Associations of muscular fitness and body composition in children

Purpose: To examine the associations between muscular fitness (MF) and body composition. Method: MF was assessed with three tests of FitnessGram test battery. Total body fat percentage (BF%), abdominal fat percentage (AF%) and fat-free mass (FFM) were measured by dual-energy X-ray absorptiometry (DXA). The IOTF body mass index (BMI) cut-offs were used to define healthy weight, overweight, and obesity. Results: MF was inversely associated with BF% and AF%. The children in the moderate and high MF groups had significantly lower BF% and AF% compared with the children in the low MF group within the same BMI category. After adjusting for cardiorespiratory fitness (CRF), BMI and sex, the differences between the MF groups were significant for BF% but not for AF%. Conclusion: There were significant inverse associations between MF and DXA -measured adiposity. Within the same BMI category, total and abdominal adiposity were lower in children with moderate or high MF than in children with low MF.Peer reviewe

Associations of muscular fitness and body composition in children

Purpose: To examine the associations between muscular fitness (MF) and body composition. Method: MF was assessed with three tests of FitnessGram test battery. Total body fat percentage (BF%), abdominal fat percentage (AF%) and fat-free mass (FFM) were measured by dual-energy X-ray absorptiometry (DXA). The IOTF body mass index (BMI) cut-offs were used to define healthy weight, overweight, and obesity. Results: MF was inversely associated with BF% and AF%. The children in the moderate and high MF groups had significantly lower BF% and AF% compared with the children in the low MF group within the same BMI category. After adjusting for cardiorespiratory fitness (CRF), BMI and sex, the differences between the MF groups were significant for BF% but not for AF%. Conclusion: There were significant inverse associations between MF and DXA -measured adiposity. Within the same BMI category, total and abdominal adiposity were lower in children with moderate or high MF than in children with low MF.Peer reviewe

Developing physical activity counselling in primary care through participatory action approach

Record sheet on patient visits. (DOCX 102 kb

Liikuntaneuvonnan kehittäminen terveyskeskuksissa

Suomalaiset liikkuvat terveytensä kannalta liian vähän. Neuvonta on perusterveydenhuollon tärkein liikkumisen edistämisen keino, mutta sen toteuttamisessa on puutteita. Liikuntaneuvonnan kehittäminen terveyskeskuksissa -hankkeen tavoitteena oli lisätä erityisesti lääkäreiden, hoitajien ja fysioterapeuttien 1) terveysliikunnan ja liikuntaneuvonnan osaamista, 2) liikuntaneuvonnan toteuttamista ja sisällön monipuolisuutta, 3) Liikkumisreseptin tuntemista ja käyttöä, 4) sisäistä ja sektorirajat ylittävää liikuntaneuvonnan yhteistyötä ja 5) liikuntaneuvonnan kirjaamista potilastietojärjestelmään. Aineisto kerättiin neljästä pirkanmaalaisesta terveyskeskuksesta. Kukin nimesi vastuutiimin puoli vuotta kestäneelle kehittämistyölle. Tutkijaryhmä tuki tiimejä neljällä tutortapaamisella. Tavoitteiden toteutumista arvioitiin 19 tulosmuuttujan alku- ja lopputilanteen välisillä eroilla prosenttiyksiköissä ja niiden 95 prosentin luottamusväleinä (LV). Mittareina käytettiin työntekijäkyselyä (N=75 alussa ja 80 lopussa), työtekijöiden kirjanpitoa potilaskäynneistä (N=1008 ja 1000), potilaskyselyä (N=441 ja 431) ja yhteistyötoimijoiden puhelinhaastatteluja (N=48 ja 28). Prosessia arvioitiin kehittämisvastuun ja -toimien toteutumisella vastuutiimin ja tutorin muistioiden avulla. Liikkumisreseptin tunteminen lisääntyi (työntekijäkysely, 39 %; LV 25,5–52,5) ja käyttö yleistyi (työntekijäkysely, 32 %; LV 18,9–45,1 ja kirjanpito, 4 %; LV 2,7–5,3). Suurempi osa työntekijöistä oli sopinut Liikkumisreseptin käytöstä työpaikalla (työntekijäkysely, 32 %; LV 20,3–43,7) ja käyttänyt Liikkumisreseptiä lähetteenä terveyskeskuksen sisällä (kirjanpito, 1 %; LV 0,3–1,7). Terveysliikunnan ja liikuntaneuvonnan osaaminen lisääntyi, mutta ei tilastollisesti merkitsevästi. Kehittämisvastuu jakautui vastuutiimeissä epätasaisesti ja ajan varaaminen kehittämistyölle oli vaikeaa, mikä heijastui kehittämistoimien määrään. Hanke onnistui parhaiten Liikkumisreseptin tuntemisen ja käytön mutta vähäisemmässä määrin terveysliikunnan ja liikuntaneuvonnan osaamisen lisäämisessä. Muiden tavoitteiden saavuttaminen saattaa edellyttää sitoutuneempaa, monipuolisempaa ja pidempikestoisempaa kehittämisotetta

