Elämänlaadun ja elämäntapojen huomioonottaminen perusterveydenhuollossa

Viime vuosikymmeninä elämäntapoihin liittyvät sairaudet ovat nousseet maailmanlaajuisesti johtaviksi kuolinsyiksi. Koholla oleva verenpaine, korkeat veren rasva- ja sokeriarvot sekä tupakointi ovat tärkeimpiä sydän- ja verenkiertoelinten sairauksien riskitekijöitä. Suureen osaan riskitekijöistä voidaan vaikuttaa suotuisasti jo ennen varsinaisen sairauden puhkeamista elämäntapoja muuttamalla, mutta elämäntapojen muuttaminen on osoittautunut hyvin haasteelliseksi tehtäväksi. Tietoa on käytettävissä paljon ja ihmiset pitävät terveyttä tärkeänä asiana. Pelkän tiedon ja mahdollisten uhkakuvien esiin tuominen eivät kuitenkaan motivoi ihmisiä riittävästi muutokseen. Elämäntilanteella ja elämänlaadulla arvioidaan olevan tärkeä osuutensa elämäntapamuutosten onnistumisessa. Kartoitimme perusterveinä itseään pitäneiden, mutta jonkin valtimotaudin riskitekijän omanneiden henkilöiden elämänlaatua Lounais-Suomen alueella vuosina 2005–2007 toteutetun väestötutkimuksen aineistosta. Osallistujien määrä oli 2752. Totesimme, että sokeritaudin esiasteilla ei ollut vaikutusta tutkittujen terveyteen liittyvään elämänlaatuun, mutta tuoreella tyypin 2 diabeteksella oli elämänlaatua huonontava vaikutus. Sen perusteella heräsi kysymys siitä, missä vaiheessa perusterveydenhuollossa toimivan lääkärin on syytä aloittaa diagnostiset sokeritaudin tutkimukset ja mahdollinen hoito. Epidemian lailla lisääntyvään ylipainoon ja painon hallintaan liittyviä elämänlaatutekijöitä kartoitettiin samasta tutkimusaineistosta. Totesimme, että ylipaino ja lihavuus heikensivät erityisesti tutkittujen henkilöiden fyysistä elämänlaatua, mutta vaikutukset psyykkiseen elämänlaatuun vaihtelivat. Painonhallinnan onnistumisen suhteen todettiin, että henkilöt, joiden terveyteen liittyvä elämänlaatu oli huono tutkimuksen alkaessa, onnistuivat huonoimmin painonsa hallinnassa. Perusterveydenhuollossa asioivien potilaiden halukkuutta keskustella elämäntavoistaan lääkärin kanssa selvitettiin kyselytutkimuksen avulla, n=459. Tulosten mukaan tutkittavan tupakointi ja ylipaino lisäsivät hänen keskusteluhaluttomuuttaan. Terveydenhuollon ammattilaisten tulisi osata kiinnittää huomiota vastaanotolle tulevien potilaiden elämäntilanteeseen ennen kuin terveyden kannalta merkityksellisiä muutosohjeita aletaan antaa. Näin toimien ei lisättäisi potilaan elämäntilanteen kuormittavuutta ja voitaisiin odottaa elämäntapamuutosten onnistumisia.Considering patient’s health related quality of life and life style in primary health care During the last few decades, diseases relating to lifestyle, so called noncommunicable diseases (NCD), have become the leading causes of death. Elevated blood pressure, increased plasma lipids, hyperglycemia as well as smoking are the most important risk factors of cardiovascular diseases. Most parts of these risk factors can be favor-ably influenced by lifestyle changes even before the onset of the disease. Lifestyle changes, however, have been proved a very challenging task. There is plenty of information available, and people perceive health as an important issue. Highlighting bare information and potential risks do not, however, motivate people sufficiently to change their lifestyle. It has been assumed that situation in life and health related quality of life (HRQL) play an important part in a successful change of lifestyle. We charted the HRQL of people who considered themselves healthy but with some risk factor for cardiovascular diseases, n=2752. We found that impaired glucose tolerance has no impact on HRQL, but new type 2 diabetes does have a negative impact. Based on this finding there arose the question of when the GP in primary health care should start diagnostic examinations and potential therapy. HRQL factors relating to almost epidemically increasing overweight and attempted weight control were mapped out from the same research material. Overweight and obesity reduced the physical HRQL, but influences on emotional HRQL fluctuated. Regarding successful weight control, we found that people with poor HRQL at the initial stage of this study were the least successful in weight control. The willingness of primary health care patients to discuss their lifestyle with the GP was mapped out by a questionnaire. Smoking and overweight increased reluctance to discuss lifestyle with a GP. Health care professionals should be able to pay attention to the lifestyle of patients before beginning to hand out meaningful health related advice on lifestyle change. This way we would not increase the stress on patient’s life situation and would expect more successful lifestyle changes.Siirretty Doriast

