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E Kumpusalo

Publications and source records attributed to E Kumpusalo.

35 records · Page 2Linked to original sources
PubMed1996

Where should special attention be paid in undergraduate medical education? Two surveys among Finnish physicians.

The study focuses on Finnish doctors' views of their undergraduate medical education. In 1988, a study (Junior Physician 88 Study) involving all the doctors registered during the years 1977-1986 in Finland (n = 5208) was carried out. A questionnaire was sent to a random sample of 2632 doctors, and after two mailings 1745 questionnaires (66.3%) were returned. A total of 1334 gave at least one answer to the question: 'Where should special attention be paid in undergraduate medical education?' Five years later, in 1993, another study (Physician 93 Study) involving all medical doctors registered in Finland during the years 1982-1991 (n = 4671) was carried out. The same questionnaire was sent to a random sample of 2332 doctors, and after two reminders 1818 questionnaires (78.0%) were returned, and 1228 doctors also answered the open-ended question. Content analysis was used to analyse the answers qualitatively and quantitatively. About 90% of the answers could be classified into two main categories: practical skills and evaluation of subjects. The most common proposal for the improvement of undergraduate medical education was that the practical skills needed in general practice should be taught. More education in administration and health economics was also desired. Respondents said that preclinical and clinical studies should be more closely integrated. In answers to the open question, the course in public health was strongly criticized for being too theoretical. Learning of the core knowledge for medical practice was considered essential.

Clinical Competence↗
PubMed1996

Thyroid ultrasound findings 7 years after the Chernobyl accident. A comparative epidemiological study in the Bryansk region of Russia.

AIMS: The accident at the Chernobyl nuclear power station occurred in April 1986. We report on a comparative epidemiological study on thyroid abnormalities in the contaminated and uncontaminated populations of the Bryansk region, South-West Russia, in 1993, 7 years after the accident. MATERIAL AND METHODS: The study material consisted of all inhabitants aged 3-34 years in the contaminated village of Mirnyi and in the uncontaminated village of Krasnyi Rog, excluding those who had moved to the villages after the accident. The total material comprised 302 inhabitants in Mirnyi and 200 in Krasnyi Rog. RESULTS: No pathological US findings in either village were found in children born after the accident. In the age group 0-9 years old at the time of the accident, the prevalence of thyroid abnormalities was 8.1% in the contaminated village compared to 1.6% in the uncontaminated village. In the age group 10-27 years the corresponding figures were 18.8% and 17.7%. Only 55% of the pathological US findings were detected by physical palpation. CONCLUSION: The total prevalence of thyroid abnormalities was higher among children in the contaminated village. We recommend an active screening of young contaminated subjects with US, supplemented with fine needle biopsy.

Adolescent↗
PubMed1995

The Chernobyl accident and mental wellbeing--a population study.

We studied the long-term effects of the 1986 Chernobyl nuclear power plant accident on mental wellbeing 7 years after the event. Mental wellbeing was assessed using a 12-item General Health Questionnaire (GHQ). The study group comprised 325 persons (aged 15-54 years) who had continued to live in the high-fallout area in Bryansk, Russian Federation, classified as a strict control zone with respect to the level of fallout and subsequent radiation protection countermeasures. The control group comprised 278 persons living in a noncontaminated area. The mental wellbeing of women in the study group was poorer than in controls (age-adjusted means). Based on the GHQ score, a minor mental disorder was detected in 48% of the women in the study group and 34% of the female controls. The corresponding figures for men were 26% and 28%, respectively. Those living with a partner coped better mentally than the others. The level of education was not associated with the GHQ score. Poor financial situation and self-rated poor health were associated with a high GHQ score. Fifty-nine per cent of the study group and 14% of the control group wanted to move away from the area of residence, but it was not associated with GHQ score. In a logistic regression analysis, independent factors explaining the GHQ score in the study group were uncertainty about the future in the men and, in addition, poor financial situation and insufficient social support in the women. According the results, the Chernobyl nuclear power plant accident impaired the long-term mental wellbeing of women living in the contaminated area.

Adaptation, Psychological↗
PubMed1993

More women enter medicine: young doctors' family origin and career choice.

