Capital Region Of Finland Research Articles

The impact of COVID-19 on private healthcare service utilisation: time series analysis in the capital region of Finland during 2020–2022

BackgroundMost current studies on COVID-19 have focused on the first weeks or months of the pandemic or have addressed specific diseases. The long-term effects of the COVID-19 pandemic on healthcare services are insufficiently understood. We analysed the long-term effects of the COVID-19 pandemic on outpatient healthcare utilisation in the full spectrum of diseases in Uusimaa, the capital region of Finland.MethodsOur data included 632 466 individual patients between the ages of 18 and 65 and 6 521 394 visits to healthcare personnel from electronic health records. We fitted an autoregressive integrated moving average (ARIMA) model to pre-2020 data to predict the expected quantity of diagnoses for the period between 1 January 2020 and 16 June 2022. Expected and observed quantities of diagnoses were compared.ResultsThe overall quantity of diagnoses declined by one-fourth immediately following the onset of the pandemic and remained around 15% below predicted values for most of the pandemic. After the pandemic-related restrictions were lifted, the total diagnostic activity started to recover to pre-pandemic projection levels. However, this recovery has been mainly driven by upper respiratory system-related activity. The number of diagnoses for many diagnosis groups has remained below the predicted levels, even after the concurrent removal of mobility restrictions and increased coverage of vaccinations in this population.ConclusionsThe pandemic resulted in an overall reduction in outpatient healthcare utilisation which persisted for 30 months. While the overall diagnostic activity has eventually recovered to predicted levels, many classes of diagnoses display reduced levels in the study population over the follow-up period. Some diseases that may have long-lasting effects when left untreated seem to remain underdiagnosed, potentially increasing pressure on the healthcare system in the future.

Associations of adolescent academic performance, sports, disordered eating, and menstrual dysfunction

Abstract Background Regular menstruation is a crucial indicator of comprehensive well-being in adolescents. We aimed to assess risk factors associated with menstrual cycle dysfunction in a population-based cohort of high school students, focusing on academic performance, sports participation, and disordered eating. Methods In 2022, we recruited 1161 female first-year students from 21 diverse high schools in the capital region of Finland. They completed an online survey comprising questions about menstrual cycle, academic achievement, sports involvement, disordered eating and school burnout. Results Of 935 (81%) participants (mean age 16) not using hormonal preparations, 336 (37%) reported irregular menstruation. Adolescents with irregular menstruation showed higher middle school grade point average (GPA) (OR 1.4, 95% CI 1.1-1.8), lower body mass index (OR 2.2, 95% CI 1.3-3.5), and more disordered eating symptoms (OR 2.1, 95% CI 1.4-3.0) than adolescents with regular menstruation. While overall physical activity showed no significant correlation with irregular menstruation, casual exercisers with irregular menstruation exhibited both higher GPAs (OR 1.4, 95% CI 1.4-1.9) and more disordered eating symptoms (OR 2.6, 95% CI 1.6-4.1) than competitive athletes, whereas competitive athletes with irregular menstruation showed higher school burnout scores than casual exercisers but no disordered eating. Conclusions We recommend the use of screening tools to recognize disordered eating and school burnout among female high school students facing menstrual irregularities. Key messages • A third of adolescent females had irregular menstruation. Casual exercisers with irregular menstrual cycle were at risk of eating disorders and competitive athletes at risk of school burnout. • Screening of disordered eating and school burnout among adolescent females facing menstrual irregularities could be beneficial.

Urban residential clustering and mobility of ethnic groups: impact of fertility

We studied residential clustering and mobility of ethnic minorities using a theoretical framework based on null models of spatial distributions and movements of populations. Using microdata from population registers we compared the patterns of clustering amongst various socioethnic groups living in and around the capital region of Finland. The models enabled us to connect the factors influencing intraurban migration to the spatial patterns that have developed over time. The observed clustering seems to be a combined effect of fertility and the tendency to migrate locally. The models also highlight the importance of factors like proximity to the city centre, neighbourhood income levels, and similarity of socioeconomic profiles. While the demonstrated relationship between clustering, mobility, and fertility is based on a limited number of observations, it could serve as a motivation for future research in different urban settings. Overall, these insights are expected to contribute to our understanding of demographic dynamics in culturally diverse environments.

