'Globesization': ecological evidence on the relationship between fast food outlets and obesity among 26 advanced economies

The aim of this study was to investigate the relationship between the density of fast food restaurants and the prevalence of obesity by gender across affluent nations. Data on Subway’s restaurants per 100,000 people and proportions of men and women aged 15 years or older with a body mass index (BMI) higher or equal than 30 Kg/m2 were obtained for 26 of 34 advanced economies. Countries with the highest density of Subway restaurants such as the US (7.52 per 100,000) and Canada (7.43 per 100,000) tend also to have a higher prevalence of obesity in both men (31.3% and 23.2% respectively) and women (33.2% and 22.9% respectively). On the other hand, countries with a relatively low density of Subway restaurants such as Japan (0.13 per 100,000) and Norway (0.19 per 100,000) had a lower prevalence of obesity in both men (2.9% and 6.4% respectively) and women (3.3% and 5.9% respectively). Unadjusted linear regression models showed a significant correlation between the density of Subway’s outlets and the prevalence of adult obesity (β=.46; p=0.02 in men and β=.48; p=0.013 in women). When the data were weighted by population size, the association became substantially stronger in both men and women (β=.85; p=0.0001 and β=.84; p=0.0001, respectively). Covariate adjustment did not reduce the size of the associations. Our study raises serious concerns about that the diffusion of fast food outlets worldwide and calls for coordinated political actions to address what we term ‘globesization’, the ongoing globalization of the obesity epidemic

The role of age and digital competence on the use of online health and social care services : A cross-sectional population-based survey

Objective Online health and social care services are getting widespread which increases the risk that less advantaged groups may not be able to access these services resulting in digital exclusion. We examined the combined effects of age and digital competence on the use of online health and social care services. Methods We used a large representative population-based sample of 4495 respondents from Finland. Paper-based self-assessment questionnaire with an online response option was mailed to participants. The associations were analyzed using survey weighted logistic regression, exploring potential non-linear effects of age and controlling for potential sex differences. Results Higher age, starting from around the age of 60 was associated with a lower likelihood of using online services for receiving test results, renewing prescriptions and scheduling appointments. Good digital competence was able to hinder the age-related decline in online services use, but only up to around the age of 80. Conclusions Our results suggest that older adults are at risk of digital exclusion, and not even good digital competence alleviates this risk among the oldest. We suggest that health and social care providers should consider older users' needs and abilities more thoroughly and offer easy to use online services. More digital support and training possibilities should be provided for older people. It is equally important that face-to-face and telephone services will be continued to be provided for those older people who are not able to use online services even when supported.Peer reviewe

Antidepressant use and work-related injuries

Background. Adverse effects of antidepressants are most common at the beginning of the treatment, but possible also later. We examined the association between antidepressant use and work-related injuries taking into account the duration of antidepressant use. Method. Antidepressant use and work-related injuries between 2000 and 2011 were measured among 66 238 employees (mean age 43.8 years, 80% female) using linkage to national records (the Finnish Public Sector study). We analysed data using time-dependent modelling with individuals as their own controls (self-controlled case-series design). Results. In 2238 individuals who had used antidepressants and had a work-related injury during a mean follow-up of 7.8 years, no increase in the risk of injury was observed in the beginning of antidepressant treatment. However, an increased injury risk was seen after 3 months of treatment (rate ratio, compared with no recent antidepressant use, 1.27, 95% confidence interval 1.10-1.48). This was also the case among those who had used only selective serotonin re-uptake inhibitors (n = 714; rate ratio 1.41, 95% confidence interval 1.08-1.83). Conclusions. Antidepressant use was not associated with an increased risk of work-related injury at the beginning of treatment. Post-hoc analyses of antidepressant trials are needed to determine whether long-term use of antidepressants increases the risk of work-related injury.Peer reviewe

Physical working conditions and subsequent sickness absence : a record linkage follow-up study among 19-39-year-old municipal employees

Purpose Physical work exposures are associated with sickness absence among older employees. We aimed to examine if they similarly contribute to all-cause sickness absence during early and mid-careers. Methods We used questionnaire data on physical work exposures linked to register data on sickness absence from 3542 municipal employees aged 19-39 years. Follow-up for the number of sickness absence days was 12 months. Exposures to physical workload, occupational environmental hazards, and sedentary work were divided into quartiles. In addition, duration of daily exposure to heavy work was included. Negative binomial regression models were used. Results Higher exposure to physical workload or hazardous exposures was associated with a higher number of sickness absence days. The age and gender adjusted rate ratios for sickness absence days among the participants whose exposure to physical workload was in the highest exposure quartile were 2.1 (95% CI 1.8-2.5) compared with those whose exposure was in the lowest quartile. In addition, rate ratios for sickness absence days among participants who reported that they do heavy physical work 1.1-2.0 h, 2.1-4.0 h or over 4 h daily were 1.6 (1.3-1.9), 1.5 (1.3-1.8) and 1.7 (1.5-2.1), respectively, compared with those who reported not doing physical work. Further adjustment for lifestyle factors or health characteristics attenuated the associations only slightly. Conclusion Exposure to physically demanding work is associated with a higher number of sickness absence days among municipal employees below 40 years of age. Physical working conditions should be considered when aiming to support later work ability.Peer reviewe

