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Background: Although loneliness and social isolation have been linked to an increased risk of non-communicable diseases such as cardiovascular disease and dementia, their association with the risk of severe infection is uncertain. We aimed to examine the associations between loneliness and social isolation and the risk of hospital-treated infections using data from two independent cohort studies. Methods: We assessed the association between loneliness and social isolation and incident hospital-treated infections using data for participants from the UK Biobank study aged 38–73 years at baseline and participants from the nationwide population-based Finnish Health and Social Support (HeSSup) study aged 20–54 years at baseline. For inclusion in the study, participants had to be linked to national health registries, have no history of hospital-treated infections at or before baseline, and have complete data on loneliness or social isolation. Participants with missing data on hospital-treated infections, loneliness, and social isolation were excluded from both cohorts. The outcome was defined as a hospital admission with a primary diagnosis of infection, ascertained via linkage to electronic health records. Findings: After exclusion of 8·6 million participants for not responding or not providing appropriate consent, the UK Biobank cohort consisted of 456 905 participants (249 586 women and 207 319 men). 26 860 (6·2%) of 436 001 participants with available data were reported as being lonely and 40 428 (9·0%) of 448 114 participants with available data were socially isolated. During a median 8·9 years (IQR 8·0–9·6) of follow-up, 51 361 participants were admitted to hospital due to an infectious disease. After adjustment for age, sex, demographic and lifestyle factors, and morbidities, loneliness was associated with an increased risk of a hospital-treated infection (hazard ratio [HR] 1·12 [95% CI 1·07–1·16]), whereas social isolation was not (HR 1·01 [95% CI 0·97–1·04]). Of 64 797 individuals in the HeSSup cohort, 18 468 (11 367 women and 7101 men) were eligible for inclusion. 4466 (24·4%) of 18 296 were lonely and 1776 (9·7%) of 18 376 socially isolated. During a median follow-up of 10·0 years (IQR 10·0–10·1), 814 (4·4%) participants were admitted to hospital for an infectious disease. The HRs for the HeSSup study replicated those in the UK Biobank (multivariable-adjusted HR for loneliness 1·32 [95% CI 1·06–1·64]; 1·08 [0·87–1·35] for social isolation). Interpretation: Loneliness might increase susceptibility to severe infections, although the magnitude of this effect appears modest and residual confounding cannot be excluded. Interventional studies are required before policy recommendations can advance. Funding: Academy of Finland, the UK Medical Research Council, and Wellcome Trust UK. CC BY 4.0This is an Open Access article under the CC BY 4.0 license© 2023 The Author(s)Correspondence Address: M. Elovainio; Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, 00014, Finland; email: marko.elovainio@helsinki.fiME was supported by the Academy of Finland (339390). PNS was supported by the Emil Aaltonen Foundation and Finnish Medical Foundation. JV was supported by the Academy of Finland (321409 and 329240). MK was supported by the UK Medical Research Council (S011676), Wellcome Trust UK (221854/Z/20/Z), National Institute on Aging USA (R01AG056477), and the Academy of Finland (350426). STN was supported by NordForsk (75021) and the Finnish Work Environment Fund (190424). CH was supported by the European Research Council under the European Union’s Horizon 2020 research and innovation programme (grant number 101040247). This research has been done using the UK Biobank Resource under application number 14801.

