Suchergebnisse

Résumé Koskinen (Seppo), Martelin (Tuija). - Pourquoi les femmes sont-elles moins inégales que les hommes devant la mort ? Une analyse des données finlandaises Les disparités socio-économiques en matière de mortalité sont plus fortes pour les hommes que pour les femmes. Quel rôle jouent dans ce constat 1) le choix des indicateurs de position socio-économique, 2) d'autres variables socio-démographiques, masquant des inégalités chez les femmes ou les accentuant chez les hommes, 3) les différences dans la répartition par cause des décès masculins et féminins ? L'analyse porte sur le rapprochement des certificats de décès recueillis en 1981-1985 et des bulletins individuels extraits du recensement de 1980 en Finlande. Quel que soit l'indicateur socio-économique retenu (niveau d'instruction, catégorie professionnelle, peuplement et équipement du logement), les inégalités face à la mort sont sensiblement moindres pour les femmes que pour les hommes. L'observation ne vaut cependant que pour les mariés. Mais, pour la plupart des causes de décès, les différentiels sont équivalents pour les deux sexes et l'ampleur des disparités socio-économiques de la mortalité masculine tient donc essentiellement aux particularités de la répartition des décès par cause chez les hommes.

INTRODUCTION: Multimorbidity, defined as the co-occurrence of two or more long-term medical conditions, is an increasing public health concern worldwide causing enormous burden to individuals, healthcare systems and societies. The most effective way of decreasing the burden caused by multimorbidity is to find tools for its successful prevention but gaps in research evidence limit capacities to develop prevention strategies. The aim of the MOLTO study (Multimorbidity - identifying the most burdensome patterns, risk factors and potentials to reduce future burden) is to provide novel evidence required for cost-effective prevention of multimorbidity by defining the multimorbidity patterns causing the greatest burden at the population level, by examining their risk and protective factors and by estimating the potentials to reduce the future burden. METHODS AND ANALYSIS: The MOLTO study is based on the data from the Finnish population-based cross-sectional (FINRISK 2002–2012, FinHealth 2017 the Migrant Health and Well-being Study 2010–2012) and longitudinal (Health 2000/2011) health examination surveys with individual-level link to administrative health registers, allowing register-based follow-up for the study participants. Both cross-sectional and longitudinal study designs will be used. Multimorbidity patterns will be defined using latent class analysis. The burden caused by multimorbidity as well as risk and protective factors for multimorbidity will be analysed by survival analysis methods such as Cox proportional hazards and Poisson regression models. ETHICS AND DISSEMINATION: The survey data have been collected following the legislation at the time of the survey. The ethics committee of the Hospital District of Helsinki and Uusimaa has approved the data collection and register linkages for each survey. The results will be published as peer-reviewed scientific publications.

The COVID-19 pandemic has led to an increase in the digitalisation of services that poses the risk of digital exclusion, especially among older adults. We examined the predictors of Internet use for services and its increase or decrease among a longitudinal population-based sample of 1426 older adults from Finland aged between 70 and 100 years, gathered in 2017 and 2020. High education and high income positively predicted the use of the Internet for services, and age, deteriorated health and deteriorated memory negatively. High age, low education and a change to living alone predicted a decrease in use. High education predicted the increased Internet use due to COVID-19. Thus, it seems that those older adults who have low education level are very old, whose health or memory has deteriorated and those who have changed to living alone are particularly in danger of digital exclusion. Actions targeted to these people are needed.

Abstract Background Bone stress injuries are common in athletes and military recruits. Only a minority of bone stress changes are available on plain radiographs. Acute bone stress is often visible on MRI as bone marrow edema, which is also seen in many other disease processes such as malignancies, inflammatory conditions and infections. The purpose of this study was to investigate the ability of radiographs, 1.5T and 3T MRI to identify acute bone marrow changes in the foot. Methods Ten patients with 12 stress fractures seen on plain radiographs underwent MRI using 1.5T and 3T scanners. T1 FSE and STIR axial, sagittal, and coronal view sequences were obtained. Two musculoskeletal radiologists interpreted the images independently and by consensus in case of disagreement. Results Of the 63 acute bone stress changes seen on 3T images, 61 were also seen on 1.5T images. The sensitivity of 1.5T MRI was 97% (95% CI: 89%-99%) compared with 3T. The 3T MRI images where, therefore, at least equally sensitive to 1.5T scanners in detection of bone marrow edema. On T1-weighted sequences, 3T images were slightly superior to 1.5T images in visualizing the demarcation of the edema and bone trabeculae. The kappa-value for inter-observer variability was 0.86 in the MRI indicating substantial interobserver agreement. Conclusions Owing to slightly better resolution of 3T images, edema characterization is easier, which might aid in the differential diagnosis of the bone marrow edema. There was, however, no noteworthy difference in the sensitivity of the 1.5T and 3T images to bone marrow edema. Routine identification of acute bone stress changes and suspected stress injuries can, therefore, be made with 1.5T field strength.

