Multiple socioeconomic circumstances and health : associations and explanations among Finnish and British public sector employees

Socioeconomic health inequalities have been widely documented, with a lower social position being associated with poorer physical and general health and higher mortality. For mental health the results have been more varied. However, the mechanisms by which the various dimensions of socioeconomic circumstances are associated with different domains of health are not yet fully understood. This is related to a lack of studies tackling the interrelations and pathways between multiple dimensions of socioeconomic circumstances and domains of health. In particular, evidence from comparative studies of populations from different national contexts that consider the complexity of the causes of socioeconomic health inequalities is needed. The aim of this study was to examine the associations of multiple socioeconomic circumstances with physical and mental health, more specifically physical functioning and common mental disorders. This was done in a comparative setting of two cohorts of white-collar public sector employees, one from Finland and one from Britain. The study also sought to find explanations for the observed associations between economic difficulties and health by analysing the contribution of health behaviours, living arrangements and work-family conflicts. The survey data were derived from the Finnish Helsinki Health Study baseline surveys in 2000-2002 among the City of Helsinki employees aged 40-60 years, and from the fifth phase of the London-based Whitehall II study (1997-9) which is a prospective study of civil servants aged 35-55 years at the time of recruitment. The data collection in the two countries was harmonised to safeguard maximal comparability. Physical functioning was measured with the Short Form (SF-36) physical component summary and common mental disorders with the General Health Questionnaire (GHQ-12). Socioeconomic circumstances were parental education, childhood economic difficulties, own education, occupational class, household income, housing tenure, and current economic difficulties. Further explanatory factors were health behaviours, living arrangements and work-family conflicts. The main statistical method used was logistic regression analysis. Analyses were conducted separately for the two sexes and two cohorts. Childhood and current economic difficulties were associated with poorer physical functioning and common mental disorders generally in both cohorts and sexes. Conventional dimensions of socioeconomic circumstances i.e. education, occupational class and income were associated with physical functioning and mediated each other’s effects, but in different ways in the two cohorts: education was more important in Helsinki and occupational class in London. The associations of economic difficulties with health were partly explained by work-family conflicts and other socioeconomic circumstances in both cohorts and sexes. In conclusion, this study on two country-specific cohorts confirms that different dimensions of socioeconomic circumstances are related but not interchangeable. They are also somewhat differently associated with physical and mental domains of health. In addition to conventionally measured dimensions of past and present socioeconomic circumstances, economic difficulties should be taken into account in studies and attempts to reduce health inequalities. Further explanatory factors, particularly conflicts between work and family, should also be considered when aiming to reduce inequalities and maintain the health of employees.

Kurt and Hal Gottschalk exercising with a medicine ball in a reproduction of an illustration for the book "Kinder-Turnen in Haus" by Fritz Strube. Sports

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Search For Susceptibility Genes In Schizophrenia