Type D personality and metabolic syndrome among Finnish female municipal workers

Abstract Background Type D personality is a combination of high negative affectivity (NA) and high social inhibition (SI). This personality trait is suspected to impair cardiovascular patients’ recovery. The 2016 European Guidelines on cardiovascular disease prevention in clinical practice recommend screening of psychosocial risk factors as Type D personality. The aim of this study was to assess the relationship between Type D personality and Metabolic syndrome (MetS) in working-age female population. Methods Six hundred thirty-four female employees with mean age of 48 ± 10 years were evaluated. Type D personality and its components (NA) and (SI) were screened with DS14 questionnaire. The definition of MetS was based on measurements done by trained medical staff. We investigated the relationship between Mets and Type D personality, NA and SI using the logistic regression models adjusting for age, education years, leisure-time physical activity, smoking, alcohol use and depressive symptoms. Results The prevalence of Type D personality was 10.6% (n = 67) [95% CI: 8.3 to 13.2] and MetS 34.7% (n = 220). Type D personality or its subcomponents were not associated with MetS. Women with Type D personality had significantly worse quality of sleep and lower LTPA. They were also more often unsatisfied with their economic situation, they had more often depressive symptoms and psychiatric disorders than non-D type persons. There were no differences in risk factors for cardiovascular diseases. Conclusion Screening for Type D personality among working- age, reasonably healthy female population seems not to be practical method for finding persons with risk for cardiovascular disease

Type D personality and metabolic syndrome among Finnish female municipal workers

BackgroundType D personality is a combination of high negative affectivity (NA) and high social inhibition (SI). This personality trait is suspected to impair cardiovascular patients' recovery. The 2016 European Guidelines on cardiovascular disease prevention in clinical practice recommend screening of psychosocial risk factors as Type D personality. The aim of this study was to assess the relationship between Type D personality and Metabolic syndrome (MetS) in working-age female population.MethodsSix hundred thirty-four female employees with mean age of 4810years were evaluated. Type D personality and its components (NA) and (SI) were screened with DS14 questionnaire. The definition of MetS was based on measurements done by trained medical staff. We investigated the relationship between Mets and Type D personality, NA and SI using the logistic regression models adjusting for age, education years, leisure-time physical activity, smoking, alcohol use and depressive symptoms.ResultsThe prevalence of Type D personality was 10.6% (n=67) [95% CI: 8.3 to 13.2] and MetS 34.7% (n=220). Type D personality or its subcomponents were not associated with MetS. Women with Type D personality had significantly worse quality of sleep and lower LTPA. They were also more often unsatisfied with their economic situation, they had more often depressive symptoms and psychiatric disorders than non-D type persons. There were no differences in risk factors for cardiovascular diseases.Conclusion Screening for Type D personality among working- age, reasonably healthy female population seems not to be practical method for finding persons with risk for cardiovascular disease.Peer reviewe

