830 research outputs found
Environmental, individual and personal goal influences on older adults’ walking in the helsinki metropolitan area
Physical activity is a fundamental factor in healthy ageing, and the built environment has been linked to individual health outcomes. Understanding the linkages between older adult’s walking and the built environment are key to designing supportive environments for active ageing. However, the variety of different spatial scales of human mobility has been largely overlooked in the environmental health research. This study used an online participatory mapping method and a novel modelling of individual activity spaces to study the associations between both the environmental and the individual features and older adults’ walking in the environments where older adult’s actually move around. Study participants (n = 844) aged 55+ who live in Helsinki Metropolitan Area, Finland reported their everyday errand points on a map and indicated which transport mode they used and how frequently they accessed the places. Respondents walking trips were drawn from the data and the direct and indirect effects of the personal, psychological as well as environmental features on older adults walking were examined. Respondents marked on average, six everyday errand points and walked for transport an average of 20 km per month. Residential density and the density of walkways, public transit stops, intersections and recreational sports places were significantly and positively associated with older adult’s walking for transport. Transit stop density was found having the largest direct effect to older adults walking. Built environment had an independent effect on older adults walking regardless of individual demographic or psychological features. Education and personal goals related to physical activities had a direct positive, and income a direct negative, effect on walking. Gender and perceived health had an indirect effect on walking, which was realized through individuals’ physical activity goals
The contribution of psychological distress to socio-economic differences in cause-specific mortality: a population-based follow-up of 28 years
<p>Abstract</p> <p>Background</p> <p>Psychological factors associated with low social status have been proposed as one possible explanation for the socio-economic gradient in health. The aim of this study is to explore whether different indicators of psychological distress contribute to socio-economic differences in cause-specific mortality.</p> <p>Methods</p> <p>The data source is a nationally representative, repeated cross-sectional survey, "Health Behaviour and Health among the Finnish Adult Population" (AVTK). The survey results were linked with socio-economic register data from Statistics Finland (from the years 1979-2002) and mortality follow-up data up to 2006 from the Finnish National Cause of Death Register. The data included 32451 men and 35420 women (response rate 73.5%). Self-reported measures of depression, insomnia and stress were used as indicators of psychological distress. Socio-economic factors included education, employment status and household income. Mortality data consisted of unnatural causes of death (suicide, accidents and violence, and alcohol-related mortality) and coronary heart disease (CHD) mortality. Adjusted hazard ratios were calculated using the Cox regression model.</p> <p>Results</p> <p>In unnatural mortality, psychological distress accounted for some of the employment status (11-31%) and income level (4-16%) differences among both men and women, and for the differences related to the educational level (5-12%) among men; the educational level was associated statistically significantly with unnatural mortality only among men. Psychological distress had minor or no contribution to socio-economic differences in CHD mortality.</p> <p>Conclusions</p> <p>Psychological distress partly accounted for socio-economic disparities in unnatural mortality. Further studies are needed to explore the role and mechanisms of psychological distress associated with socio-economic differences in cause-specific mortality.</p
Children as urbanites: mapping the affordances and behavior settings of urban environments for Finnish and Japanese children
© 2018, © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & amp; Francis Group. Increasingly, children are residing in urban environments, yet little is known about the urban affordances for children. A place-based approach was employed to map the urban experiences of over 1300 children residing in Helsinki (Finland) and in Tokyo (Japan) in terms of meaningful places (affordances), travel mode and accompaniment to these places. Shared affordances were considered behavior settings, and audited on-site by trained experts for their main function, land use, openness, and communality. Significant differences were found between countries for all affordance categories. Although differences in behavior settings were observed between countries, a number of patterns emerged: outdoor settings and those with shared communality were the most prevalent behavior settings, traffic settings were predominantly evaluated negatively and commercial and indoor settings most positively. Findings suggest that although the context is important, independent mobility and the possibility to actualize environmental affordances seem to be fundamental in both contexts as the key criteria for environmental child-friendliness
Socioeconomic deprivation, urban-rural location and alcohol-related mortality in England and Wales
Background: Many causes of death are directly attributable to the toxic effects of alcohol and deaths from these causes are increasing in the United Kingdom. The aim of this study was to investigate variation in alcohol-related mortality in relation to socioeconomic deprivation, urban-rural location and age within a national context.
Methods: An ecological study design was used with data from 8797 standard table wards in England and Wales. The methodology included using the Carstairs Index as a measure of socioeconomic deprivation at the small-area level and the national harmonised classification system for urban and rural areas in England and Wales. Alcohol-related mortality was defined using the National Statistics definition, devised for tracking national trends in alcohol-related deaths. Deaths from liver cirrhosis accounted for 85% of all deaths included in this definition. Deaths from 1999-2003 were examined and 2001 census ward population estimates were used as the denominators.
Results: The analysis was based on 28,839 deaths. Alcohol-related mortality rates were higher in men and increased with increasing age, generally reaching peak levels in middle-aged adults. The 45-64 year age group contained a quarter of the total population but accounted for half of all alcohol-related deaths. There was a clear association between alcohol-related mortality and socioeconomic deprivation, with progressively higher rates in more deprived areas. The strength of the association varied with age. Greatest relative inequalities were seen amongst people aged 25-44 years, with relative risks of 4.73 (95% CI 4.00 to 5.59) and 4.24 (95% CI 3.50 to 5.13) for men and women respectively in the most relative to the least deprived quintiles. People living in urban areas experienced higher alcohol-related mortality relative to those living in rural areas, with differences remaining after adjustment for socioeconomic deprivation. Adjusted relative risks for urban relative to rural areas were 1.35 (95% CI 1.20 to 1.52) and 1.13 (95% CI 1.01 to 1.25) for men and women respectively.
