Patient-controlled intravenous versus on-demand oral, intramuscular or mcs intravenous administration of oxycodone during medical induced abortion from 64 to 128 days of Gestation : A randomized controlled trial

Publisher Copyright: © 2022 The AuthorsObjective: To compare oxycodone administration via intravenous patient-controlled analgesia (IVPCA) vs on-demand administration during late-first- and second-trimester medically induced abortion. Study design: A prospective randomized controlled study. We enrolled women between 64 to 128 days of gestation in the study between June 2016 and August 2018. Participants were randomized to receive oxycodone either via IVPCA or given on-demand orally, intramuscularly, or intravenously. Pain intensity and satisfaction with care were measured using the visual analogue scale (VAS, 0–100mm). Results: Altogether 99 participants were randomized: 48 in IVPCA group and 51 in on-demand group. Median gestational age was similar between groups (74 days [Interquartile range, IQR 69–81] in the IVPCA group vs 72 [69–80] in the control group, p = 0.587). Peak maximal pain was severe in both groups (median pain VAS was 62 [IQR 44–84] and 71 [IQR 56–90], p = 0.52). The odds for severe pain (highest pain VAS≥70) were similar between the groups (IVPCA group OR 0.51 [95% Confidence Interval 0.22–1.18], p = 0.118). In contrast, the odds for mild or tolerable pain (highest pain VAS≤40) were higher in the IVPCA group (OR 4.06 [95% CI 1.05–16.04], p = 0.043). Nevertheless, satisfaction with care was high (VAS 94 [89–100]) in both groups. Of those experiencing severe pain, 94.0% declared pain medication as adequate. Conclusion: Women often experience severe pain during medical abortion irrespective of the mode of opiate administration. Oxycodone administration via IVPCA permits women to self-administer analgesics when experiencing pain, raising the odds for mild or tolerable pain during abortion care. Satisfaction with care was high.Peer reviewe

Pain during medical abortion in early pregnancy in teenage and adult women

Introduction Women experience pain during medical abortion, yet optimal pain management remains unclear. We studied the pain experience and need of analgesics during early medical abortion (= 70) during abortion care and 93.5% of women needed additional analgesics in addition to prophylactic pain medication. Teenagers needed additional analgesics more often than adults (5 [3-8] vs 3 [2-6] times,P = .021); 38.0% of all teenagers (64.7% of the minors) received additional opiates compared with 7.9% in adult women. Severe pain (VAS >= 70) was associated with history of dysmenorrhea (adjusted odds ratio [OR] 2.60 [95% confidence interval [CI] 1.21-5.59,P = .014]), anxiety at baseline (2.64 [1.03-6.77],P = .044) and emesis during abortion (5.24 [2.38-11.57],P <.001). Hospital administration of misoprostol did not lower the risk for severe pain experience (OR 0.84 [95% CI 0.34-2.05],P = .694). Satisfaction with care was high in study population (median VAS 91 [interquartile range 79-97]) and was not associated with the use of narcotic analgesic or place of misoprostol administration. Conclusions Pain intensity was high both in teenage and adult women undergoing medical abortion, yet satisfaction on care was high. More effective analgesics than ibuprofen and paracetamol should be offered to all women undergoing early medical abortion, especially to those with history of dysmenorrhea. Also, routine use of antiemetics might be advisable.Peer reviewe

THE ROLE OF SUSTAINABILITY IN ONLINE CUSTOMER EXPERIENCES : A QUALITATIVE STUDY ON FEMALE FASHION SHOPPERS

This qualitative study aims to understand sustainability’s role in responsible consumers’ Online Customer Experiences (OCEs). In this study, we focus on female fashion shoppers, and study three dimensions of their OCE: cognitive, affective, and social. Although online shopping and responsible consumer behaviour have increased tremendously, sustainability’s role in OCE has not been studied before fromthe customer’s perspective. The data consists of nine semi-structural interviews of Finnish female self-proclaimed responsible consumers and is analyzed with qualitative content analysis. The findings show that sustainability issues are present in all OCE dimensions, which are also all interconnected. In short, we find that OCE’s cognitive dimension includes customers’ evaluation of the online store’s social and environmental sustainability as well as the product’s sustainability, necessity, and longevity. The affective dimension of OCE includes a wide range of feelings arising from perceived sustainability and one’s consumption choices. The social dimension includes one’s self-presentation, social channels, and the socio-technical implementation of online stores and their social features. The findings are beneficial for online store providers and academics interested in studying sustainability and OCE from the information systems perspective

