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Biomedical subjects

E Hemminki

Publications and source records attributed to E Hemminki.

At least 145 records · Page 8Linked to original sources
PubMed1991

Controlled trial on medical birth notification design.

In a controlled trial, two different forms were compared with respect to thoroughness of completing medical data on procedures during pregnancy, labor, and in newborns. The contents of 547 forms filled in by hospital personnel were compared to data abstracted from hospital records by trained research assistants. Forms with open-ended questions lacked information on 29% of the most common procedures and forms with a check-box format 9%. The results support the use of the check-box format in routine collection of data on common medical procedures.

Birth Certificates↗
PubMed1990

Mother's social class and perinatal problems in a low-problem area.

This study reports the variation in perinatal problems related to social class in one area in Finland. Data on length of gestation, birthweight, one-minute Apgar score, and need for special care in relation to social class were obtained from a large clinical trial (n = 2912) on iron prophylaxis during pregnancy. Social class was determined from the woman's own occupation and education. Occupation was obtained from the women themselves and classified as upper white collar, lower white collar I, lower white collar II, and workers; entrepreneurs, students and women with no information were excluded. Education was obtained by record linkage to the national education register, and all women were classified by the years normally required to attain a certain level: greater than or equal to 13, 12, 10-11, and less than or equal to 9 years of education. Adjusted for age and parity, a week U-shaped curve was found for gestation length and birthweight, best results being found for the women in the second highest social class. The lower the social class, the more infants with poor Apgar scores. As potential intervening variables we studied marital status, pre-pregnancy weight, smoking, and haematocrit in the 28th week of pregnancy. Their inclusion in multivariate analyses influenced only slightly the differences in perinatal problems between the groups. Our results suggest that in Finland there are still differences in perinatal problems between social classes, but that the relationship is not always linear.

Abortion, Spontaneous↗
PubMed1990

Comparability of reasons for cesarean sections in patient records and mothers' interviews.

Reasons for cesarean sections from three different data sources were compared. One hundred mothers were interviewed, their patient records were read, and the discharge diagnoses were noted. In about 70% of cases at least two of the data sources gave similar reasons for cesarean section, but when all three sources were compared, in only one-third was information similar. These figures cast doubt on the utility of recorded indications in studying reasons for cesarean sections.

Adult↗
PubMed1990

Prenatal care in Finland: from primary to tertiary health care?

Traditionally, the Finnish prenatal care system has been based on special maternity centers outside hospitals. In recent years, however, the use of hospital outpatient clinics has increased. The purpose of this study was to describe the use of the clinics and to see whether clinics serve as an addition or as an alternative to maternity centers. We used several different data sources (statistics, documents, interviews, questionnaires). The main source was data on visits for all women who gave birth in Helsinki in a five-week period in 1987. The content of care and means of care delivery differ between clinics and maternity centers. Clinics are technologically and provider-oriented without continuity of care. Clinics are not just referral centers for high-risk mothers; at least half of pregnant women visit them. Ultrasound screening is an important reason for use of the clinic. Background characteristics as well as the outcome of pregnancy were similar among women visiting a hospital clinic a maximum of one time (low users), two to three times, or four times or more (high users). Standardizing for the length of gestation, high users made fewer visits to maternity centers than did low users. Hospital clinic care now seems to replace care in maternity centers, and we found a weak trend toward a pluralistic prenatal care.

Adult↗
PubMed1989

Iron supplementation during pregnancy--experiences of a randomized trial relying on health service personnel.

This article reports the design and feasibility of a randomized controlled trial of the benefits of routine iron prophylaxis during pregnancy. The multicenter trial, supported by a small budget, relied on health service personnel in Finnish maternity centers. Iron prophylaxis has had an established position in Finnish maternity care, and iron is freely available. This contributed to our decision to ask for informed consent after randomization. During a year, 2960 mothers were recruited by midwives in 27 maternity health centers and randomized into two groups: selective and routine iron supplementation. Mothers were followed until the postpartum checkup, and data were collected by five different questionnaires and abstracted from the infant's patient record. Adherence of the midwives to the study protocol was satisfactory, as was mothers' compliance with recommended treatments. However, because the study was designed to compare two treatment policies, problems of nonmasking hamper of the biologic effects of iron. This trial encourages the use of existing health services and their personnel in evaluation of medical technology.