Neck–Shoulder Region Training for Chronic Headache in Women : A Randomized Controlled Trial

Objectives: We investigated whether a specific exercise program for the neck–shoulder region reduces headache intensity, frequency, and duration, and how it influences neck disability among women with chronic headache compared to a control group. Design: Two-center randomized controlled trial. Subjects: 116 working-age women. Intervention: The exercise group (n = 57) performed a home-based program with six progressive exercise modules, over 6 months. The control group (n = 59) underwent six placebo-dosed transcutaneous electrical nerve stimulation sessions. Both groups performed stretching exercises. Main measures: The primary outcome was pain intensity of headache, assessed using the Numeric Pain Rating Scale. Secondary outcomes were frequency and duration of weekly headaches, and neck disability assessed using the Neck Disability Index. Generalized linear mixed models were used. Results: Mean pain intensity at baseline was 4.7 (95% CI 4.4 to 5.0) in the exercise group and 4.8 (4.5 to 5.1) in the control group. After 6 months the decrease was slight with no between-group difference. Headache frequency decreased from 4.5 (3.9 to 5.1) to 2.4 (1.8 to 3.0) days/week in the exercise group, and from 4.4 (3.6 to 5.1) to 3.0 (2.4 to 3.6) in the control group (between-group p = 0.017). Headache duration decreased in both groups, with no between-group difference. Greater improvement in the Neck Disability Index was found in the exercise group (between-group change −1.6 [95% CI −3.1 to −0.2] points). Conclusion: The progressive exercise program almost halved headache frequency. The exercise program could be recommended as one treatment option for women with chronic headache.publishedVersionPeer reviewe

Human papillomavirus vaccine efficacy against invasive, HPV-positive cancers : population-based follow-up of a cluster-randomised trial

Background Human papillomavirus (HPV) vaccination protects against HPV, a necessary risk factor for cervical cancer. We now report results from population-based follow-up of randomised cohorts that vaccination provides HPV-type-specific protection against invasive cancer. Methods Individually and/or cluster randomised cohorts of HPV-vaccinated and non-vaccinated women were enrolled in 2002-2005. HPV vaccine cohorts comprised originally 16-17 year-old HPV 16/18-vaccinated PATRICIA (NCT00122681) and 012 trial (NCT00169494) participants (2465) and HPV6/11/16/18-vaccinated FUTURE II (NCT00092534) participants (866). Altogether, 3341 vaccines were followed by the Finnish Cancer Registry in the same way as 16 526 non-HPV-vaccinated controls. The control cohort stemmed from 15 665 originally 18-19 years-old women enrolled in 2003 (6499) or 2005 (9166) and 861 placebo recipients of the FUTURE II trial. The follow-up started 6 months after the clinical trials in 2007 and 2009 and ended in 2019. It was age aligned for the cohorts. Findings During a follow-up time of up to 11 years, we identified 17 HPV-positive invasive cancer cases (14 cervical cancers, 1 vaginal cancer, 1 vulvar cancer and 1 tongue cancer) in the non-HPV-vaccinated cohorts and no cases in the HPV-vaccinated cohorts. HPV typing of diagnostic tumour blocks found HPV16 in nine cervical cancer cases, HPV18, HPV33 and HPV52 each in two cases and HPV45 in one cervical cancer case. The vaginal, vulvar and tongue cancer cases were, respectively, positive for HPV16, HPV52/66 and HPV213. Intention-to-treat vaccine efficacy against all HPV-positive cancers was 100% (95% CI 2 to 100, p Interpretation Vaccination is effective against invasive HPV-positive cancer.Peer reviewe