The impact of COVID-19 on healthcare booking and cancellation patterns: time series analysis of private healthcare service utilisation in Finland

BackgroundCOVID-19 has had wide-reaching effects on healthcare services beyond the direct treatment of the pandemic. Most current studies have reported changes in realised service usage, but the dynamics of how patients engage with healthcare services are less well understood. We analysed the effects of COVID-19 on healthcare bookings and cancellations for various service channels between January 2020 and July 2021.MethodsOur data includes 7.3 million bookings, 11.0 million available appointments, and 405.1 thousand cancellations by 900.6 thousand individual patients between the ages of 18 and 65 years. The data were collected from electronic health record data, including laboratory and imaging services as well as inpatient stays, between January 2017 and July 2021. The patients were Finnish private and occupational healthcare customers in the capital region of Finland. We fitted an autoregressive moving average (ARIMA) model on data between 2017 and 2019 to predict the expected numbers of bookings, available appointments, and cancellations, which were compared to observed time series data between 2020 and 2021.ResultsUtilisation of physical, in-person primary care physician appointments decreased by up to 50% during the first 18 months of the pandemic. At the same time, digital care channels experienced a rapid, multi-fold increase in service usage. Simultaneously, the number of bookings for laboratory and imaging services decreased by 50% below the pre-pandemic projections. The number of specialist and hospital service bookings remained at the predicted level during the study period. Cancellations for most health services increased sharply by up to three times the pre-COVID levels during the first weeks of the pandemic but returned to the pre-pandemic levels for the rest of the study period.ConclusionsThe reduction in in-person appointments and the increase in the utilisation of digital services was likely a contributing factor in the decrease of the utilisation of diagnostic and imaging services throughout the study period. Utilisation of specialist care and hospital services were not affected. Cancellations contributed to the changes in service utilisation only during the first weeks of the pandemic.

Balancing Differences through Highlighting the Common: Religious Education Teachers’ Perceptions of the Diversity of Islam in Islamic Religious Education in Finnish State Schools

Muslims are Finland’s largest and fastest-growing religious minority. In Finnish state schools, the number of pupils studying Islamic religious education (IRE) has almost doubled in a decade, and IRE has its own national curriculum, which is based on the general principles of Islam. Pupils are diverse in terms of their languages, cultures, ethnicities and in their religious and worldview backgrounds, religious diversity being reflected in the religious education curriculum content in which the diversity of Islam is addressed. In this study, we examine the diversity of Islam in IRE. The research results are based on interviews with IRE teachers (N = 17) working in comprehensive schools in the capital region of Finland, and we use data-driven content analysis to explore teachers’ perceptions. This study shows that IRE teachers use balancing pedagogical tools in order to deal with the diversity of Islam. According to the findings of our study, dealing with this diversity in religious education requires a dialogicity that both highlights and blurs differences related to diversity. Religion-related dialogue in IRE provides an arena for a balanced discussion about religious differences as well as what they have in common.

A voluntary-sector meeting place as a site for interpreting and ‘doing’ integration: a case of later-life Russian-speaking migrants

While a great deal of research has been conducted on implications of integrative policies targeted at migrants, later-life migrants and their relational and spatial negotiations and enactments of the policy-driven discourse of integration, and the dynamics under which it is interpreted remains understudied. Older migrants are presented as ‘special cases’ in the Finnish integration policy and are discussed mainly in relation to their social and health care needs. Integration is the model and aim for migrant settlements in Finland, however the aim to integrate possesses intrinsic value. Therefore, they need to make sense of what integration is for them in their everyday lives. This paper focuses on the interpretations and mundane enactments of ‘integration’ in a voluntary sector-organised meeting place for later-life Russian-speaking migrants in Finland. By comparing the views of different actors within the meeting place (steering group, organisers and attendees), the paper presents a nuanced understanding of the dynamics under which the later-life migrants negotiate their positions in the Finnish community of value, vis-à-vis the expectations of integration. The paper argues that ‘doing integration’ as a category of practice is an emergent feature in places where it is possible to negotiate integration as a lived experience. Drawing from participant observations, interviews, and applications and reports gathered in a meeting in the capital region of Finland, the paper foregrounds the lived and contested experiences of finding a sense of belonging in dialogue with the omnipresent discourse of integration. The paper concludes that the interpretations of the policy-driven discourse of integration are context-bound and negotiated in a set of relationships.

