European Community Multi-Center Trial "Fetal ECG Analysis During Labor": ST plus CTG analysis

This report form part of the European Community Multi-Center Trial "Fetal ECG Analysis during Labor". Aim of this prospective trial was to identify changes in the fetal ECG waveform with cases of verified fetal hypoxia. In this paper we also report on the use of a newly developed automatic system for identification of ST waveform changes (ST Log). All ECG were recorded with the STAN recorder (Neoventa Medical AB, Gothenburg, Sweden). The ECG information was not displayed during labor in order not to influence the clinical management. This report includes data from 320 cases and include six cases of fetal intrapartum hypoxia. Twenty seven cases showed changes in ST waveform. All five cases with the most marked ST change (a rise in T/QRS of >0.10 units and lasting more then 10 minutes) had signs of ongoing intrapartum hypoxia. Six out of six cases with evidence of intrapartum asphyxia, showed ST changes. On the basis of our multi-center trial it appears that the combined analysis of CTG and ST waveform changes provides an accurate way to identify adverse events during labor. The work is continuing with a new STAN recorder developed by Neoventa Medical in Goteborg and currently being tested in a Swedish randomized, controlled multi-center trial

Food insecurity among Finnish private service sector workers : validity, prevalence and determinants

Objective: To examine the prevalence and determinants of food insecurity among private sector service workers in Finland and assess validity of the Household Food Insecurity Access Scale (HFIAS) tool. Design: In this cross-sectional study, food insecurity and background characteristics were collected from Finnish private service workers via electronic questionnaires (2019) and national register data (2018-2019). We conducted univariate and multivariate logistic regression analyses to determine the variables explaining food insecurity. Validity of HFIAS was assessed with rotated principal component analysis and Cronbach's alpha. Setting: Members of the trade union for private sector service workers, Service Union United (PAM), from all municipalities in Finland participated in the study in 2019. Participants: The subjects were 6435 private sector workers that were members of the Service Union United (PAM) in Finland. Mean age of participants was 44 years (sd 12 center dot 7 years). Results: Two-thirds of the participants (65 %) were food insecure with over a third (36 %) reporting severe food insecurity. Reporting great difficulties in covering household expenses and young age markedly increased the risk of severe food insecurity (OR 15 center dot 05; 95 % CI 10 center dot 60, 21 center dot 38 and OR 5 center dot 07; 95 % CI 3 center dot 94, 6 center dot 52, respectively). Not being married, low education, working in the hospitality industry, being male and living in rented housing also increased the probability of severe food insecurity. The HFIAS tool demonstrated acceptable construct and criterion validity. Conclusions: Severe food insecurity was widespread and associated with low socio-economic status, young age and being male among Finnish private sector service workers, emphasising the need for regular monitoring of food insecurity in Finland.Peer reviewe

Periconception endogenous and exogenous maternal sex steroid hormones and risk of asthma and allergy in offspring : protocol for a systematic review and meta-analysis

Introduction Pregnancy is associated with several hormonal changes which influence the developing fetus. Variations in maternal endogenous hormones and prepregnancy use of hormonal preparations have been linked to asthma and allergy in the offspring, but findings are inconsistent. We plan to undertake a systematic review to synthesise the evidence on the association between endogenous and exogenous maternal sex hormones and the risk of asthma and allergy in the offspring. Methods and analysis We will search Medline, Embase, Cochrane Library, Institute of Scientific Information Web of Science, Cumulative Index of Nursing and Allied Health, Scopus, Google Scholar, Allied and Complementary Medicine Database, Global Health, Psychological Information (PsycINFO), Centre for Agriculture and Bioscience (CAB) International and WHO Global Health Library from inception until 2016 to identify relevant studies on the topic. Additional studies will be identified by searching databases of proceedings of international conferences, contacting international experts in the field and searching the references cited in identified studies. We will include analytical epidemiological studies. Two researchers will independently screen identified studies, undertake data extraction and assess risk of bias in eligible studies, while a third reviewer will arbitrate any disagreement. We will use the Effective Public Health Practice Project tool to assess the risk of bias in the studies. We will perform a random-effects meta-analysis to synthesise the evidence. We will use the Grading of Recommendations Assessment, Development and Evaluation approach to rate the strength and quality of the overall evidence with respect to each outcome. Ethics and dissemination Ethical approval is not required since the study is a systematic review of published literature. Our findings will be reported in a peer-reviewed scientific journal.Peer reviewe

