Teenagers' sexuality in Estonia and Finland in the 1990s

The present study assessed adolescent knowledge of sexual issues and sexual behavior in Estonia and Finland. The Estonian survey was conducted among students in the final grade of comprehensive school in March 1994, with a questionnaire translated trom the Finnish KISS-92 study. The Estonian sample comprised 532 boys and 548 girls 15.0 years old on average; part of the Finnish KISS group of 1992, covering 680 boys and 687 girls 15.8 years old on average, served for comparison. Significance of difference was tested. Estonian adolescents were found to have significantly less sexual experiences than their Finnish counterparts. At the same time quite a large proportion of the Estonian adolescents were attitudinally ready to start sexual intercourse. From this point of view, it is alarming that knowledge of sexual issues was poor among Estonian adolescents: only one out of ten respondents had good and about one- half had poor knowledge of sexual issues. A good level of knowledge was five times more common among Finnish boys compared to Estonian boys. Among girls the difference was eightfold, respectively

Emergency contraception among Finnish adolescents: awareness, use and the effect of non-prescription status

Background Adolescents need to be aware that there is a method of preventing pregnancy even after an unprotected intercourse. Limited information is available on the awareness of young adolescents and the effects of selling emergency contraception (EC) over-the-counter, and the findings are controversial. The aims of this study were to investigate awareness and use of EC among Finnish girls aged 12–18 years in 1999–2003, and to assess the effect of the 2002 non-prescription status on the use. Methods A self-administered questionnaire was sent to a population-based sample of 12–18-year-olds girls in 1999, 2001, and 2003. Response rate was 83% in 1999 (N = 4,369), 79% in 2001 (N = 4,024) and 77% in 2003 (N = 3,728), altogether N = 12,121. Logistic regression model was used to examine the association of unawareness and use of EC with socio-economic background and health behaviour. Results In 2001, nearly all 14–18-year-olds and a majority of 12-year-olds were aware of EC. Among 12–14-year-olds, a slight increase in awareness between 1999 and 2003 was observed but this was not related to non-prescription status. Health-compromising behavior (alcohol use, smoking), dating and having good school achievement were related to higher awareness of EC. Nine percent of 14–18-year-olds had used EC once and 1% three times or more. No statistically significant change in EC use was found after non-prescription status. EC use increased with increasing alcohol consumption, particularly at age 14. Smoking, dating, and poor school achievement were related to increased use as well as not living in nuclear family. A lower use was observed if living in rural area or father's education was high. Mother's education was not related to use. Conclusion Adolescent girls were well aware of the existence of emergency contraception even before the non-prescription status. Over-the-counter selling did not increase the use.BioMed Central Open acces

Nuorten tyttöjen ehkäisypillerit – suositus maksuttomuudesta toteutuu huonosti

Seksuaali- ja lisääntymisterveyden edistämisen toimintaohjelmassa (2007–2011) asetettiin tavoitteeksi alle 20-vuotiaiden ehkäisyvälineiden maksuttomuus. Tutkimuksessa selvitettiin, miten suositus on toteutunut ehkäisypillereiden osalta ja oliko toteutumisessa eroja käytön pituuden tai maan eri osien välillä. Aineistona käytettiin Nuorten terveystapatutkimuksen yhdistettyjä kyselyitä vuosilta 2009 ja 2011. Ehkäisy-pillerit oli saanut maksutta puolet 14-vuotiaista, hieman yli kolmasosa 16-vuotiaista, mutta vain alle joka viides 18-vuotiaista tytöistä. Kun käytön pituus oli 1–3 kuukautta, 77 prosenttia käyttäjistä oli saanut pillerit ilmaiseksi. Yli puoli vuotta pillereitä käyttäneistä vain 9 prosenttia oli saanut ne ilmaiseksi. Suositus alle 20-vuotiaiden maksuttomasta ehkäisystä oli toteutunut vain osittain. Uudellamaalla ja pääkaupunkiseudulla maksuttomuus toteutui muuta maata huonommin

Excess use of thyroid hormone treatment among patients with fibromyalgia : a cross-sectional study in primary health care

Objective: From previous studies, it is known that the association between fibromyalgia and thyroid autoimmunity diseases exists. On the other hand, it was recently suggested that in many cases thyroid hormone treatment might be unnecessary. The aim of our study is to explore the thyroid hormone treatment among primary health care fibromyalgia patients. Our study is cross-sectional and based on fibromyalgia study from the city of Nokia Health Center. Clinical examination was performed to participants, patients filled five questionnaires and information from electronic patient records was gathered. In addition to other parameters, we studied patient’s thyroid function levels at the beginning of thyroid hormone treatment. Results: From those patients participating in the study (n = 103), 34% (n = 33) had thyroid hormone treatment. From those taking thyroid hormone treatment, 48% (n = 16) had information regarding the initial TSH and T4-V levels at the beginning of the treatment. 37% (n = 6) of them had normal thyroid function. Small sample size and data gathered from single health center effects on the generalizability of our findings. However, we suggest further studies to confirm the potential association between fibromyalgia and inappropriate thyroid hormone treatment.publishedVersionPeer reviewe

