Purpose:
To examine whether retrospectively assessed sports participation (SP) and competitive sports (CS) at the age of 12 years is associated with mental health and health behavior in young ...adulthood among males.
Design:
A cross-sectional study using self-administered questionnaires.
Setting:
Conducted prior to compulsory military refresher training course in Finland allowing geographically representative sample of Finnish young men.
Participants:
Six hundred eighty males aged between 20 and 35 years.
Measures:
Mental well-being was measured with the short version of Warwick-Edinburgh Mental Well-Being Scale and mental distress with 5 items of The Short Form Helalth Survey (SF-36) scale.
Analysis:
Binary logistic regression models.
Results:
Sports participation at the age of 12 was associated with better mental health in young adulthood, with both mental well-being (odds ratio OR = 1.86, 95% confidence interval 1.11-3.11) and mental distress (OR = 0.61, 0.41-0.90). Age, years of education, and current physical activity were controlled. Higher level of intensity of SP and the level of CS in childhood were associated with lower level of mental distress in adulthood. No association was found between the level of CS in childhood and mental well-being in adulthood. Further, youth SP seemed to be a risk factor for increased alcohol consumption and use of snuff in adulthood.
Conclusions:
Despite negative outcomes related to health behavior, the findings provide support for the association between youth SP and positive mental health outcomes in adulthood among males.
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FSPLJ, NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
Objective. To examine frequencies of the use of hormone replacement therapy (HRT) in a follow‐up cohort of women aged 57–61 years in 2005 and to discover reasons why the women who used HRT in 2000 ...discontinued it. Design. Questionnaire survey. Setting. Five‐year cross‐sectional follow‐up study. Sample. Cohort of 52‐ to 56‐year‐old Finnish women. Methods. Single‐ and multi‐predictor model analyses. Main Outcome Measures. Frequency of HRT users and quitters and reasons behind the discontinuation. Results. Altogether, 35.9% of the women aged 57–61 years used HRT in 2005. Main reasons for the initial use of HRT among users and among those who discontinued included the perceived experience of severe climacteric symptoms as well as maintenance of health and prevention of mostly cardiovascular diseases. Main reasons to discontinue HRT included desire to stay without medication, side‐effects, reaction to recent controversial findings in ‘HRT publications’ and fear of cancer. Those women who used but discontinued HRT had used it for less time than those who continued. Women who discontinued were older and initially started using HRT to maintain health. Neither the severity of climacteric symptoms nor reporting on positive or negative effects prior to starting use had influence on the women's discontinuance of HRT. Conclusions. The use of HRT was still frequent in Finland in 2005 despite the impact of controversial research results from the early 2000s. For those who discontinued HRT, these reports played an important role.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
•Little is known about the cohort effect on the experience of climacteric symptoms.•The present study reveals that women aged 52–56 years not now or previously on menopausal hormone therapy ...experienced more severe climacteric symptoms in 2010 than had a similarly aged cohort in 2000.•We did not find any significant associations between sociodemographic or health background and climacteric symptoms.
To analyze and compare the experience of climacteric symptoms and their associations with sociodemographic and health-related characteristics in two cohorts of Finnish women aged 52–56 years, born ten years apart and not now or previously on menopausal hormone therapy (MHT).
Nationwide population-based time-trend study with a large number of participants (n = 1986 + 1988).
The experience of climacteric symptoms was assessed by 12 commonly used menopause-related symptoms.
Women aged 52–56 experienced more moderate or severe symptoms and fewer mild symptoms in 2010 than in 2000. Being unemployed or inactive was associated with more severe symptoms (P = 0.007), but employment status had no effect on the relative odds estimates.
The influence of the birth cohort and time-period effects as well as work-related factors on the experience of climacteric symptoms in women not now or previously on MHT needs further research, particularly since the change in the experience of symptoms found in this study occurred within only ten years.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Introduction
Recently, it has been suggested that the occurrence of posthysterectomy vaginal cuff dehiscence has increased. Consequently, we evaluated the incidence of vaginal cuff dehiscence after ...different types of hysterectomies. Our hypothesis is that vaginal cuff dehiscence is more often associated with total laparoscopic hysterectomy (TLH) than other types of uterine removal.
Material and methods
A total of 13 645 hysterectomies from 1992 to 2015 were evaluated in the Turku University Hospital district, Finland. The primary outcome was occurrence of vaginal dehiscence after different types of hysterectomy. The hysterectomy and postoperative vaginal dehiscence trends were analyzed as the secondary outcome. In a subanalysis of dehiscence cases, women’s characteristics and perioperative vaginal cuff opening and closure techniques were compared between conventional hysterectomies (vaginal, abdominal, and laparoscopic with vaginal closure) and TLH.
Results
Altogether, 22 cases of vaginal cuff dehiscence were included. Most cases (n = 15) occurred after TLH (n = 1104), resulting in an incidence of 1.27%. After conventional laparoscopic hysterectomy with vaginal closure (n = 2853), vaginal (n = 4150), and abdominal (n = 5538) hysterectomies, the incidence rates were 0.11%, 0.05%, and 0.02%, respectively. Compared to abdominal hysterectomy, which was associated with the lowest incidence rate, vaginal dehiscence after TLH had an odds ratio (OR) 71.1 (9.34‐541.38, P < 0.001). In the subanalysis of possible underlying factors, the technique of opening of the vaginal cuff with or without electrocoagulation, duration of operation, and occurrence of postoperative infection or hematoma prior to VCD were observed differences between TLH and conventional hysterectomies.
