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Article ; Online: Reflective capacity and context of reflections: qualitative study of second-year medical students' learning diaries related to a general practice course.

Paloniemi, Elina / Hagnäs, Maria / Mikkola, Ilona / Timonen, Markku / Vatjus, Ritva

2024 Volume 24, Issue 1, Page(s) 222

Abstract: Background: Reflective capacity is a prerequisite for transformative learning. It is regarded as an essential skill in professional competence in the field of medicine. Our aim was to investigate the reflective capacity and the objects of action (themes) ...

Abstract	Background: Reflective capacity is a prerequisite for transformative learning. It is regarded as an essential skill in professional competence in the field of medicine. Our aim was to investigate the reflective capacity and the objects of action (themes) which revealed reflective writing of medical students during a general practice/family medicine course. Methods: Second-year medical students were requested to write learning diaries during a compulsory course in general practice/family medicine consisting of the principles of the physician-patient relationship. The course included a group session supervised by a clinical lecturer and a 3-day training period in a local health centre. We conducted data-driven content analysis of the learning diaries. In the learning diaries, student observations were most commonly directed to events during the training period and to group sessions. Occasionally, observation was directed at inner experience. Results: The following themes were related to reflective writing: feelings towards the end of life, demanding situations in practice, physician's attitude to patient, student's inner experiences, and physician's well-being. The entries indicated different types of reflective capacity. Three subgroups were identified: 'simple reporting,' 'reflective writing,' and 'advanced reflective writing.' Conclusion: Professional growth requires the development of reflective capacity, as it is essential for successful patient care and better clinical outcomes. To develop and enhance the reflective capacity of medical students during their education, the curriculum should provide frequent opportunities for students to assess and reflect upon their various learning experiences.
MeSH term(s)	Humans ; Students, Medical ; Family Practice/education ; Education, Medical, Undergraduate ; Education, Medical ; Learning
Language	English
Publishing date	2024-03-01
Publishing country	England
Document type	Journal Article
ZDB-ID	2044473-4
ISSN	1472-6920 ; 1472-6920
ISSN (online)	1472-6920
ISSN	1472-6920
DOI	10.1186/s12909-024-05199-3
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Article ; Online: Cross-sectional analysis of depressive symptom profiles and serum C-reactive protein levels: data from the Northern Finland 1966 birth cohort.

Moilanen, Pauli / Liukkonen, Timo / Jokelainen, Jari / Keinänen-Kiukaanniemi, Sirkka / Puukka, Katri / Timonen, Markku / Auvinen, Juha / Eskola, Pasi

Nordic journal of psychiatry

2024 Volume 78, Issue 2, Page(s) 95–102

Abstract: Purpose: Individuals with depression exhibit significantly higher levels of systemic inflammation than those without depression, particularly among those with atypical depression. However, this association has been less convincing at the population ... ...

Abstract	Purpose: Individuals with depression exhibit significantly higher levels of systemic inflammation than those without depression, particularly among those with atypical depression. However, this association has been less convincing at the population level among individuals without a formal depression diagnosis but with suggestive symptoms. Our aim was to clarify this association. Materials and methods: In a large birth cohort sample of the Finnish general population, we examined the cross-sectional association between high-sensitivity C-reactive protein (hsCRP) levels in venous blood samples and atypical/non-atypical depressive symptoms using the Beck Depression Inventory-II to screen 5443 middle-aged participants. Results: As expected, depressive symptoms associated to elevated hsCRP-levels compared to non-depressed. Participants with the atypical subtype of depressive symptoms ( Conclusions: These results provide additional support for previous research linking depression and inflammation and add to the field with a unique and sizeable study population. Furthermore, the current results support the notion that different types of depressive symptoms may be associated with inflammatory markers in slightly different ways.
MeSH term(s)	Humans ; Middle Aged ; Biomarkers ; Birth Cohort ; C-Reactive Protein/analysis ; Cross-Sectional Studies ; Depression/diagnosis ; Depression/epidemiology ; Finland/epidemiology ; Inflammation/epidemiology
Chemical Substances	Biomarkers ; C-Reactive Protein (9007-41-4) ; CRP protein, human
Language	English
Publishing date	2024-01-31
Publishing country	England
Document type	Journal Article
ZDB-ID	1104974-1
ISSN	1502-4725 ; 0803-9488 ; 0029-1455
ISSN (online)	1502-4725
ISSN	0803-9488 ; 0029-1455
DOI	10.1080/08039488.2023.2274341
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Article ; Online: Association between Pruritus and Psychosocial Well-being: A Population-based Study among 6,809 Subjects.

