Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019
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Large-Scale Gene-Centric Meta-Analysis across 39 Studies Identifies Type 2 Diabetes Loci
To identify genetic factors contributing to type 2 diabetes (T2D), we performed large-scale meta-analyses by using a custom ∼50,000 SNP genotyping array (the ITMAT-Broad-CARe array) with ∼2000 candidate genes in 39 multiethnic population-based studies, case-control studies, and clinical trials totaling 17,418 cases and 70,298 controls. First, meta-analysis of 25 studies comprising 14,073 cases and 57,489 controls of European descent confirmed eight established T2D loci at genome-wide significance. In silico follow-up analysis of putative association signals found in independent genome-wide association studies (including 8,130 cases and 38,987 controls) performed by the DIAGRAM consortium id…
Hostility, unemployment and health status: testing three theoretical models.
This study examined three theoretical models of hostility, health and life context. According to the psychosocial vulnerability hypothesis, there is an interaction between hostility and adverse conditions. The increased health risk in hostile individuals is assumed to stem from their lower ability to benefit from existing psychosocial resources. The second hypothesis, called here the social context model, considers adverse conditions as an antecedent of both hostility and health problems. The third model states that hostility is a predictor of being selected to adverse conditions involving risk to health (the selection hypothesis). The results from a survey of a population-based random samp…
Collective stress and coping in the context of organizational culture
We examined from a cultural perspective how well-being was collectively defined, what were the sources of collective stress, and what kind of collective coping mechanisms were used to alleviate such stress in three divisions of a multinational company. In the first phase of the study we collected data on organizational culture by using individual thematic interviews ( N = 63). Applying the grounded theory methodology and an inductive analysis, specific cultures describing the divisions were identified. In terms of co-operation we found the following fundamental cultural recipes: joint focused efforts on money-making, despite the awareness of the common goals employees interested only in ful…
The burden of mental disorders, substance use disorders and self-harm among young people in Europe, 1990–2019: Findings from the Global Burden of Disease Study 2019
Artículo escrito por un elevado número de autores, solo se referencian el que aparece en primer lugar, el nombre del grupo de colaboración, si le hubiere, y los autores pertenecientes a la UAM
Separating the Mechanism-Based and Off-Target Actions of Cholesteryl Ester Transfer Protein Inhibitors With CETP Gene Polymorphisms
Background— Cholesteryl ester transfer protein (CETP) inhibitors raise high-density lipoprotein (HDL) cholesterol, but torcetrapib, the first-in-class inhibitor tested in a large outcome trial, caused an unexpected blood pressure elevation and increased cardiovascular events. Whether the hypertensive effect resulted from CETP inhibition or an off-target action of torcetrapib has been debated. We hypothesized that common single-nucleotide polymorphisms in the CETP gene could help distinguish mechanism-based from off-target actions of CETP inhibitors to inform on the validity of CETP as a therapeutic target. Methods and Results— We compared the effect of CETP single-nucleotide polymorphisms …
Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
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Sense of coherence as a mediator between hostility and health
Abstract Objective: We proposed and tested a model in which low sense of coherence (SOC) was hypothesized to underlie the association between hostility and health problems. Methods: Structural equation modeling was based on cross-lagged 7-year follow-up data, relating to five measurement points in 433 female municipal employees. Results: The mediated model fitted well with the data. After adjustment for baseline characteristics, hostility was associated with increased risk of health problems, as indicated by records of sickness absences and poor self-rated health. Incorporating SOC into the model attenuated this association by 33–50%, depending on the indicator of health. The mediated effec…
Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
Background Rigorous analysis of levels and trends in exposure to leading risk factors and quantification of their effect on human health are important to identify where public health is making progress and in which cases current efforts are inadequate. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a standardised and comprehensive assessment of the magnitude of risk factor exposure, relative risk, and attributable burden of disease. Methods GBD 2019 estimated attributable mortality, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs) for 87 risk factors and combinations of risk factors, at the…