Elinvoimaisuus tulevaisuuden voimavarana - Monialaiset YAMK opinnäytetyöt pohjoista elinvoimaisuutta kehittämässä

Elinvoimaisuuden lisääminen ja lisääntyminen ovat olleet pääteemoja oheisen julkaisun kuudelle monialaiselle YAMK-opinnäytetyölle. Alkusysäyksen kehittämistehtävälle nämä kymmenen opiskelijaa ovat löytäneet läheltä; joko opinnäytetyön tekijän omalta työpaikalta tai läheisestä toimintaympäristöstä. Kokoomajulkaisu sisältää YAMK-opinnäytetyön tuotokset artikkelimuodossa. Julkaisun alkuun on koottu opinnäytetyöryhmän yhdessä kirjoittama taustoitus julkaisun pääteemoista ja käytetyistä kehittämis- ja tutkimusmenetelmistä

Ten-year follow-up of human papillomavirus vaccine efficacy against the most stringent cervical neoplasia end-point-registry-based follow-up of three cohorts from randomized trials

Objective Due to long lag time between infection/ cancer diagnoses human papillomavirus (HPV) vaccination programs will deliver vaccine efficacy (VE) estimates against cancer end-points late. Cancer registry follow-up of population-based, randomised trial cohorts of vaccinated and unvaccinated women was undertaken for the estimation of VE against cervical intraepithelial neoplasia grade three and invasive cancer (CIN3+). Methods We report interim results with 98 561 person years of Finnish Cancer Registry -based follow-up of individually and/or cluster randomised cohorts of HPV-16/ 18 vaccinated and unvaccinated adolescent women enrolled in June 2003/2005, and between May 2004 and April 2005, respectively. The cohorts comprised 15 627 18-to 19-year-old unvaccinated women (NCT01393470), and 2 401 and 64 16-to 17-year-old HPV-16/18 vaccinated women participating the PATRICIA (NCT00122681) and HPV-012 (NCT00169494) trials, respectively. The age-aligned passive follow-up started 6 months after the clinical trials' end. Results During the follow-up of 4.5 to 10 years post enrolment we identified 75 cases of cervical intraepithelial neoplasia grade 3 (CIN3) and 4 cases of invasive cervical cancer (ICC) in the unvaccinated cohort, and 4 CIN3 cases in the HPV-16/18 vaccinated women. Diagnostic blocks were available for HPV typing from 87% of the cases. CIN3+ lesions were detectable in 54 cases. HPV16 was found in 26 of 50 unvaccinated CIN3+ cases, and in 3 CIN3+ cases in the HPV-16/18 vaccinated women. The latter were all baseline positive for cervical HPV16 DNA. Baseline data was not available for the unvaccinated women. Intention-to-treat VE against any CIN3+ was 66% (95% CI 8, 88). Conclusions Ten years post vaccination the AS04-adjuvanted HPV-16/18 vaccine shows continued efficacy against CIN3+ irrespectively of HPV type. Vaccine efficacy was not observed in baseline HPV16 DNA positive subjects.Peer reviewe