Perinteistä työelämän varhaiskuntoutusta on kritisoitu huonosta kytkennästä työhön. Kelan työhönkuntoutuksen kehittämishankkeessa (TK2) on pyritty vahvistamaan kuntoutuksen työkytkentää. Tässä tutkimuksessa tarkastellaan TK2-hankkeessa toteutetun kuntoutuksen aikana tapahtuneita muutoksia kuntoutujien työssä, hyvinvoinnissa ja työkyvyssä sekä näiden muutosten välisiä yhteyksiä. Tulokset perustuvat kuntoutuksen alku- ja loppukyselyyn vastanneiden kuntoutujien joukkoon (217 kuntoutujaa, 89 % osallistujista). Kysely kartoitti työhön liittyviä stressitekijöitä (kiire, ryhmätyöongelmat ja fyysinen kuormitus) ja hyvinvointia (RAND-36, unihäiriöt). Työkykyä mitattiin Työkykyindeksin kolmella itsearviointiin perustuvalla kysymyksellä. Tuloksia analysoitiin toistuvien mittausten varianssianalyysillä ja hierarkkisella regressioanalyysillä. Kun tausta- ja lähtötilannetekijöiden vaikutus oli huomioitu, kuntoutujien työssä kokema kiire ja ryhmätyöongelmat vähenivät kuntoutuksen aikana ja fyysinen ja psyykkinen hyvinvointi sekä unen laatu paranivat. Lisäksi itse arvioitu ruumiillinen ja henkinen työkyky ja yleinen työkykyarvio paranivat. Fyysisen työkyvyn ja unen laadun kohentuminen olivat yhteydessä fyysisen työkyvyn ja yleisen työkykyarvion kohentumiseen, psykososiaalisen hyvinvoinnin paraneminen taas henkisen työkyvyn kohentumiseen. Työssä koetun kiireen yhteys työkykyyn välittyi hyvinvointitekijöiden kautta, mutta muutos ryhmätyöongelmissa oli muista tekijöistä riippumatta yhteydessä muutoksiin henkisessä työkyvyssä ja fyysisen kuormituksen väheneminen oli yhteydessä muutoksiin fyysisessä työkyvyssä. Tulokset tukevat TK2-kuntoutuksen onnistuneen työkytkennässä, mutta syy-seuraussuhteiden todentaminen edellyttää vertailuryhmäasetelmaa ja pidempää seurantaa. Abstract Changes in work, well-being and work ability among participants in Return to Work Rehabilitation – Results of the development project of Return to Work Rehabilitation Traditional work-related early rehabilitation has been criticized for being poorly connected to work. National Insurance Institution initiated a development project “Rehabilitation into work” (RIW) to enhance the work-connection of early rehabilitation model. This study examined changes in work-related stressors, well-being and work ability among participants on one year RIW programme. The data is comprised of questionnaire surveys conducted for rehabilitees at the beginning and at the end of the programme. All together rehabilitees 217 filled in both questionnaires (89 % of all participants). The questionnaire included measures for work-related stressors, health and well-being (RAND-36, quality of sleep). Work-ability was measured by three self-assessment items in the Work Ability Index (WAI). The results were analysed by repeated measures ANCOVA and hierarchical regression analyses. The results showed significant positive changes in workload (time-pressure) and team work at work and in physical and psychosocial well-being and in quality of sleep. Furthermore self-assessed physical and mental work ability as well as general self-assessed work ability improved significantly during RIW programme. Improvement of physical well-being and quality of sleep were strongly related to positive changes in physical and general work ability assessments, while improvements of psychosocial well-being was related to enhanced mental and general work ability assessments. The association between work-related time-pressure changes to workability was mediated by health and well-being but improved teamwork and decreased physical strain at work were independently related to improvement of work ability. The RIW was seen as having good relevance to work but further controlled studies with longer follow-ups are needed to establish causal effects.

