Associations of vacation time with lifestyle, long-term mortality and health-related quality of life in old age : The Helsinki Businessmen Study

Introduction: There are few longitudinal studies of relationships between vacation and later health outcomes. We studied these during a 26-year follow-up of the Helsinki Businessmen Study. Methods: In 1974, at mean age of 47 years, 2741 members of a cohort of executives and businessmen born 1919-1934 were clinically examined and reported their annual vacation time (dichotomized >21 [n = 2001]vs. Results: At baseline, shorter vacation was associated with longer work time, higher BMI, more coffee consumption and worse SRH. During the 26-year follow-up, 778 men out of 2741 (28.4%) had died. Shorter annual vacation was associated with higher mortality with curves starting to diverge after 18 years of follow-up, (fully adjusted hazard ratio 1.29, 95% confidence interval 1.08-1.55, P = 0.005). In old age, shorter vacation in midlife was tentatively associated with worse general health. Conclusions: Shorter vacation time in midlife was associated with characteristics related to lifestyle and with worse perceived health status, and predicted mortality up to old age in men. (C) 2017 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.Peer reviewe

Common mental disorders in young adults born late-preterm

Background Results of adulthood mental health of those born late-preterm (34 + 0–36 + 6 weeks + days of gestation) are mixed and based on national registers. We examined if late-preterm birth was associated with a higher risk for common mental disorders in young adulthood when using a diagnostic interview, and if this risk decreased as gestational age increased. Method A total of 800 young adults (mean = 25.3, s.d. = 0.62 years), born 1985–1986, participated in a follow-up of the Arvo Ylppö Longitudinal Study. Common mental disorders (mood, anxiety and substance use disorders) during the past 12 months were defined using the Composite International Diagnostic Interview (Munich version). Gestational age was extracted from hospital birth records and categorized into early-preterm (<34 + 0, n = 37), late-preterm (34 + 0–36 + 6, n = 106), term (37 + 0–41 + 6, n = 617) and post-term (≥42 + 0, n = 40). Results Those born late-preterm and at term were at a similar risk for any common mental disorder [odds ratio (OR) 1.11, 95% confidence interval (CI) 0.67–1.84], for mood (OR 1.11, 95% CI 0.54–2.25), anxiety (OR 1.00, 95% CI 0.40–2.50) and substance use (OR 1.31, 95% CI 0.74–2.32) disorders, and co-morbidity of these disorders (p = 0.38). While the mental disorder risk decreased significantly as gestational age increased, the trend was driven by a higher risk in those born early-preterm. Conclusions Using a cohort born during the advanced neonatal and early childhood care, we found that not all individuals born preterm are at risk for common mental disorders in young adulthood – those born late-preterm are not, while those born early-preterm are at a higher risk. Available resources for prevention and intervention should be targeted towards the preterm group born the earliest

Transverse myocutaneous gracilis flap reconstruction is feasible after pelvic exenteration : 12-year surgical and oncological results

Introduction: Pelvic exenteration (PE) is the only curative treatment for certain locally advanced intrapelvic malignancies. PE has high morbidity, and optimal reconstruction of the pelvic floor remains undetermined. Materials and methods: A retrospective chart review was performed at a tertiary university center to assess the surgical and oncological outcomes of 39 PE procedures over a 12-year period. The majority of patients (n = 25) underwent transverse musculocutaneous gracilis (TMG) flap reconstruction for pelvic floor reconstruction. Results: The 1- and 5-year overall survival (OS) was 72% (95%CI 58%-86%) and 48% (95%CI 31%-65%), respectively. In multivariate analysis, lymph node metastasis (HR 3.070, p = 0.024) and positive surgical margins (HR 3.928, p = 0.009) were risk factors for OS. In this population, 71.8% of the patients had at least one complication. The complication rate was 65.4% and 84.6% for patients with versus without flap reconstruction, respectively (p = 0.191). The length of stay was longer for patients with a major complication 16,0 +/- 5,9 days vs. 29,4 +/- 14,8 days, p = 0.001, but complications did not affect OS. Conclusion: For selected patients, PE is a curative option for locally advanced, residual, or recurrent intrapelvic tumors. Pelvic floor and vulvovaginal defects can reliably be reconstructed using TMG flaps. TMG flaps are favored in our institution over abdominal-based flaps because the donor site morbidity is reasonable and TMG does not interfere with enterostomy. (C) 2019 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.Peer reviewe