Childhood Environmental and Genetic Predictors of Adulthood Obesity: The Cardiovascular Risk in Young Finns Study
Obesity from childhood to adulthood is associated with adverse health later in life. Increased youth BMI is a risk factor for later obesity, but it is unknown whether identification of other risk factors, including recently discovered genetic markers, would help to identify children at risk of developing adult obesity.Our objective was to examine the childhood environmental and genetic predictors of adult obesity.We followed 2119 individuals of the Cardiovascular Risk in Young Finns Study for up to 27 yr since baseline (1980, age 3-18 yr).We evaluated adult obesity [body mass index (BMI) ≥ 30 kg/m(2)].The independent predictors (P0.05) of adult obesity included childhood BMI, C-reactive pro…
The Role of Work Group in Individual Sickness Absence Behavior
The purpose of our two-year follow-up study was to examine the effect of the social components of the work group, such as group absence norms and cohesion, on sickness absence behavior among individuals with varying attitudes toward work attendance. The social components were measured using a questionnaire survey, and data on sickness absence behavior were collected from the employers' records. The study population consisted of 19,306 Finnish municipal employees working in 1,847 groups (78% women). Multilevel Poisson regression modeling was applied. The direct effects of work group characteristics on sickness absence were mostly insignificant. In contrast, both of the social components of …
Burden of non-communicable diseases among adolescents aged 10-24 years in the EU, 1990-2019: a systematic analysis of the Global Burden of Diseases Study 2019
Background: Disability and mortality burden of non-communicable diseases (NCDs) have risen worldwide; however, the NCD burden among adolescents remains poorly described in the EU. Methods: Estimates were retrieved from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Causes of NCDs were analysed at three different levels of the GBD 2019 hierarchy, for which mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) were extracted. Estimates, with the 95% uncertainty intervals (UI), were retrieved for EU Member States from 1990 to 2019, three age subgroups (10–14 years, 15–19 years, and 20–…
Organizational justice at school and its associations with pupils' psychosocial school environment, health, and wellbeing.
It has been shown that the psychosocial environment perceived by school staff is associated with children's academic performance and wellbeing. In this study we examined the associations between organizational justice (procedural and relational justice) as reported by school staff and pupils' perceptions of their school environment, health problems, academic performance, and absenteeism. We combined data from two surveys: for the staff (the Finnish Public Sector Study, n = 1946) and pupils (the Finnish school health promotion survey, n = 11,781 boys and 12,842 girls) of 136 secondary schools, collected during 2004-2005. Multilevel cumulative logistic regression analyses showed that after ad…
Life-time risk factors and progression of carotid atherosclerosis in young adults: the Cardiovascular Risk in Young Finns study.
Aims The aim of this study is to evaluate whether childhood risk factors are associated with a 6-year change in carotid intima-media thickness (IMT) in young adulthood independent of the current risk factors. Methods and results The Cardiovascular Risk in Young Finns cohort consisted of 1809 subjects who were followed-up for 27 years since baseline (1980, age 3–18 years) and having carotid IMT measured both in 2001 and 2007. Cardiovascular risk factors were assessed repeatedly since childhood. A genotype risk score was calculated using 17 newly identified genetic variants associating with cardiovascular morbidity. The number of childhood risk factors (high LDL-cholesterol, low HDL-cholester…
Contribution of parental and school personnel smoking to health risk behaviours among Finnish adolescents.
Abstract Background This study compared parental smoking with school personnel smoking in relation to adolescents' smoking behaviours, alcohol use, and illicit drug use. Methods A cross-sectional survey for 24,379 adolescents was linked to a survey for 1946 school employees in 136 Finnish schools in 2004-2005. Surveys included smoking prevalence reported by school staff, adolescents' reports of school staff and parental smoking, adolescents' own smoking behaviours, alcohol use, and illicit drug use. Multilevel analyses were adjusted for individual and school-level confounding factors. Results Parental smoking was associated with all health risk behaviours among both sexes (risk range 1.39 t…
Role clarity, fairness, and organizational climate as predictors of sickness absence: a prospective study in the private sector.
