Health-related quality of life in metabolically healthy obese individuals

Peer reviewe

Physical Activity Improves Borderline Ankle-Brachial Index Values in a Cardiovascular Risk Population

Background: Peripheral, arterial disease (PAD) is an underdiagnosed and undertreated disease because it remains asymptomatic for so long. The ankle brachial index (ABI) is a valid method for detecting PAD: in lower extremities. ABI Methods: A total of 193 subjects with borderline ABI were examined in 2005-2006. None of them had previously diagnosed diabetes, cardiovascular or renal disease or intermittent claudication. They were given conventional treatment for multiple risk factors of cardiovascular diseases (hypertension, hypercholesterolemia, elevated blood glucose, smoking, and overweight). Sixty-four percent of these subjects (n = 1.23) attended a follow-up visit in 2012. Results: Of the 123 subjects with borderline ABI (mean age 59.0 years, 62% female) at baseline, 18 (15%, 95% confidence intervals {Cl] 9%-22%) developed incident PAD during the follow-up. The mean ABI was 0.97 +/- 0.03 at baseline and 1.01 +/- 0.12 at 7-year follow-up visit. The change in mean ABI was 70:04 (95% CI: 0.03-0.07), P <0.001. ABI improved significantly in 25 (20%) subjects. In multivariate ordered logistic regression analyses high and even moderate leisure-time physical activity :(LTPA; odds ratio 6.15; 95% CI: 1.99-19.1) predicted a rise in ABI in comparison to low LTPA. Conclusions: Physical activity seems to improve significantly ABI values among men and women with borderline ABI (0.91-1.00).Peer reviewe

Impaired long-term outcomes of patients with schizophrenia spectrum disorder after coronary artery bypass surgery : nationwide case-control study

Background Patients with schizophrenia spectrum disorder have increased risk of coronary artery disease. Aims To investigate long-term outcomes of patients with schizophrenia spectrum disorder and coronary artery disease after coronary artery bypass grafting surgery (CABG). Method Data from patients with schizophrenia spectrum disorder (n = 126) were retrospectively compared with propensity-matched (1:20) control patients without schizophrenia spectrum disorder (n = 2520) in a multicentre study in Finland. All patients were treated with CABG. The median follow-up was 7.1 years. The primary outcome was all-cause mortality. Results Patients with diagnosed schizophrenia spectrum disorder had an elevated risk of 10-year mortality after CABG, compared with control patients (42.7 v. 30.3%; hazard ratio 1.56; 95% CI 1.13-2.17; P = 0.008). Schizophrenia spectrum diagnosis was associated with a higher risk of major adverse cardiovascular events during follow-up (49.9 v. 32.6%, subdistribution hazard ratio 1.59; 95% CI 1.18-2.15; P = 0.003). Myocardial infarction (subdistribution hazard ratio 1.86; P = 0.003) and cardiovascular mortality (subdistribution hazard ratio 1.65; P = 0.017) were more frequent in patients with versus those without schizophrenia spectrum disorder, but there was no difference for stroke. Psychiatric ward admission, antipsychotic medication, antidepressant use and benzodiazepine use before CABG were not associated with outcome differences. After CABG, patients with schizophrenia spectrum disorder received statin therapy less often and had lower doses; the use of other cardiovascular medications was similar between schizophrenia spectrum and control groups. Conclusions Patients with schizophrenia spectrum disorder have higher long-term risks of death and major adverse cardiovascular events after CABG. The results underline the vulnerability of these patients and highlight the importance of intensive secondary prevention and risk factor optimisation.Peer reviewe

Frailty, walking ability and self-rated health in predicting institutionalization : an 18-year follow-up study among Finnish community-dwelling older people