Childhood cognitive ability and physical activity in young adulthood

Objective: Childhood cognitive ability is associated with lifestyle in adulthood, including self-reported physical activity (PA). We examined whether childhood cognitive ability is associated with objectively-measured PA and sedentary time (ST) in young adulthood. Methods: Participants of the Arvo Ylppö Longitudinal Study (n=500) underwent tests of general reasoning, visuo-motor integration, verbal competence and language comprehension at the age of 56 months yielding a general intelligence factor score; at the age of 25 years they wore omnidirectional accelerometers for 9 days (Range=4-10 days) measuring overall daily PA (counts per minute, cpm), ST and light and moderate-to-vigorous PA (MVPA) (minutes), and completed a questionnaire on occupational, commuting, leisure-time conditioning and non-conditioning PA. Results: After adjustment for sex, age, BMI-for-age SD score at 56 months and mean of valid minutes of measurement period for PA, per each one SD increase in the childhood general intelligence factor score, overall daily PA decreased by -8.99 CPM/day, ST increased by 14.93 minutes/day, time spent in light PA decreased by -14.39 minutes/day, and the odds per each level increase in physical demandingness of the work and in time spent in non-conditioning leisure-time PA decreased by 38% and 31%, respectively (p-values<0.04). These associations were mediated via higher young adulthood level of education. Conclusions: In contrast to expected, in this cohort of young adults with high variability in PA, of whom many were still studying, higher childhood cognitive ability was associated with more objectively-measured and self-reported physical inactivity. Whether these findings persist beyond young adulthood is a subject of further studies

Pre-pregnancy overweight or obesity and gestational diabetes as predictors of body composition in offspring twenty years later : evidence from two birth cohort studies

Background. Global prevalence of overweight/obesity and gestational diabetes (GDM) is increasing. In pregnant women both conditions affect offspring's later health. Overweight/obesity is a risk factor of GDM; to what extent maternal overweight/obesity explains long-term effects of GDM in offspring is unknown. Objective. To evaluate effects of maternal pre-pregnancy overweight/obesity (BMI ⩾25 kg/m2) and GDM, occurring together or separately, on body composition among adult offspring. Methods. Participants include 891 individuals aged 24.1 years (s.d. 1.4) from two longitudinal cohort studies (ESTER and AYLS). Adult offspring of normoglycemic mothers with overweight/obesity (ONOO, n=153), offspring of mothers with GDM (OGDM; n=191) and controls (n=547) underwent anthropometric measurements and bioimpedance analysis. GDM was diagnosed by oral glucose tolerance test. Data were analyzed by linear regression models adjusted for confounders. Results. Compared with controls, ONOO-participants showed higher BMI [men 1.64 kg/m2 (95% confidence interval 0.57, 2.72); women 1.41 kg/m2 (0.20, 2.63)] and fat percentage [men 2.70% (0.99, 4.41); women 2.98% (0.87, 5.09)] with larger waist circumferences [men 3.34 cm (0.68, 5.99); women 3.09 cm (0.35, 5.83)]. Likewise, OGDM-participants showed higher fat percentage [men 1.97% (0.32, 3.61); women 2.32% (0.24, 4.41)]. BMI was non-significantly different between OGDM-participants and controls [men 0.88kg/m2 (-0.17, 1.92); women 0.82 kg/m2 (-0.39, 2.04)]. Also waist circumferences were larger [men 2.63 cm (-0.01, 5.28); women 3.39 cm (0.60, 6.18)], this difference was statistically significant in OGDM-women only. Differences in body composition measures were stronger among offspring of women with both GDM and overweight/obesity. For instance, fat mass was higher among OGDM-participants of overweight mothers [men 4.24 kg (1.36, 7.11) vs controls; women 5.22 kg (1.33, 9.11)] than OGDM participants of normal weight mothers [men 1.50 kg (-2.11, 5.11) higher vs controls; women 1.57 kg (-3.27, 6.42)]. Conclusions. Maternal pre-pregnancy overweight and GDM are associated with unhealthy body size and composition in offspring over 20 years later. Effects of maternal pre-pregnancy overweight appear more pronounced