Association between sleep duration and dietary patterns among finnish pre-schoolers

According to the results obtained in the present study, it could be concluded that: 1. Sleep length during the whole week, during the weekdays and weekend is inversely associated with a sweet dietary pattern consumption. On the other hand, sleep length both during the whole week and the weekdays is positively associated with a higher intake of healthy foods. 2. Girls tend to have a higher consumption of sweet foods the less they sleep, during the weekdays and the whole week. Whereas in general they are more likely to follow a healthy dietary pattern the longer the sleeping hours. Such associations do not seem to be present among boys. 3. There do not seem to exist differences between sleep length and dietary patterns when considering different socio-economic backgrounds among children from pre-schools in Finland. However, the literature research and the obtained results highlight the fact that, when talking together about sleep and diet, we are still on a narrow piece of terra ferma in a wide sea of the unknown

Effects of the DAGIS randomized controlled trial on home environment and children's food consumption according to the degree of implementation

Background Combining process evaluation data with effectiveness data and examining the possible mediators of intervention effects elicits valuable knowledge about how and for whom these interventions are effective. The aim of this study was to examine whether the parental degree of implementation (DOI) of a home-involving preschool intervention affected children's food consumption via home mediators. Methods The five-month Increased Health and Wellbeing in Preschools (DAGIS) intervention involved 476 participating children aged 3-6 years and was conducted in 2017-2018. Parents reported children's food consumption (g/day) outside childcare hours, the availability of foods at home, role modelling of food consumption, and the norms related to food consumption. In addition, parents reported the extent to which they had implemented the intervention program at home. Mediation analyses were conducted to examine the effect of low and high DOI compared to control group on the change in children's consumption of fruit and vegetables (FV), sugary everyday foods, sugary treats, and sugar-sweetened beverages (SSB) via food availability in the home, parental role modelling and parental norms. Results Compared to the control group, there was a direct effect of a high DOI on diminishing consumption of SSB (B -27.71, 95% CI -49.05, -4.80). No indirect effects were detected. In the high DOI group, a change in parental norm was associated with increased FV consumption showing an indirect effect (B 4.31, 95% CI 0.23, 10.59). In the low DOI group, there was an indirect effect via decreased food availability leading to decreased sugary everyday food consumption (B -2.17, 95% CI -5.09, -0.09). Conclusions Combining process evaluation and effectiveness data revealed a decrease in children's SSB consumption only in the high DOI group, as well as indirect effects on children's consumption of FV and sugary everyday foods. In order to gain more intervention effects, further studies are required in order to examine parental facilitators and barriers to the implementation of interventions and how to impact effectively the determinants of the targeted behavior.Peer reviewe

Private sector service workers’ well-being before and during the COVID-19 pandemic

Background: Workers attending to the essential functions of society have been most affected by COVID-19, but the well-being of workers outside the health care sector has scarcely been documented. We describe well-being profiles of Finnish blue-collar workers in private sector services and changes in their well-being during the COVID-19 pandemic. Methods: Altogether 6345 members of the Service Union United provided cross-sectional pre-COVID data in April-June 2019, and 2702 provided follow-up data on health-related indicators in November 2020. Job industry-specific profiles (retail, hospitality, and property maintenance) and change patterns were analysed. Regression models appropriate for different response types with a random intercept and time component were used. Results: Before COVID-19, the well-being profile − food security, body mass index, alcohol use, smoking, and self-perceived health, and adequacy of income − was worse among service workers than the population average and it varied by industry sector. During the first year of COVID-19 self-perceived health deteriorated (adjusted OR 0.78, 95% confidence interval 0.70-0.87). The proportion of severely food insecure fell from a third to a quarter (OR for improvement 2.66, 95% CI 2.37-2.99). Slight improvements were observed in heavy episodic drinking, smoking, and self-perceived adequacy of income. Employees in property maintenance were the most vulnerable regarding well-being profile and COVID-19-related changes. Conclusions: COVID-19 caused divergent changes, including improved food security and deteriorated self-perceived health. Workers with the lowest socioeconomic position and those facing job uncertainty were the most vulnerable to adverse outcomes. Provision of support to these groups is essential in welfare policy considerations.Peer reviewe

Lapsuusiän vegaaniruokavalion pitkäaikaisvaikutuksia ei tunneta

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Assisted reproductive technology and risk of asthma and allergy in the offspring: protocol for a systematic review and meta-analysis

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