Clinical Protocols↗
PubMed1989

Clustering and consistency of use of medicines among mid-aged women.

This paper describes the use of drugs among middle-aged Massachusetts women from 1982 to 1986. Data were obtained from follow-up interviews of women (n = 2565) who were premenopausal in a baseline survey of a representative sample of women with an age range of 45-55. In the first follow-up interview, 92% of women had used nonprescribed drugs ("current use"), but most only sporadically, while 47% had used prescribed drugs. The use of different types of drugs was concentrated in the same women, and women who had used prescribed drugs had also used nonprescribed drugs more often than the other women. In the first follow-up, women were classified as nonusers (includes sporadic nonprescribed drug use), nonprescribed medicine users, prescribed drug users, and mixed users; 43% of the women were in a different class three years later. Comparison of individual drug groups also showed changes in the user status between the two surveys. With the exception of poorer health, users of nonprescribed and prescribed drugs were similar to nonusers. Because use of drugs is common, further research on both its determinants and appropriateness is needed.

Analgesics↗
PubMed1989

Effect of spectacle use and accommodation on myopic progression: final results of a three-year randomised clinical trial among schoolchildren.

Two hundred and forty mildly myopic schoolchildren aged 9-11 years were randomly allocated to three treatment groups and the progression of myopia was followed-up for three years. The treatment groups were: (1) minus lenses with full correction for continuous use (the reference group), (2) minus lenses with full correction to be used for distant vision only, and (3) bifocal lenses with +1.75 D addition. Three-year refraction values were received from 237 children. The differences in the increases of the spherical equivalents were not statistically significant in the right eye, but in the left eye the change in the distant use group was significantly higher (-1.87 D) than in the continuous use group (-1.46 D) (p = 0.02, Student's t test). There were no differences between the groups in regard to school achievement, accidents, or satisfaction with glasses. In all three groups the more the daily close work done by the children the faster was the rate of myopic progression (right eye: r = 0.253, p = 0.0001, left eye: r = 0.267, p = 0.0001). Myopic progression did not correlate positively with accommodation, but the shorter the average reading distance of the follow-up time the faster was the myopic progression (right eye: r = 0.222, p = 0.0001, left eye: r = 0.255, p = 0.001). It seems that myopic progression is connected with much use of the eyes in reading and close work and with short reading distance but that progression cannot be reduced by diminishing accommodation with bifocals or by reading without spectacles.

Accommodation, Ocular↗
PubMed1988

Coffee drinking among Finnish youth.

The suggestion that coffee may have negative health effects has made coffee-drinking habits medically interesting. This paper reports upon coffee use among young people and describes how coffee-users differ from non-users. Data comes from questionnaires from representative nationwide samples of 12-18-year-old Finnish youth in 1977-1985. Their coffee use decreased from 1977 to 1985, and the decrease could be seen in all age and socio-demographic groups studied. In 1981, 35% of the girls and 45% of the 12-year-old boys drank coffee daily. For 18-year-olds the corresponding percentages were 67 and 75, and the mean number of cups consumed per day was 2.3 and 3.1. Compared to the non-users, the coffee-users were from lower social classes, lived more often in the countryside, and had poorer school achievement. Health-damaging habits such as smoking were more common among the coffee-users, their perceived health was somewhat poorer, and they seemed to mature earlier. The difference in regard to health disappeared after adjusting for differences in socio-demographic background and health habits. The heavy users (four cups or more a day) usually differed more from the non-users than did the moderate users (one to three cups daily).

Adolescent↗
PubMed1988

The use of combined estrogen-progestin replacement therapy.