Statistical approach to identify variables predicting sulphide clay occurrence in southern Finland

Acid sulphate soil and sulphide-bearing sediments cause various challenges in construction projects and land use planning, as well as harmful environmental effects. Fine-grained sulphide sediments were mainly formed in coastal areas during the Litorina Sea water phase at approximately 7000 BP in the capital region of Finland, but not all these sediments contain sulphide clay. In this study, environmental and material property variables related to the depositional conditions of sulphide clay were selected for statistical analyses to find their association with the occurrence of sulphide. The datasets consisted of sulphide investigations by the City of Espoo, the City of Helsinki, and the Geological Survey of Finland. Statistically significant associations were found in the study area between the occurrence of sulphide and enumerative variables (i.e., sediment organic content, total clay depth, topographic class in the Litorina Sea phase, and water depth) in the Litorina Sea phase. Locations where sulphide clay is especially likely to occur consist of organic-rich (≥ 2%) thick clay (≥ 15 m) deposits in a topographically narrow depression with deep Litorina water (≥ 30 m), or where there is a moderate depth clay (3–5 m) in a local depression with shallow Litorina water (10–20 m). The best individual predictor for sulphide clay occurrence in the study area was found to be the sediment organic content, and, together with sediment water content, these variables very accurately predicted the occurrence of sulphide clay. In addition, clay depth is a very good predictor and, together with the topographic class narrow depression and the Litorina water depth or current elevation, can be used to predict sulphide occurrence.

Modelling exposure between populations using networks of mobility during COVID-19

The use of mobile phone call detail records and device location data for the calling patterns, movements, and social contacts of individuals, have proven to be valuable for devising models and understanding of their mobility and behaviour patterns. In this study we investigate weighted exposure networks of human daily activities in the capital region of Finland as a proxy for contacts between postal code areas during the pre-pandemic year 2019 and pandemic years 2020, 2021 and early 2022. We investigate the suitability of gravity and radiation type models for reconstructing the exposure networks based on geo-spatial and population mobility information. For this we use a mobile phone dataset of aggregated daily visits from a postal code area to cellphone grid locations, and treat it as a bipartite network to create weighted one mode projections using a weighted co-occurrence function. We fit a classical gravity model and a radiation model to the averaged weekly and yearly projection networks with geo-spatial and socioeconomic variables of the postal code areas and their populations. We also consider an extended gravity type model comprising of additional postal area information such as distance via public transportation and population density. The results show that the co-occurrence of human activities, or exposure, between postal code areas follows both the gravity and radiation type interactions, once fitted to the empirical network. The effects of the pandemic beginning in 2020 can be observed as a decrease of the overall activity as well as of the exposure of the projected networks. These effects can also be observed in the network structure as changes towards lower clustering and higher assortativity. Evaluating the parameters of the fitted models over time shows on average a shift towards a higher exposure of areas in closer proximity as well as a higher exposure towards areas with larger population. In general, the results show that the postal code level networks changed to be more proximity weighted after the pandemic began, following the government imposed non-pharmaceutical interventions, with differences based on the geo-spatial and socioeconomic structure of the areas.

Cross-sectional study of the proportion of antibiotic use during childbirth in full-term deliveries in Finland