Funding Information: This study was supported by the Strategic Research Council of the Academy of Finland (project 327145) and the Ministry of Social Affairs and Health (project 414919001). ME was supported by the Academy of Finland (project 339 390). The authors would like to express their gratitude to all physicians who responded to the questionnaire as well as the Finnish Medical Association for collaboration. Publisher Copyright: © 2022 Journal of Medical Internet Research. All rights reserved. Background: In health care, the benefits of digitalization need to outweigh the risks, but there is limited knowledge about the factors affecting this balance in the work environment of physicians. To achieve the benefits of digitalization, a more comprehensive understanding of this complex phenomenon related to the digitalization of physicians'work is needed. Objective: The aim of this study was to examine physicians' perceptions of the effects of health care digitalization on their work and to analyze how these perceptions are associated with multiple factors related to work and digital health usage. Methods: A representative sample of 4630 (response rate 24.46%) Finnish physicians (2960/4617, 64.11% women) was used. Statements measuring the perceived effects of digitalization on work included the patients' active role, preventive work, interprofessional cooperation, decision support, access to patient information, and faster consultations. Network analysis of the perceived effects of digitalization and factors related to work and digital health usage was conducted using mixed graphical modeling. Adjusted and standardized regression coefficients are denoted by b. Centrality statistics were examined to evaluate the relative influence of each variable in terms of node strength. Results: Nearly half of physicians considered that digitalization has promoted an active role for patients in their own care (2104/4537, 46.37%) and easier access to patient information (1986/4551, 43.64%), but only 1 in 10 (445/4529, 9.82%) felt that the impact has been positive on consultation times with patients. Almost half of the respondents estimated that digitalization has neither increased nor decreased the possibilities for preventive work (2036/4506, 45.18%) and supportiveness of clinical decision support systems (1941/4458, 43.54%). When all variables were integrated into the network, the most influential variables were purpose of using health information systems, employment sector, and specialization status. However, the grade given to the electronic health record (EHR) system that was primarily used had the strongest direct links to faster consultations (b=0.32) and facilitated access to patient information (b=0.28). At least 6 months of use of the main EHR was associated with facilitated access to patient information (b=0.18). Conclusions: The results highlight the complex interdependence of multiple factors associated with the perceived effects of digitalization on physicians'work. It seems that a high-quality EHR system is critical for promoting smooth clinical practice. In addition, work-related factors may influence other factors that affect digital health success. These factors should be considered when developing and implementing new digital health technologies or services for physicians' work. The adoption of digital health is not just a technological project but a project that changes existing work practices.

Vertaisarvioitu. Kansainvälisen adoption kautta vuosittain Suomeen tulevien lasten määrä on pienentynyt sadoista lapsista kymmeniin, joista suurin osa on erityistarpeisia. Erityistarpeiden kirjo on laaja ja käsittää esimerkiksi leikkauksella korjattavia rakennepoikkeamia, sydänvikoja, kehitysviivästymiä ja aistiongelmia. Kun vuoden 2012 adoptiolaki rajoitti lasten ja vanhempien ikäeroa, siitä seurasi, että ulkomailta adoptoidaan myös aikaisempaa vanhempia lapsia, jopa kouluikäisiä. Kaikkia lapsia - myös terveitä - yhdistää vähintään yksi hylkäämiskokemus. Jotkut lapset ovat kokeneet useita hylkäämisiä, vaille jäämistä ja kaltoinkohtelua. Tämä tekee kansainväliseen adoptioon tulevista lapsista erityistarpeisia, joten adoptoituja kohtaavalta lääkäriltä vaaditaan erityisosaamista.

Supplemental material, sj-docx-1-SJP-10.1177_14034948221075433 for Subjective mental well-being among higher education students in Finland during the first wave of COVID-19 by Kiira K. Sarasj��rvi, Pia H. Vuolanto, Pia C.M. Solin, Kaija L. Appelqvist-Schmidlechner, Nina M. Tamminen, Marko Elovainio and Sebastian Therman in Scandinavian Journal of Public Health

Additional file 1. Supplementary Material. Healthcare workers’ heterogeneous mental-health responses to prolonging Covid-19 pandemic: A full year of monthly follow up in Finland. Supplementary data on a Logistic regression mixed model and on the latent class mixture models.

Organizational justice refers to employees' perceptions of the fairness of decision-making rules and policies in the workplace. Lack of justice is suggested to be a significant psychosocial risk factor that affects employees' attitudes and health. The aim of this narrative review was to compile the evidence available about the effects of organizational justice on health. To this end, a literature search was carried out using the Web of Science, PubMed, and PsycINFO databases. The final sample consisted of 103 articles that studied the effects of justice on mental health (40 results), job stress (26), sickness absence (15), physical health (14), absenteeism/presenteeism (3), safety at work (3), and health of third parties (2). The results show that perceptions of workplace justice predict employees' mental health, stress-related health problems, and lower levels of sickness absence were relatively compelling. Future studies should focus on less-researched outcomes and on how these associations are modified by other variables for a better understanding of how justice affects health, with a view to being able to carry out preventive measures more efficiently.

Additional file 1. Measures used in the study.

