Longitudinal changes in mobility among nonagenarians : the Vitality 90+Study

Background: Several studies have focused on predictors of mobility limitations and disabilities. Yet little is known about the pace and patterns of mobility changes among very old people. This study examined changes in functional mobility among individuals aged 90 years and older during a 2-9-year follow-up. In addition, we were interested in the patterns of mobility changes. Methods: Data were collected through a mailed questionnaire in the years 2001, 2003, 2007 and 2010. The study population (n = 948) consisted of individuals from three cohorts (2001, 2003, 2007) who participated in at least two survey rounds and answered the mobility questions. The length of the follow-up varied from 2-9 years between individuals as well as according to how many times an individual took part in the survey. Multilevel ordinal logistic regression analysis was used to evaluate the effects of time, age, gender, cohort and chronic conditions on changes in mobility. Results: At the baseline, "younger" old people, men and individuals in the cohorts for 2003 and 2007 had significantly better mobility compared with women, older individuals and individuals in the 2001 cohort. In addition, individuals with fewer chronic conditions had better mobility than those with more diseases. Mobility declined for most of the participants during the follow-up. The difference in the change in mobility over time for gender, age or chronic conditions was not statistically significant. The analyses were performed with a subgroup of participants aged 90-91 years at the baseline, and results did not differ substantially from the results for the entire study sample. However, the effect of chronic conditions on the change in mobility was statistically significant among participants aged 90-91years. Conclusions: No differences were observed in the rate of mobility decline over time between age or gender. The effect of chronic conditions on the change in mobility was significant only among individuals aged 90-91 years. The prevention efforts are important and should focus even more, also among the oldest-old, on additional modifiable risk factors such as maintaining muscle strength.Peer reviewe

Cardiorespiratory and muscular fitness in young adult Finnish men between 2003 and 2015

Introduction Physical fitness is strongly related to health and may offer valuable information about public health. We investigated trends in physical fitness, leisure-time physical activity (LTPA), and anthropometry of young healthy adult Finnish men in representative population-based samples between 2003 and 2015. Methods Three independent cross-sectional samples of 18- to 35-year-old Finnish men were assessed in 2003 (n = 889), 2008 (n = 803), and 2015 (n = 690). Cardiorespiratory (VO(2)max) and muscular fitness (1-minute sit-ups and push-ups), body mass, and height were measured. Self-reported LTPA was assessed. Results After adjusting for age, education, and smoking, cardiorespiratory fitness was higher in 2003 (mean: 43.5, 95%CI: 42.9-44.1 mL/kg/min) compared to 2008 (41.3, 95%CI: 40.7-41.9 mL/kg/min) and 2015 (40.6, 95%CI: 40.0-41.2 mL/kg/min) (P <.001), whereas no difference was observed between 2008 and 2015. The lowest values in muscular fitness were observed in 2003, while no clear trends were further noticed. The adjusted BMI was higher in 2008 (25.1, 95%CI: 24.9-25.4) and 2015 (25.3, 95%CI: 25.3, 95%CI: 25.0-25.6) compared to 2003 (24.5, 95%CI: 24.3-24.8) (P <.005). In 2015, a higher proportion of individuals exercised at least four times per week compared to 2003 and 2008 (P <.05). Conclusion The decrease in cardiorespiratory fitness that took place between 2003 and 2008 plateaued after 2008. The plateau is in accordance with the previously observed trend of 5-10 years younger Finnish men. Moreover, muscular fitness was for the most part higher in 2008 and 2015 compared to 2003. Efforts directed to promote regular physical activity and improve physical fitness are needed.Peer reviewe

Nuorten osallistuminen ilmastolainvalmisteluun

publishedVersionPeer reviewe

Biological clocks and physical functioning in monozygotic female twins

Background: Biomarkers of biological aging - DNA methylation age (DNAm age) and leukocyte telomere length (LTL)-correlate strongly with chronological age across the life course. It is, however, unclear how these measures of cellular wear and tear are associated with muscle strength and functional capacity, which are known to decline with older age and are associated with mortality. We investigated if DNAm age and LTL were associated with body composition and physical functioning by examining 48 monozygotic twin sisters. Methods: White blood cell DNAm age (predicted years) was calculated from Illumina 450 k BeadChip methylation data using an online calculator. DNAm age acceleration was defined from the residuals derived from a linear regression model of DNAm age on chronological age. LTL was measured by qPCR. Total body percentage of fat and lean mass were estimated using bioimpedance. Physical functioning was measured by grip strength, knee extension strength and by 10 m maximal walking speed test. Results: In all participants, DNAm age (58.4 +/- 6.6) was lower than chronological age (61.3 +/- 5.9 years). Pairwise correlations of monozygotic co-twins were high for DNAm age (0.88, 95% CI 0.79, 0.97), age acceleration (0.68, 95% CI 0.30, 0.85) and LTL (0.77, 95% CI 0.60, 0.94). Increased age acceleration i.e. faster epigenetic aging compared to chronological age was associated with lower grip strength (beta = -5.3 SE 1.9 p = 0.011), but not with other measures of physical functioning or body composition. LTL was not associated with body composition or physical functioning. Conclusions: To conclude, accelerated DNAm age is associated with lower grip strength, a biomarker known to be associated with physiological aging, and which predicts decline in physical functioning and mortality. Further studies may clarify whether epigenetic aging explains the decline in muscle strength with aging or whether DNAm age just illustrates the progress of aging.Peer reviewe