Type D personality and metabolic syndrome among Finnish female municipal workers

BackgroundType D personality is a combination of high negative affectivity (NA) and high social inhibition (SI). This personality trait is suspected to impair cardiovascular patients' recovery. The 2016 European Guidelines on cardiovascular disease prevention in clinical practice recommend screening of psychosocial risk factors as Type D personality. The aim of this study was to assess the relationship between Type D personality and Metabolic syndrome (MetS) in working-age female population.MethodsSix hundred thirty-four female employees with mean age of 4810years were evaluated. Type D personality and its components (NA) and (SI) were screened with DS14 questionnaire. The definition of MetS was based on measurements done by trained medical staff. We investigated the relationship between Mets and Type D personality, NA and SI using the logistic regression models adjusting for age, education years, leisure-time physical activity, smoking, alcohol use and depressive symptoms.ResultsThe prevalence of Type D personality was 10.6% (n=67) [95% CI: 8.3 to 13.2] and MetS 34.7% (n=220). Type D personality or its subcomponents were not associated with MetS. Women with Type D personality had significantly worse quality of sleep and lower LTPA. They were also more often unsatisfied with their economic situation, they had more often depressive symptoms and psychiatric disorders than non-D type persons. There were no differences in risk factors for cardiovascular diseases.Conclusion Screening for Type D personality among working- age, reasonably healthy female population seems not to be practical method for finding persons with risk for cardiovascular disease.</div

Genetic association study of childhood aggression across raters, instruments, and age

Childhood aggressive behavior (AGG) has a substantial heritability of around 50%. Here we present a genome-wide association metaanalysis (GWAMA) of childhood AGG, in which all phenotype measures across childhood ages from multiple assessors were included. We analyzed phenotype assessments for a total of 328 935 observations from 87 485 children aged between 1.5 and 18 years, while accounting for sample overlap. We also meta-analyzed within subsets of the data, i.e., within rater, instrument and age. SNP-heritability for the overall meta-analysis AGGoverall was 3.31% (SE= 0.0038). We found no genome-wide significant SNPs for AGGoverall. The gene-based analysis returned three significant genes: ST3GAL3 (P= 1.6E-06), PCDH7 (P= 2.0E-06), and IPO13 (P= 2.5E-06). All three genes have previously been associated with educational traits. Polygenic scores based on our GWAMA significantly predicted aggression in a holdout sample of children (variance explained = 0.44%) and in retrospectively assessed childhood aggression (variance explained = 0.20%). Genetic correlations rg among rater-specific assessment of AGG ranged from rg= 0.46 between self- and teacher-assessment to rg= 0.81 between mother- and teacher-assessment. We obtained moderate-to-strong rgs with selected phenotypes from multiple domains, but hardly with any of the classical biomarkers thought to be associated with AGG. Significant genetic correlations were observed with most psychiatric and psychological traits (range |rg|: 0.19-1.00), except for obsessive-compulsive disorder. Aggression had a negative genetic correlation (rg=∼-0.5) with cognitive traits and age at first birth. Aggression was strongly genetically correlated with smoking phenotypes (range |rg| : 0.46-0.60). The genetic correlations between aggression and psychiatric disorders were weaker for teacher-reported AGG than for mother- and self-reported AGG. The current GWAMA of childhood aggression provides a powerful tool to interrogate the rater-specific genetic etiology of AGG.</p

Grouping facilitates avoidance of parasites by fish

Background. Parasite distribution is often highly heterogeneous, and intensity of infection depends, among other things, on how well hosts can avoid areas with a high concentration of parasites. We studied the role of fish behaviour in avoiding microhabitats with a high infection risk using Oncorhynchus mykiss and cercariae of Diplostomum pseudospathaceum as a model. Spatial distribution of parasites in experimental tanks was highly heterogeneous. We hypothesized that fish in groups are better at recognizing a parasitized area and avoiding it than solitary fish. Methods. Number of fish, either solitary or in groups of 5, was recorded in different compartments of a shuttle tank where fish could make a choice between areas with different risk of being infected. Intensity of infection was assessed and compared with the number of fish recorded in the compartment with parasites and level of fish motility. Results. Both solitary fish and fish in groups avoided parasitized areas, but fish in groups avoided it more strongly and thus acquired significantly fewer parasites than solitary fish. Prevalence of infection among grouped and solitary fish was 66 and 92 %, respectively, with the mean abundance two times higher in the solitary fish. Between-individual variation in the number of parasites per fish was higher in the “groups” treatment (across all individuals) than in the “solitary” treatment. Avoidance behaviour was more efficient when fish were allowed to explore the experimental arena prior to parasite exposure. High motility of fish was shown to increase the acquisition of D. pseudospathaceum. Conclusion. Fish in groups better avoided parasitized habitat, and acquired significantly fewer parasites than solitary fish. We suggest that fish in groups benefit from information about parasites gained from other members of a group. Grouping behaviour may be an efficient mechanism of parasite avoidance, together with individual behaviour and immune responses of fishes. Avoidance of habitats with a high parasite risk can be an important factor contributing to the evolution and maintenance of grouping behaviour in fish.peerReviewe