Conclusions
Compared with other types of hysterectomies, vaginal dehiscence was observed at the highest rate after TLH. Studies are needed to define if vaginal opening technique contributes to the risk of dehiscence.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Abstract Objectives To establish the trends in pelvic floor surgery in Finnish female population and to evaluate the age-specific incidence as well as the lifetime risk for pelvic organ prolapse ...surgery. Study Design We conducted a population-based register study, which includes all Finnish women ( n = 77 906), who underwent surgery for pelvic organ prolapse in Finland 1987-2009. The women were identified in the Care Register for Health Care based on the procedure codes. Number of procedures, age-adjusted incidence, age-specific incidence, cumulative incidence, lifetime risk were calculated. Results A total of 93 226 surgical procedures for POP were performed. The age-adjusted incidence of prolapse surgery was 1.3/1000 women in 1987. After that there was an increase which peaked in 1996 with 1.9/1000, and a decline thereafter back to 1.3/1000 in 2009. The lifetime risk for a woman to have undergone at least one surgical procedure for prolapse was 12.8%. Surgery was most common within women aged 70 to 79 years, followed by women aged 60 to 69 years. The most popular procedure until 1991 was cervix amputation with colporraphies, surpassed thereafter by colporraphies only or with combined vaginal hysterectomy. Conclusion Surgery for pelvic organ prolapse is common and more than every tenth woman underwent such surgery during lifetime.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
BACKGROUND
Hysterectomy guidelines highlight an increase in urinary tract injuries with laparoscopic hysterectomy (LH). This national survey analyses complications of LH, abdominal hysterectomy (AH) ...and vaginal hysterectomy (VH).
METHODS
A prospective cohort undergoing hysterectomy for benign indications during 2006 was drawn from 53 hospitals in Finland; all communal hospitals participated. Detailed questionnaires covered surgical data and intra- and post-operative major and minor complications, for which risk factors were analysed by a multivariate logistic regression model adjusted for surgical data and patient characteristics.
RESULTS
Major complications rates in AH (n= 1255, 24%), LH (1679, 32%) and VH (2345, 44%) were 4.0, 4.3 and 2.6%, and total complications rates were 19.2, 15.4 and 11.7%, respectively. Logistic regression showed no statistically significant differences between approaches for any organ injuries or other major complications. Most bladder and bowel injuries (88 and 83%), but not ureter injuries (10%), were recognized intra-operatively. The ureter injury rate was low after LH (0.3%), as it was after other types of hysterectomy. Compared with LH, AH increased the odds of wound infection, and was an independent risk factor for urinary infections and febrile events. Compared with AH, LH and VH both presented a higher risk for pelvic infection; surgically treated equally often regardless of the type of hysterectomy. No differences in complications emerged between LH and VH. Obesity was a risk factor for many infections. Surgical adhesiolysis odds ratio (OR) 2.41, 95% confidence interval (CI) 1.38–4.21 was the strongest single risk factor for major complications as a whole. Bladder injury was associated with a history of caesarean section (OR 4.01, 95% CI 2.06–7.83) and with a large uterus ≥500 g (OR 2.88, 95% CI 1.05–7.90), while bowel injury was associated with adhesiolysis (OR 29.07, 95% CI 7.17–117.88).
CONCLUSIONS
FINHYST is a large prospective hysterectomy study illustrating actual complications. Whenever possible, hysterectomy should be minimally invasive.
Introduction
An association between a history of induced abortion and psychological well‐being post‐abortion has been demonstrated in recently published studies, which is contrary to the findings of ...existing known high‐quality studies.
Material and methods
An evaluation was conducted to determine whether a history of abortion affected the psychological well‐being and parental self‐efficacy of first‐time mothers and their partners; this assessment was performed when the child was aged 18 months. Questionnaires were administered to 492 first‐time mothers, 37 of whom had a history of abortion, and their partners (n = 436). Women with previous miscarriages, ectopic pregnancies, and deliveries were excluded. The women were allocated to an abortion group or a comparison group, depending on each woman's abortion history obtained from medical birth registry data. Psychological well‐being, which encompassed social and emotional loneliness, marital satisfaction, social phobia, and depression, was evaluated as a predictor of maternal and paternal self‐efficacy within the two groups. The analysis was conducted using multi‐group structural equation modeling.
Results
Induced abortion was not predictive of maternal or paternal well‐being or parental self‐efficacy. Overall, maternal and paternal psychological well‐being was predictive of parental self‐efficacy when an assessment was performed, regardless of an abortion history. After testing the invariance of multi‐group models, psychological well‐being was similarly found to predict parental self‐efficacy in both the abortion history and comparison groups.