Päiväkotien allergiaruokavalioiden kuormaa voidaan vähentää käytänteitä uusimalla

Lähtökohdat Perusteettomat allergiaruokavaliot kuormittavat perheitä ja päivähoitoa ja voivat haitata lapsen normaalia kasvua ja kehitystä. Tämän LILLA-tutkimuksen tavoitteena oli päivähoidon allergiaruokavalioiden määrän vähentäminen käyttämällä uutta erityisruokavalion ilmoituslomaketta, joka ohjasi arvioimaan ruokavaliota allergiaohjelman perusteiden mukaisesti. Menetelmät Tutkimusryhmämme kehitti uuden allergiaohjelmaan perustuvan erityisruokavalioiden ilmoituslomakkeen ja siihen liitetyn saatekirjeen. Uusi lomake otettiin käyttöön 40:ssä pääkaupunkiseudun päiväkodissa vuoden 2013 syksystä alkaen (n = 3 216 lasta, 6 kk–7 v), ja allergiaruokavalioiden määrää ja laatua seurattiin kahden vuoden ajan. Vertailuryhmä muodostui luontaisesti lapsista, joiden allergiaruokavalio oli edelleenkin ilmoitettu vanhojen käytänteiden mukaisesti. Erillisillä kyselyillä selvitettiin allergiaruokavalioiden toteuttamisen käytänteitä ja henkilökunnan allergiatietämystä. Tulokset Kahden vuoden seurannan jälkeen uusi lomake oli käytössä 64 %:lla (95/148) allergiaruokavaliota noudattavista lapsista. Allergiaruokavalioiden esiintyvyys tutkimuspäiväkodeissa väheni 43 % ja oli 4,3 % (kvartiiliväli 3,05–5,96) vuonna 2015 (148/3 411 lasta). Kaikkien keskeisten ruoka-aineiden (maito, kananmuna, viljat) sekä ­pähkinöiden, hedelmien, kasvisten, palkokasvien, lihan, kaakaon ja mausteiden välttäminen väheni merkitsevästi. Päivähoidon ja ruokapalvelujen henkilökunta otti uuden toimintakäytännön hyvin vastaan. Henkilökunnan allergiatietämys oli osittain virheellistä ja vanhentunutta. Päätelmät Päiväkotien allergiaruokavalioiden kuormaa voidaan vähentää yksinkertaisella lomakeuudistuksella, joka pohjaa allergiaohjelmaan. Päivähoitohenkilöstön allergiakoulutukselle on edelleen tarvetta.Peer reviewe

Ilmastonmuutos ja avustettu leviäminen

Nopea ilmastonmuutos on vaaraksi monille lajeille. Ruijanesikko (Primula nutans) on pohjoinen kasvilaji, joka esiintyy maassamme suhteellisen pienellä alueella Perämeren rannikolla. Laji on rauhoitettu, mutta kenties tämä ei riitä lämpenevässä maailmassa. Voitaisiinko ruijanesikon tulevaisuus turvata, jos sen siemeniä levitetään tai taimia istutetaan uusille kasvupaikoille, joissa näkymät lajin säilymiselle ovat nykytilannetta valoisammat ja joihin se tilanteen salliessa voisi itsekin levittäytyä? Tällaista uutta lajiensuojelun keinoa kutsutaan avustetuksi leviämiseksi. Se on herättänyt kiinnostusta, hämmennystä ja kiistaa luonnonsuojelutieteissä

Enemmän irti kuulemisprosessista: kohti yhteistoiminnallisia menettelyjä lainvalmistelussa

Tässä julkaisussa arvioidaan, minkälaisia hyötyjä uudenlaiset osallistumisen ja yhteistoiminnan (collaboration) menetelmät ovat tuoneet lainvalmisteluprosesseihin ja mitä näistä kokemuksista voidaan oppia lainvalmistelun kehittämisessä. Julkaisussa esitellään neljässä eri lainvalmisteluhankkeessa toteutetut kuulemisprosessit ja niissä hyödynnettyjä osallistumisen ja yhteistoiminnan menetelmiä. Yhteistoiminnallisilla menetelmillä tarkoitetaan osallistumisen prosesseja, jotka tähtäävät erilaisten näkökulmien yhteensovittamiseen ja yhteiseen ongelmanratkaisuun. Esimerkkihankkeissa on hyödynnetty erilaisia kuulemisen menetelmiä. Tällaisia ovat tavanomaisten lausuntopyyntöjen ohella muun muassa sähköiset kyselyt, verkkokeskustelut, työryhmät, työpajat, esittelytilaisuudet ja dialogitilaisuudet. Olennaiseksi osoittautuu se, miten valmisteluprosessin kokonaisuus jäsentyy ja mihin tarkoitukseen osallistumisen menetelmiä hyödynnetään. Selvimmin yhteistoiminnallisia elementtejä sisältävissä menettelyissä osalliset ovat yhdessä ratkaisemassa lainsäädäntöhankkeiden keskeisiä pulma- ja kiistakysymyksiä. Tarkastelu osoittaa, että yhteistoiminnallisuus ei kuitenkaan sovellu yhtä hyvin kaikkiin lainvalmisteluhankkeisiin