PurposeIn developed countries, data on the frequency of antibiotics given to mothers during childbirth are limited beyond the overall effect of all various prophylactic indications. Also, data on the impact of such antibiotics to the well-being of term babies are scarce. We aimed to characterize the frequency of antibiotic use during childbirth of term pregnancy. Secondly, we assessed whether the use of antibiotics was associated with any symptoms in infants.MethodsThis was a cross-sectional study of 1019 term deliveries of women participating in the prospective Health and Early Life Microbiota (HELMi) birth cohort study between March 2016 and March 2018 in the capital region of Finland. The data on antibiotic use were collected from the hospital records.ResultsIn total, 37% of the mothers received antibiotics during childbirth and 100% in Caesarean Sects. (17% of the deliveries). Less than 5% of antibiotics were non-prophylactic. In vaginal deliveries, the most common indication (18%) was prophylaxis for Group B Streptococcus. The most frequently used antibiotics were cefuroxime (22%) and benzylpenicillin (15%), and 56% received only one dose. In infants exposed to antibiotics during delivery, defecation frequency was higher during the first months (p-value < 0.0001- 0.0145), and weight gain was higher at the age of three months (p-value 0.0371).ConclusionMore than every third new-born in a developed country is exposed to antibiotics during birth. Our findings support the hypothesis that maternal antibiotics given during birth have an impact on the well-being of the infants. These findings should inform current policies for prophylactic antibiotics in childbirth.

Enablers and barriers associated with high MMR uptake among the Finnish Somali population

Abstract Introduction In Finland, the Somali-speaking community is the fourth largest migrant group after Russian, Estonian, and Arabic-speaking communities. Finland is home to 21,000 Somali-speaking individuals, with around 70 % of them living in the capital region. Even though vaccine uptake in most ethnic minority communities is usually lower, MMR coverage in Finnish Somali children is partly higher than that of ethnic Finns. Methods We interviewed 30 Somali-origin mothers living in the capital region of Finland in terms of childhood vaccination acceptance, and in specific, issues affecting their children's MMR vaccine uptake. All interviews were conducted by a Somali researcher either in Somali or Finnish language. The interviews were recorded, transcribed, translated, and analysed using thematic analysis of the transcripts. To understand the enablers presented by the health care system in Finland, 10-15 public health nurses working in maternal and child health clinics in the capital region will be interviewed. Results and discussion Preliminary results show that trust in the health care system is the main enabler of high MMR vaccine coverage in the Somali population - even when mother's knowledge of the vaccine was very limited. In terms of information sources, mothers indicated that they ask, and trust maternal and child health clinics in all vaccine-related information- often more than any other source, including the internet. Conclusions This study enhances our understanding of system level enablers in the Finnish Somali community regarding MMR vaccination. The results of this study are applicable to improve vaccine uptake in other underserved minority communities throughout Europe.

Mapping Digital Discourses of the Capital Region of Finland

This article discusses the three Finnish city names Helsinki, Espoo, and Vantaa, and the urban discourses that surround them. The study reveals patterns of socio-spatial differentiation by examining what meanings people attach to these capital region cities and investigating how these meanings are expressed in online discourses. Using the methodological approach of corpus-assisted onomastics (CAO), this study incorporates onomastics, geographical information systems (GIS), and corpus linguistics. This interdisciplinary research also examines how corpus-assisted discourse studies (CADS) and GIS can be combined to reveal and visualize the contextual information and discursive patterns of toponyms. For this investigation, a data set of 2.7 billion words was collected from the Suomi24 Corpus, one of the biggest discussion fora in Finland. The use of social media corpus as a data source increases the authenticity of this research, as the data was not collected specifically for this study. The analysis reveals that the most frequent digital discourses about the cities refer to places and directions, housing, and mobility. The occurrences differ quantitatively and qualitatively between each city. This paper paves the way for future onomastic studies to research actual name usage using this new methodology. Knowledge gained from such research may not only enrich the field of onomastics, but also facilitate more socially sustainable urban planning.

The Role of Atmosphere in Negotiations of Groupness: A Study of a Meeting Place for Older Russian-speaking Migrants

ABSTRACT While existing literature on third-sector support for ageing migrants shows that social clubs can be a vital source of social support, what remains unclear is how these positive outcomes are attained on an interactional level. Drawing on fieldwork conducted over the course of one year in a meeting place for older Russian-speaking migrants in the capital region of Finland, this paper adopts a processual approach to examine how a sense of groupness is negotiated in the meeting place. The attendees of the meeting place comprise of different nationalities and backgrounds, who mainly share age and Russian language. This heterogeneity creates a situation where the attendees, together with the organisers, negotiate a sense of groupness with the category of ‘Russian-speaking’. I argue that such a sense of groupness is reached by drawing from shared traits of culturality, while excluding aspects that could cause conflicts. The paper further contributes to the literature on groupness by analysing what role atmosphere plays in attaining a sense of groupness, and argues that the notion of atmosphere is important to take into consideration when thinking how different places can support ageing and wellbeing.

