Vanhus ja helle:suojaudu, viilennä, nesteytä

Tiivistelmä Suomessa helteet (lämpötila yli +25 °C) ovat yleistyneet 2010-luvulla, ja ne tulevat haittaamaan etenkin ikääntyneitä (1). Terveydenhuollon ammattilaisten on tärkeää ymmärtää kuuman ympäristön terveysvaikutukset, kun he antavat ohjeita ja huolehtivat ikääntyneiden tarkoituksenmukaisesta suojautumisesta. Kuvaamme artikkelissamme helteestä aiheutuvia riskejä ikääntyneen terveydelle ja keinoja hallita niitä.Abstract Older people and hot spells : protect, cool and hydrate Climate warming increases the occurrence of hot spells with detrimental health effects especially on older people. Hot spells cause heat illnesses and worsen chronic diseases, resulting in increased morbidity and mortality. The ageing population is susceptible to these effects because of their altered thermoregulation (reduced capacity to lose heat), high prevalence of chronic diseases and related medication, as well as due to behavioural, environmental, housing and social factors. Heat action plans are needed for systematic long- and short-term preparedness and require national, regional and local multisector co-operation. These activities include developing early warning systems, practising long-term urban planning, reducing indoor heat exposure, increasing preparedness of health care, caring for vulnerable populations and developing real-time surveillance and monitoring. Increasing awareness among the elderly themselves, as well as among their caretakers, is crucial for protection from the health risks of hot spells. Older people need instructions regarding adequate and sustained hydration, how their health condition can be affected by heat, use of appropriate clothing, how and when to engage in physical activity and how to cool their homes or cool themselves by regular cool showers or baths. Equally important is to increase awareness among caretakers of older people in healthcare facilities or care homes. During hot spells the personnel in healthcare facilities need to identify symptoms of heat illnesses and apply cooling methods and related treatment, consider the use and monitor the effects of medication, as well as monitoring water intake. In addition, the indoor temperature of healthcare facilities needs to be kept below 25°C. If air conditioning is not available, facilities can be cooled through increasing ventilation and passive cooling methods. In the worst case, older people need to be evacuated from the healthcare facilities or homes

How to mound a horse?:remembrance and thoughts of afterlife at Finnish companion animal cemetery

Abstract This article presents the results of a combined archaeological and cultural anthropological study of 170 horse burials at a pet (companion animal) cemetery in Mikonkangas, Oulu, Finland. The applied methods include archaeological documentation, interviews with the horse caretakers, and visits to the site. Contrary to socially and legislatively controlled human burial grounds with organized maintenance, companion animal cemeteries with their inherent do-it-yourself character are often displays for more spontaneous expressions of grief and longing. The evidence of remembrance varies from nearly unmarked graves to elaborate memorials with headstones, epitaphs, flowers, and personal objects. The thought of a reunion in the afterlife is evident in some of the epitaphs and could also have influenced the use of crosses and angel symbols on some of the graves

The built environment as a determinant of physical activity:a systematic review of longitudinal studies and natural experiments

Abstract Background: Physical inactivity is a global problem that increases the risk of many chronic diseases and shortens life expectancy. The built environment contributes to physical inactivity through accessibility of amenities and transportation patterns. With better urban planning, cities could be designed to enhance active transportation and population health on a permanent basis. Purpose: We conducted a systematic review to identify determinants of the built environment associated with physical activity and to evaluate how changes in the built environment are associated with changes in physical activity. Methods: We searched six databases, from the inception of each until December 2015, for studies that were written in English, used longitudinal before-and-after design and assessed changes in both the built environment and physical activity. A total of 21 prospective cohort studies and 30 natural experiments were included in the review. Results: The review showed that changes in the built environment and in physical activity were related. A higher objective accessibility and new infrastructure for walking, cycling and public transportation were associated with increased overall and transportation-related physical activity. Some evidence was found for perceived aesthetics and safety as determinants of physical activity. Conclusions: Improved objectively measured accessibility of different type of destinations and public transportation and land use mix were associated with increased physical activity. Creating new infrastructure for walking, cycling and public transportation could induce demand for walking and cycling. The results support the creation of compact and diverse residential areas and investments into infrastructure that encourage active modes of transportation