Fear of childbirth after medical versus surgical abortion. Population-based register study from Finland

Introduction To evaluate the effect of method of induced abortion and other abortion-associated variables on the incidence of fear of childbirth in subsequent pregnancy. Material and methods This population-based register study cohort includes all nulliparous women with their first pregnancy ending in an induced abortion in 2000-2015 and subsequent pregnancy with live singleton delivery between 2000 and 2017 (n = 21 479). Data were derived from three national registers maintained by the Finnish Institute for Health and Welfare. We divided the study population in three cohorts: (a) medical and (b) surgical abortion during first trimester ( Results The overall incidence of fear of childbirth was 5.6% (n = 1209). Altogether, 19.2% (n = 4121) of women underwent cesarean delivery. The odds were elevated especially for elective cesarean delivery (odds ratio [OR] 9.30, 95% CI 7.95-10.88, P <.001) in women with fear of childbirth. In multivariable analysis, the odds for fear of childbirth (adjusted OR [aOR] 0.80, 95% CI 0.68-0.94) and cesarean delivery (aOR 0.66, 95% CI 0.84-0.90) were decreased in women with a history of first-trimester medical abortion compared with those with first-trimester surgical abortion. Second-trimester medical abortion had no effect on the odds for fear of childbirth (aOR 1.04, 95% CI 0.71-1.50). Maternal age of 30-39 years and interpregnancy interval over 2 years were additional risk factors for both fear of childbirth and cesarean delivery, but surgical evacuation of uterus after the abortion was not. Conclusions One first- or second-trimester medical abortion does not increase the odds for fear of childbirth, and cesarean delivery related to it in subsequent pregnancy when compared with first-trimester surgical abortion. Older maternal age and longer interpregnancy interval emerged as risk factors for fear of childbirth.Peer reviewe

What is meaningful for responsible shoppers in online fashion retail?

This qualitative study investigates what is meaningful for responsible shoppers in online fashion retail. The study aims to identify and describe these essential themes from the customers’ perspective. The data were collected by interviewing nine self-proclaimed responsible shoppers aged 26–51 years. All participants were female. The findings highlight six meaningful themes for responsible shoppers. These include 1) comprehensive and versatile information; 2) familiar brands and retailers; 3) domesticity; 4) pricing; 5) justification of purchase; and 6) the durability of fashion wear. The study indicates that these meaningful themes are related to the online store characteristics and brands sold in them, as well as to the shopper. Online fashion retailers create the conditions for a responsible purchase by the information the retailers present, their selection of brands, and pricing. However, favorable purchasing conditions alone do not guarantee purchases, as responsible shoppers avoid clothing purchases, and their purchases must be well justified. Future studies should examine how online retailers and service providers can appeal to these careful and reluctant shoppers.peerReviewe

Matkailijan silmän terveys

Uudet kokemukset houkuttelevat ihmisiä matkustamaan niin lähi- kuin kaukokohteisiin. Yleensä ennen matkalle lähtöä tutkitaan, mitä matkalle kannattaa ottaa mukaan ja minkälaisiin olosuhteisiin kannattaa varautua. Näitä ovat yleensä ilmastoon ja lämpötilaan tutustuminen, mahdollisten taskuvarkaiden esiintymisen yleisyys, hanaveden käyttö, ruoka ja hygienia sekä kulttuuriin perehtyminen. Yksi tärkeimmistä on myös rokotteiden ottaminen sairauksia vastaan. Usein unohdetaan, että myös silmät saattavat reagoida eri tavoin matkustaessa. Ärtyneistä silmistä saa inhottavan matkaseuralaisen. Vaikka silmät ovat pieni osa ihmistä, jotkin sairaudet saattavat oireilla myös silmissä, ja toiset sairaudet voivat kohdistua pelkästään silmiin. Toisaalta on hyvin harvinaista saada pahempaa infektiota matkan aikana, mutta on hyvä varautua ja perehtyä mahdollisiin paikallisiin sairauksiin ja ottaa selvää oireista. Opinnäytetyön tavoitteena oli tuottaa ja koota tiivis opas yleisimmistä ja tärkeimmistä matkailuun liittyvistä mahdollisista silmävaivoista, niiden ennaltaehkäisystä ja hoidosta, ja sen avulla välittää tietoa kaikille asiasta kiinnostuneille