Characterization of sedimentary depositional environments for land use and urban planning in Espoo, Finland

The capital region of Finland is growing rapidly and into areas with challenging con­struction conditions such as deep fine-grained sediments. In the coastal city of Espoo, present land use is mainly focused in the southern and central parts, which were submerged by the Baltic Sea during the early and mid-Holocene. These areas have experienced saline and brackish water phases during the history of the Baltic Sea Basin. The deposition environments of the presently studied onshore areas are an analogue for the present day offshore Baltic Sea sedimentation settings for fine-grained material. The results from Baltic Sea studies have demonstrated that the seabed topography has a significant role in the deposition of sediments and their properties. In this study, paleotopographic models were created for the ancient Baltic Sea Basin in the Espoo area 1) after deglaciation and 2) during the Litorina transgression and classified into bathymetric (terrain) zones and structures. Topographic classification was combined with the water depth of the Litorina stage, the thickness of fine-grained deposits and wind fetch to establish the overall characteristics of sedimentary environments in the coastal area. Fine-grained sediments can be found mainly in depressions that are classified here as broad, narrow or local. The study found the most challenging environments for construction purposes in sheltered narrow depressions that contain thick layers of fine-grained sediments deposited during the Litorina transgression. These are mainly located in the southern and central parts of Espoo. Minor deep canyons were also found in the northern parts of Espoo. This study provides new prior knowledge for urban planning and construction design in Espoo. The methodology could be applied to other Baltic Sea coastal cities and areas with fine-grained sediments.

Mental health problems in youth and later receipt of social assistance: do parental resources matter?

ABSTRACT In this article, we study the association between mental health problems in adolescence and early adulthood and later receipt of social assistance in the capital region of Finland. Using register data and following a cohort of adolescents to their early adulthood, we also examine whether the strength of this association varies according to household income during adolescence. We find that mental health problems from the ages of 16–17 and thereafter were associated with the receipt of social assistance at age 24, and more strongly among those with lower household income during their adolescence. Importantly, the same disorder groups emerged as the most important ones in predicting the use of social assistance across income quintiles. In this sense, we find similarity regardless of parental resources. This evidence is important for better understanding the mechanisms between circumstances during adolescence and later socioeconomic outcomes, including benefit use, yet the underlying factors should be studied further.

City as a Growth Platform: Responses of the Cities of Helsinki Metropolitan Area to Global Digital Economy

The aim of this article is to shed light on how ongoing structural change towards the global digital economy condition urban economic development. Discussion starts with a brief reference to the growth machine thesis and its emphasis on the interests of local land and real estate owners. This theory serves as a contrasting point for the second element of our framework, the platform economy, which brings digital platforms and the transnational capitalist class into the picture. The transition from the urban growth machines of the industrial age to the digital growth platforms of the information age imply a radical change in the context of urban economic development. On this basis, we discuss cities’ need to adjust their growth strategies to the conditions of the emerging platform economy. Our illustrative case is the capital region of Finland. We interviewed officials and experts who hold key positions in the design of economic development policy in the three largest cities of this area. The empirical results show that the platform economy is rather vaguely conceptualized, and its challenges are ambiguously addressed. Cities have, however, started to adopt platform and ecosystem thinking in their strategies and established urban innovation platforms, talent and start-up attraction programs, and open data initiatives that reflect the gradual adoption of platform logic in urban economic development.

