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Pyrhonen K.,South Karelia District of Social and Health Services | Pyrhonen K.,University of Oulu | Hiltunen L.,University of Oulu | Kaila M.,University of Tampere | And 3 more authors.
Pediatric Allergy and Immunology | Year: 2011

The heredity of food allergies (FA) has not previously been addressed in a large unselected child population. Our target population comprised all children born from April 2001 to March 2006 resident in one province of South-East Finland (n c.6000).as identified from the national population register. In a questionnaire survey conducted in 2005-2006.data were obtained on allergic manifestations (FA symptoms.atopic rash.allergic asthma.hay fever/pollen allergy.or animal allergy) in the biologic parents of 3800 children (64% of the total). Concurrently with the survey but independently of it.results of specific immunoglobulin E antibodies (sIgE).skin prick tests (SPT).and open food challenges (OFC) in the offspring were collected from patient records throughout the province. Up to the age of 4yr.the incidences of any positive FA test.a positive SPT or sIgE for food items.and a positive OFC in these children were threefold higher if both parents reported having an allergic manifestation and twofold higher if either mother or father had such a manifestation when compared with children whose parents did not report any of these conditions. The estimated risk of any positive FA test increased by a factor of 1.3 (95% CI 1.2-1.4) for each additional allergic manifestation in the parents. Positive FA tests in the offspring were relatively strongly associated with the reports of allergic phenotypes and the number of these phenotypes in their biologic parents. © 2010 John Wiley & Sons A/S. Source

Pyrhonen K.,South Karelia District of Social and Health Services | Pyrhonen K.,University of Oulu | Laara E.,University of Oulu | Hiltunen L.,University of Oulu | And 4 more authors.
Journal of Epidemiology and Community Health | Year: 2012

Objective: To examine whether the season of birth or season of the early phase of gestation is associated with sensitisation to food allergens in children, with special reference to mothers' pollen exposure in spring. Design: A population-based cohort study linking information from a questionnaire survey to allergy tests performed on the target population and regional pollen counts. Population: Children born in 2001-6 who were resident in the province of South Karelia, Finland, at the time of the survey (N=5920). Main Outcome Measures: A positive result in any food allergy test or food-specific immunoglobulin E test (sIgE). Results: The cumulative incidence of a positive food allergy test up to the age of 4 years was highest among children born in October-November (10%) and lowest among those born in June-July (5%), and correspondingly highest among children who were in their 11th gestational week in April-May (11%), the season of high concentrations of birch and alder pollen, and lowest among those reaching that stage in December-January (6%). The amplitude of seasonal variation in any test, estimated as the relative ratio between the peak and trough of the smoothed incidence curve over the year, was 2.03 (95% CI 1.52 to 2.76). The amplitudes of positive sIgE were especially pronounced for milk (3.07; 95% CI 1.81 to 5.50) and egg (3.03; 95% CI 1.86 to 5.18). Conclusions: Children having their early gestational period in the pollen season for broad-leafed trees are more prone to sensitisation to food allergens than other children. Source

Pyrhonen K.,South Karelia District of Social and Health Services | Pyrhonen K.,University of Oulu | Laara E.,University of Oulu | Kaila M.,University of Tampere | And 3 more authors.
Scandinavian Journal of Public Health | Year: 2011

Background: Few epidemiological studies exist on food-associated symptoms and allergies in large unselected child populations. Aims: To describe the design, methods and participation rate of the South Karelian Allergy Research Project (SKARP), a population-based epidemiological study on food-associated symptoms and physician-diagnosed food allergies. Methods: The study population of 5,973 children born between 2001 and 2006 and resident in the province of South Karelia, Finland, was identified from the nationwide population register. The parents received a questionnaire to be returned at their child's annual visit to the child health clinic, where supplementary interviews were performed. Results of allergy tests (skin prick tests, immunoglobulin E antibodies and open food challenges) performed on participants and non-participants were collected from the relevant health care units in the area. Results: Participation rates in the questionnaire study were 54% (644/1,194) among the parents of neonates and 69% (3308/4,779) among those of the children aged 1 to 4 years. Cooperation with the child health clinics and mailing of a reminder questionnaire improved participation by 8 and 10 percentage points, respectively. The final participation rate seemed to be unaffected by whether the child had or had not been tested for suspected allergy. Conclusions: A reasonably good participation rate and almost complete coverage of allergy tests were achieved thanks to successful cooperation with the child health clinics and test laboratories. This baseline study forms a representative database to estimate the occurrence of food-associated symptoms, physician-diagnosed food allergies and allergy testing in the general population. © 2011 the Nordic Societies of Public Health. Source

Pyrhonen K.,South Karelia District of Social and Health Services | Pyrhonen K.,Lappeenranta University of Technology | Pyrhonen K.,University of Oulu | Nayha S.,University of Oulu | And 2 more authors.
Acta Paediatrica, International Journal of Paediatrics | Year: 2013

Aim: To provide evidence on the association between caesarean section and allergic manifestations in an unselected child population. Methods: Research focused on all children aged from one to 4 years (N = 4779), born between April 2001 and March 2005 and living in the province of South Karelia, Finland. They were identified from the nationwide population register. Questionnaire data on 3181 participants were individually merged with allergy test results (skin prick tests, IgE antibodies and open food challenges) from all patient records. Results: Compared with vaginal delivery, the adjusted relative incidence of positive allergy tests (with 95% confidence intervals, CI) in children born by caesarean section was 1.14 (0.79, 1.65) for food, 1.16 (0.66, 2.05) for animals, 0.94 (0.46, 1.92) for pollen and 1.19 (0.87, 1.63) for any allergens. The corresponding adjusted prevalence odds ratios (with 95% CI) of physician-diagnosed allergic manifestations were 1.15 (0.80, 1.63) for food allergy, 0.90 (0.47, 1.59) for pollen allergy or hay fever, 1.00 (0.75, 1.31) for atopic eczema, 0.96 (0.53, 1.65) for asthma and 1.08 (0.85, 1.38) for any allergic manifestation. Conclusion: Insufficient evidence was found in our population for any association between birth by caesarean section and allergic manifestations. Further evidence from unselected populations, with longer follow-up periods, is needed. © 2013 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd. Source

Korpela J.,Tekniikantie 14 | Elfvengren K.,Lappeenranta University of Technology | Kaarna T.,South Karelia District of Social and Health Services | Tepponen M.,South Karelia District of Social and Health Services | Tuominen M.,Tekniikantie 14
International Journal of Integrated Care | Year: 2012

Objective: To present a collaboration process for creating a roadmap for the implementation of a strategy for integrated health and social care. The developed collaboration process includes multiple phases and uses electronic group decision support system technology(GDSS). Method: A case study done in the South Karelia District of Social and Health Services in Finland during 2010-2011. An expert panel of 13 participants was used in the planning process of the strategy implementation. The participants were interviewed and observed during the case study. Results: As a practical result, a roadmap for integrated health and social care strategy implementation has been developed. The strategic roadmap includes detailed plans of several projects which are needed for successful integration strategy implementation. As an academic result, a collaboration process to create such a roadmap has been developed. Conclusions: The collaboration process and technology seem to suit the planning process well. The participants of the meetings were satisfied with the collaboration process and the GDSS technology. The strategic roadmap was accepted by the participants, which indicates satisfaction with the developed process. Source

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