Work careers in adults separated temporarily from their parents in childhood during World War II

Introduction: Traumatic experiences, such as separation from parents in childhood causing early life stress (ELS) may increase the risk of adverse long-term health outcomes and biological age-related changes. This may have an impact on work career. Our aim was to examine long term consequences of ELS due to temporary separation from parents during World War II (WWII) in relation to work career. Material and methods: The Helsinki Birth Cohort Study comprises 13,345 individuals born in Helsinki, Finland, between the years 1934-1944. From the original cohort, 1781 individuals were identified as being separated temporarily from their parents due to World War II. Information on date and type of pension was provided by the Finnish Centre for Pensions and the Social Insurance Institution of Finland. The cohort members either transitioned into old age pension at the statutory retirement age or retired earlier and transitioned into disability, unemployment, part-time pension or died before retirement. Results: Those who were separated were more likely to have transitioned into disability pension (RRR: 1.26: 95% CI: 1.06-1.48), especially due to diseases of the musculoskeletal system (OR: 1.57; 95% CI: 1.20-2.07), or into unemployment pension (RRR: 1.25; 95% CI: 1.02-1.53) compared with those not separated from their parents. Longer duration of separation was associated with early exit from the workforce compared with non-separation. Conclusions: Exposure to ELS may have an impact upon lifetime work career. Early interventions preventing exposure to ELS or mitigating its negative effects may prolong future work careers along with healthier aging across the life-span.Peer reviewe

FoxO1, A2M, and TGF-beta 1: three novel genes predicting depression in gene X environment interactions are identified using cross-species and cross-tissues transcriptomic and miRNomic analyses

To date, gene-environment (GxE) interaction studies in depression have been limited to hypothesis-based candidate genes, since genome-wide (GWAS)-based GxE interaction studies would require enormous datasets with genetics, environmental, and clinical variables. We used a novel, cross-species and cross-tissues "omics" approach to identify genes predicting depression in response to stress in GxE interactions. We integrated the transcriptome and miRNome profiles from the hippocampus of adult rats exposed to prenatal stress (PNS) with transcriptome data obtained from blood mRNA of adult humans exposed to early life trauma, using a stringent statistical analyses pathway. Network analysis of the integrated gene lists identified the Forkhead box protein O1 (FoxO1), Alpha-2-Macroglobulin (A2M), and Transforming Growth Factor Beta 1 (TGF-beta 1) as candidates to be tested for GxE interactions, in two GWAS samples of adults either with a range of childhood traumatic experiences (Grady Study Project, Atlanta, USA) or with separation from parents in childhood only (Helsinki Birth Cohort Study, Finland). After correction for multiple testing, a meta-analysis across both samples confirmed six FoxO1 SNPs showing significant GxE interactions with early life emotional stress in predicting depressive symptoms. Moreover, in vitro experiments in a human hippocampal progenitor cell line confirmed a functional role of FoxO1 in stress responsivity. In secondary analyses, A2M and TGF-beta 1 showed significant GxE interactions with emotional, physical, and sexual abuse in the Grady Study. We therefore provide a successful 'hypothesis-free' approach for the identification and prioritization of candidate genes for GxE interaction studies that can be investigated in GWAS datasets

Epigenomic profiling of men exposed to early-life stress reveals DNA methylation differences in association with current mental state

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