Segmenting Patients With Diabetes With the Navigator Service in Primary Care and a Description of the Self-Acting Patient Group : Cross-Sectional Study

BACKGROUND: The aim of patient segmentation is to recognize patients with similar health care needs. The Finnish patient segmentation service Navigator segregates patients into 4 groups, including a self-acting group, who presumably manages their everyday life and coordinates their health care. Digital services could support their self-care. Knowledge on self-acting patients' characteristics is lacking. OBJECTIVE: The study aims are to describe how Navigator assigns patients with diabetes to the 4 groups at nurses' appointments at a health center, the self-acting patient group's characteristics compared with other patient groups, and the concordance between the nurse's evaluation of the patient's group and the actual group assigned by Navigator (criterion validity). METHODS: Patients with diabetes ≥18 years old visiting primary care were invited to participate in this cross-sectional study. Patients with disability preventing informed consent for participation were excluded. Nurses estimated the patients' upcoming group results before the appointment. We describe the concordance (%) between the evaluation and actual groups. Nurses used Navigator patients with diabetes (n=304) at their annual follow-up visits. The self-acting patients' diabetes care values (glycated hemoglobin [HbA1c], urine albumin to creatinine ratio, low-density lipoprotein cholesterol, blood pressure, BMI), chronic conditions, medication, smoking status, self-rated health, disability (World Health Organization Disability Assessment Schedule [WHODAS] 2.0), health-related quality of life (EQ-5D-5L), and well-being (Well-being Questionnaire [WBQ-12]) and the patients' responses to Navigator's question concerning their digital skills as outcome variables were compared with those of the other patients. We used descriptive statistics for the patients' distribution into the 4 groups and demographic data. We used the Mann-Whitney U test with nonnormally distributed variables, independent samples t test with normally distributed variables, and Pearson chi-square tests with categorized variables to compare the groups. RESULTS: Most patients (259/304, 85.2%) were in the self-acting group. Hypertension, hyperlipidemia, and joint ailments were the most prevalent comorbidities among all patients. Self-acting patients had less ischemic cardiac disease (P=.001), depression or anxiety (P=.03), asthma or chronic obstructive pulmonary disease (P<.001), long-term pain (P<.001), and related medication. Self-acting patients had better self-rated health (P<.001), functional ability (P<.001), health-related quality of life (P<.001), and general well-being (P<.001). All patients considered their skills at using electronic services to be good. CONCLUSIONS: The patients in the self-acting group had several comorbidities. However, their functional ability was not yet diminished compared with patients in the other groups. Therefore, to prevent diabetic complications and disabilities, support for patients' self-management should be emphasized in their integrated care services. Digital services could be involved in the care of patients willing to use them. The study was performed in 1 health center, the participants were volunteers, and most patients were assigned to self-acting patient group. These facts limit the generalizability of our results. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/20570.Peer reviewe

Kouluterveydenhuollon käynnit 1994–2005 – Toteutuiko tasa-arvo terveyskeskusten välillä informaatio-ohjauksen aikakaudella?

Kunnat ovat vastanneet kouluterveydenhuollosta normiohjauksen purkamisen (1993) jälkeen. Palvelutarjonnan tasa-arvoisuutta informaatio-ohjauksen aikana selvitetään terveyskeskusten välisellä kouluterveydenhuollon käyntivaihtelulla 1994–2005. Tutkimuksen aineistona olivat 227 terveyskeskuksen kouluterveydenhuollon käynnit. Väestöön suhteutettujen käyntimäärien vaihtelua tutkittiin Gini-kertoimella ja regressiosuoralla, käyntimäärien yhteyttä terveyskeskusta kuvaaviin tekijöihin regressioanalyysillä. Koululääkärikäyntien määrän vaihtelu terveyskeskusten välillä oli suurta jakson alussa ja lisääntyi hieman tarkasteluaikana. Vuonna 2005 lääkärikäyntien mediaani oli 22 tuhatta 7–18-vuotiasta kohden (vaihteluväli 0–633), muiden käyntien 1695 (612–3316). Lääkärikäynnit vähenivät tarkastelujaksolla ja vaihtelu lisääntyi 1997 jälkeen. Muilla ammattihenkilöillä käyntien vaihtelu väheni. Koululääkärikäyntimäärän vähenemistä eivät selittäneet kouluterveydenhuollon muilla ammattihenkilöillä käyntien, yksityislääkärikäyntien tai muiden lasten/nuorten lääkärikäyntien lisääntyminen. Terveyskeskusten välinen vaihtelu kouluterveydenhuollon käynneissä pysyi informaatio-ohjauksen aikana suurena ja osin lisääntyi