Cardiovascular health of Finnish women working in the public sector with special reference to psychosocial and work-related factors, self-rated health and physical capability

Background: In 2010 the American Heart Association (AHA) released the positive concept of ideal cardiovascular health (CVH) aiming to improve the population’s health by setting goals and targets reachable with a healthy lifestyle. According to AHA, ideal CVH consists of not smoking, eating a healthy diet, and being physically active, together with maintaining normal weight, total cholesterol, blood pressure and fasting glucose. Aims: The aim of the present study was to identify the prevalence of ideal CVH in females working in the municipal sector, and to study the relationships of ideal CVH metrics with the non-traditional cardiovascular disease (CVD) risk factors. Participants and methods: The present study is part of the PORTAAT (PORi To Aid Against Threats) study designed to evaluate CVD risk factors among the employees of the city of Pori, Finland. Female participants of the 2014 study were included in this thesis with no exclusion criteria (n=732, age-range 19-66 years). Classical CVD risk factors were studied with the ideal CVH metrics of AHA, and health questionnaires were filled in by the subjects, including core questions about psychosocial risk factors, UWES-9 (Utrecht Work Engagement Scale), and self-rated health. Also, physical capability (grip strength, chair-rise time, one-legged standing balance, and six minutes’ walking test) was measured. Results: All 7 ideal CVH metrics were achieved only by 1.2% of the subjects, while 25.0% fulfilled 5-7 of the ideal CVH metrics. Psychosocial risk factors had a negative relationship, while work engagement had a positive relationship with the sum of ideal CVH metrics. The presence of even one psychosocial risk factor had the potential to associate negatively with work engagement regardless of the sum of ideal CVH metrics. In addition, even among women with 5–7 ideal CVH metrics, over 50.0% had at least one psychosocial risk factor. Our study also revealed that the sum of ideal CVH metrics positively associated with good self-rated health driven by favorable health behaviors (nonsmoking, normal body mass index, healthy diet and physical activity). Moreover, physical capability was related to the sum of ideal CVH metrics, as well as the categories of recommended level of aerobic physical activity. Conclusions: Ideal CVH was rare among female employees. Furthermore, all studied non-traditional CVD risk factors had an association with the ideal CVH concept. However, the causal relationship of the associations remains unsolved due to the cross-sectional study design.Kunta-alalla työskentelevien suomalaisten naisten ihanteellinen sydänterveys – mielenkiinnon kohteina psykososiaaliset riskitekijät, työn imu, itsekoettu terveys sekä fyysinen suorituskyky Tausta: Vuonna 2010 julkaistiin Yhdysvaltain sydänjärjestön toimesta ihanteellisen sydänterveyden konsepti, joka pyrkii parantamaan kansanterveyttä asettamalla tavoitteita, jotka ovat saavutettavissa terveellisillä elämäntavoilla. Ihanteellinen konsepti koostuu seitsemästä muuttujasta: tupakoimattomuudesta, terveellisestä ruokavaliosta ja riittävästä liikunnasta yhdessä normaalin painon, kokonaiskolesterolin, verenpaineen sekä paastosokerin kanssa. Tavoite: Tämän tutkimuksen tavoitteena oli määrittää ihanteellisen sydänterveyden esiintyvyys naispuolisilla kuntatyöntekijöillä sekä tutkia konseptin yhteyttä ei-perinteisiin sydän- ja verisuonitautien riskitekijöihin. Menetelmät: Tämä tutkimus on osa PORTAAT-tutkimusta, joka on suunniteltu tarkastelemaan sydän-ja verisuonitautien riskitekijöitä Porin kaupungin työntekijöillä. Tähän tutkimukseen otettiin ilman poissulkukriteereitä vuonna 2014 osallistuneet naistyöntekijät (n=732). Sydän- ja verisuonitautien riskitekijät määritettiin ihanteellisen sydänterveyden muuttujin sekä tutkittavien täyttämillä kyselykaavakkeilla, jotka sisälsivät psykososiaalisten riskitekijöiden avainkysymykset ja kyselyt työn imusta ja itsekoetusta terveydestä. Lisäksi fysioterapiaopiskelijat mittasivat tutkittavien fyysisen suorituskyvyn (puristusvoima, tuolilta ylösnousutesti, yhden jalan tasapainotesti ja kuuden minuutin kävelytesti). Tulokset: Vain 1.2% tutkittavista saavutti ihanteellisen sydänterveyden määritelmän, vaikka 25.0% täytti 5-7 ihanteellista muuttujaa. Psykososiaalisilla riskitekijöillä oli negatiivinen yhteys, kun taas työn imulla positiivinen yhteys ihanteelliseen sydänterveyteen. Kuitenkin yhdenkin psykososiaalisen riskitekijän olemassaolo liittyi negatiivisesti työn imuun huolimatta ihanteellisesta sydänterveydestä. Vähintään yksi psykososiaalinen riskitekijä oli yli puolella naisista, joilla oli hyvä sydänterveyden taso (5-7 ihanteellista muuttujaa). Konsepti liittyi positiivisesti myös hyvään itsekoettuun terveyteen elintapojen välityksellä (tupakoimattomuus, normaali paino, terveellinen ruokavalio ja liikunnallinen aktiivisuus) sekä fyysiseen suorituskykyyn. Johtopäätökset: Ihanteellinen terveys oli harvinaista työikäisillä naisilla. Lisäksi ei-perinteiset sydän- ja verisuonitautien riskitekijät olivat yhteydessä ihanteelliseen sydänterveyteen. Kuitenkin yhteyksien syy-seuraussuhde jää varmistumatta tutkimuksen poikkileikkausasetelman vuoksi