Background Even though child psychopathology assessment guidelines emphasize comprehensive multi-method, multimodal, and multi-informant methodologies, maternal-report symptom-rating scales often serve as the predominant source of information. Research has shown that parental mood symptomatology affects their reports of their offspring's psychopathology. For example, the depression-distortion hypothesis suggests that maternal depression promotes a negative bias in mothers' perceptions of their children's behavioral and emotional problems. We investigated this difference of perception between adoptive mothers and internationally adopted children. Most previous studies suffer from the potential bias caused by the fact that parents and children share genetic risks. Methods Data were derived from the Finnish Adoption (FinAdo) survey study (a subsample of adopted children aged between 9 and 12 years, n = 222). The Child Behavior Checklist (CBCL) was used to assess emotional and behavioral problems and competences of the adopted children. The CBCL was filled in by the adopted children and the adoptive mothers, respectively. Maternal depressive symptoms were measured using the short version of the General Health Questionnaire. Results On average, mothers reported less total CBCL symptoms in their children than the children themselves (0.25 vs 0.38, p-value < 0.01 for difference). Mothers' depressive symptoms moderated the discrepancy in reporting internalizing symptoms (beta = - 0.14 and p-value 0.01 for interaction) and the total symptoms scores (beta = - 0.22 and p-value < 0.001 for interaction) and externalizing symptoms in girls in the CBCL. Limitations The major limitation of our study is its cross-sectional design and the fact that we only collected data in the form of questionnaires. Conclusions The results of our research support the depression-distortion hypothesis concerning the association of maternal depressive symptoms and child internalizing symptoms and externalizing symptoms in girls in a sample without genetic bias

Lack of social contacts has been associated with an increased risk of cancer mortality, but it is not known whether living alone increases the risk of cancer incidence or case fatality. We examined the association between living alone with cancer incidence, case-fatality and all-cause mortality in eight most common cancers. All patients with their first cancer diagnosis in 2000–2017 were identified from the nationwide Finnish Cancer Registry. Information on living arrangements was derived from Statistics Finland. The incidence analyses were conducted using Poisson regression. The total Finnish population served as the population at risk. Fine-Gray model was used to estimate case-fatality and Cox proportional regression model all-cause mortality. In men, we found an association between history of living alone and excess lung cancer incidence but living alone seemed to be associated with lower incidence of prostate cancer and skin melanoma. In women, living alone was more consistently associated with higher incidence of all studied cancers. Cancer patients living alone had an 11%–80% statistically significantly increased case-fatality and all-cause mortality in all studied cancers in men and in breast, colorectal and lung cancer in women. Living alone is consistently associated with increased cancer incidence risk in women but only in some cancers in men. Both men and women living alone had an increased risk of all-cause mortality after cancer diagnosis. publishedVersion

Lack of social contacts has been associated with an increased risk of cancer mortality, but it is not known whether living alone increases the risk of cancer incidence or case fatality. We examined the association between living alone with cancer incidence, case-fatality and all-cause mortality in eight most common cancers. All patients with their first cancer diagnosis in 2000–2017 were identified from the nationwide Finnish Cancer Registry. Information on living arrangements was derived from Statistics Finland. The incidence analyses were conducted using Poisson regression. The total Finnish population served as the population at risk. Fine-Gray model was used to estimate case-fatality and Cox proportional regression model all-cause mortality. In men, we found an association between history of living alone and excess lung cancer incidence but living alone seemed to be associated with lower incidence of prostate cancer and skin melanoma. In women, living alone was more consistently associated with higher incidence of all studied cancers. Cancer patients living alone had an 11%–80% statistically significantly increased case-fatality and all-cause mortality in all studied cancers in men and in breast, colorectal and lung cancer in women. Living alone is consistently associated with increased cancer incidence risk in women but only in some cancers in men. Both men and women living alone had an increased risk of all-cause mortality after cancer diagnosis., Highlights • We studied the effect of living alone on cancer incidence and mortality in total Finnish population. • Excess cancer incidence risk was only found consistently in women. • We found persistent excess cancer-specific mortality in cancer patients living alone. • Cancer patients living alone had also a higher all-cause mortality risk. • Further studies should study pathways to care among socially isolated individuals.