Conclusions: Large inequalities in alcohol-related mortality exist between sub-groups of the population in England and Wales. These should be considered when designing public health policies to reduce alcohol-related harm
The Australian National University Alzheimer's Disease Risk Index (ANU-ADRI) score as a predictor for cognitive decline and potential surrogate outcome in the FINGER lifestyle randomized controlled trial
Background and purpose: The complex aetiology of Alzheimer's disease suggests prevention potential. Risk scores have potential as risk stratification tools and surrogate outcomes in multimodal interventions targeting specific at-risk populations. The Australian National University Alzheimer's Disease Risk Index (ANU-ADRI) was tested in relation to cognition and its suitability as a surrogate outcome in a multidomain lifestyle randomized controlled trial, in older adults at risk of dementia. Methods: In this post hoc analysis of the Finnish Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), ANU-ADRI was calculated at baseline, 12, and 24 months (n = 1174). The association between ANU-ADRI and cognition (at baseline and over time), the intervention effect on changes in ANU-ADRI, and the potential impact of baseline ANU-ADRI on the intervention effect on changes in cognition were assessed using linear mixed models with maximum likelihood estimation. Results: A higher ANU-ADRI was significantly related to worse cognition, at baseline (e.g., estimate for global cognition [95% confidence interval] was −0.028 [−0.032 to −0.025]) and over the 2-year study (e.g., estimate for 2-year changes in ANU-ADRI and per-year changes in global cognition [95% confidence interval] was −0.068 [−0.026 to −0.108]). No significant beneficial intervention effect was reported for ANU-ADRI, and baseline ANU-ADRI did not significantly affect the response to the intervention on changes in cognition. Conclusions: The ANU-ADRI was effective for the risk prediction of cognitive decline. Risk scores may be crucial for the success of novel dementia prevention strategies, but their algorithm, the target population, and the intervention design should be carefully considered when choosing the appropriate tool for each context
Thermal treatment for radioactive waste minimisation
Safe management of radioactive waste is challenging to waste producers and waste management organisations. Deployment of thermal treatment technologies can provide significant improvements: volume reduction, waste passivation, organics destruction, safety demonstration facilitation, etc. The EC-funded THERAMIN project enables an EU-wide strategic review and assessment of the value of thermal treatment technologies applicable to Low and Intermediate Level waste streams (ion exchange media, soft operational waste, sludges, organic waste, and liquids). THERAMIN compiles an EU-wide database of wastes, which could be treated by thermal technologies and documents available thermal technologies. Applicability and benefits of technologies to the identified waste streams will be evaluated through full-scale demonstration tests by project partners. Safety case implications will also be assessed through the study of the disposability of thermally treated waste products. This paper will communicate the strategic aims of the ongoing project and highlight some key findings and results achieved to date
Analyzing Recent Coronary Heart Disease Mortality Trends in Tunisia between 1997 and 2009.
BACKGROUND: In Tunisia, Cardiovascular Diseases are the leading causes of death (30%), 70% of those are coronary heart disease (CHD) deaths and population studies have demonstrated that major risk factor levels are increasing.
OBJECTIVE: To explain recent CHD trends in Tunisia between 1997 and 2009.
METHODS: DATA SOURCES: Published and unpublished data were identified by extensive searches, complemented with specifically designed surveys.
ANALYSIS: Data were integrated and analyzed using the previously validated IMPACT CHD policy model. Data items included: (i)number of CHD patients in specific groups (including acute coronary syndromes, congestive heart failure and chronic angina)(ii) uptake of specific medical and surgical treatments, and(iii) population trends in major cardiovascular risk factors (smoking, total cholesterol, systolic blood pressure (SBP), body mass index (BMI), diabetes and physical inactivity).
RESULTS: CHD mortality rates increased by 11.8% for men and 23.8% for women, resulting in 680 additional CHD deaths in 2009 compared with the 1997 baseline, after adjusting for population change. Almost all (98%) of this rise was explained by risk factor increases, though men and women differed. A large rise in total cholesterol level in men (0.73 mmol/L) generated 440 additional deaths. In women, a fall (-0.43 mmol/L), apparently avoided about 95 deaths. For SBP a rise in men (4 mmHg) generated 270 additional deaths. In women, a 2 mmHg fall avoided 65 deaths. BMI and diabetes increased substantially resulting respectively in 105 and 75 additional deaths. Increased treatment uptake prevented about 450 deaths in 2009. The most important contributions came from secondary prevention following Acute Myocardial Infarction (AMI) (95 fewer deaths), initial AMI treatments (90), antihypertensive medications (80) and unstable angina (75).
CONCLUSIONS: Recent trends in CHD mortality mainly reflected increases in major modifiable risk factors, notably SBP and cholesterol, BMI and diabetes. Current prevention strategies are mainly focused on treatments but should become more comprehensive
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