Schizophrenia is a severe mental disorder affecting 0.4-1% of the population worldwide. It is characterized by impairments in the perception of reality and by significant social or occupational dysfunction. The disorder is one of the major contributors to the global burden of diseases. Studies of twins, families, and adopted children point to strong genetic components for schizophrenia, but environmental factors also play a role in the pathogenesis of disease. Molecular genetic studies have identified several potential positional candidate genes. The strongest evidence for putative schizophrenia susceptibility loci relates to the genes encoding dysbindin (DTNBP1) and neuregulin (NRG1), but studies lack impressive consistency in the precise genetic regions and alleles implicated. We have studied the role of three potential candidate genes by genotyping 28 single nucleotide polymorphisms in the DNTBP1, NRG1, and AKT1 genes in a large schizophrenia family sample consisting of 441 families with 865 affected individuals from Finland. Our results do not support a major role for these genes in the pathogenesis of schizophrenia in Finland. We have previously identified a region on chromosome 5q21-34 as a susceptibility locus for schizophrenia in a Finnish family sample. Recently, two studies reported association between the γ-aminobutyric acid type A receptor cluster of genes in this region and one study showed suggestive evidence for association with another regional gene encoding clathrin interactor 1 (CLINT1, also called Epsin 4 and ENTH). To further address the significance of these genes under the linkage peak in the Finnish families, we genotyped SNPs of these genes, and observed statistically significant association of variants between GABRG2 and schizophrenia. Furthermore, these variants also seem to affect the functioning of the working memory. Fetal events and obstetric complications are associated with schizophrenia. Rh incompatibility has been implicated as a risk factor for schizophrenia in several epidemiological studies. We conducted a family-based candidate-gene study that assessed the role of maternal-fetal genotype incompatibility at the RhD locus in schizophrenia. There was significant evidence for an RhD maternal-fetal genotype incompatibility, and the risk ratio was estimated at 2.3. This is the first candidate-gene study to explicitly test for and provide evidence of a maternal-fetal genotype incompatibility mechanism in schizophrenia. In conclusion, in this thesis we found evidence that one GABA receptor subunit, GABRG2, is significantly associated with schizophrenia. Furthermore, it also seems to affect to the functioning of the working memory. In addition, an RhD maternal-fetal genotype incompatibility increases the risk of schizophrenia by two-fold.

Genetic Mechanisms of Tumourigenesis in von Hippel-Lindau-Associated Tumours with the Emphasis on Capillary Hemangioblastoma

The von Hippel-lindau (VHL) disease is a dominantly inherited neoplastic disorder which predisposes patients to multiple tumours including capillary haemangioblastomas (CHBs), pheochromocytomas (PCCs), renal cell carcinomas (RCCs). CHBs are the most common manifestations of VHL disease, occurring sporadically or as a manifestation of VHL disease. Inactivation of the VHL gene at 3p25-26 is believed to cause both familial and sporadic VHL-associated tumours and germ-line mutation of the VHL gene have been detected in 100% of the CHBs studied. However, a limited number of sporadic CHBs, PCCs display VHL inactivation. Other molecular alterations involved in tumourigenesis of sporadic CHBs, PCCs remain largely unknown. The purpose of the present work was to search for genetic alterations, or other mechanisms of inactivation, in addition to the VHL gene, that may be important in the development of VHL-associated tumours. Though less satisfactory than cure, prevention and early detection are the most promising and feasible means reducing cancer morbidity and mortality. This work is based on the view that increasing knowledge about the molecular events underlying tumour development will eventually aid in early detection and lead to improved treatment. We evaluated a large set of VHL-associated patients, searched for a clinical and radiologic signs of the disease. We succesfully performed a germ-line mutation analysis and characterised three patient groups, VHL, suspect VHL and sporadic, a germ-line mutation analysis revealed a 50% mutation rate only in the VHL groups, no sporadic or suspect cases displayed any mutation. We also utilized comparative genomic hybridization (CGH) to screen for DNA copy number changes in both sporadic and VHL-associated CHB. Our analysis revealed (27%) DNA copy number losses. The most common finding was loss of chromosomal arm 6q, seen in (23%) cases, No differences were noted between VHL-associated and sporadic tumours. Furthermore a loss of heterozygosity (LOH) study on chromosome 3p and 6q was done with the purpose to determine allele losses not observable by CGH, and to uncover the location of putative tumour suppressor genes important in CHB and PCC tumourigenesis. We identified loss of chromosome 6q and a minimal deleted area at 6q23-24 in CHBs. We also showed LOH at 6q23-24 in PCCs and identified the ZAC1 (6q24-25) as a candidate gene, ZAC1 is a maternally imprinted tumour suppressor gene with anti proliferative properties. To study further the role of ZAC inactivation in CHBs, we investigated LOH, promoter hypermethylation and expression status of the ZAC1 gene in mainly sporadic CHBs. Our LOH analysis revealed that the majority of the tumours with allele loss. The gene promoter methylation analysis similarly detected predominance of the methylated ZAC sequence in almost all tumours. Immunohistochemistry exhibited a strongly reduced expression of ZAC in stromal cells of all CHBs studied. Our current results indicate that the absence of the unmethylated, ZAC1 promoter sequence was highly concurrent with LOH for the ZAC1 region or 6q loss. This observation together with lack of ZAC expression, points to preferential loss of the non imprinted, expressed ZAC allele in CHB, in summary, our series of studies reveal a new chromosomal region 6q, emphasizes the importance of ZAC1 gene in the development of CHB and PCC, particularly in non-VHL associated cases.