This study is part of the Finnish Junior Physicians 88 Study, the purpose of which was to shed light on the life situation, career choice and future plans of young doctors and their views on medical education. The survey population included all the medical doctors registered during the years 1977-1986 in Finland (n = 5208). A postal questionnaire was sent to a sample of 2632 doctors born on odd-numbered days. After a reminder letter, 1745 questionnaires (66%) were returned. Forty-nine per cent of the respondents were women. Typically both men and women doctors had a father who was an upper-level white-collar worker and a mother who was a housewife. More men than women had a father who was a doctor or other health professional. More women than men mentioned that a lifelong calling (42% vs 30%), success at school (58% vs 47%) and an interest in helping people (78% vs 71%) had considerable influence on their decision to become a doctor. Men more often than women emphasized the medical profession being regarded as a highly paid (56% vs 47%) and a high status profession (64% vs 56%) and also that a family member was a doctor (15% vs 11%).

Adult↗
PubMed1992

Identification of health status dimensions in a working-age population. An exploratory study.

With regard to health care there is a growing demand for comprehensive and reliable instruments of general health status measurement. In the Finnish Healthy Village Study, 427 men and 366 women of working age participated in a comprehensive health examination that included more than 120 physical, psychological, and social health status variables. On the basis of minimum correlation values, 37 health status variables were chosen for factor analytic study. Principal component factor analysis with varimax rotation identified six dimensions of health status: physical functioning, emotional state, perceived health, anthropometric state and blood pressure, social functioning, and biochemical state. These six factors accounted for 46% of the total variance of health status variables. Health profile analysis of both men and women revealed the same dimensions but in different order. Men ranked their self-rated general health more closely with their physical functioning, whereas women ranked it with perceived health. The identification of general health status dimensions has implications for planning health promotion programs and evaluating their outcomes.

Adult↗
PubMed1992

Oral mucosal changes related to plasma ascorbic acid levels.

The role of vitamin C in maintaining mucosal health is poorly documented. The purpose of this study was to examine the presence of oral mucosal lesions in subjects with low ascorbic acid (AA) levels in plasma. AA plasma levels of 843 working elderly people in six rural villages in Eastern Finland were determined. All subjects with low plasma AA levels (< or = 25 mumol/l) (n = 106) formed the study group. Controls with normal AA levels (> or = 50 mumol/l) (n = 103) were drawn from the same population. They were matched for age, sex and number of teeth. Oral mucosal lesions in all subjects were recorded clinically using a double-blind method in all subjects. Petechias, leukoplakia and lichenoid lesions were the commonest lesions of the oral mucosa. Only in leukoplakia there was a statistically significant difference between the groups (p < 0.01). Smokers had more leukoplakia than non-smokers. The prevalence of leukoplakia was higher when smoking was combined with AA deficiency.

Adult↗
PubMed1992

Epidemiology of vitamins A, E, D and C in rural villages in Finland: biochemical, nutritional and socioeconomical aspects.

We carried out an extensive health profile analysis in spring-winter 1986 in four Eastern Finnish rural villages as a part of the Healthy Village Study. Altogether, 793 people at working age (20-64 years of age, 427 men and 366 women) participated (80%). Serum lipids (total cholesterol, HDL-cholesterol and triglycerides) and plasma vitamins (vitamin A, D, E and C) were measured as biochemical indicators of health. The dietary habits were reflected in high serum total cholesterol, and in low plasma vitamin C (ascorbic acid, mean 34.4 mumol/l in men, and 51.2 mumol/l in women). The plasma levels of the other vitamins studied were, in general, satisfactory. The mean plasma concentration of vitamin A (retinol) was 2.70 mumol/l in men, and 2.23 mumol/l in women. The gender, high body weight and the use of animal fats had the strongest association to apparent plasma retinol concentrations. The corresponding plasma concentrations of vitamin D (25-hydroxy-D) were 34.1 nmol/l and 35.4 nmol/l, and vitamin E (d-alpha-tocopherol) 22.1 mumol/l and 22.2 mumol/l. Vitamin D deficiency (plasma 25-OHD less than 12.5 nmol/l) was seen in 5% of the subjects. A good vitamin D status was correlated with the use of vitamin supplements, and, surprisingly, with the frequent consumption of alcohol.

