Characteristics associated with initiation of hormone replacement therapy among Finnish women : A register-linkage study

Objective: To investigate which patient characteristics are associated with the initiation of hormone replacement therapy (HRT) in a cohort of Finnish women. Study design: Responses to postal questionnaires distributed to a nationwide, randomly selected cohort of women in 1998, 2000, 2003, 2005 and 2010 were analyzed. The cohort members were aged 40-44 years at the beginning of the study. Information on hormone replacement therapy was received from the national prescription register. Women who started taking HRT between January 1, 1999 and December 31, 2011 were included and previous users were excluded from the analysis. Main outcome measures: Initiation of HRT was the main outcome measure. The following explanatory factors for predicting the use of HRT were examined: sociodemographic factors, personality, health behavior, physiological and mental symptoms, chronic diseases and use of psychopharmaceuticals. The associations between starting HRT and the explanatory factors were analyzed with single-predictor and multi-predictor logistic regression models. Results: Factors predicting that a woman would start taking HRT were: living with a partner, weak sense of coherence, BMI less than 30 kg/m(2), heavy or moderate alcohol use, symptoms of hyperactivity of the sympathetic nervous system, climacteric symptoms and use of psychopharmaceuticals. Conclusions: Women with a good sense of coherence can cope with climacteric symptoms without resorting to HRT. Clinicians need to bear in mind the burden of menopausal symptoms on a woman's personal and working life when HRT is being considered. (C) 2016 Elsevier Ireland Ltd. All rights reserved.Peer reviewe

Jyväskylän opiskelija-asumisen kehittäminen sosiaalisen kestävyyden näkökulmasta

Tiivistelmä. Alueellinen eriytyminen eli segregaatio on ollut viime aikoina paljon esillä kaupunkitutkimuksessa. Eriytymisellä on merkittäviä yhteiskunnallisia vaikutuksia, sillä se esimerkiksi lisää väestön sosiaalista etäisyyttä, heikentää mahdollisuuksien tasa-arvoa ja vähentää paikkaan kiinnittymistä. Eriytymistä on pyritty estämään niin sanotun sosiaalisen sekoittamisen politiikkaa edistämällä ja kiinnittämällä kaupunkisuunnittelussa huomiota asuinalueiden asuntokannan monipuolisuuteen. Tämän tutkielman tavoitteena on selvittää, miten Jyväskylän opiskelija-asumisen kehittämisessä huomioidaan asuinalueiden sosiaalinen kestävyys. Tutkimusalueena on Jyväskylä, jossa toimii kolme korkeakoulua ja väestöstä keskimääräistä suurempi osa on opiskelijoita. Ympäristöministeriön selvityksen mukaan Jyväskylän opiskelija-asumista tulee kehittää tulevaisuudessa vastaamaan paremmin tämän hetkistä kysyntää. Muualla maailmassa opiskelija-asumisen keskittymistä kampusalueille on tutkittu jonkin verran, ja havaintojen perusteella keskittymisellä on sekä positiivisia että negatiivisia seurauksia. Opiskelijavaltaisilla alueilla esiintyy meluamista ja sotkemista muita alueita enemmän ja muut väestöryhmät karttavat näitä alueita. Suomessa ei opiskelija-asumisen alueellista eriytymistä ole juurikaan tutkittu, mistä syystä tälle tutkielmalle on tarvetta. Aineiston muodostavat 12 Jyväskylän opiskelija-asumisen kanssa tekemisissä olevan henkilön asiantuntijahaastattelua. Haastattelut tehtiin joulukuussa 2019 ja tammikuussa 2020. Aineisto analysoitiin teorialähtöisen sisällönanalyysin keinoin. Tulokset osoittavat, että sosiaalinen kestävyys huomioidaan opiskelija-asumisen kehittämisessä melko hyvin. Opiskelija-asumista pyritään sijoittamaan moniin eri sijainteihin kuitenkin niin, että opiskelijoiden elämä on mahdollisimman sujuvaa. Opiskelija-asuntorakentamisessa yksiöiden osuutta on kasvatettu ja opiskelijoiden sosiaalisia kontakteja on pyritty lisäämään erityisesti yhteistiloja rakentamalla. Tulevaisuudessa opiskelija-asumista tullaan rakentamaan myös muiden väestöryhmien asumisen yhteyteen. Asiantuntijoilla kuitenkin oli hieman eriäviä näkemyksiä siitä, kuinka opiskelija-asumista tulisi kehittää, mikä kertoo sosiaalisen sekoittamisen käsitteen monitahoisuudesta. Sosiaalisen kestävyyden huomioiminen opiskelija-asumisen kehittämisessä on tärkeää, jotta opiskelijat eivät jää ulkopuolelle ja syrjäydy muusta yhteiskunnasta. Tämä ylläpitää myös suomalaisen hyvinvointiyhteiskunnan keskeisimpiä arvoja eli mahdollisuuksien tasa-arvon toteutumista ja kaikkien väestöryhmien hyvinvoinnista huolehtimista

Global Assessment of Grassland Carrying Capacities and Relative Stocking Densities of Livestock