New Functional Biomaterials for Medicine and Healthcare

The book begins with an overview of the use of biomaterials in contemporary healthcare and the process of developing novel biomaterials; the key issues and challenges associated with the design of complex implantable systems are also highlighted. The book then reviews the main materials used in functional biomaterials, particularly their properties and applications. Individual chapters focus on both natural and synthetic polymers, metallic biomaterials, and bio-inert and bioactive ceramics.

Older job seekers' job search intensity: The interplay of proactive personality, age and occupational future time perspective

Long-term unemployment of older people can have severe consequences for individuals, communities and ultimately economies, and is therefore a serious concern in countries with an ageing population. However, the interplay of chronological age and other individual difference characteristics in predicting older job seekers' job search is so far not well understood. This study investigated relationships among age, proactive personality, occupational future time perspective (FTP) and job search intensity of 182 job seekers between 43 and 77 years in Australia. Results were mostly consistent with expectations based on a combination of socio-emotional selectivity theory and the notion of compensatory psychological resources. Proactive personality was positively related to job search intensity and age was negatively related to job search intensity. Age moderated the relationship between proactive personality and job search intensity, such that the relationship was stronger at higher compared to lower ages. One dimension of occupational FTP (perceived remaining time left in the occupational context) mediated this moderating effect, but not the overall relationship between age and job search intensity. Implications for future research, including the interplay of occupational FTP and proactive personality, and some tentative practical implications are discussed.

The buffering effect of selection, optimization, and compensation strategy use on the relationship between problem solving demands and occupational well-being: A daily diary study

This study investigated within-person relationships between daily problem solving demands, selection, optimization, and compensation (SOC) strategy use, job satisfaction, and fatigue at work. Based on conservation of resources theory, it was hypothesized that high SOC strategy use boosts the positive relationship between problem solving demands and job satisfaction, and buffers the positive relationship between problem solving demands and fatigue. Using a daily diary study design, data were collected from 64 administrative employees who completed a general questionnaire and two daily online questionnaires over four work days. Multilevel analyses showed that problem solving demands were positively related to fatigue, but unrelated to job satisfaction. SOC strategy use was positively related to job satisfaction, but unrelated to fatigue. A buffering effect of high SOC strategy use on the demands-fatigue relationship was found, but no booster effect on the demands-satisfaction relationship. The results suggest that high SOC strategy use is a resource that protects employees from the negative effects of high problem solving demands.

Remaining time and opportunities at work: Relationships between age, work characteristics, and occupational future time perspective

The authors adapted the concept of future time perspective (FTP) to the work context and examined its relationships with age and work characteristics (job complexity and control). Structural equation modeling of data from 176 employees of various occupations showed that age is negatively related to 2 distinct dimensions of occupational FTP: remaining time and remaining opportunities. Work characteristics (job complexity and control) were positively related to remaining opportunities and moderated the relationship between age and remaining opportunities, such that the relationship became weaker with increasing levels of job complexity and control.