Sinikumpu, Suvi-Päivikki / Jokelainen, Jari / Tasanen, Kaisa / Timonen, Markku / Huilaja, Laura

Acta dermato-venereologica

2023 Volume 103, Page(s) adv00837

Abstract: Pruritus has an extensive impact on functional, social and psychosocial behaviour. The association between pruritus and psychological well-being has mostly been studied among selected patient groups, whereas population-based studies are lacking. The aim ... ...

Abstract	Pruritus has an extensive impact on functional, social and psychosocial behaviour. The association between pruritus and psychological well-being has mostly been studied among selected patient groups, whereas population-based studies are lacking. The aim of this study was to determine the association between pruritus and insomnia, quality of life, depression and anxiety at the population level in the general population. A cross-sectional population-based study was conducted in 2012 to 2013. Study subjects (n = 6,809) belonging to the Northern Finland Birth Cohort 1966 Study participated in a large follow-up study at the age of 45-47 years. They completed an extensive health questionnaire including questions on pruritus and several previously validated questionnaires regarding symptoms of psychosocial well-being. Pruritus affected 19.9% of the study subjects weekly, being more common in women than in men (p < 0.001). A significant association was found between both localized and generalized pruritus and symptoms of insomnia, depression, anxiety and decreased quality of life. The association was seen even in those with mild psychological symptoms/insomnia, and it affected both sexes. The severity of psychological symptoms increased with increasing frequency of pruritus. In conclusion, pruritus has a multiple effect on psychosocial well-being. Physicians should consider possible psychosocial symptoms in patients with pruritus.
MeSH term(s)	Male ; Humans ; Female ; Middle Aged ; Quality of Life ; Sleep Initiation and Maintenance Disorders/diagnosis ; Sleep Initiation and Maintenance Disorders/epidemiology ; Cross-Sectional Studies ; Follow-Up Studies ; Anxiety/diagnosis ; Anxiety/epidemiology ; Surveys and Questionnaires ; Pruritus/diagnosis ; Pruritus/epidemiology ; Pruritus/psychology ; Depression/diagnosis ; Depression/epidemiology
Language	English
Publishing date	2023-01-04
Publishing country	Sweden
Document type	Journal Article
ZDB-ID	80007-7
ISSN	1651-2057 ; 0001-5555
ISSN (online)	1651-2057
ISSN	0001-5555
DOI	10.2340/actadv.v103.2922
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Article ; Online: Association of Rosacea with Depressive and Anxiety Symptoms: A General Population Study.

Sinikumpu, Suvi-Päivikki / Jokelainen, Jari / Tasanen, Kaisa / Timonen, Markku / Huilaja, Laura

Dermatology (Basel, Switzerland)

2023 Volume 240, Issue 2, Page(s) 189–194

Abstract: Background: The association between rosacea and psychiatric comorbidity has been reported previously. However, there is a lack of general population studies about this subject area.: Objectives: The aim of this study was to the association between ... ...

Abstract	Background: The association between rosacea and psychiatric comorbidity has been reported previously. However, there is a lack of general population studies about this subject area. Objectives: The aim of this study was to the association between rosacea with depressive and anxiety symptoms at the population level. Methods: A clinical whole-body examination was performed by dermatologists for 1,932 subjects belonging to the Northern Finland Birth Cohort 1966 Study during the 46-year follow-up survey. The presence of depressive and anxiety symptoms was gathered by using validated Hopkins Symptom Checklist-25 (HSCL-25) included in the self-administered questionnaires. Binary logistic regression analysis was used to identify associations between rosacea and psychological symptoms. Results: Rosacea was found in dermatological evaluation in 15.1% of the study subjects (n = 292). In logistic regression analyses, after adjusting for confounding factors, those with rosacea had 1.6-fold (OR 1.55, 95% CI: 1.02-2.32) risk for psychiatric symptoms according to HSCL-25 when compared with controls. In separate analyses of the HSCL-25 depression subscale, the risk was increased, especially for depressive symptoms (OR 1.56, 95% CI: 1.10-2.18). Conclusions: Patients with rosacea seem to have increased risk for depressive and anxiety symptoms in general population. Physicians treating patients with rosacea should pay more attention to the psychosocial health of patients.
MeSH term(s)	Humans ; Depressive Disorder/epidemiology ; Depressive Disorder/diagnosis ; Anxiety/epidemiology ; Comorbidity ; Surveys and Questionnaires ; Rosacea/complications ; Rosacea/epidemiology ; Rosacea/psychology ; Depression/epidemiology
Language	English
Publishing date	2023-11-26
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	1099692-8
ISSN	1421-9832 ; 1018-8665
ISSN (online)	1421-9832
ISSN	1018-8665
DOI	10.1159/000535034
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Article ; Online: Atopic dermatitis and the risk of eating disorders: A population-based cohort study.