Molecular detection and phylogenetic analysis of Borrelia miyamotoi strains from ticks collected in the capital region of Finland

Borrelia miyamotoi is an emerging pathogen that shares high similarity with relapsing fever Borrelia, but has an atypical clinical presentation. Within the framework of tick-borne disease surveillance in Finland, human serum samples suspected for tick-borne encephalitis (n=974) and questing ticks (n=739) were collected from the capital region in Finland to determine the prevalence of B. miyamotoi. All tested human samples were negative and 5 (0.68 %) Ixodes ricinus ticks were positive for B. miyamotoi. Partial sequencing of the flagellin (flaB) gene of 3 positive samples and 27 B. miyamotoi-positive tick samples obtained from previous studies across Finland were amplified, sequenced, and included in the phylogenetic analysis.The phylogenetic tree revealed that most B. miyamotoi strains isolated from ticks in Finland share high similarity with other European strains, including strains related to human infection. Possible disease transmission may occur during exposure to tick bites. A single strain collected from an I. persulcatus tick in Pajujärvi grouped with an outlier of B. miyamotoi strains isolated from Russia and Far East Asian countries. Further studies should investigate the pathogen’s role in human infection in Finland.Another important finding is the occurrence of I. persulcatus ticks (8%) collected by crowdsourcing from the coastal southern part of Finland. This suggests a regular introduction and a possible wide expansion of this tick species in the country. This could be associated with transmission of new pathogens.

- From inclusive practices to personal strategies

The main purpose of this doctoral thesis is to co-design and examine digitally supported inclusive practices in science learning. Inclusive practices aim to provide quality education and quality learning opportunities for all students. Inclusive practices are characterised by process-oriented development that takes into account a student’s personal abilities and needs concerning both knowledge and competencies as well as the classroom context. Since there are very few research-based models for inclusive practices, the longitudinal educational design research (EDR) project aimed to co-design digitally supported inclusive practices at the grassroots level with researchers, teachers and students. The EDR project took place during two years in a medium-sized primary school in the capital region of Finland, where inclusive education was employed as part of teacher collaboration. The participating class (44 students; 10 students with learning difficulties [LD]) had two primary teachers and one special education teacher, the defender of this thesis. The EDR consisted of four macro-cycles, which intended to increase understanding of co-designing and implementing inclusive practices in science learning. The first macro-cycle focused on exploring possibilities for using smartphone technology in a water project. In the second macro-cycle, students used the developed personal solutions and designed collaborative solutions while studying the following science-related themes: forest, human, motions and forces, and space. In the third macro-cycle, students studied Europe and Asia, plants, human and states of matter. The participants developed further both personal solutions and collaborative solutions. Finally, the fourth macro-cycle focused on one science theme, electricity, where solutions were designed for collaborative learning and especially for active participation.&#x0D; The thesis is comprised of four publications that form a holistic picture of the possibilities of digital technology when considering the adaptation, use and benefits for the student both at the personal and group level. Publication I reports the results of the first macro-cycle of the EDR. Publication II discusses the benefits of using a smartphone in science learning from a student’s personal learning perspective, reflecting all four macro-cycles. Publication III describes the EDR project’s final macro-cycle, electricity project, in which students utilised personal strategies that were supported by the teacher through respectful grouping, differentiated learning tasks and a reflective discussion after lessons. Finally, Publication IV evaluates the development and implementation of the inclusive practises throughout the EDR project from the perspective of the LD students. The data was collected through video recordings of ideating sessions, questionnaires, students’ notes from the e-learning environment, the teacher’s memo and interviews; it was analysed via quantitative analysis of frequencies, qualitative content analysis and co-occurrence network analysis.&#x0D; As its theoretical contribution, this thesis weaves together the two frameworks of inclusive practices in science learning. First, the digitally supported inclusive science learning supports a student’s personal learning through the differentiation of content, process and product through the use of multimodality. The teacher employs a student’s personal strategies when preparing a collaborative learning project, especially at the levels of process and product. In light of the objective of inclusion, the teacher’s support during the process should aim at giving intensified support and structured guidance in collaborative activities where students require various competences. Second, such a long-term, reflective, co-designing project supports both the use of digital technology and the development of inclusive practices. LD students benefit from a process-oriented, comprehensive, structured and reflective use of technology in their learning. Differences between students’ digital competencies bring a new element to the classroom alongside academic knowledge, both of which affirm LD students’ social status in the classroom. The thesis emphasises that a long-term co-designing project can both develop teaching practices and engage students to develop their personal learning, and hence, promote inclusive education at the grassroots level.