Experiences of belonging in the narratives of Japanese immigrants in Finland

Tämä tutkielma käsittelee Suomeen aikuisena muuttaneiden japanilaisten henkilöiden kokemuksia muutosta ja sen vaikutuksista elämään. Tutkielma osallistuu antropologiseen keskusteluun käsittelemällä erityisesti keskiluokkaisen muuttoliikkeen vaikutuksia ja uudelleentyöstämistä sekä jäämisen mahdollistamista. Keskeisin tutkimuskysymys on, minkälaisia kuuluvuuden käsityksiä Suomeen muuttaneiden japanilaisten kertomuksissa ilmeni. Kuuluvuuden lisäksi tutkielmassa analysoidaan holistisella otteella useita aiheita, kattaen kulttuurisen toiminnan, mielikuvien, vallan, kansallisuuden ja kansalaisuuden, yhteisöllisyyden sekä toimijuuden näkökulmia. Tutkielmassa tyypitellään ja luokitellaan havaintoja, jotka nousivat viidestä kahdenkeskisestä puolistrukturoidusta ja litteroidusta haastattelusta. Suomeen muuttamisen syyt liittyivät erityisesti arvostettuun ja tuettuun koulutukseen ja muihin positiivisiin mielikuviin Suomesta ja muista Pohjoismaista. Muuttoliikettä motivoivat erityisesti tuet ja ilmainen koulutus. Jäämistä hankaloittivat väliaikaiset oleskeluluvat, kaksoiskansalaisuuden mahdollisuuden puuttuminen ja suomen kielen oppimisen haasteet. Jäämistä mahdollistivat taloudellinen tuki, lasten koulutusmahdollisuudet, vakituinen työ, yhteisöihin osallistuminen, työn ja vapaa-ajan tasapaino sekä tyytyväisyys. Suomessa asumisen eduiksi koettiin esimerkiksi Japania parempi työn ja vapaa-ajan tasapaino, suurempi tasa-arvo ja matalampi hierarkia. Osallistujilla oli erilaisia, osin tilannesidonnaisia identiteettejä ja kuuluvuuden kokemuksia, jotka eivät vaikuttaneet liittyvän Suomessa vietetyn ajan pituuteen. Osallistujat osallistuivat vietetystä ajasta riippumatta suomalaiseksi, kansainväliseksi ja japanilaiseksi miellettyihin aktiviteetteihin ja yhteisöihin. Juhla- ja ruokakulttuuri olivat näkyvimpiä japanilaisen kulttuurin ilmenemismuotoja. Osallistujat suhtautuivat epäröivästi Suomen kansalaisuuden hakemiseen, sillä se tarkoittaisi Japanin kansalaisuudesta luopumista. Suomesta poismuuttamista kohtaan ei ollut vahvoja pyrkimyksiä

Physical and mental health factors associated with work engagement among Finnish female municipal employees: A cross-sectional study

Objectives: Work engagement is related to mental health, but studies of physical health’s association with work engagement are scarce. This study aims to evaluate the relationship between physical health, psychosocial risk factors and work engagement among Finnish women in municipal work units.Methods: A cross-sectional study was conducted in 2014 among 726 female employees from 10 municipal work units of the city of Pori, Finland. Work engagement was assessed with the nine-item Utrecht Work Engagement Scale. The American Heart Association’s concept of ideal cardiovascular health (CVH) was used to define physical health (non-smoking, body mass index Results: Of the study subjects, 25.2% had favourable 5–7 CVH metrics. The sum of CVH metrics, healthy diet and physical activity at goal were positively associated with work engagement. In subjects without psychosocial risk factors (36.7%), work engagement was high and stable. Presence of even one psychosocial risk factor was associated with a lower level of work engagement regardless of the sum of ideal CVH metrics.Conclusions: Both physical and mental health factors have a positive relationship with work engagement, whereas the presence of even one psychosocial risk factor has a negative association regardless of the level of classic cardiovascular risk factors.</p