Adult↗
PubMed1992

Absorption of ascorbic acid from a film-coated tablet and from a new enteric-coated pellet preparation in subjects with inadequate plasma levels of ascorbic acid.

The effects of a film-coated tablet and a novel enteric-coated pellet preparation of ascorbic acid (CAS 50-81-7) on the plasma concentration and on the urinary excretion of ascorbic acid were investigated. The pharmacokinetic properties of these dosage forms were also compared both after a single dose and in steady state. The study was carried out as a randomized, single blind parallel group trial in 11 volunteers with inadequate plasma levels of ascorbic acid. The duration of the treatment period was 7 days. After the first dose, higher plasma ascorbic acid concentration as well as AUC and Cmax values were achieved with the film-coated preparation. After the multiple dosing in steady state, plasma ascorbic acid concentration as well as AUC and Cmax values were higher with the new pellet preparation. In addition, the plasma ascorbic acid concentration remained on higher level with pellet preparation on the 7th day. Tmax values for the pellet preparation were also slightly higher on both of the pharmacokinetic test days. The amount of ascorbic acid excreted in urine was higher with the film-coated tablet. According to the results of this study it can be supposed that during the long-term supplementation the more complete absorption can be achieved with the new enteric-coated pellet preparation.

Adult↗
PubMed1991

Medical education and the corresponding professional needs of young doctors: the Finnish Junior Physician 88 study.

The Universities of Kuopio and Tampere in collaboration with the Ministry of Social Affairs and Health and Finnish Medical Association carried out the 'Junior Physician 88' study in 1988, the purpose of which was to shed further light on the life situation and future plans of young doctors and their views concerning undergraduate and postgraduate medical education. The study concerned all the doctors registered during the years 1977-1986 in Finland (n = 5208). After randomization, a postal questionnaire was sent to one half (n = 2631) of these doctors. After the first reminder letter, 1745 questionnaires (66.3%) were returned. According to the views of the respondents undergraduate hospital teaching was adequate but the teaching of practice in health centres, school health care, team-work, health care of the elderly, home health care, rehabilitation, environmental health care and administration did not meet the professional needs of doctors. All doctors were satisfied with the hospital teaching in their undergraduate curriculum. However, only the doctors who graduated from the two modern universities in Kuopio and Tampere were satisfied with their undergraduate health centre teaching.

Adult↗
PubMed1990

Multivitamin supplementation of adult omnivores and lactovegetarians: circulating levels of vitamin A, D and E, lipids, apolipoproteins and selenium.

Serum levels of fat-soluble vitamins, lipids, apolipoproteins, total protein, hemoglobin, iron, and selenium were determined in healthy Finnish adults during a 7-month period beginning in January and ending in August. The subjects were either omnivores or established lactovegetarians, who had consumed their respective diets for at least 6 months prior to the study. Half of the subjects in both groups received daily multivitamin supplementation and the other half served as controls. In the beginning, the lactovegetarians differed from the omnivores in having lower serum levels of protein, apolipoproteins A-I and C-II, and higher levels of standardized alpha-tocopherol. During the study, serum retinol and standardized alpha-tocopherol (in March and May), as well as apolipoproteins A-I and C-II, and selenium decreased in the omnivores and 25-hydroxyvitamin D2, 25-hydroxyvitamin D3, cholesterol, HDL-cholesterol, and the HDL-cholesterol/cholesterol ratio increased. Apolipoprotein B decreased and then increased. In the lactovegetarians, serum selenium and protein decreased during the study, whereas retinol and alpha-tocopherol stayed higher than in the omnivores. Consumption of the lactovegetarian diet was accompanied by lower circulating levels of cholesterol and selenium and higher levels of retinol and standardized alpha-tocopherol than the mixed diet. Multivitamin supplementation may have value especially for omnivores in northern countries, like Finland, in providing better retinol, alpha-tocopherol, vitamin D, and selenium status in late winter and early spring.

Adult↗
PubMed1987

Teaching of primary health care in practice: a model using local health centres in undergraduate medical education.