The evaluation of innovations which use old technology poses different problems than does the evaluation of new technologies. The main necessity is the targeting of its use rather than the technology itself. The need to evaluate the extent of use and its problems is illustrated by the example of progestin use among menopausal and postmenopausal women in the United States. There progestins are not officially approved for use in menopause, even though they have been on the market for a long time with other indications. Estrogen-replacement therapy was widely used from the early 1960s until 1975, when the claim that estrogens cause endometrial cancer notably decreased their use. The use of estrogens increased again in the early 1980s, and one reason for this revival was the claim that progestins offered protection against endometrial cancer. When recommendations for combined estrogen-progestin therapy have been made, other health effects have been ignored. Two consensus conferences as well as the drug control authority have recommended against combined estrogen-progestin therapy until further research is completed. Absence of good research, specialization in medicine, and advantages for prescribers and the drug industry may have contributed to the wide use of this unassessed treatment. Possible solutions for prevention of the diffusion of these kinds of innovations are discussed.

Communication↗
PubMed1988

Content of prenatal care in the United States. A historic perspective.

The purpose of this study was to describe the content of prenatal care in the United States over time. Secondary data sources were reviewed and selected data were analyzed, mainly in the last two decades. Data reviewed included special surveys from the National Center for Health Statistics, advice given by professional organizations, obstetric textbooks, commercial advertisements in obstetric journals, and occasional surveys. The data suggest that American prenatal care has emphasized screening for biomedical problems, while health education and support functions have been less central. It appears that some prenatal practices from earlier years, such as strict weight-gain restriction, wide use of diuretics and some other drugs, use of x-ray, have been harmful.

Data Collection↗
PubMed1988

Spectacle-use, bifocals and prevention of myopic progression. The two-years results of a randomized trial among schoolchildren.

This paper gives the two-year follow-up results of a randomized trial of three different types of corrective lenses: 1) minus lenses with full correction for continuous use (the Reference group); 2) minus lenses with full correction to be used for distant vision only; and 3) bifocal lenses. A total of 240 9-11-years old mildly myopic schoolchildren were randomly allocated to the three different treatment groups to be followed up for 3 years. After 2-years follow-up the change in the spherical equivalent was greatest in the distant use group. There were no significant positive correlations between changes in refraction and accommodation or refraction and convergence.

Accommodation, Ocular↗
PubMed1988

Prescribing of noncontraceptive estrogens and progestins in the United States, 1974-86.

This paper describes changes in the prescribing of noncontraceptive estrogens and progestins, using data from pharmaceutical marketing surveys. The number of estrogen prescriptions decreased from 1975 to 1980, and then increased through 1986. Progestin use has increased since 1982; concomitant use of estrogens and progestins increased over time and was common in 1986. The trends suggest that the use of estrogens, particularly the combined use of estrogens and progestins, will continue to increase.

Adult↗
PubMed1987

Prevention of myopic progress by glasses. Study design and the first-year results of a randomized trial among schoolchildren.

We report the design and first-year follow-up results of a randomized trial of three different types of corrective lenses: (1) minus lenses with full correction for continuous use (the reference group); (2) minus lenses with full correction for distant vision only; and (3) bifocal lenses. Two hundred and forty 9- to 11-year-old mildly myopic schoolchildren were randomly allocated to the three treatment groups to be followed up to 3 years. During the first year, 73% of the children were compliant with their treatment. Refraction values after the first year were obtained from all but one child. In the second group (spectacles for distant vision only) myopia had progressed somewhat more than in the reference group. In respect of other values (school achievement, reading habits, and accidents) there were no statistically significant differences between the groups.

Accommodation, Ocular↗
PubMed1987

Time trends of ectopic pregnancies.

Whether the increase of ectopic pregnancies could be explained by methodological problems or by changing age structure was examined in data from one hospital (Tampere, Finland) between 1972 and 1984. Numbers of ectopic pregnancies, births, and induced and spontaneous abortions were obtained by 5-year age-groups and county of residence from the hospital discharge register. Introduction of a more sensitive pregnancy test in 1979 was coincident with the most rapid increase in the role of ectopic pregnancies. Use of incomplete denominators and varying catchment areas and correction of changing age-distribution of pregnant women did not markedly influence the time trends. Our analysis suggests that the observed increase in ectopic pregnancies in this area was partly real and partly due to better diagnosis.

Age Factors↗