Parental factors related to physical activity among adolescent men living in built and natural environment:a population-based MOPO study

Abstract Introduction: Physical inactivity is a global concern, especially among adolescent men. Little research has been done on the association between parental factors and young adults’ physical activity in the context of residential environment. We aimed to reveal what parental factors are associated with physical activity among adolescent men living in built and natural environments. Methods: A population-based sample of 1,904 men (mean age = 17.9, SD = 0.7 years) completed a questionnaire regarding physical activity, parental factors, and lifestyle in Northern Finland in 2012 and 2013. Geographical information system methods and dominant land-use type were used to define the residential environment in a 1-kilometer radius buffer zone surrounding each participant’s home address. If the residential area included more artificial surfaces, it was defined as a built environment, and areas including more nature were defined as natural environments. Results: According to multivariable analyses, a mother’s physical activity (OR = 1.9; 95% CI: 1.3–2.8) was positively associated with the physical activity of adolescent men living in built environments, and the father’s physical activity was positively associated with the physical activity of adolescent men living in natural environments (2.8; 1.7–4.8). Self-rated health (built 5.9 [4.0–8.7]; natural 5.2 [3.0–9.0]) was positively associated with physical activity level. Those with symptoms of depression were more likely to be physically inactive (built 0.5 [0.3–0.8]; natural 0.3 [0.1–0.6]). Adolescent men were equally physically active regardless of the living environment. Conclusions: The level of physical activity of parents, self-rated health, and depressive symptoms should be considered when designing physical activity promotions for adolescent men according to their residential environments

Residential relocation trajectories and neighborhood density, mixed land use and access networks as predictors of walking and bicycling in the Northern Finland Birth Cohort 1966

Abstract Background: Given the high global prevalence of physical inactivity, there is a need to design cities that support active modes of transportation. High density diverse neighborhoods with good access networks have been associated with enhanced walking and cycling, but there is a lack of large-scale longitudinal studies utilizing a life course perspective to model residential relocation trajectories. The objectives of the present longitudinal study were to model and visualize residential relocation trajectories between 31 and 46 years of age based on neighborhood density, mixed land use and access networks (DMA), and to assess neighborhood DMA as a predictor of self-reported regular walking and cycling and objectively measured physical activity. Methods: Based on data from the Northern Finland Birth Cohort 1966 (N = 5947), we used self-reported regular walking and cycling and objectively measured physical activity as outcome variables and objectively assessed neighborhood DMA as the main explanatory variable. We conducted sequence analysis to model residential relocation trajectories, and generalized linear mixed models and Fisher’s exact test were used to explore longitudinal associations between neighborhood DMA and physical activity. Results: Over 80% of the participants lived in a neighborhood with the same level of neighborhood DMA during the follow-up. Relocation occurred more often from higher to lower DMA neighborhoods than reverse. Increased neighborhood DMA was associated with increased regular walking (OR 1.03; 95% CI: 1.00, 1.05; p = 0.023) and cycling (OR 1.17; 95% CI: 1.12, 1.23; p <  0.001). Residential relocation trajectory from lower to highest neighborhood DMA increased the odds of starting regular walking (OR 3.15; 95% CI: 1.50, 7.14; p = 0.001) and cycling (OR 2.63; 95% CI: 1.23, 5.79; p = 0.009) as compared to higher to lower neighborhood DMA trajectory. Conclusions: The results strongly support the hypothesis that increasing urban DMA can enhance regular walking and cycling at population level and so improve public health. The findings have implications for zoning and transportation policies, favoring the creation of dense and diverse neighborhoods with good access networks to support regular walking and cycling

Cold weather increases respiratory symptoms and functional disability especially among patients with asthma and allergic rhinitis