Reports of poor work well-being and fluctuating productivity in software engineering have been reported in both academic and popular sources. Understanding and predicting these issues through repository analysis might help manage software developers' well-being. Our objective is to link data from software repositories, that is commit activity, communication, expressed sentiments, and job events, with measures of well-being obtained with a daily experience sampling questionnaire. To achieve our objective, we studied a single software project team for eight months in the software industry. Additionally, we performed semi-structured interviews to explain our results. The acquired quantitative data are analyzed with generalized linear mixed-effects models with autocorrelation structure. We find that individual variance accounts for most of the $R^2$ values in models predicting developers' experienced well-being and productivity. In other words, using software repository variables to predict developers' well-being or productivity is challenging due to individual differences. Prediction models developed for each developer individually work better, with fixed effects $R^2$ value of up to 0.24. The semi-structured interviews give insights into the well-being of software developers and the benefits of chat interaction. Our study suggests that individualized prediction models are needed for well-being and productivity prediction in software development., Comment: Accepted to Empirical Software Engineering journal

Vertaisarvioitu. English summary Ihmisen havainnot sekä ympäristöstä että omasta itsestään ovat ennakkokäsitysten ohjaamia. Koettujen haittojen ja oireiden määrä liittyy siihen, mitä odotetaan. Ilmiötä kutsutaan nosebo- eli lumehaittavaikutukseksi, ja se on tunnettu lääketieteessä jo hyvin kauan. Nosebovaikutukset voivat ilmetä joko uusina oireina, niiden pahenemisena tai hoidon tehon vähenemisenä. Kaikki ihmiset ovat alttiita nosebovaikutuksille, ja vaikka ihmisten välillä on eroja, mitään yleistä näille vaikutuksille herkkää ihmistyyppiä ei ole olemassa. Nosebovaikutukset eivät rajoitu vain kliiniseen työhön, vaan niillä on osoitettu olevan keskeinen osuus oireiden ja toiminnallisten häiriöiden sekä ympäristöherkkyyden kehittymisessä. On tärkeää, että nosebovaikutukset otetaan vakavasti, jotta tuetaan positiivisia terveysvaikutuksia ja toipumista sekä vältetään tarpeettomia kielteisiä vaikutuksia.

A burgeoning body of literature suggests that poor childhood health leads to adverse health outcomes. lower educational attainment and weaker labour market outcomes in adulthood. We focus on an important but under-researched topic, which is the role played by infection-related hospitalization (IRH) in childhood and its links to labour market outcomes later in life. The participants aged 24-30 years in 2001 N =1706 were drawn from the Young Finns Study, which includes comprehensive registry data on IRHs in childhood at ages 0-18 years. These data are linked to longitudinal registry information on labour market outcomes (2001-2012) and parental background (1980). The estimations were performed using ordinary least squares (OLS). The results showed that having an additional IRH is associated with lower log earnings (b = 95% confidence interval (CI): -0.193; -0.026). fewer years of being employed (b = -0.018. 95% CI: -0.031; -0.005). a higher probability of receiving any social income transfers (b = 0.012, 95 % CI: -0.002; 0.026) and larger social income transfers, conditional on receiving any (b = 0.085,95 % CI: 0.025; 0.145). IRHs are negatively linked to human capital accumulation. which explains a considerable part of the observed associations between IRHs and labour market outcomes. We did not find support for the hypothesis that adult health mediates the link. (C) 2020 The Authors. Published by Elsevier B.V.

Purpose – A prominent labour market feature in recent decades has been the increase in abstract and service jobs, while the demand for routine work has declined. This article examines whether the components of Type A behaviour predict workers’ selection into nonroutine abstract, non-routine service and routine jobs. Design/methodology/approach – Building on the work by Barrick et al. (2013), this article first presents how the theory of purposeful work behaviour can be used to explain how individuals with different levels of Type A components sort into abstract, service and routine jobs. Then, using longitudinal data, it examines whether the components of Type A behaviour predict occupational sorting. Estimations were performed based on the linear regression method. Findings – The results show that the Type A dimension “leadership” was associated with a higher level of abstract and service job tasks in occupation. High eagerness-energy and responsibility were also positively linked with occupation’s level of abstract tasks. These results suggest that workers sort into jobs that allow them to pursue higher-order implicit goals. Originality/value – Job market polarisation towards low-routine jobs has had a pervasive influence on the labour market during the past few decades. Based on high-quality data that combine prime working-age register information on occupational attainment with information about personality characteristics, the findings contribute to our knowledge of how personality characteristics contribute to occupational sorting in terms of this important job aspect. peerReviewed