Aims: The majority of the research on the effects of the psychosocial work environment on sickness absenteeism has focused on components of job strain and social support among public sector employees without stratification by socioeconomic status. The authors examined less-studied work-related psychosocial predictors of sickness absence in the private sector by socioeconomic status. Methods: Questionnaire data on psychosocial factors at work were used to predict the rates of recorded short (1 - 3 days), long (4 - 21 days), and very long (over 21 days) sickness absences among 3,850 white- and blue-collar male and female employees in a large-scale enterprise. Multivariate Poisson regression …
The effects of using participatory working time scheduling software on working hour characteristics and wellbeing : a quasi-experimental study of irregular shift work
Background: Studies in the health care sector indicate that good work time control is associated with better perceived wellbeing but also with non-ergonomic work schedules, such as compressed work schedules. Participatory working time scheduling is a collaborative approach to scheduling shift work. Currently, there is a lack of information on whether working hour characteristics and employees' wellbeing in irregular shift work change after implementing participatory working time scheduling. Objective: To investigate the effects of using digital participatory working time scheduling software on working hour characteristics and well-being among Finnish hospital employees. Participants and met…
Mental health and hostility as predictors of temporary employment: Evidence from two prospective studies
We used two studies to examine whether mental health and hostility predicted temporary employment. Study 1 involved a cohort of 970 Finnish hospital employees (102 men, 868 women) who had temporary job contracts at baseline. After adjustment for demographics, organisational tenure and part-time work status, doctor-diagnosed psychiatric disorder predicted continuing in temporary employment instead of receiving a permanent job by the end of the 2-year follow-up. A higher level of hostility was also associated with temporary employment, but only among employees in low socioeconomic positions. In Study 2, anxiety and aggressive behaviour were measured in a cohort of 226 Finnish school children …
Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020
Background: The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. Methods: For this analysis, we constructed burden-weighted dose-response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and …
Estimates, trends, and drivers of the global burden of type 2 diabetes attributable to PM2·5 air pollution, 1990–2019: an analysis of data from the Global Burden of Disease Study 2019
Background: Experimental and epidemiological studies indicate an association between exposure to particulate matter (PM) air pollution and increased risk of type 2 diabetes. In view of the high and increasing prevalence of diabetes, we aimed to quantify the burden of type 2 diabetes attributable to PM2·5 originating from ambient and household air pollution.Methods: We systematically compiled all relevant cohort and case-control studies assessing the effect of exposure to household and ambient fine particulate matter (PM2·5) air pollution on type 2 diabetes incidence and mortality. We derived an exposure–response curve from the extracted relative risk estimates using the MR-BRT (meta-regress…
Factors associated with innovative climate: what is the role of stress?
We explored the role of occupational stress as a potential determinant of innovative climate by using samples of employees from health care organizations and from enterprises in the metal and retail industries (total N=1767). Factor analyses of the responses to a questionnaire suggested that stress represents a distinguishable element independent of other correlates of innovative climate, including, for example, goal clarity, sufficiency of feedback and communication. In multiple regression analyses, high stress was associated with poor innovative climate but did not moderate the effects of other correlates on innovativeness. The results were reproduced across different samples and differen…
Associations of overweight and metabolic health with successful aging: 32-year follow-up of the Helsinki Businessmen Study
Background & aims: Prognostic significance of metabolically healthy overweight and obesity (MHO) is under debate. However the relationship between MHO and health-related quality of life (HRQoL) is less studied. We compared successful aging (longevity plus HRQoL) in men with MHO, metabolically healthy normal weight (MHN) and metabolically unhealthy overweight and obesity (MUO). Methods: In the Helsinki Businessmen Study longitudinal cohort, consisting of men born 1919 to 1934. In 1985/86, overweight (BMI >= 25 kg/m(2)) and metabolic health were determined in 1309 men (median age 60 years). HRQoL was assessed using RAND-36/SF-36 in 2000 and 2007, and all-cause mortality retrieved from registe…
Metabolic mediators of the effects of body-mass index, overweight, and obesity on coronary heart disease and stroke: a pooled analysis of 97 prospective cohorts with 1.8 million participants.