Background In clinical practice, there is a need for an instrument to screen older people at risk of institutionalization. Aims To analyze the association of frailty, walking-ability and self-rated health (SRH) with institutionalization in Finnish community-dwelling older people. Methods In this prospective study with 10- and 18-year follow-ups, frailty was assessed using FRAIL Scale (FS) (n = 1087), Frailty Index (FI) (n = 1061) and PRISMA-7 (n = 1055). Walking ability was assessed as self-reported ability to walk 400 m (n = 1101). SRH was assessed by a question of general SRH (n = 1105). Cox regression model was used to analyze the association of the explanatory variables with institutionalization. Results The mean age of the participants was 73.0 (range 64.0-97.0) years. Prevalence of institutionalization was 40.8%. In unadjusted models, frailty was associated with a higher risk of institutionalization by FS in 10-year follow-up, and FI in both follow-ups. Associations by FI persisted after age- and gender-adjustments in both follow-ups. By PRISMA-7, frailty predicted a higher risk of institutionalization in both follow-ups. In unadjusted models, inability to walk 400 m predicted a higher risk of institutionalization in both follow-ups and after adjustments in 10-year follow-up. Poor SRH predicted a higher risk of institutionalization in unadjusted models in both follow-ups and after adjustments in 10-year follow-up. Discussion Simple self-reported items of walking ability and SRH seemed to be comparable with frailty indexes in predicting institutionalization among community-dwelling older people in 10-year follow-up. Conclusions In clinical practice, self-reported walking ability and SRH could be used to screen those at risk.Peer reviewe

Expansion induced microRNA changes in bone marrow mesenchymal stromal cells reveals interplay between immune regulation and cell cycle

Mesenchymal stromal cells (MSC) are currently used in many cell based therapies. Prior to use in therapy, extensive expansion is required. We used microarray profiling to investigate expansion induced miRNA and mRNA expression changes of bone marrow MSCs (BM-MSCs) derived from old and young donors. The expression levels of 36 miRNAs were altered in cells derived from the old and respectively 39 miRNAs were altered in cells derived from young donors. Of these, only 12 were differentially expressed in both young and old donor BM-MSCs, and their predicted target mRNAs, were mainly linked to cell proliferation and senescence. Further qPCR verification showed that the expression of miR-1915-3p, miR-1207, miR-3665, and miR-762 correlated with the expansion time at passage 8. Previously described BM-MSC-specific miRNA fingerprints were also detected but these remained unchanged during expansion. Interestingly, members of well-studied miR-17/92 cluster, involved in cell cycle regulation, aging and also development of immune system, were down regulated specifically in cells from old donors. The role of this cluster in MSC functionality is worth future studies since it links expansion, aging and immune system together.Peer reviewe

Both lean and fat body mass associate with blood pressure

10.1016/j.ejim.2021.04.025European Journal of Internal Medicine9140-4

Factors associated with quality of life and work ability among Finnish municipal employees: a cross-sectional study

Objectives Quality of life (QoL) and work ability are elementary parts in defining the well-being of an employed person. The aim of this study was to demonstrate factors associated with QoL and self-reported work ability among public sector employees, while taking into account several confounding factors, including sleep quality, occupational stress and psychological symptoms.Methods A cross-sectional study was conducted in Finland among 710 employees (89% women, mean age 49 (SD=10) years) from 10 municipal work units in 2015. Information about the participants was collected by physical examination, self-administered questionnaire and from medical history. QoL was assessed with the EUROHIS-Quality of Life 8-item index and work ability with the Work Ability Score (WAS).Results The EUROHIS-QOL mean score among all participants was 4.07 (95% CI 4.03 to 4.11). QoL was positively associated with good sleep quality, cohabiting, university-level education and lower body mass index (BMI), and negatively associated with occupational stress, depression and/or anxiety and disease burden. Work ability was reported good or excellent by 80% of the participants and the WAS mean score among all participants was 8.31 (95% CI 8.21 to 8.41). Work ability was positively associated with good sleep quality, younger age, lower BMI and university-level education, and negatively associated with occupational stress and disease burden.Conclusions Occupational stress and self-reported sleep quality were strongly associated with both QoL and work ability among Finnish public sector employees. These findings highlight the need for screening and handling of work stress and sleep problems in occupational and primary healthcare

Rethinking graduate employability in context: discourse, policy and practice

This open access book offers critical, multidisciplinary analyses on graduate employability. The book examines employability at the macro, meso and micro levels: higher education policy, the labour market, higher education institutions, organisations, individuals and social groups, in European, North American and Australian contexts. The contributors provide social and contextual analysis of graduate employability as a theoretical concept, a discourse and policy imperative and a social and discursive practice. The volume also introduces novel methodological perspectives to study the process of graduate employability. There is an urgent need for comprehensive and unified critical perspectives on graduate employability, as such analyses have so far been scarce and often isolated. Besides filling this gap in the literature, the book will also serve as essential reading on courses that focus on graduate careers and employability as well as higher education policy and practice