FinDonor 10 000 study: a cohort to identify iron depletion and factors affecting it in Finnish blood donors.

Background and ObjectivesThere is increasing evidence that frequent blood donation depletes the iron stores of some blood donors. The FinDonor 10 000 study was set up to study iron status and factors affecting iron stores in Finnish blood donors. In Finland, iron supplementation for at‐risk groups has been in place since the 1980s.Material and MethodsA total of 2584 blood donors (N = 8003 samples) were recruited into the study alongside standard donation at three donation sites in the capital region of Finland between 5/2015 and 12/2017. All participants were asked to fill out a questionnaire about their health and lifestyle. Blood samples were collected from the sample pouch of whole blood collection set, kept in cool temperature and processed centrally. Whole blood count, CRP, ferritin and sTFR were measured from the samples, and DNA was isolated for GWAS studies.ResultsParticipant demographics, albeit in general similar to the general blood donor population in Finland, indicated some bias towards older and more frequent donors. Participation in the study increased median donation frequency of the donors. Analysis of the effect of time lag from the sampling to the analysis and the time of day when sample was drawn revealed small but significant time‐dependent changes.ConclusionThe FinDonor cohort now provides us with tools to identify potential donor groups at increased risk of iron deficiency and factors explaining this risk. The increase in donation frequency during the study suggests that scientific projects can be used to increase the commitment of blood donors.

Cohort profile: Finnish Health and Early Life Microbiota (HELMi) longitudinal birth cohort.

PurposeHELMi (Health and Early Life Microbiota) is a longitudinal, prospective general population birth cohort, set up to identify environmental, lifestyle and genetic factors that modify the intestinal microbiota development in the first years of life and their relation to child health and well-being.ParticipantsThe HELMi cohort consists of 1055 healthy term infants born in 2016–2018 mainly at the capital region of Finland and their parents. The intestinal microbiota development of the infants is characterised based on nine, strategically selected, faecal samples and connected to extensive online questionnaire-collected metadata at weekly to monthly intervals focusing on the diet, other exposures and family’s lifestyle as well as the health and growth of the child. Motor and cognitive developmental screening takes place at 18 months. Infant’s DNA sample, mother’s breast milk sample and both parent’s spot faecal samples have been collected.Findings to dateThe mean age of the mothers was 32.8 (SD 4.1) and fathers/coparents 34.8 (5.3) years at the time of enrolment. Seventeen percentage (n=180) of the infants were born by caesarean section. Just under half (49%) were firstborns; 50.7% were males. At 3 months of age, 86% of the babies were exclusively breastfed and 2% exclusively formula-fed.Future plansThe current follow-up from pregnancy to first 24 months will be completed in March 2020, totalling to over 10 000 biological samples and over 50 000 questionnaire entries. The results are expected to identify environmental and host factors that affect early gut microbiota development and health, and hence give indications of how to prevent or reverse microbiota perturbations in infancy. This prospective cohort will be followed up further to identify how the early microbiota relates to later health outcomes, especially weight gain, infections and allergic and other chronic diseases.Trial registration number NCT03996304; Pre-results.

Students negotiating the borders between general and special education classes: an ethnographic and participatory research study

ABSTRACTAlthough Finnish basic education is based on inclusion, 37% of students receiving special support still study in either separate schools or separate classes in comprehensive schools. In this study we explore how policies of inclusion are implemented in a school with separated special educational needs (SEN) and general education (GE) classes. More specifically we conducted a two-year ethnographic study focusing particularly on exclusion and the sense of belonging in a lower secondary school (students aged 13–16) in the capital region of Finland. During the fieldwork, several students attending the SEN-class expressed an interest in changing from the SEN-class to a GE-class, or in breaking the borders between SEN and GE classes in other ways. As part of the negotiations with the school, students who criticised the GE- and SEN-class division were offered an opportunity to transfer to GE-classes but in the end, all of them wanted to stay in the SEN-class. In this investigation, we focus on the students’ reasoning and the teachers’ reactions when students negotiate the borders between SEN and GE-classes. In this study we found a clash between integration and inclusive thinking.