The effect of cumulative childhood exposure to neighbourhood socioeconomic disadvantage on school performance-a register-based study on neighbourhoods, schools, and siblings

Several studies show that exposure to neighbourhood disadvantage predicts poorer educational outcomes among adolescents. Selective sorting into neighbourhoods, other unobserved childhood family characteristics, and failing to account for other relevant social contexts such as schools inhibit strong causal inference from the associations reported in previous studies. Based on longitudinal register data on the total population of Finnish children in major cities, we studied the extent to which variation in grade point average (GPA) was attributable to schools, neighbourhoods, and families. We also sought to determine whether exposure to neighbourhood disadvantage predicted GPA after accounting for non-random selection into neighbourhoods by comparing siblings with differential exposure to neighbourhoods. Overall, we observed no effect of neighbourhood disadvantage on GPA after accounting for observed and unobserved family characteristics in the general population. However, we did observe a non-negligible but not statistically significant effect of neighbourhood disadvantage among children of parents with only basic education. Family factors accounted for most of the variation in GPA, and only around 1 per cent of the variance was attributable to the neighbourhood. This weak relevance of the neighbourhood to educational outcomes may reflect the success of educational and other social policies limiting the emergence of neighbourhood effects.Peer reviewe

Divided City.

The urban inequality of large cities and the accumulation of disadvantage present a problem all across the globe. People from similar backgrounds occupy the same areas, resulting in the division of urban space and city districts, among other factors, by ethnicity, income level, religion and language. Why is this and how can this trend be influenced? The event introduces examples of urban division and development in Finland, Europe and the Global South. Venla Bernelius, Teemu Kemppainen and Katja Vilkama look at the regional differentiation in Helsinki. Florencia Quesada Avendaño, Filip de Boeck and Anja Nygren talk about cities in Latin America and Africa. The first discussion is in Finnish and the latter in English. The event is hosted by Reetta Räty.status: publishe

Fear of childbirth after induced abortion in primiparous women : Population-based register study from Finland

Introduction: Fear of childbirth (FOC) is a common obstetrical challenge that complicates about every 10th pregnancy. Background factors of FOC are diverse. We evaluated the association of induced abortion (IA) and FOC in subsequent pregnancy. Material and methods: Population-based register study based on three Finnish national registers: the Register of Induced Abortions, the Medical Birth Register and the Hospital Discharge Register. The study cases were primigravid women undergoing an IA in 2000–2015 and subsequent pregnancy ending in live singleton birth up to 2017. Each case had three controls, matched by age and residential area, whose first pregnancy ended in a live birth. The main outcome was the incidence of FOC in the subsequent pregnancy. In a secondary analysis, we assessed other risk factors for FOC. Results: The study cohort consisted of 21 455 women and 63 425 controls. Altogether, 4.2% of women had a diagnosis of FOC. The incidence was higher in women with a history of IA than in controls (5.6% vs 3.7%, P < 0.001). A history of IA was associated with higher odds for FOC: adjusted odds ratio [aOR] 1.20 with 95% confidence interval (CI) 1.11–1.30. In addition, a history of psychiatric diagnosis (aOR 3.48, 95% CI 3.15–3.83), high maternal age, 30–39 years old (aOR 1.55, 95% CI 1.43–1.67; P < 0.001) and ≥40 years old (aOR 3.00, 95% CI 2.37–3.77; P < 0.001) and smoking (aOR 1.20, 95% CI 1.11–1.31; P < 0.001) were associated with increased odds for FOC. Women living in densely populated or rural areas and those with lower socioeconomic class had lower odds for FOC. Conclusions: A history of IA is associated with increased odds for FOC in subsequent pregnancy. However, the associations of FOC with a history of psychiatric diagnosis and elevated maternal age (especially ≥40 years old) are more pronounced.Peer reviewe