Was wollen jüngere und ältere Erwerbstätige erreichen? Altersbezogene Unterschiede in den Inhalten und Merkmalen beruflicher Ziele [What do younger and older workers want to accomplish? Age-related differences in content and characteristics of occupational goals ]

Demographic changes necessitate that companies commit younger workers and motivate older workers through work design. Age-related differences in occupational goals should be taken into account when accomplishing these challenges. In this study, we investigated goal contents and goal characteristics of employees from different age groups. We surveyed 150 employees working in the service sector (average age = 44 years, age range 19 to 60 years) on their most important occupational goals. Employees who stated goals from the area of organizational citizenship were significantly older than employees with other goals. Employees who stated goals from the areas of training and pay/career were significantly younger than employees with other goals. After controlling for gender, education, and work characteristics, no age-related differences were found in the goal areas teamwork, job security, working time, well-being, and new challenges. In addition, no relationships were found between age and the goal characteristics specificity, planning intensity, as well as positive and negative goal emotions. We recommend that companies provide older workers with more opportunities for organizational citizenship and commit younger workers by providing development opportunities and adequate pay

Links between emotional job demands and occupational well-being: Age differences depend on type of demand

In the growing health care sector, meeting emotional job demands is crucial to organizational outcomes but may negatively affect employees’ well-being. Drawing on the emotional aging literature, we predicted that two common emotional job demands, display demands (expressing positive, negative, and neutral emotions toward clients) and sensitivity demands (knowing what the client is feeling), affect older health care workers’ occupational well-being differently than young workers, as indicated by their job satisfaction and need for recovery. Survey data from employees of senior care homes (N = 141, aged between 17 and 62 years) confirmed the moderating role of age for links between emotional job demands and occupational well-being indicators. Emotional display demands were generally positively associated with emotional dissonance; however, the association between demands to display neutral emotions and emotional dissonance was stronger among young compared with older employees. In contrast, among older but not young employees, emotional dissonance was negatively associated with job satisfaction, and emotional sensitivity demands were positively associated with need for recovery. These findings suggest that age may confer both advantages (facing neutral display demands) and vulnerabilities (facing emotional dissonance and sensitivity demands) in managing emotional job demands.

Micro-breaks matter: A diary study on the effects of energy management strategies on occupational well-being

Organizational researchers and practitioners are increasingly interested in self-regulatory strategies employees can use at work to sustain or improve their occupational well-being. A recent cross-sectional study on energy management strategies suggested that many work-related strategies (e.g., setting a new goal) are positively related to occupational well-being, whereas many micro-breaks (e.g., listening to music) are negatively related to occupational well-being. We used a diary study design to take a closer look at the effects of these energy management strategies on fatigue and vitality. Based on conservation of resources theory, we hypothesized that both types of energy management strategies negatively predict fatigue and positively predict vitality. Employees (N = 124) responded to a baseline survey and to hourly surveys across one work day (6.7 times on average). Consistent with previous research, between-person differences in the use of work-related strategies were positively associated with between-person differences in vitality. However, results of multilevel analyses of the hourly diary data showed that only micro-breaks negatively predicted fatigue and positively predicted vitality. These findings suggest that taking micro-breaks during the work day may have short-term effects on occupational well-being, whereas using work-related strategies may have long-term effects.

Age, Occupational Strain, and Well-Being: A Person-Environment Fit Perspective

We develop a conceptual model, based on person-environment fit theory, which explains how employee age affects occupational strain and well-being. We begin by explaining how age directly affects different dimensions of objective and subjective P-E fit. Next, we illustrate how age can moderate the relationship between objective P-E fit and subjective P-E fit. Third, we discuss how age can moderate the relationships between P-E fit, on one hand, and occupational strain and well-being on the other. Fourth, we explain how age can impact occupational strain and well-being directly independent of P-E fit. The chapter concludes with implications for future research and practice.