In Finland primary health care has a long historical background. The local communities, the state and the church have at various times and places been responsible for primary health care during the last few centuries. In 1972, a major reform took place when a new Primary Health Care Act came into force. In the same year two new medical faculties, at Kuopio and Tampere Universities, began to educate undergraduate medical students. In both of these new medical schools special attention was focused on the teaching of primary health care. Today practical teaching, which takes place at a primary health care centre, forms an important part of medical education at Kuopio University. This teaching of undergraduate students is part of the regular duties of general practitioners and public health nurses in the primary health care centres of eastern Finland that have agreed to collaborate in the teaching programme. The main principles are presented for the teaching programme in primary health care at the University of Kuopio.

Community Health Centers↗
PubMed1985

Caries, periodontal status and some salivary factors in lactovegetarians.

Twenty-eight lactovegetarians as well as age- and sex-matched controls were interviewed about their dietary habits, especially the frequency of ingesting acid fruits, drinks and foods, as well as their dental health habits. Samples of stimulated saliva were collected in connection with the clinical and radiologic study. Plaque, Gingival and Calculus Indices were not significantly different in lactovegetarians and controls. Of the lactovegetarians 76.9% and of the controls none had dental erosions on some tooth surfaces. In lactovegetarians the rate of flow of stimulated saliva was lower than in controls but did not decrease with advancing age as it did in controls. Salivary pH was lower in lactovegetarians than in controls.

Adult↗
PubMedDate not supplied

Primary health care ICD--a tool for general practice research.

The International Classification of Diseases (ICD) has become the only diagnostic classification system of international standard that allows reliable comparisons of epidemiological data between countries, parts of a country, levels of health care systems, or different periods of time. However, for primary health care purposes it is too specific to describe problems relevant to the work of general practitioners (GPs). Tools are thus needed to 'compress' data in primary health care for educational, administrative and research purposes. The objective of this paper was to introduce a diagnosis coding system that can be used in primary health care settings for these purposes. Principal diagnoses, as assessed by medical doctors, were collected from 20,648 patient visits. After primary coding, according to the ICD on a five-digit scale, the diagnoses were grouped into larger entities, which reduced the number of diagnoses to one eighth of the original number. The ten most common original five-digit diagnoses accounted for one quarter of all consultations, whereas the ten most common diagnoses counted for one half of all consultations after compressing the data into new categories. Analysing epidemiological data in the records of primary health care by the ICD offers benefits because of the latter's wide use. These are discussed below.

Adult↗
PubMedDate not supplied

Drug treatment for hypertension in Finnish primary health care.

OBJECTIVE: To analyse the prescribing patterns of antihypertensive drugs in Finnish primary health care and to describe the profiles of monotherapy and combination therapy in relation to the duration of high blood pressure. METHODS: Thirty out of 250 primary health care centres were randomly selected for the study. All doctors (n=337) from the participating health centres recorded all hypertensive patients (n=4405) during a 2-week period in May 1995. Adequate information was obtained concerning 4294 hypertensives, of whom 65% were women with a mean age for the total study population of 64 years. 85% of the patients (n=3638) had antihypertensive medication which was classified into five main categories: diuretics, beta blocking agents, calcium channel blockers, ACE inhibitors and hypotensives. RESULTS: Of the patients using antihypertensive medication, 48% were undergoing monotherapy and 52% combination therapy. Beta blocking agents were the most frequently prescribed drugs for hypertension, being used by half of the patients. ACE inhibitors and diuretics were prescribed in a different manner for male and female hypertensives, with men receiving more ACE inhibitors and women more diuretics. The number of antihypertensive drugs increased with the duration of hypertension, though 38% of the patients having hypertension for over 10 years were still undergoing monotherapy. Among patients undergoing combination therapy, 75% received two different agents, most often a diuretic with a beta blocking agent. CONCLUSIONS: With increasing duration of hypertension, the number of antihypertensive drugs also increased. Beta blocking agents were the drug of choice for all patients. For women, combination therapy more frequently included diuretics, whereas ACE inhibitors were favoured for men.

Age Factors↗