Longitudinal Analyses of Diet Quality and Maternal Depressive Symptoms During Pregnancy : The Kuopio Birth Cohort Study

Publisher Copyright: © 2022 Academy of Nutrition and DieteticsBackground: Depression and diet quality appear to be associated in the general population. Nevertheless, little is known about their relationship among pregnant females. Objective: The aims of this study were first, to investigate longitudinally whether or not diet quality is associated with depressive symptoms during pregnancy; second, to examine whether or not variation in diet quality during pregnancy predicts variation in depressive symptoms; and third, to explore how individual dietary components are associated with depressive symptoms. Design: A longitudinal secondary analysis of the Kuopio Birth Cohort Study in eastern Finland was conducted. Data were collected from pregnant females during the first and third trimesters of pregnancy. Participants/setting: The participants were 1,362 pregnant females who entered the study between 2012 and 2017. Main outcome measures: Depressive symptoms, as measured with the Edinburgh Postnatal Depressive Scale during the first and third trimesters of pregnancy were used as continuous variables. Statistical analyses performed: The main analyses consisted of linear mixed model analyses adjusted for potential confounders to longitudinally assess the association between diet quality as measured by the Healthy Eating Index-2015, calculated using data from a food frequency questionnaire completed during the first trimester and third trimester, and depressive symptoms during the study period. An exploratory set of linear mixed models was also used to longitudinally assess the associations between selected individual food frequency questionnaire food groups and depressive symptoms. Results: Descriptive analyses revealed that 12.3% of the participants had clinically relevant levels of depressive symptoms (ie, Edinburgh Postnatal Depressive Scale score ≥10) during either the first or third trimester. Longitudinal modeling suggested that depressive symptoms in pregnant females tend to remain stable throughout pregnancy. Females with a poorer quality diet already displayed higher levels of depressive symptoms during the first trimester of pregnancy (β = –.038 ± .016; P = 0.022). Variation in diet quality did not predict variation in depressive symptoms over the course of pregnancy (β = –9.741 × 10–5 ± .001; P = 0.869). Conclusions: Females entering pregnancy with a poorer quality diet also displayed higher levels of depressive symptoms compared with females with a higher quality diet at the beginning of pregnancy, and this association remained constant throughout pregnancy. Further research is needed to assess the direction and the potential causality of the observed associations between diet quality and depressive symptoms.Peer reviewe

Parental Alcohol Problems, Parental Divorce, and Type 2 Diabetes in Adulthood: A Longitudinal Prospective Cohort Study in Middle-Aged Men

Objective Type 2 diabetes is a chronic disease and a serious global public health concern increasing both mortality and morbidity. Previous studies have found evidence for an association between early psychological stress and diabetes later in life. Methods This study examined the association between parental alcohol problems and parental divorce and the incidence of type 2 diabetes in Finnish men aged 42 to 61 years (n = 754) in a prospective setting. Information on parental alcohol problems and parental divorce was derived from school records and subjective experiences of the same events from self-rated questionnaires. The average follow-up time for the participants until the first type 2 diabetes diagnosis was 23.3 years (25th-75th percentile, 21.2-27.9 years). Results Cox regression analyses revealed that parental alcohol problems (hazard ratio = 3.09, 95% confidence interval = 1.38-6.88) were associated with an increased risk of type 2 diabetes during the follow-up, even after adjustment for age, marital status, education, Human Population Laboratory Depression Scale scores, smoking, alcohol consumption, body mass index, and serum high-sensitivity C-reactive protein. In a similar model, parental divorce (hazard ratio = 1.69, 95% confidence interval = 0.40-7.05) was not associated with an increased risk of type 2 diabetes during the follow-up. Conclusions Our findings suggest that not all adverse childhood experiences contribute equally to the risk of type 2 diabetes. Parental alcohol problems, but not parental divorce, were associated with an increased risk of type 2 diabetes in men. These findings highlight the need for early interventions targeting parents with excessive alcohol consumption to reduce their offspring's risk of life-style-related disorders.</div

The association between gestational diabetes mellitus and postpartum depressive symptomatology : A prospective cohort study