Coming to Terms with the Concept of Moving Species Threatened by Climate Change - A Systematic Review of the Terminology and Definitions

Intentional moving of species threatened by climate change is actively being discussed as a conservation approach. The debate, empirical studies, and policy development, however, are impeded by an inconsistent articulation of the idea. The discrepancy is demonstrated by the varying use of terms, such as assisted migration, assisted colonisation, or managed relocation, and their multiple definitions. Since this conservation approach is novel, and may for instance lead to legislative changes, it is important to aim for terminological consistency. The objective of this study is to analyse the suitability of terms and definitions used when discussing the moving of organisms as a response to climate change. An extensive literature search and review of the material (868 scientific publications) was conducted for finding hitherto used terms (N = 40) and definitions (N = 75), and these were analysed for their suitability. Based on the findings, it is argued that an appropriate term for a conservation approach relating to aiding the movement of organisms harmed by climate change is assisted migration defined as follows: Assisted migration means safeguarding biological diversity through the translocation of representatives of a species or population harmed by climate change to an area outside the indigenous range of that unit where it would be predicted to move as climate changes, were it not for anthropogenic dispersal barriers or lack of time. The differences between assisted migration and other conservation translocations are also discussed. A wide adoption of the clear and distinctive term and definition provided would allow more focused research on the topic and enable consistent implementation as practitioners could have the same understanding of the concept.Peer reviewe

Common Inflammation-Related Candidate Gene Variants and Acute Kidney Injury in 2647 Critically Ill Finnish Patients

Acute kidney injury (AKI) is a syndrome with high incidence among the critically ill. Because the clinical variables and currently used biomarkers have failed to predict the individual susceptibility to AKI, candidate gene variants for the trait have been studied. Studies about genetic predisposition to AKI have been mainly underpowered and of moderate quality. We report the association study of 27 genetic variants in a cohort of Finnish critically ill patients, focusing on the replication of associations detected with variants in genes related to inflammation, cell survival, or circulation. In this prospective, observational Finnish Acute Kidney Injury (FINNAKI) study, 2647 patients without chronic kidney disease were genotyped. We defined AKI according to Kidney Disease: Improving Global Outcomes (KDIGO) criteria. We compared severe AKI (Stages 2 and 3, n = 625) to controls (Stage 0, n = 1582). For genotyping we used iPLEX(TM) Assay (Agena Bioscience). We performed the association analyses with PLINK software, using an additive genetic model in logistic regression. Despite the numerous, although contradictory, studies about association between polymorphisms rs1800629 in TNFA and rs1800896 in IL10 and AKI, we found no association (odds ratios 1.06 (95% CI 0.89-1.28, p = 0.51) and 0.92 (95% CI 0.80-1.05, p = 0.20), respectively). Adjusting for confounders did not change the results. To conclude, we could not confirm the associations reported in previous studies in a cohort of critically ill patients.Peer reviewe

Heme oxygenase-1 repeat polymorphism in septic acute kidney injury

Acute kidney injury (AKI) is a syndrome that frequently affects the critically ill. Recently, an increased number of dinucleotide repeats in the HMOX1 gene were reported to associate with development of AKI in cardiac surgery. We aimed to test the replicability of this finding in a Finnish cohort of critically ill septic patients. This multicenter study was part of the national FINNAKI study. We genotyped 300 patients with severe AKI (KDIGO 2 or 3) and 353 controls without AKI (KDIGO 0) for the guanine-thymine (GTn) repeat in the promoter region of the HMOX1 gene. The allele calling was based on the number of repeats, the cut off being 27 repeats in the S-L (short to long) classification, and 27 and 34 repeats for the S-M-L2 (short to medium to very long) classification. The plasma concentrations of heme oxygenase-1 (HO-1) enzyme were measured on admission. The allele distribution in our patients was similar to that published previously, with peaks at 23 and 30 repeats. The S-allele increases AKI risk. An adjusted OR was 1.30 for each S-allele in an additive genetic model (95% CI 1.01-1.66; p = 0.041). Alleles with a repeat number greater than 34 were significantly associated with lower HO-1 concentration (p<0.001). In septic patients, we report an association between a short repeat in HMOX1 and AKI risk