Background Few studies have examined long-term associations of unfavorable and favorable changes in vascular risk factors with incident coronary heart disease (CHD). We examined this issue in a middle-aged disease-free population. Methods We used repeat data from the Whitehall II cohort study. Five biomedical, behavioral and psychosocial examinations of 8335 participants without CHD produced up to 20,357 person-observations to mimic a non-randomized pseudo-trial. After measurement of potential change in 6 risk factors twice (total cholesterol, blood pressure, smoking, overweight, psychological distress, problems in social relationships), a 5-year follow-up of CHD was undertaken. Results Incidence of CHD was 7.4/1000 person-years. Increases from normal to high cholesterol (hazard ratio, HR = 1.59, 95% CI 1.26–2.00) and from normal to high blood pressure (HR = 1.64, 95% CI 1.33–2.03), as compared to remaining at the normal level, were associated with increased risk of CHD. In contrast, decreases from high to low levels of cholesterol (HR = 0.73, 95% CI 0.58–0.91), psychological distress (HR = 0.68, 95% CI 0.51–0.90), and problems in social relationships (HR = 0.65, 95% CI 0.50–0.85), and quitting smoking (HR = 0.49, 95% CI 0.29–0.82) were associated with a reduced CHD risk compared to remaining at high risk factor levels. The highest absolute risk was associated with persistent exposure to both high cholesterol and hypertension (incidence 18.1/1000 person-years) and smoking and overweight (incidence 17.7/1000 person-years). Conclusions While persistent exposures and changes in biological and behavioral risk factors relate to the greatest increases and reductions in 5-year risk of CHD, also favorable changes in psychosocial risk factors appear to reduce CHD risk., Highlights • We examined the association between changes in biological, behavioural and psychosocial factors and the incidence of CHD. • Increases in cholesterol and blood pressure, as compared to remaining at the normal level were associated with risk of CHD. • Favorable changes in cholesterol, distress and social relationships, as well as quitting smoking decreased the CHD risk. • The absolute risk was highest in a combination of persistent high cholesterol and hypertension, or smoking and overweight. • In addition to biological and behavioral factors, favorable changes in psychosocial risk factors appear to reduce CHD risk.

Background: Problems in the usability of health information systems (HISs) are well acknowledged, but research still lacks a validated questionnaire for measuring and monitoring different dimensions of usability of HISs. Such questionnaires are needed not only for research but also for developing usability of HISs from the viewpoint of end-user experiences. Objective: This study aimed to develop and test the validity of the questionnaire measuring the National Usability-Focused HIS-Scale (NuHISS) among a nationally representative sample of Finnish physicians. Methods: We utilized 2 cross-sectional data collected from a random sample of Finnish physicians in 2014 (N=3781; of which 2340 [61.9%] were women) and 2017 (N=4018; of which 2604 [64.8%] were women). Exploratory and confirmatory factor analyses (structural equation modeling [SEM]) were applied to test the structural validity of the NuHISS. As the concurrent validity measure, we used the self-reported overall quality of the electronic health record system (school grade) provided by the participants using marginal structural models. Results: The exploratory factor analyses with Varimax rotation suggested that the 7-factor solution did offer a good fit to the data in both samples (C2=2136.14 in 2014 and C2=2109.83 in 2017, both P

Figure S3. Exploratory factor analyses using exp-transformed items. (DOCX 110 kb)