A genome-wide association study of total child psychiatric problems scores: summary statistics

Summary statistics for EAGLE GWAS on total child psychiatric problems scores. Data is provided in R binary format and can be loaded within R with load("total_child_psychiatric_GWAS.Rdata"). snp: SNP RS ID effect_allele: Effect allele other_allele: Other allele beta: Change in total psychiatric problem score in SD per number of effect allele se: Standard Error p: p-value n: Sample Size For more information, see PLOS ONE publication: Neumann A, Nolte IM, [...], Hartman C &amp; Tiemeier H. A genome-wide association study of total child psychiatric problems scores. PloS one. 2022 Aug 22;17(8):e0273116. https://doi.org/10.1371/journal.pone.0273116 Abstract: Substantial genetic correlations have been reported across psychiatric disorders and numerous cross-disorder genetic variants have been detected. To identify the genetic variants underlying general psychopathology in childhood, we performed a genome-wide association study using a total psychiatric problem score. We analyzed 6,844,199 common SNPs in 38,418 school-aged children from 20 population-based cohorts participating in the EArly Genetics and Lifecourse Epidemiology (EAGLE) consortium. The SNP heritability of total psychiatric problems was 5.4% (SE=0.01) and two loci reached genome-wide significance: rs10767094 and rs202005905. We also observed an association of SBF2, a gene associated with neuroticism in previous GWAS, with total psychiatric problems. The genetic effects underlying the total psychiatric problem score were shared with known genetic variants for common psychiatric disorders only (attention-deficit/hyperactivity disorder, anxiety, depression, insomnia) (rG &gt; 0.49), but not with autism or the less common adult disorders (schizophrenia, bipolar disorder, or eating disorders) (rG &lt; 0.01). Importantly, the total psychiatric problem score also showed at least a moderate genetic correlation of with intelligence, educational attainment, wellbeing, smoking, and body fat (rG &gt; 0.29).The results suggest that many common genetic variants are associated with childhood psychiatric symptoms and related phenotypes in general instead of with specific symptoms. Further research is needed to establish causality and pleiotropic mechanisms between psychiatric disorders and related traits

A genome-wide association study of total child psychiatric problems scores.

Substantial genetic correlations have been reported across psychiatric disorders and numerous cross-disorder genetic variants have been detected. To identify the genetic variants underlying general psychopathology in childhood, we performed a genome-wide association study using a total psychiatric problem score. We analyzed 6,844,199 common SNPs in 38,418 school-aged children from 20 population-based cohorts participating in the EAGLE consortium. The SNP heritability of total psychiatric problems was 5.4% (SE = 0.01) and two loci reached genome-wide significance: rs10767094 and rs202005905. We also observed an association of SBF2, a gene associated with neuroticism in previous GWAS, with total psychiatric problems. The genetic effects underlying the total score were shared with common psychiatric disorders only (attention-deficit/hyperactivity disorder, anxiety, depression, insomnia) (rG > 0.49), but not with autism or the less common adult disorders (schizophrenia, bipolar disorder, or eating disorders) (rG 0.29). The results suggest that many common genetic variants are associated with childhood psychiatric symptoms and related phenotypes in general instead of with specific symptoms. Further research is needed to establish causality and pleiotropic mechanisms between related traits