Although many suggest that future diets should include more plant-based proteins, animal-sourced foods are unlikely to completely disappear from our diet. Grasslands yield a notable part of the world’s animal protein production, but thus far, there is no global insight into the relationship between current livestock stocking densities and the availability of grassland forage resources. This inhibits acting upon concerns over the negative effects of overgrazing in some areas and utilising the potential for increasing production in others. Previous research has examined the potential of sustainable grazing but lacks generic and observation-based methods needed to fully understand the opportunities and threats of grazing. Here we provide a novel framework and method to estimate global livestock carrying capacity and relative stocking density, i.e. the reported livestock distribution relative to the estimated carrying capacity. We first estimate the aboveground biomass that is available for grazers on grasslands and savannas based on the MODIS Net Primary Production (NPP) approach on a global scale. This information is then used to calculate reasonable livestock carrying capacities, using slopes, forest cover and animal forage requirements as restrictions. With this approach, we found that stocking rates exceed the forage provided by grasslands in northwestern Europe, midwestern United States, southern China and the African Sahel. In this study, we provide the highest resolution global datasets to date. Our results have implications for prospective global food system modelling as well as national agricultural and environmental policies. These maps and findings can assist with conservation efforts to reduce land degradation associated with overgrazing and help identify undergrazed areas for targeted sustainable intensification efforts

Corticomuscular Coherence Is Tuned to the Spontaneous Rhythmicity of Speech at 2-3 Hz

Human speech features rhythmicity that frames distinctive, fine-grained speech patterns. Speech can thus be counted among rhythmic motor behaviors that generally manifest characteristic spontaneous rates. However, the critical neural evidence for tuning of articulatory control to a spontaneous rate of speech has not been uncovered. The present study examined the spontaneous rhythmicity in speech production and its relationship to cortex–muscle neurocommunication, which is essential for speech control. Our MEG results show that, during articulation, coherent oscillatory coupling between the mouth sensorimotor cortex and the mouth muscles is strongest at the frequency of spontaneous rhythmicity of speech at 2–3 Hz, which is also the typical rate of word production. Corticomuscular coherence, a measure of efficient cortex–muscle neurocommunication, thus reveals behaviorally relevant oscillatory tuning for spoken language.Peer reviewe

The first human report of mobile colistin resistance gene, mcr-1, in Finland

Colistin resistance mediated by mobile mcr-1 gene has raised concern during the last years. After steep increase in mcr-1 reports, other mcr-gene variants (mcr-2 to mcr-5) have been revealed as well. In 2016, a clinical study was conducted on asymptomatic stool carriage of extended spectrum beta-lactamase (ESBL) producing Escherichia coli and Klebsiella pneumoniae among Finnish adults. All suspected ESBL producing bacterial isolates were first tested by phenotypic ESBL-confirmation methods, and then further analyzed with whole genome sequencing to identify the resistance genes. We found one study subject carrying a colistin resistant E.coli with a transferrable mcr-1 gene. This multi-drug resistant isolate, although initially suspected to be an ESBL producer, did not carry any ESBL genes, but was proven to carry several other resistance genes by using whole genome sequencing. Sequence type was ST93. The mcr-1 gene was connected to IncX4 plasmid which suggests that the colistin resistance gene locates in the respective plasmid. Here, we report the finding of a mcr-1 harboring human E.coli isolate from Finland. Clinical antimicrobial resistance (AMR) rates are low in Finland, and mobile colistin resistance has not been reported previously. This highlights the importance of AMR surveillance also in populations with low levels of resistance

Scedosporium apiospermum as a rare cause of central skull base osteomyelitis.

We report a case of Scedosporium apiospermum mold causing ear infection, central skull base osteomyelitis and finally, occlusion of carotid artery in a 48-year-old diabetic man. The exact diagnosis was established and the severity of the disease understood several months after the onset of symptoms. Despite of appropriate antifungal therapy, and repeated surgical and otological procedures, the infection progressed to fatal cerebral infarction

Coincidental detection of the first outbreak of carbapenemase-producing Klebsiella pneumoniae colonisation in a primary care hospital, Finland, 2013

In Finland, occurrence of Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-KP) has previously been sporadic and related to travel. We describe the first outbreak of colonisation with KPC-KP strain ST512; it affected nine patients in a 137-bed primary care hospital. The index case was detected by chance when a non-prescribed urine culture was taken from an asymptomatic patient with suprapubic urinary catheter in June 2013. Thereafter, all patients on the 38-bed ward were screened until two screening rounds were negative and extensive control measures were performed. Eight additional KPC-KP-carriers were found, and the highest prevalence of carriers on the ward was nine of 38. All other patients hospitalised on the outbreak ward between 1 May and 10 June and 101 former roommates of KPC-KP carriers since January had negative screening results. Two screening rounds on the hospital's other wards were negative. No link to travel abroad was detected. Compared with non-carriers, but without statistical significance, KPC-KP carriers were older (83 vs 76 years) and had more often received antimicrobial treatment within the three months before screening (9/9 vs 90/133). No clinical infections occurred during the six-month follow-up. Early detection, prompt control measures and repetitive screening were crucial in controlling the outbreak.Peer reviewe

Chlamydia trachomatis samples testing falsely negative in the Aptima Combo 2 test in Finland, 2019

Since February 2019, over 160 Chlamydia trachomatis (CT) cases testing negative or equivocal by Aptima Combo 2 (AC2) but positive by Aptima CT test run with Panther instruments occurred in Finland. The AC2 test targets chlamydial 23S rRNA while the CT test targets 16S rRNA. Sequencing of 10 strains revealed a nucleotide substitution in 23S rRNA. The significance of this for the failure of the AC2 test to detect the variant is not yet known.Peer reviewe