Ideal cardiovascular health and psychosocial risk factors among Finnish female municipal workers

Aims: Ideal cardiovascular health has been defined by the American Heart Association as the absence of disease and the presence of seven key health factors and behaviours. However, little is known about the mental aspects associated with ideal cardiovascular health metrics. The objective of this study was to assess the relationships between psychosocial risk factors and ideal cardiovascular health metrics among Finnish women at municipal work units. Method: A cross-sectional study was conducted in Finland among 732 female employees (mean +/- SD age 48 +/- 10 years) from ten work units in 2014. Ideal cardiovascular health metrics were evaluated with a physical examination, laboratory tests, medical history and self-administrated questionnaires. Psychosocial risk factors (social isolation, stress, depressive symptoms, anxiety, hostility and type D personality) were assessed with core questions as suggested by the European Society of Cardiology. Results: The prevalence of having 5-7 ideal cardiovascular health metrics was 183 (25.0%), of whom 54.1% had at least one psychosocial risk factor. Anxiety (31.3%), work stress (30.7%) and type D personality (26.1%) were the most prevalent of the psychosocial risk factors. The prevalence of depressive symptoms (pPeer reviewe

The role of psychosocial risk factors in the burden of headache

Purpose: Psychosocial risk factors are common in headache patients and affect the impact of headache in multiple ways. The aim of our study was to assess how psychosocial risk factors correlate with the headache impact test-6 (HIT-6). To our knowledge this is the first study to evaluate the impact of several psychosocial factors on the HIT-6 score. Patients and methods: Our study population consisted of 469 Finnish female employees reporting headache during the past year. Psychosocial risk factors were assessed using validated, self-administered questionnaires: the generalized anxiety disorder 7-item scale (GAD-7) for anxiety, the major depression inventory (MDI) for depressive symptoms, the ENRICHD short social support instrument (ESSI) for social isolation, the cynical distrust scale for hostility and the Bergen burnout indicator (BBI-15) for work stress. Results: Exploratory factor analysis of the HIT-6 scores revealed two factors, one describing psychological and quality of life aspects affected by headache and the other describing severity of pain and functional decline. Internal consistency of the HIT-6 was 0.87 (95% CI: 0.85-0.89). Correlations between the total HIT-6 score and all measured psychosocial risk factors except for hostility were weak, but statistically significant. Conclusion: The HIT-6 questionnaire has good construct validity and it describes reliably and independently the impact of headache without interference of psychosocial factors in general working-aged female population.Peer reviewe

Self-rated health as an indicator of ideal cardiovascular health among working-aged women

Objective: The aim of this study was to assess the relationship between self-rated health (SRH) and the American Heart Association's (AHA) concept of ideal cardiovascular health (CVH) among female municipal employees. Studies about the association are scarce, even though AHA recommends to use SRH status surveys in clinical practice and research settings of CVH.Design: Cross-sectional study conducted in 2014.Setting: SRH was assessed with a one-item question and the data of seven ideal CVH measurements (nonsmoking, body mass index <25.0 kg/m(2), healthy diet, physical activity at goal, blood pressure <120/80 mmHg, cholesterol <5.18 mmol/l and glucose (HbA1c < 6.0%)) was gathered with a physical examination, laboratory tests, medical history and self-administrated questionnaires.Subjects: A total of 725 female subjects from 10 work units of the city of Pori, Finland.Main outcome measures: SRH and ideal CVH.Results: Of the study subjects, 28.8% reported ill-health (poor/fair SRH). The sum of ideal CVH metrics was positively associated with good SRH driven by favorable health behaviors (nonsmoking, normal body mass index, healthy diet and physical activity). A linear decrease in the prevalence of 0-2 ideal CVH metrics, and a linear increase in 5-7 metrics was associated with better SRH. Nonsmoking and normal weight were the most potent indicators of good SRH in multivariate analysis.Conclusions: Most of the subjects with 0-3 of the seven CVH metrics at ideal level were dissatisfied with their health. Since unhealthy lifestyle factors accumulate mainly to people feeling ill-health, the value of SRH is worth recognizing especially in primary health care

Ideal cardiovascular health and quality of life among Finnish municipal employees