Kauppi, Saana / Jokelainen, Jari / Timonen, Markku / Tasanen, Kaisa / Huilaja, Laura

Journal of the American Academy of Dermatology

2021 Volume 87, Issue 2, Page(s) 474–476

MeSH term(s)	Cohort Studies ; Dermatitis, Atopic/epidemiology ; Feeding and Eating Disorders ; Humans ; Risk Factors
Language	English
Publishing date	2021-10-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	603641-7
ISSN	1097-6787 ; 0190-9622
ISSN (online)	1097-6787
ISSN	0190-9622
DOI	10.1016/j.jaad.2021.10.021
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Article ; Online: Difficulties that unexpected results face to be accepted: suicide and the moon.

Benno Meyer-Rochow, V / Hakko, Tapani / Hakko, Helinä / Riipinen, Pirkko / Timonen, Markku

Molecular psychiatry

2021 Volume 26, Issue 9, Page(s) 4566–4567

MeSH term(s)	Humans ; Moon ; Suicide
Language	English
Publishing date	2021-02-01
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	1330655-8
ISSN	1476-5578 ; 1359-4184
ISSN (online)	1476-5578
ISSN	1359-4184
DOI	10.1038/s41380-021-01028-x
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Article: Cross-cultural comparison of depressive symptoms on the Beck Depression Inventory-II, across six population samples.

Seppänen, Marjo / Lankila, Tiina / Auvinen, Juha / Miettunen, Jouko / Korpelainen, Raija / Timonen, Markku

BJPsych open

2022 Volume 8, Issue 2, Page(s) e46

Abstract: Background: The Beck Depression Inventory (BDI) and BDI-II (revised version) are some of the most widely used and comparable self-report scales for assessing the presence and severity of depressive symptoms in many countries. However, although the ... ...

Abstract	Background: The Beck Depression Inventory (BDI) and BDI-II (revised version) are some of the most widely used and comparable self-report scales for assessing the presence and severity of depressive symptoms in many countries. However, although the relative mean score of each symptom in different countries may vary, the cultural differences of BDI-II symptoms for each item have not been previously studied. Aims: To examine the overall picture of the magnitude of the symptoms in the Finnish population, and compare the relative mean score of each symptom between all published population-based samples from different countries fulfilling the search criteria. Method: We conducted a search for population-based studies reporting BDI-II item, using Scopus, PsycINFO and PubMed, and five population-based samples were identified. Relative average scores for each item of the scale were calculated for the Finnish population and five populations from other countries. Meta-regression methods were used to test the differences in the relative score of each symptom between each country separately, and results were then visually compared with spider charts. Results: We found significant differences in several BDI-II item scores between countries: lower indecisiveness, higher changes in sleep pattern and higher irritability in Finland; higher loss of pleasure in Norway; higher loss of interest in the Dominic Republic; higher self-criticalness and feelings of punishment in Mexico; and higher sadness in Japan. Conclusions: Based on the study fundings and including all currently published population-based samples with BDI-II scores, cultural differences in depressive symptoms should be considered when interpreting BDI-II item scores.
Language	English
Publishing date	2022-02-11
Publishing country	England
Document type	Journal Article
ZDB-ID	2829557-2
ISSN	2056-4724
ISSN	2056-4724
DOI	10.1192/bjo.2022.13
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Article ; Online: Premorbid temperament as predictor of onset of depression: 23-year follow-up.

Ahola, Aleksi / Rautio, Nina / Timonen, Markku / Nordström, Tanja / Jääskeläinen, Erika / Miettunen, Jouko

Comprehensive psychiatry

2022 Volume 121, Page(s) 152359

Abstract: Background: Previously Cloninger's temperament traits have been researched as a risk factor for depression mostly in cross-sectional studies. In these studies, especially high harm avoidance has been associated with an increased risk of depression. The ... ...

Abstract	Background: Previously Cloninger's temperament traits have been researched as a risk factor for depression mostly in cross-sectional studies. In these studies, especially high harm avoidance has been associated with an increased risk of depression. The main objective of this study was to investigate how temperament traits affect the risk of the onset of depression in a previously mentally healthy adult population. Methods: This study includes a follow-up period of 23 years from the age of 31 until 54 in the Northern Finland Birth Cohort 1966 Study. Temperament was measured at the 31-year follow-up using Temperament and Character Inventory (TCI). The outcome of the study was depressive disorder diagnosis during the follow-up in both sexes. To be able to take correlations between temperament traits we also did an analysis using temperament clusters. Results: Our sample size was 3999 individuals, out of which 240 were diagnosed with depression. For women an increase in the TCI score for novelty seeking (NS), harm avoidance (HA) or persistence (P) increased the risk of depression during the follow-up. For men only HA was a significant predictor of depression. An increase in reward dependence (RD) was found to reduce the risk of psychotic depression. In the analysis using the temperament clusters, the cluster including shy and pessimistic individuals was associated with risk for depression diagnosis in men. Conclusions: This prospective general population-based cohort study added to previous knowledge of high HA being a risk factor for depression, but it also found new associations such as higher P and NS.
MeSH term(s)	Adult ; Male ; Humans ; Female ; Temperament ; Cohort Studies ; Depression/diagnosis ; Depression/epidemiology ; Follow-Up Studies ; Prospective Studies ; Cross-Sectional Studies ; Character ; Personality Inventory
Language	English
Publishing date	2022-12-05
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	127556-2
ISSN	1532-8384 ; 0010-440X
ISSN (online)	1532-8384
ISSN	0010-440X
DOI	10.1016/j.comppsych.2022.152359
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Article ; Online: Multimorbidity and achievement of treatment goals among patients with type 2 diabetes: a primary care, real-world study.