Abstract Cold weather affects the respiratory epithelium and induces bronchial hyperresponsiveness. We hypothesized that individuals with allergic rhinitis or/and asthma experience cold weather-related functional disability (FD) and exacerbation of health problems (EH) more commonly than individuals without these. This was a population-based study of 7330 adults aged 25–74 years. The determinants of interest, including doctor-diagnosed asthma and allergic rhinitis, and the outcomes, including cold weather-related FD and EH, were measured using a self-administered questionnaire. The prevalences of cold-related FD and EH were 20.3% and 10.3%, respectively. In Poisson regression, the risk of FD increased in relation to both allergic rhinitis (adjusted prevalence ratio (PR) 1.19, 95% CI 1.04–1.37 among men; 1.26, 95% CI 1.08–1.46 among women), asthma (1.29, 0.93–1.80; 1.36, 0.92–2.02, respectively) and their combination (1.16, 0.90–1.50; 1.40, 1.12–1.76, respectively). Also the risk of cold weather-related EH was related to both allergic rhinitis (1.53, 1.15,−2.04 among men; 1.78, 1.43–2.21 among women), asthma (4.28, 2.88–6.36; 3.77, 2.67–5.34, respectively) and their combination (4.02, 2.89–5.59; 4.60, 3.69–5.73, respectively). We provide new evidence that subjects with allergic rhinitis or/and asthma are more susceptible to cold weather-related FD and EH than those without pre-existing respiratory diseases

Physical activity, residential environment, and nature relatedness in young men:a population-based MOPO study

Abstract Background: In general, nature relatedness is positively associated with physical activity, health, and subjective well-being. However, increased residence in urban areas, and the decrease in natural spaces, may affect the younger generation most adversely. The associated environmental changes can increase youths’ risk of spending most of their time indoors, and weaken their nature relatedness, making them less likely to enjoy nature’s health benefits. This is a serious public health issue, since inadequate physical activity, combined with minimum time spent in green space, can affect health across the whole lifespan. Thus, to develop effective interventions for physical activation and promote health and well-being among young men, further knowledge of the determinants of their nature relatedness is necessary. Aims: To explore factors related to nature relatedness, including physical activity, physical activity with parents, and residential environment. Methods: The study population consisted of all 914 young men (mean—17.8 years; SD—0.5) who participated in mandatory call-ups for military service and completed the study questionnaire in 2013. The questionnaire inquired about their nature relatedness, demographic characteristics, socioeconomic status, physical activity, health, and subjective well-being. A geographic information system (GIS) was used to assess the features of their residential environments. Multivariable linear regression was used to analyze the data. Results: Physical activity (p = 0.021) and physical activity with parents at primary school age (p = 0.007), and currently (p = 0.001) as well as good self-rated health (p = 0.001), and father’s higher socioeconomic status (p = 0.041), were positively connected to nature relatedness. Conclusions: Physical activity in general, physical activity with parents, and nature relatedness were positively related. This knowledge can be utilized in promoting physical activity and health among young men

Cold weather-related cardiorespiratory symptoms predict higher morbidity and mortality

Abstract Symptoms perceived in cold weather reflect physiological responses to body cooling and may worsen the course of a pre-existing disease or precipitate disease events in ostensibly healthy individuals. However, the associations between cold-related symptoms and their health effects have remained unknown. We examined whether cold-related cardiac and respiratory symptoms perceived in cold weather predict future morbidity and mortality. Methods: Cold-related symptoms were inquired in four national FINRISK surveys conducted in 1997, 2002, 2007, 2012 in Finland including altogether 17 040 respondents. A record linkage was made to national hospital discharge and cause-of-death registers. The participants were followed up until the first hospital admission due to a cardiovascular or respiratory disease or death, or until the end of 2015. The individual follow-up times ranged from 0 to 18 years (mean 11 years). The association of cold-related symptoms with morbidity and mortality was examined by Kaplan-Meyer and Cox-regression analyses. Results: Cold-related cardiac [hazard ratio (HR), 1.76 and its 95% confidence interval (95% CI), 1.44–2.15] and combined cardiac and respiratory symptoms [1.50 (1.29–1.73)] were associated with hospitalization due to cardiovascular causes. The respective HRs for admissions due to respiratory causes were elevated for cold-related respiratory [1.22 (1.07–1.40)], cardiac [1.24 (0.88–1.75)] and cardiorespiratory [1.82 (1.50–2.22)] symptoms. Cold-related cardiorespiratory symptoms were associated with deaths from all natural [1.38 (1.11–1.72)], cardiovascular [1.77 (1.28–2.44)] and respiratory [2.19 (0.95–5.06)] causes. Interpretation: Cold weather-related symptoms predict a higher occurrence of hospital admissions and mortality. The information may prove useful in planning measures to reduce cold-related adverse health effects