We used genome wide expression (GWE) data of circulating blood cells and pathway analysis to investigate the inflammatory and other molecular pathways that may be associated with long-standing depressive symptoms. Participants were 607 women and 316 men (mean age 42 years) from the Young Finns Study who participated in three consecutive study phases in 2001, 2007 and 2012. Using Gene-set enrichment analyses (GSEA) we focused our analyses to pathways (available in MSigDB database) that are likely to affect immunological and inflammatory processes. GSEA were performed for blood cell GWE data in 2012. Depressive symptoms were assessed using a modified 21-item Beck Depression Inventory in each of the three study phases. Participants who scored in the top quartile of depressive symptoms in each of the three measurement points (n = 191) differed from other participants (n = 732) in several gene-set pathways related to inflammatory processes or immune-inflammatory signaling including interleukin (IL-1) pathway, and pathways related to various immuno-inflammatory processes, such as toll-like, the NEF protein, the nuclear factor kB, the kinase AKT and the mature B cell antigen receptor pathway (false discovery rates, FDRs
We examined the association between adulthood emotionality-activity-sociability temperament scale and preclinical atherosclerosis and, whether this association is mediated by cardiovascular risk factors (low-density lipoprotein cholesterol, systolic blood pressure, diastolic blood pressure and body-mass index (BMI)). The participants were a nationally representative sample of 537 men and 811 women from the Cardiovascular Risk in Young Finns study aged 15-30 years at the baseline in 1992 and aged 24-39 years at the follow-up in 2001. Carotid atherosclerosis was assessed by ultrasound scans of the common carotid artery intima-media thickness (IMT) and brachial flow-mediated dilation (FMD). In men, there was an association between the temperament dimension activity and IMT (ß = 0.08, p = 0.036) which was partially mediated by BMI (ß decreased from 0.08 to 0.05; p-value of Sobel test = 0.002). However, after correction for multiple comparisons the association between IMT and the temperament dimension activity in men was only of borderline significance. In women, there were no associations between temperament and IMT or FMD. These results suggest that a highly active temperament may contribute to early signs of atherosclerosis in men and that body mass may mediate this association.
It is generally acknowledged that depressed patients need specific attention during the first weeks after initiation of antidepressant (AD) treatment because of the increased risk of suicide.
The study population consisted of all individuals residing in Finland from 1999 to 2003 who had purchased a prescribed antidepressant at least once but had no preceding antidepressant prescription. Data sources were the National Prescription Register, the Causes of Death Register, Census Data of Statistics Finland, and the National Care Register. Follow-up started at the first purchase and ended at the end of 2003 or death. Data on prescriptions were used to construct contiguous treatment periods of follow-up time. Life-table analysis with Poisson regression was used to estimate risk ratios (RR) of antidepressant use with respect to all-cause mortality and to deaths from suicide.
Current AD use was associated with a lowered all-cause mortality (RR = 0.18, 95% CI = 0.18-0.19) compared with those who filled one previous prescription only. There was no difference in suicide mortality when any current antidepressant usage was compared to the one-prescription group. Current SSRI usage was associated with lower risk of suicide compared to the one-prescription or other antidepressant groups (RR 0.47, 0.38-0.59).
Current AD treatment is associated with decreased all-cause mortality rates in patients who have ever had AD treatment.
Work done in the emergency departments is one stressful aspect of physicians' work. Numerous previous studies have highlighted the stressfulness of on-call work and especially of night on call. In addition, previous studies suggest that there may be individual differences in adjusting to changes in circadian rhythms and on-call work.
The objective of this study was to examine whether physicians' on-call work is associated with perceived work-related stress factors and job resources and whether there are groups that are more vulnerable to on-call work according to sex, age, and specialization status.
This was a cross-sectional questionnaire study among 3230 Finnish physicians (61.5% women). The analyses were conducted using analyses of covariance adjusted for sex, age, specialization status, and employment sector.
Physicians with on-call duties had more time pressure and stress related to team work and patient information systems compared with those who did not have on-call duties. In addition, they had less job control opportunities and experienced organization as less fair and team climate as worse. Older physicians and specialists seemed to be especially vulnerable to on-call work regarding stress factors, whereas younger and specialist trainees seemed vulnerable to on-call work regarding job resources.
Focusing on team issues and resources is important for younger physicians and trainees having on-call duties, whereas for older and specialists, attention should be focused on actual work load and time pressure.
A growing body of research indicates that cross-cultural competence in nurses can improve migrant patients' health-related outcomes, but little is known about the potential benefits of cross-cultural competence on the nurses' own well-being.
To examine whether cross-cultural competence (empathy, skills, positive attitudes, and motivation) is associated with perceived time pressure at work, psychological distress, and sleep problems among registered nurses in Finland, and whether there are differences in these potential associations between native and foreign-born nurses.
The present cross-sectional study was based on a sample of 212 foreign-born nurses licensed to practice in Finland and a random sample of 744 native Finnish nurses. Data were collected with a questionnaire and analyzed using multiple linear regression and structural equation modeling (SEM).
Of all four dimensions of cross-cultural competence, only empathy was associated with perceived time pressure (ß = -0.13, p = .018), distress (ß = -0.23, p .05).