Abstract Background The current political agenda aims to promote active environments and physical activity while commuting to work, but research on it has provided mixed results. This study examines whether the proximity of green space and people's residence in different travel-related urban zones contributes to commuting physical activity. Methods Population-based cross-sectional health examination survey, Health 2011 study, and geographical information system (GIS) data were utilized. The GIS data on green space and travel-related urban zones were linked to the individuals of the Health 2011 study, based on their home geocoordinates. Commuting physical activity was self-reported. Logistic regression models were applied, and age, gender, education, leisure-time and occupational physical activity were adjusted. Analyses were limited to those of working age, living in the core-urban areas of Finland and having completed information on commuting physical activity ( n = 2 098). Results Home location in a pedestrian zone of a main centre (odds ratio = 1.63; 95 % confidence interval = 1.06–2.51) or a pedestrian zone of a sub-centre (2.03; 1.09–3.80) and higher proportion of cycling and pedestrian networks (3.28; 1.71–6.31) contributed to higher levels of commuting physical activity. The contribution remained after adjusting for all the environmental attributes and individuals. Based on interaction analyses, women living in a public transport zone were almost two times more likely to be physically active while commuting compared to men. A high proportion of recreational green space contributed negatively to the levels of commuting physical activity (0.73; 0.57–0.94) after adjusting for several background factors. Based on interaction analyses, individuals aged from 44 to 54 years and living in sub-centres, men living in pedestrian zones of sub-centres, and those individuals who are physically inactive during leisure-time were less likely to be physically active while commuting. Conclusions Good pedestrian and cycling infrastructure may play an important role .

It is widely recognized that social networks and loneliness have effects on health. The present study assesses the differential association that the components of the social network and the subjective perception of loneliness have with health, and analyzes whether this association is different across different countries. Methods: A total of 10 800 adults were interviewed in Finland, Poland and Spain. Loneliness was assessed by means of the 3-item UCLA Loneliness Scale. Individuals' social networks were measured by asking about the number of members in the network, how often they had contacts with these members, and whether they had a close relationship. The differential association of loneliness and the components of the social network with health was assessed by means of hierarchical linear regression models, controlling for relevant covariates. Results: In all three countries, loneliness was the variable most strongly correlated with health after controlling for depression, age, and other covariates. Loneliness contributed more strongly to health than any component of the social network. The relationship between loneliness and health was stronger in Finland (|β| = 0.25) than in Poland (|β| = 0.16) and Spain (|β| = 0.18). Frequency of contact was the only component of the social network that was moderately correlated with health. Conclusions: Loneliness has a stronger association with health than the components of the social network. This association is similar in three different European countries with different socioeconomic and health characteristics and welfare systems. The importance of evaluating and screening feelings of loneliness in individuals with health problems should be taken into account. Further studies are needed in order to be able to confirm the associations found in the present study and infer causality ; The research leading to these results has received funding from the European Community's Seventh Framework Programme (FP7/2007-2013) under grant agreement number 223071 (COURAGE in Europe), from the European Commission Horizon 2020 under grant number 635316 (ATHLOS), from the Instituto de Salud Carlos III-FIS research grant numbers PS09/00295, PS09/01845, PI12/01490 and PI13/00059, and from the Spanish Ministry of Science and Innovation ACI-Promociona (ACI2009-1010). Projects PI12/01490 and PI13/00059 have been co-funded by the European Union European Regional Development Fund (ERDF) "A Way to Build Europe". Laura Rico is supported by the programme "Contratos predoctorales para Formación de Personal Investigador, FPI-UAM", Universidad Autónoma de Madrid, Spain. Marta Miret is grateful to the Spanish Ministry of Economy and Competitiveness for the postdoctoral fellowship (FPDI-2013-15793). Beatriz Olaya is part of the Sara Borrell postdoctoral programme (reference no. CD12/00429) supported by the Instituto de Salud Carlos III, Spain