Summary Background Body-mass index (BMI) and diabetes have increased worldwide, whereas global average blood pressure and cholesterol have decreased or remained unchanged in the past three decades. We quantified how much of the effects of BMI on coronary heart disease and stroke are mediated through blood pressure, cholesterol, and glucose, and how much is independent of these factors. Methods We pooled data from 97 prospective cohort studies that collectively enrolled 1·8 million participants between 1948 and 2005, and that included 57 161 coronary heart disease and 31 093 stroke events. For each cohort we excluded participants who were younger than 18 years, had a BMI of lower than 20 kg/…
Organizational justice, sickness absence and employee age
Purpose – The aim of this paper is to study age-related differences in how perceptions of two forms of organizational justice, i.e. procedural and interactional justice, are related to short (i.e. non-certified) spells and long (i.e. medically certified) spells of sickness absence. Design/methodology/approach – The authors conducted a study on a large sample of Finnish public sector employees (n=37,324), in which they matched employees' 2004 survey data with their records-based sick absences in 2005 and 2006. Findings – The results suggest that age moderates the association between perceptions of procedural justice and long sickness absences after controlling for gender, tenure, occupationa…
Sense of coherence and health: evidence from two cross-lagged longitudinal samples
We explored the stability of sense of coherence (SOC) and the relationship between SOC and health in two cross-lagged longitudinal samples by using structural equation modeling. In Study 1, comprising 577 municipal male and female employees, SOC was found to be stable in both sexes. In women, SOC significantly predicted sickness absences in the 4-year follow-up period. A low SOC, but not a high SOC, was associated with health prospects. Surprisingly, SOC did not influence sickness absences among men. Study 2 further tested the relationship between SOC and health in 320 male technical designers. Although SOC was cross-sectionally associated with psychological and somatic health complaints, i…
Genetic associations at 53 loci highlight cell types and biological pathways relevant for kidney function
Reduced glomerular filtration rate defines chronic kidney disease and is associated with cardiovascular and all-cause mortality. We conducted a meta-analysis of genome-wide association studies for estimated glomerular filtration rate (eGFR), combining data across 133,413 individuals with replication in up to 42,166 individuals. We identify 24 new and confirm 29 previously identified loci. Of these 53 loci, 19 associate with eGFR among individuals with diabetes. Using bioinformatics, we show that identified genes at eGFR loci are enriched for expression in kidney tissues and in pathways relevant for kidney development and transmembrane transporter activity, kidney structure, and regulation o…
Personal need for structure and occupational strain: An investigation of structural models and interaction with job complexity
We explored the relation between personal need for structure (PNS), as a global construct and as divided into two components, and occupational strain. Analyses of questionnaire data from two independent samples of Finnish social and health care personnel (n = 3015 and n = 1840) suggest that a high personal desire for structure (DS-component) decreases the risk of psychological strain symptoms, whereas a personal tendency to express negative reactions when one is confronted with a lack of structure (RLS-component) increases this risk. The moderated effect of job context was then tested in a third sample of social and health care personnel (n = 734). The elevated risk of strain in high-RLS em…
Sense of coherence and work characteristics: A cross-lagged structural equation model among managers
This study investigated the dominance of predictive relationships between Sense of Coherence (SOC) and work characteristics (organizational climate and job control) in cross-lagged longitudinal data with two measurement points and a time lag of 3 years. The sample consisted of 615 (587 men and 28 women) managers, aged between 27 and 64 years. The cross-lagged longitudinal analysis was done by the use of Structural Equation Modelling (SEM) within the framework by LISREL. The results of the chi-square difference tests indicated that the model where SOC at Time 1 predicted work characteristics at Time 2 better accounted for the data than the competitive models. However, the only significant pa…
Staff reports of psychosocial climate at school and adolescents' health, truancy and health education in Finland.
Background: Psychosocial climate at school reported by school personnel may be related to pupils’ reports of being heard at school, depression, physical and psychological symptoms, truancy and received health education. Methods: Cross-sectional study combining data from two independent surveys conducted between 2004 and 2005 in 136 public schools in Finland. The pupil sample comprised 11 583 boys and 12 706 girls from the eighth and ninth grades of lower secondary school and first and second grades of upper secondary school. A personnel survey ( n = 1946) was used to measure psychosocial climate indexed by trust and opportunity for participation, support for innovation, orientation towards…
Global, regional, and national burden of stroke and its risk factors, 1990–2019 : a systematic analysis for the Global Burden of Disease Study 2019
Background Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. Methods We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]…