Cross-cultural empathy may protect against perceived time pressure, distress, and sleep problems in both native and foreign-born nurses. Thus, the promotion of this component of cross-cultural competence among nursing personnel should be encouraged.
The psychosocial determinants of prediabetes are poorly understood. The aims of our study were (1) to analyse the association between perceived social support in young adulthood and fasting glucose levels and prediabetes in mid-adulthood in a cohort of healthy Finns, (2) to explore whether body mass index (BMI), inflammation or depression mediate this relationship, (3) and to examine the association between social support trajectory groups and fasting glucose.
A prospective design was used with an analytic sample of 1250 participants aged 3-18 years at baseline (1980) and aged 12-39 years when social support was measured. Fasting glucose and prediabetes were assessed 32 years after baseline. Linear and logistic regression was used to examine the association between social support and the outcome measures. A bootstrapping technique was used to examine mediation effects.
Social support was associated with future glucose levels in women after adjusting for childhood socioeconomic status (SES) and youth depression (ß = -0.136, p = 0.001) and also predicted prediabetes in women after adjusting for childhood SES (ß = 1.31, 95 % CI 1.02 to 1.69, p = 0.031). Both associations were attenuated after adjusting for BMI in mid-adulthood. BMI was found to mediate the relationship between social support and prediabetes in women (ß for indirect effect ß = 0.09, SE = 0.03, CI = 0.03 to 0.16).
Low perceived social support in young adulthood is associated with high fasting glucose and prediabetes in mid-adulthood in women but not men. The association between social support and prediabetes in women can be partly explained by BMI.
Cites: Int J Epidemiol. 2008 Dec;37(6):1220-618263651
Mixed results have been reported on the association between the type 4 dopamine receptor gene (DRD4) and the temperament dimension of novelty seeking. We tested this association by specifying the analysis to components of novelty seeking.
Participants were 150 high and low novelty-seeking scorers (the highest and lowest 10%) from a randomized, population-based sample of Finnish citizens in six age cohorts. We genotyped a 48-bp repeat polymorphism in the DRD4 gene. Novelty seeking was assessed by the Temperament and Character Inventory.
No difference in overall novelty seeking between individuals with no seven-repeat allele (short) and any seven-repeat allele (long), between the 4,4 and 4,7 genotype groups, and between long (l/l and s/l) and short (s/s) polymorphism groups were found. The odds ratio for high overall novelty seeking in the presence of any two- or five-repeated alleles vs. none was 2.41 (95% CI, 1.11-5.20). Corresponding odds ratios were significant for exploratory excitability (2.94; 95% CI, 1.32-6.59) and impulsiveness (2.74; 95% CI, 1.23-6.11) but not for other components of novelty seeking. No interactions with age or gender were detected.
The present study confirmed previous findings on the association between the type 4 dopamine receptor gene and novelty seeking, in particular exploratory excitability and impulsiveness. The tendency to avoid or approach a novel situation is a core concept of several temperamental theories. The present findings support the hypothesis that this tendency is associated with DRD4 and might concern temperament psychology in general, not only the concept of novelty seeking.
It is unclear whether age at menarche is an independent determinant of future cardiovascular risk.
We aimed to determine whether menarcheal age is an independent predictor of body mass index (BMI) and a wide range of cardiovascular risk factors in adolescence and adulthood.
We examined the associations of menarcheal age with BMI (in kg/m(2)) and other cardiovascular risk factors in adolescence and adulthood in a population-based sample of 794 female adolescents aged 9-18 y at baseline. Their age at first menstruation was requested at baseline and again 3 and 6 y later. Cardiovascular risk factors were assessed at baseline and at age 30-39 y.
A 1-y decrease in menarcheal age was associated with 0.81 (95% CI: 0.53, 1.08) higher adult BMI as well as greater waist circumference and waist-to-hip ratio, elevated systolic blood pressure, higher insulin resistance, and greater risk of metabolic syndrome (P
We examined the associations of contractual job insecurity (fixed-term vs permanent employment contract) and subjectively assessed job insecurity with sickness presenteeism among those who had no sickness absences during the study year.
Survey data from a sample of 18,454 Public sector employees were gathered in 2004 (the Finnish Public Sector study).
Fixed-term employees were less likely to report working while ill (odds ratio = 0.88, 95% confidence interval = 0.77 to 0.99) than permanent employees. Subjective insecurity was associated with higher levels of working while ill, and this association was stronger among older employees. These results remained after adjustments for demographics, health-related variables, and optimism.
Our results suggest that subjective job insecurity might be even more important than contractual insecurity when a public sector employee makes the decision to go to work despite feeling ill.
The present study examined whether job control moderated the association between stress indicators (distress and sleeping problems) and intentions to change profession among 2,650 Finnish physicians. Ordinal logistic regression analysis was applied. The authors found that high levels of distress and sleeping problems were associated with higher levels of intentions to change profession, whereas high job control was associated with lower levels of intentions to change profession even after adjusting for the effects of gender, age, and employment sector. In addition, high job control was able to mitigate the positive association that distress and sleeping problems had with intentions to change profession. Our findings highlight the importance of offering more job control to physicians to prevent unnecessary physician turnover.