Background: The literature suggests an association between type 2 diabetes mellitus and depression, but data on the association between gestational diabetes mellitus (GDM) and postpartum depressive symptomatology (PPDS) are scarce. Methods: Altogether, 1066 women with no previous mental health issues enrolled in the Kuopio Birth Cohort (KuBiCo, www.kubico.fi) were selected for this study. GDM was diagnosed according to the Finnish Current Care Guidelines. Depressive symptomatology was assessed with the Edinburgh Postnatal Depression Scale (EPDS) during the third trimester of pregnancy and eight weeks after delivery. Additionally, a subgroup of women (n = 505) also completed the EPDS during the first trimester of pregnancy. Results: The prevalence rates of GDM and PPDS in the whole study population were 14.1% and 10.3%, respectively. GDM was associated with an increased likelihood of belonging to the PPDS group (OR 2.23, 95% CI 1.23-4.05; adjusted for maternal age at delivery, BMI in the first trimester, smoking before pregnancy, relationship status, nulliparity, delivery by caesarean section, gestational age at delivery, neonatal intensive care unit admission and third-trimester EPDS scores). A significant association between GDM and PPDS was found in the subgroup of women with available data on first-trimester depression (n = 505). Limitations: The participation rate of the KuBiCo study was relatively low (37%). Conclusions: Women with GDM may be at increased risk of PPDS. Future studies should investigate whether these women would benefit from a closer follow-up and possible supportive interventions during pregnancy and the postpartum period to avoid PPDS.Peer reviewe

Asiakaskokemuksesta kilpailuetu

Opinnäytetyön tarkoituksena on tarjota toimeksiantajalle, Seinäjoen Keittiötukulle tietoa, jonka pohjalta yritys voi alkaa kehittämään asiakaskokemukseen keskittynyttä kilpailu-strategiaa, jolla kasvattaa kilpailukykyä. Työtä varten kerättiin kirjallisuutta kilpailukyvystä, kilpailuedusta, differoinnista ja asiakaskokemuksesta. Teorian on tarkoitus selittää yrityksen kannattavuuteen vaikuttavia tekijöitä, kilpailukykyyn- ja etuun liittyviä tekijöitä, erilaistumisstrategian perusteet sekä asiakaskokemuksen tärkeys nykyaikaisille yrityksille ja sen olennaisin teoria. Työ on rajattu koskemaan vain yritysasiakkaita. Tutkimusosiossa haastateltiin toimeksiantajan yritysasiakkaita ja näiltä pyrittiin saamaan sellaista tietoa, joka auttaa parantamaan toimeksiantajan tarjoamaa asiakaskokemusta. Tutkimus toteutettiin haastattelemalla yritysten edustajia puhelimitse.The aim of this thesis is to help the case company to develop a strategy focusing on customer experience by offering relevant information. The new information will help the company to strengthen their competitiveness and to reach a competitive advantage. The theory of this thesis focuses on competitiveness, competitive advantage, differentiation, and customer experience. The aim of the theory is to describe elements affecting a company’s profitability and competitiveness, the basics for a differentiation strategy and the main aspects of customer experience. The thesis focuses on business-to-business customers. The case company’s corporate customers were interviewed by telephone in the empirical part of this thesis. The goal of the interviews was to gain the kind of information that will help the case company to improve the customer experience they offer

Takt Maturity Model: From Individual Successes Towards Systemic Change in Finland

Interest in takt production has grown globally amongst lean practitioners within the last decade. In Finland, several successful takt implementation cases within the last five years have radically increased the interest in leveraging takted production systems. However, the discussion on how to transform the first success stories of takt production to the systemic improvement of productivity has remained scarce. This study aimed to conceptualize the requirements for systemically implementing takt production within projects and organizations in the form of a maturity level model. The study was conducted as an explorative, qualitative multiple case study. Through synthesizing the learnings of 24 takt implementation cases in Finland, we propose fifteen requirements for effectively implementing takt production, structured in the form of three maturity levels: i) technical takt planning, ii) social integration & takt control, and iii) continuous improvement. The study has implications for the industry players and researchers to develop an understanding of where they are now and where they should focus next to improve their takt production processes to achieve a systemic change. For further research and development, the proposed model should be validated by testing the model with the industry players.Peer reviewe