Occupational release of engineered nanoparticles: A review

Characterising the release of different types of Engineered Nanoparticles (ENPs) from various processes is of critical importance for the assessment of human exposure, as well as understanding the possible health effects of these particles. Therefore, the main aim of this chapter is to present a comprehensive review of studies which report on the release of airborne ENPs in different nanotechnology workplaces. The chapter will cover topics of relevance to the occupational characterisation of ENP emissions, ranging from the identification of different particle release sources and scenarios, to measurement methods and working towards a more uniform approach to characterisation. Furthermore, a brief review of ENP exposure control strategies, together with the application of mathematical modelling as an effective tool for the characterisation of emissions at nanotechnology workplaces is included.

An engineering or behavioural approach? A study into employee’s perceptions regarding the effectiveness of occupational road safety initiatives

Background and Aims Considerable variation has been documented with fleet safety interventions’ abilities to create lasting behavioural change, and research has neglected to consider employees’ perceptions regarding the effectiveness of fleet interventions. This is a critical oversight as employees’ beliefs and acceptance levels (as well as the perceived organisational commitment to safety) can ultimately influence levels of effectiveness, and this study aimed to examine such perceptions in Australian fleet settings. Method 679 employees sourced from four Australian organisations completed a safety climate questionnaire as well as provided perspectives about the effectiveness of 35 different safety initiatives. Results Countermeasures that were perceived as most effective were a mix of human and engineering-based approaches: - (a) purchasing safer vehicles; - (b) investigating serious vehicle incidents, and; - (c) practical driver skills training. In contrast, least effective countermeasures were considered to be: - (a) signing a promise card; - (b) advertising a company’s phone number on the back of cars for complaints and compliments, and; - (c) communicating cost benefits of road safety to employees. No significant differences in employee perceptions were identified based on age, gender, employees’ self-reported crash involvement or employees’ self-reported traffic infringement history. Perceptions of safety climate were identified to be “moderate” but were not linked to self-reported crash or traffic infringement history. However, higher levels of safety climate were positively correlated with perceived effectiveness of some interventions. Conclusion Taken together, employees believed occupational road safety risks could best be managed by the employer by implementing a combination of engineering and human resource initiatives to enhance road safety. This paper will further outline the key findings in regards to practice as well as provide direction for future research.

Work-related well-being of Finnish anesthesiologists

Anesthesiologists, according to some studies, are highly stressed, die at a significantly earlier age than their colleagues and the general population,and are among the leaders in physicians' suicide records. Data are,however, sparse and contradictory. The aim of this study was to discover details of the work-related well-being of Finnish anesthesiologists. In 2004, a cross-sectional postal survey including all 550 working Finnish anesthesiologists produced a total of 328 responses (60%); 53% were men. The anesthesiologists had the greatest on-call workload among Finnish physicians. Their average in-hospital on-call period lasted 24 hours (range 14 to 38). Over two-thirds felt stressed. The most important causes of stress were work and combining work with family. Their main worries at work were: excessive workload and time constraints, especially being on call, organizational problems, and fear of harming patients. On-call workload correlated with burnout. Being frequently on call was correlated with severe stress symptoms--symptoms associated with sick leaves. Women were more affected by stress than men. High job control and organizational justice seemed to mitigate hospital-on-call stress symptoms. The respondents enjoyed fairly high job and life satisfaction. Job control and organizational justice were the most important correlates of these wellness indicators. Work-related factors were more important in males, whereas family life played a larger role in the well-being of female anesthesiologists. Women had less job control, fewer permanent job contracts, and a higher domestic workload. Of the respondents, 31% were willing to consider changing to another physician's specialty and 43% to a profession other than medicine. The most important correlates for these job turnover attitudes were conflicts at the workplace, low job control, organizational injustice, stress, and job dissatisfaction. One in four had at some time considered suicide. Respondents with poor health, low social support, and family problems were at the highest risk for suicidality. The highest risks at work were conflicts with co-workers and superiors, on-call-related stress symptoms, and low organizational justice. If a respondent had several risk factors, the risk for suicidality doubled with each additional factor. On-call work-burden, job control, fairness of decision-making procedures,and workplace relationships should be the focus in attempts to increase the work-related well-being of anesthesiologists.