Additional file 1: Table S1. Response rate of parents and pupils in questionnaire survey. Table S2. Prevalence estimates and rank correlation matrix between IEQ indicators. Table S3. Model fit statistics for latent class analysis models with 1 to 5 classes. Table S4. Separate IEQ indicators and respiratory symptoms: primary school pupils. Table S5. Separate IEQ indicators and general symptoms: primary school pupils. Table S6. Seaparate IEQ indicators and lower respiratory symptoms: primary school pupils. Table S7. Separate IEQ indicators and eye symptoms: primary school pupils. Table S8. Separate IEQ indicators and skin symptoms: primary school pupils. Table S9. Separate IEQ indicators and respiratory symptoms: secondary school pupils. Table S10. Separate IEQ indicators and general symptoms: secondary school pupils. Table S11. Separate IEQ indicators and lower respiratory symptoms: secondary school pupils. Table S12. Separate IEQ indicators and eye symptoms: secondary school pupils. Table S13. Separate IEQ indicators and skin symptoms: secondary school pupils. Table S14. Associations between summary score and latent classes of IEQ and symptoms: parents of primary school pupils. Table S15. Separate IEQ indicators and respiratory symptoms: parents of primary school pupils. Table S16. Separate IEQ indicators and general symptoms: parents of primary school pupils. Table S17. Separate IEQ indicators and lower respiratory symptoms: parents of primary school pupils. Table S18. Separate IEQ indicators and eye symptoms: parents of primary school pupils. Table S19. Separate IEQ indicators and skin symptoms: parents of primary school pupils. Table S20. Benjamini-Hochberg test of false discovery rate. Table S21. Odds ratios and 95% confidence intervals for associations between IEQ and symptoms of primary school pupils. Table S22. Odds ratios and 95% confidence intervals for the associations between IEQ and symptoms of secondary school pupils. Figure S1. Flowchart describing the selection of school buildings and participants.

Supplemental material, USJ827521_supplemental_material for Involuntary staying and self-rated health: A multilevel study on housing, health and neighbourhood effects by Teemu Kemppainen, Marko Elovainio, Matti Kortteinen and Mari Vaattovaara in Urban Studies

Supplemental material, USJ827521_supplemental_material for Involuntary staying and self-rated health: A multilevel study on housing, health and neighbourhood effects by Teemu Kemppainen, Marko Elovainio, Matti Kortteinen and Mari Vaattovaara in Urban Studies

Modern work life is characterized by constant change, reorganizations, and requirements of efficiency, which make the distribution of resources and obligations, as well as justice in decisionmaking, highly important. In the work life context, it is a question not only of distributing resources and obligations, but also of the procedures and rules that guide the decisionmaking in the organization. Studies of these rules and procedures have provided the basis for a new line of research that evaluates leadership and social relationships in working communities; that is, distributive, procedural, and relational justice. This review follows the development of research on organizational justice from its origins in early social and motivational psychological theories to its establishment as a major line of research in modern work and organizational psychology. The adverse consequences of injustice include poor team climate, reduced productivity and well-being, and work-related illnesses.

TIDieR-based description of training provided to facilitators in the IDEA trial. (DOCX 30Â kb)

Main outcome definitions and operationalizations. (DOCX 32Â kb)

Labels and descriptions of behaviour change techniques delivered during the IDEA intervention. (DOCX 30Â kb)

TIDieR-based intervention description for the IDEA trial. (DOCX 33Â kb)

CONSORT checklist. (DOCX 42Â kb)

Cost of delivering the IDEA intervention in primary care (nâ =â 22). (DOCX 34Â kb)

During the past years, psychological diseases related to unhealthy work environments, such as burnouts, have drawn more and more public attention. One of the known causes of these affective problems is time pressure. In order to form a theoretical background for time pressure detection in software repositories, this paper combines interdisciplinary knowledge by analyzing 1270 papers found on Scopus database and containing terms related to time pressure. By clustering those papers based on their abstract, we show that time pressure has been widely studied across different fields, but relatively little in software engineering. From a literature review of the most relevant papers, we infer a list of testable hypotheses that we want to verify in future studies in order to assess the impact of time pressures on software developers mental health., Comment: 6 pages, 6 figures