Heikkala, Eveliina / Mikkola, Ilona / Jokelainen, Jari / Timonen, Markku / Hagnäs, Maria

BMC health services research

2021 Volume 21, Issue 1, Page(s) 964

Abstract: Background: Type 2 diabetes (T2D), with its prevalence and disability-causing nature, is a challenge for primary health care. Most patients with T2D are multimorbid, i.e. have one or more long-term diseases in addition to T2D. Multimorbidity may play a ... ...

Abstract	Background: Type 2 diabetes (T2D), with its prevalence and disability-causing nature, is a challenge for primary health care. Most patients with T2D are multimorbid, i.e. have one or more long-term diseases in addition to T2D. Multimorbidity may play a role in the achievement of T2D treatment targets, but is still not fully understood. The aims of the present cross-sectional, register-based study were to evaluate the prevalence and the most common patterns of multimorbidity among patients with T2D; and to study the potential associations between multimorbidity and treatment goal achievement, including measurements of glycosylated haemoglobin A1c (HbA1c), low-density lipoprotein (LDL) and systolic blood pressure (sBP). Methods: The study population consisted of 4545 primary care patients who received a T2D diagnosis between January 2011 and July 2019 in Rovaniemi Health Centre, Finland. Data on seven long-term concordant (T2D-related) diseases, eight long-term discordant (non-T2D-related) diseases, potential confounders (age, sex, body mass index, prescribed medication), and the outcomes studied were collected from patients' records. Logistic regression models with odds ratios (ORs) and 95 % confidence intervals (CIs) were assessed to determine the associations between multimorbidity and the achievement of treatment targets. Results: Altogether, 93 % of the patients had one or more diseases in addition to T2D, i.e. were considered multimorbid. Furthermore, 21 % had only concordant disease(s) (Concordant subgroup), 8 % had only discordant disease(s) (Discordant subgroup) and 64 % had both (Concordant and discordant subgroup). As either single diseases or in combination with others, hypertension, musculoskeletal (MS) disease and hyperlipidaemia were the most prevalent multimorbidity patterns. Being multimorbid in general (OR 1.32, CI 1.01-1.70) and belonging to the Concordant (OR 1.45, CI 1.08-1.95) and Concordant and discordant (OR 1.31, CI 1.00-1.72) subgroups was associated with achievement of the HbA1c treatment target. Belonging to the Concordant and discordant subgroup was related to meeting the LDL treatment target (OR 1.31, CI 1.00-1.72). Conclusions: Multimorbidity, including cardiovascular risk and the musculoskeletal disease burden, was extremely prevalent among the T2D patients who consulted primary health care. Primary care clinicians should survey the possible co-existence of long-term diseases among T2D patients to help maintain adequate treatment of T2D.
MeSH term(s)	Cross-Sectional Studies ; Diabetes Mellitus, Type 2/epidemiology ; Diabetes Mellitus, Type 2/therapy ; Goals ; Humans ; Multimorbidity ; Primary Health Care
Language	English
Publishing date	2021-09-14
Publishing country	England
Document type	Journal Article
ISSN	1472-6963
ISSN (online)	1472-6963
DOI	10.1186/s12913-021-06989-x
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Article ; Online: Atopic Dermatitis Is Associated with Dermatitis Herpetiformis and Celiac Disease in Children.

Kauppi, Saana / Jokelainen, Jari / Timonen, Markku / Tasanen, Kaisa / Huilaja, Laura

The Journal of investigative dermatology

2020 Volume 141, Issue 1, Page(s) 191–193.e2

MeSH term(s)	Celiac Disease/complications ; Child ; Dermatitis Herpetiformis/diagnosis ; Dermatitis Herpetiformis/etiology ; Dermatitis, Atopic/diagnosis ; Dermatitis, Atopic/etiology ; Humans ; Skin/pathology
Language	English
Publishing date	2020-06-12
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	80136-7
ISSN	1523-1747 ; 0022-202X
ISSN (online)	1523-1747
ISSN	0022-202X
DOI	10.1016/j.jid.2020.05.091
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