Takt Maturity Model: From Individual Successes Towards Systemic Change in Finland

Interest in takt production has grown globally amongst lean practitioners within the last decade. In Finland, several successful takt implementation cases within the last five years have radically increased the interest in leveraging takted production systems. However, the discussion on how to transform the first success stories of takt production to the systemic improvement of productivity has remained scarce. This study aimed to conceptualize the requirements for systemically implementing takt production within projects and organizations in the form of a maturity level model. The study was conducted as an explorative, qualitative multiple case study. Through synthesizing the learnings of 24 takt implementation cases in Finland, we propose fifteen requirements for effectively implementing takt production, structured in the form of three maturity levels: i) technical takt planning, ii) social integration & takt control, and iii) continuous improvement. The study has implications for the industry players and researchers to develop an understanding of where they are now and where they should focus next to improve their takt production processes to achieve a systemic change. For further research and development, the proposed model should be validated by testing the model with the industry players.Peer reviewe

Parental alcohol problems, parental divorce, and type II diabetes in adulthood: a longitudinal prospective cohort study in middle-aged men

Objective Type 2 diabetes is a chronic disease and a serious global public health concern increasing both mortality and morbidity. Previous studies have found evidence for an association between early psychological stress and diabetes later in life. Methods This study examined the association between parental alcohol problems and parental divorce and the incidence of type 2 diabetes in Finnish men aged 42 to 61 years (n = 754) in a prospective setting. Information on parental alcohol problems and parental divorce was derived from school records and subjective experiences of the same events from self-rated questionnaires. The average follow-up time for the participants until the first type 2 diabetes diagnosis was 23.3 years (25th–75th percentile, 21.2–27.9 years). Results Cox regression analyses revealed that parental alcohol problems (hazard ratio = 3.09, 95% confidence interval = 1.38–6.88) were associated with an increased risk of type 2 diabetes during the follow-up, even after adjustment for age, marital status, education, Human Population Laboratory Depression Scale scores, smoking, alcohol consumption, body mass index, and serum high-sensitivity C-reactive protein. In a similar model, parental divorce (hazard ratio = 1.69, 95% confidence interval = 0.40–7.05) was not associated with an increased risk of type 2 diabetes during the follow-up. Conclusions Our findings suggest that not all adverse childhood experiences contribute equally to the risk of type 2 diabetes. Parental alcohol problems, but not parental divorce, were associated with an increased risk of type 2 diabetes in men. These findings highlight the need for early interventions targeting parents with excessive alcohol consumption to reduce their offspring’s risk of life-style–related disorders

The impact of postpartum depressive symptoms on self-reported infant health and analgesic consumption at the age of 12 months : A prospective cohort study

The infants of mothers with elevated depressive symptoms (EDS) postpartum appear to be at increased risk of somatic health problems during their first 12 months of life in low- and lower-middle-income countries. However, in higher-income countries, knowledge of this association is scarce. We sought to examine whether maternal reports of infant health problems, adherence to vaccination schedules and analgesic supply to the infant during the first 12 months of life differ between mothers with and without postpartum EDS. Altogether, 969 women who were enrolled in the Kuopio Birth Cohort study (www.kubico.fi) during 2012?2017 were included in this investigation. Depressive symptoms were measured with the Edinburgh Postnatal Depression Scale during pregnancy (1st and/or 3rd trimester) and at eight weeks postpartum. Infant health data were collected as a part of a 12-month online follow-up questionnaire for mothers and were based on self-reports of either maternal observations or physician-determined diagnoses. Postpartum EDS were associated with a 2- to 5-fold increased likelihood of abnormal crying and paroxysmal wheezing (based on parental observations), as well as gastroesophageal reflux and food allergy (based on physician-determined diagnoses). Mothers with postpartum EDS also supplied their infants with analgesic medication for longer periods. Adherence to vaccination schedules was similar between the examined groups. In conclusion, infants of mothers with postpartum EDS may be more likely to experience health problems or to be perceived by their mother as having health problems, and thus receive more medications.Peer reviewe