimer's disease and mild cognitive impairment.
People cohabiting with a partner in mid-life (mean age 50.4) were less likely than all other categories (single, separated, or widowed) to show cognitive impairment later in life at ages 65-79. Those widowed or divorced in mid-life and still so at follow-up had three times the risk compared with married or cohabiting people. Those widowed both at mid-life and later life had an odds ratio of 7.67 (1.6 to 40.0) for Alzheimer's disease compared with married or cohabiting people. The highest increased risk for Alzheimer's disease was in carriers of the apolipoprotein E e4 allele who lost their partner before mid-life and were still widowed or divorced at follow-up. The progressive entering of several adjustment variables from mid-life did not alter these associations.
Living in a relationship with a partner might imply cognitive and social challenges that have a protective effect against cognitive impairment later in life, consistent with the brain reserve hypothesis. The specific increased risk for widowed and divorced people compared with single people indicates that other factors are needed to explain parts of the results. A sociogenetic disease model might explain the dramatic increase in risk of Alzheimer's disease for widowed apolipoprotein E e4 carriers.
Cites: N Engl J Med. 2003 Jun 19;348(25):2489-9012815133
Cites: N Engl J Med. 2003 Jun 19;348(25):2508-1612815136