Conclusions
These findings suggest that the psychological well‐being of parents is an important predictor of maternal and paternal self‐efficacy during toddlerhood. Abortion history was not demonstrated to negatively impact the psychological well‐being of parents with respect to their capacity for parental self‐efficacy.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
•Psychological behavior patterns are one moderator affecting how women experience menopausal symptoms and cope with them.•Women with low ratings for hostility and stress tend to manage their ...menopausal symptoms without hormone therapy.•Women with high ratings for optimism and sense of coherence tend to manage their menopausal symptoms without hormone therapy.
To identify subgroups of women who differ with respect to self-evaluated stress, hostility, optimism and sense of coherence, and to identify differences, if any, in whether these subgroups use or do not use hormone replacement therapy (HT).
This time-trend study is based on the Finnish national HeSSup study, in which nationwide cohorts of Finnish women aged 52–56 years randomly selected in 2000 (n = 1321) and in 2010 (n = 1389) responded to postal questionnaires related to four psychological behavior patterns.
Relationships between psychological behavior patterns (stress, hostility, optimism and sense of coherence) and how menopausal symptoms are experienced and how this relates to the use of HT.
The proportion of HT users was higher among those with more stress and hostility and less optimism and sense of coherence than among those low in stress and hostility and high in optimism and sense of coherence.
Differences in psychological behavior patterns influence the perception of menopausal symptoms and the use of HT. When the treatment of women at menopause is planned, psychological behavior patterns should be considered, as these reflect the ability to cope with menopausal symptoms.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Introduction
Hysterectomy may have an effect on the pelvic floor. Here, we evaluated the rates and risks for pelvic organ prolapse (POP) surgeries and visits among women with a history of ...hysterectomy for benign indication excluding POP.
Material and methods
In this retrospective cohort study 3582 women who underwent hysterectomy in 2006 were followed until the end of 2016. The cohort was linked to the Finnish Care Register to catch any prolapse‐related diagnoses and operation codes following the hysterectomy. Different hysterectomy approaches were compared according to the risk for a prolapse, including abdominal, laparoscopic, laparoscopic‐assisted vaginal and vaginal. The main outcomes were POP surgery and outpatient visit for POP, and Cox regression was used to identify risk factors (hazard ratios HR).
Results
During the follow‐up, 58 women (1.6%) underwent a POP operation, of which a posterior repair was the most common (n = 39, 1.1%). Outpatient visits for POP symptoms occurred in 92 (2.6%) women of which posterior wall prolapses (n = 58, 1.6%) were the most common. History of laparoscopic‐assisted vaginal hysterectomy were associated with risk for POP operation (HR 3.0, p = 0.02), vaginal vault prolapse operation (HR 4.3, p = 0.01) and POP visits (HR 2.2, p < 0.01) as compared to the approach of abdominal hysterectomy. History of vaginal deliveries and concomitant stress urinary continence operation were associated with the risk for a POP operation (HR 4.4 and 11.9) and POP visits (HR 3.9 and 7.2).
Conclusions
Risk for POP operations and outpatient visits for POP symptoms in hysterectomized women without a preceding POP seems to be small at least 10 years after hysterectomy. History of LAVH, vaginal deliveries and concomitant stress urinary incontinence operations increased the risk for POP operations after hysterectomy. These data can be utilized in counseling women considering hysterectomy for benign indication.
After benign hysterectomy, the risk of POP operation was reported in only 1.6% patients without prior POP. The risk for POP was associated with the approach of LAVH, vaginal deliveries and concomitant SUI operations.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
This study examined the association between carotid artery intima-media thickness (IMT), serum sex hormone levels, and andropausal symptoms in middle-aged men.
Male sex hormones may play a dual role ...in the pathogenesis of atherosclerosis in men by carrying both proatherogenic and atheroprotective effects.
We studied 239 40- to 70-year-old men (mean ± SD: 57 ± 8 years) who participated in the Turku Aging Male Study and underwent serum lipid and sex hormone measurements. Ninety-nine men (age 58 ± 7 years) were considered andropausal (i.e., serum testosterone <9.8 nmol/l or luteinizing hormone LH >6.0 U/l and testosterone in the normal range), and in both situations, they had subjective symptoms of andropause (a high symptom score in questionnaire). Three were excluded because of diabetes. The rest of the men (age 57 ± 8 years) served as controls. Carotid IMT was determined using high-resolution B-mode ultrasound, and serum testosterone, estradiol (E2), LH, and sex hormone-binding globulin were measured using standard immunoassays.
Andropausal men had a higher maximal IMT compared with controls in the common carotid (1.08 ± 0.34 vs. 1.00 ± 0.23, p < 0.05) and in the carotid bulb (1.44 ± 0.48 vs. 1.27 ± 0.35, p = 0.003). Common carotid IMT correlated inversely with serum testosterone (p = 0.003) and directly with LH (p = 0.006) in multivariate models adjusted for age, total cholesterol, body mass index, blood pressure, and smoking.
Middle-aged men with symptoms of andropause, together with absolute or compensated (as reflected by high normal to elevated LH) testosterone deficiency, show increased carotid IMT. These data suggest that normal testosterone levels may offer protection against the development of atherosclerosis in middle-aged men.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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