Ideal cardiovascular health has been defined by the American Heart Association as the absence of clinically manifest cardiovascular disease together with the presence of favorable levels of cardiovascular health metrics. The ideal metrics are hard to achieve and the aim of this study was to assess the association between favorable cardiovascular health and perceived overall quality of life (QoL).A cross-sectional study was conducted in Finland among 836 employees in 2014 (732 women, 104 men, mean age 48 (SD 10) years) from ten municipal work units. The ideal metrics were evaluated with a physical examination, laboratory tests, medical history and self-administered questionnaires. The cardiovascular health was categorized into three groups by achievement of the ideal metrics. QoL was assessed with the EUROHIS-QOL 8-item index.The prevalence of having 5–7 of the ideal metrics was 25.1% (210), of having 3–4 it was 53.6% (448) and for 0–2 it was 21.3% (178). The EUROHIS-QOL mean score among all participants was 3.92 (SD 0.54). The EUROHIS-QOL mean score had a positive association with the sum of ideal metrics, and was 3.72, 3.91 and 4.10 among subjects with 0–2, 3–4 and 5–7 ideal metrics, respectively. Furthermore, poor sleep quality and disease burden had a significant negative association with QoL.A favorable cardiovascular health status together with good sleep quality seems to have a clear association with overall quality of life among employees in municipal work units.</p

Adjusting bone mass for differences in projected bone area and other confounding variables: an allometric perspective.

The traditional method of assessing bone mineral density (BMD; given by bone mineral content [BMC] divided by projected bone area [Ap], BMD = BMC/Ap) has come under strong criticism by various authors. Their criticism being that the projected bone "area" (Ap) will systematically underestimate the skeletal bone "volume" of taller subjects. To reduce the confounding effects of bone size, an alternative ratio has been proposed called bone mineral apparent density [BMAD = BMC/(Ap)3/2]. However, bone size is not the only confounding variable associated with BMC. Others include age, sex, body size, and maturation. To assess the dimensional relationship between BMC and projected bone area, independent of other confounding variables, we proposed and fitted a proportional allometric model to the BMC data of the L2-L4 vertebrae from a previously published study. The projected bone area exponents were greater than unity for both boys (1.43) and girls (1.02), but only the boy's fitted exponent was not different from that predicted by geometric similarity (1.5). Based on these exponents, it is not clear whether bone mass acquisition increases in proportion to the projected bone area (Ap) or an estimate of projected bone volume (Ap)3/2. However, by adopting the proposed methods, the analysis will automatically adjust BMC for differences in projected bone size and other confounding variables for the particular population being studied. Hence, the necessity to speculate as to the theoretical value of the exponent of Ap, although interesting, becomes redundant

The role of psychosocial risk factors in the burden of headache

Purpose: Psychosocial risk factors are common in headache patients and affect the impact of headache in multiple ways. The aim of our study was to assess how psychosocial risk factors correlate with the headache impact test-6 (HIT-6). To our knowledge this is the first study to evaluate the impact of several psychosocial factors on the HIT-6 score.Patients and methods: Our study population consisted of 469 Finnish female employees reporting headache during the past year. Psychosocial risk factors were assessed using validated, self-administered questionnaires: the generalized anxiety disorder 7-item scale (GAD-7) for anxiety, the major depression inventory (MDI) for depressive symptoms, the ENRICHD short social support instrument (ESSI) for social isolation, the cynical distrust scale for hostility and the Bergen burnout indicator (BBI-15) for work stress.Results: Exploratory factor analysis of the HIT-6 scores revealed two factors, one describing psychological and quality of life aspects affected by headache and the other describing severity of pain and functional decline. Internal consistency of the HIT-6 was 0.87 (95% CI: 0.85-0.89). Correlations between the total HIT-6 score and all measured psychosocial risk factors except for hostility were weak, but statistically significant.Conclusion: The HIT-6 questionnaire has good construct validity and it describes reliably and independently the impact of headache without interference of psychosocial factors in general working-aged female population.</p

O-sulfated bacterial polysaccharides with low anticoagulant activity inhibit metastasis

Heparin-like polysaccharides possess the capacity to inhibit cancer cell proliferation, angiogenesis, heparanase-mediated cancer cell invasion, and cancer cell adhesion to vascular endothelia via adhesion receptors, such as selectins. The clinical applicability of the antitumor effect of such polysaccharides, however, is compromised by their anticoagulant activity. We have compared the potential of chemically O-sulfated and N,O-sulfated bacterial polysaccharide (capsular polysaccharide from E. coli K5 [K5PS]) species to inhibit metastasis of mouse B16-BL6 melanoma cells and human MDA-MB-231 breast cancer cells in two in vivo models. We demonstrate that in both settings, O-sulfated K5PS was a potent inhibitor of metastasis. Reducing the molecular weight of the polysaccharide, however, resulted in lower antimetastatic capacity. Furthermore, we show that O-sulfated K5PS efficiently inhibited the invasion of B16-BL6 cells through Matrigel and also inhibited the in vitro activity of heparanase. Moreover, treatment with O-sulfated K5PS lowered the ability of B16-BL6 cells to adhere to endothelial cells, intercellular adhesion molecule-1, and P-selectin, but not to E-selectin. Importantly, O-sulfated K5PSs were largely devoid of anticoagulant activity. These findings indicate that O-sulfated K5PS polysaccharide should be considered as a potential antimetastatic agent.</p