Education achievement and type 2 diabetes-what mediates the relationship in older adults? Data from the ESTHER study : a population-based cohort study

Peer reviewe

Diabetes and risk of occupational injury: a cohort study

AimsTo investigate if diabetes is associated with a higher risk of occupational (workplace or commuting) injury.MethodsMedication data from the Finnish Prescription Register were used to identify diabetes cases in 2004 in a large employee cohort (the Finnish Public Sector study). These data were linked to injury records obtained from the Federation of Accident Insurance Institutions. A total of 1020 diabetes cases (median age 52 years, range 20 to 65 years; 66% women) and their 5234 age- and sex-matched controls were followed up until 2011. Sex-stratified Cox proportional hazards models, adjusting for age, occupational status, obesity and health behaviours, were applied. Because of the small number of men in the cohort, injury types and locations were only examined among women.ResultsDuring the median follow-up of 6.7 years, 25% of the participants with diabetes (n=252) and 20% of those without (n=1051) experienced an occupational injury. The association between diabetes and injury was stronger in women than men (P=0.048). Diabetes was associated with a higher risk of workplace (hazard ratio 1.37, 95% CI 1.11 to 1.69) and commuting (hazard ratio 1.36, 95% CI 1.03 to 1.79) injury in women. With regard to different injury types and locations, diabetes was associated with bone fractures, dislocations, sprains and strains, and injuries to upper and lower extremities. In men, there was an association between insulin-treated diabetes and commuting injury (hazard ratio 3.14, 95% CI 1.52 to 6.49).ConclusionsDiabetes was associated with workplace and commuting injuries in women. Men with insulin-treated diabetes had a higher risk of commuting injuries

Individual factors and perceived community characteristics in relation to mental health and mental well-being

Peer reviewe

Managing risks to drivers in road transport

This report presents a number of case studies in managing risks to road transport drivers. The cases feature a variety of initiatives and interventions to protect drivers.In the road transport sector, as with any other, it is important to pay attention to working conditions in order to ensure a skilled and motivated workforce. Certain characteristics of the sector make it more difficult to practice risk management than in other sectors. But by taking account of how the sector operates in practice, and the characteristics of drivers themselves and the way they work, risks can be successfully manage

Orphan G protein-coupled receptor GPRC5A modulates integrin β1-mediated epithelial cell adhesion

G-Protein Coupled Receptor (GPCR), Class C, Group 5, Member A (GPRC5A) has been implicated in several malignancies. The underlying mechanisms, however, remain poorly understood. Using a panel of human cell lines, we demonstrate that CRISPR/Cas9-mediated knockout and RNAi-mediated depletion of GPRC5A impairs cell adhesion to integrin substrates: collagens I and IV, fibronectin, as well as to extracellular matrix proteins derived from the Engelbreth-Holm-Swarm (EHS) mouse sarcoma (Matrigel). Consistent with the phenotype, knock-out of GPRC5A correlated with a reduced integrin β1 (ITGB1) protein expression, impaired phosphorylation of the focal adhesion kinase (FAK), and lower activity of small GTPases RhoA and Rac1. Furthermore, we provide the first evidence for a direct interaction between GPRC5A and a receptor tyrosine kinase EphA2, an upstream regulator of FAK, although its contribution to the observed adhesion phenotype is unclear. Our findings reveal an unprecedented role for GPRC5A in regulation of the ITGB1-mediated cell adhesion and it's downstream signaling, thus indicating a potential novel role for GPRC5A in human epithelial cancers.</p

Antonovsky’s Sense of Coherence Scale: Cultural Validation of Soc Questionnaire and Socio-Demographic Patterns in an Italian Population

BACKGROUND: The theory of salutogenesis entails that the ability to use resources for one's wellbeing is more important than the resources themselves. This ability is referred to as the Sense of Coherence (SOC). This paper present the cross-culturally adapted version of the Italian questionnaire (13 items), and the psychometric and statistical testing of the SOC properties. It offers for the first time a view of the distribution of SOC in an Italian sample, and uses a multivariate method to clarify the effects of socio-demographic determinants on SOC. METHODS: The cross-cultural adaptation of the English SOC questionnaire was carried out according to the guidelines reported in literature. To evaluate the psychometric and statistical properties we assessed reliability, validity and frequency distribution of the collected data. A Generalised Linear Model was used to analyse the effects of socio demographic variables on SOC. RESULTS: The Italian SOC scale demonstrates a good internal consistency (α = 0.825). The model obtained with factorial analysis is not related to the traditional dimensions of SOC represented in more than one factor. The multivariate analysis highlights the joint influence of gender, age and education on SOC. CONCLUSION: The validated Italian questionnaire is now available. Socio-demographic variables should be taken into account as confounders when SOC values among different populations are compared. Presenting data on SOC of the Italian population makes a control population available for comparisons with specific subgroups, such as patient populations. Now, the Italian challenge is to integrate the salutogenic approach into Public Health police