Objective To examine coronary heart disease (CHD) and its risk factors as predictors of long-term trajectories of psychological distress from midlife to old age. Methods In the Whitehall II cohort study, 6890 participants (4814 men, 2076 women; mean age 49.5 years) had up to seven repeat assessments of psychological distress over 21 years (mean follow-up 19 years). CHD and its risk factors (lifestyle-related risk factors, diabetes, hypertension and cholesterol) were assessed at baseline. Group-based trajectory modelling was used to identify clusters of individuals with a similar pattern of psychological distress over time. Results We identified four trajectories of psychological distress over the follow-up: 'persistently low (69% of the participants), 'persistently intermediate' (13%), 'intermediate to low' (12%) and 'persistently high' (7%). The corresponding proportions were 60%, 16%, 13% and 11% among participants with CHD; 63%, 15%, 12% and 10% among smokers and 63%, 16%, 12% and 10% among obese participants. In multivariable adjusted multinomial regression analyses comparing other trajectories to persistently low trajectory, prevalent CHD was associated with intermediate to low (OR 1.70, 95% CI 1.08 to 2.68) and persistently high (OR 1.92, 95% CI 1.16 to 3.19) trajectories. Smoking (OR 1.33, 95% CI 1.07 to 1.64; OR 1.55, 95% CI 1.19 to 2.04) and obesity (OR 1.33, 95% CI 1.04 to 1.70; OR 1.47, 95% CI 1.07 to 2.01) were associated with persistently intermediate and persistently high trajectories, respectively. Conclusion CHD, smoking and obesity may have a role in the development of long-lasting psychological distress from midlife to old age.

Background: Gaps in the quality of care provided to people with type 2 diabetes are regularly identified. Healthcare professionals often have a strong intention to follow practice guidelines during consultations with people with type 2 diabetes; however, this intention does not always translate into action. Action planning (planning when, where and how to act) and coping planning (planning how to overcome pre-identified barriers) have been hypothesised to help with the enactment of intentions by creating mental cue-response links that promote habit formation. This study aimed to investigate whether habit helps to better understand how action and coping planning relate to clinical behaviour in the context of type 2 diabetes care.\ud \ud Methods: The study utilised a prospective correlational design with six nested sub-studies. General practitioners and practice nurses (n = 427 from 99 UK primary care practices) completed measures of action planning, coping planning and habit at baseline and then self-reported their enactment of guideline-recommended advising, prescribing and examining behaviours 12 months later. Bootstrapped mediation analyses were used to test the indirect effect of action and coping planning on healthcare professionals' clinical behaviour via their relationship with habit.\ud \ud Results: Healthcare professionals who reported higher degrees of action or coping planning for performing six guideline recommended behaviours in the context of type 2 diabetes care were more likely to report performing these behaviours in clinical practice. All 12 bootstrapped mediation analyses showed that the positive relationship between planning (action and coping planning) and healthcare professionals' clinical behaviour operated indirectly through habit.\ud \ud Conclusions: These findings suggest that habit mediates the relationship between planning (action and coping planning) and healthcare professional behaviour. Promoting careful action and coping planning may support routinised uptake of guideline-recommended care by healthcare professionals in the primary care setting. Given the competing demands on healthcare professionals, exploring the behavioural processes involved in promoting more routinisation of behaviours where possible and appropriate could free up cognitive capacity for clinical behaviours that rely on more deliberation.

Twelve-month clinician self report behaviour questionnaire. (PDF 75Â kb)

Baseline postal questionnaire incorporating organisational and clinical questionnaires and behaviour simulation measures. (PDF 827Â kb)

Background: Problems in the usability of health information systems (HISs) are well acknowledged, but research still lacks a validated questionnaire for measuring and monitoring different dimensions of usability of HISs. Such questionnaires are needed not only for research but also for developing usability of HISs from the viewpoint of end-user experiences. Objective: This study aimed to develop and test the validity of the questionnaire measuring the National Usability-Focused HIS-Scale (NuHISS) among a nationally representative sample of Finnish physicians. Methods: We utilized 2 cross-sectional data collected from a random sample of Finnish physicians in 2014 (N=3781; of which 2340 [61.9%] were women) and 2017 (N=4018; of which 2604 [64.8%] were women). Exploratory and confirmatory factor analyses (structural equation modeling [SEM]) were applied to test the structural validity of the NuHISS. As the concurrent validity measure, we used the self-reported overall quality of the electronic health record system (school grade) provided by the participants using marginal structural models. Results: The exploratory factor analyses with Varimax rotation suggested that the 7-factor solution did offer a good fit to the data in both samples (C2=2136.14 in 2014 and C2=2109.83 in 2017, both P

Työn jatkuvaan keskeytymiseen on liitetty kielteisiä vaikutuksia, kuten päätöksenteon vaikeutumista sekä stressin, turhautumisen ja mahdollisesti virheiden lisääntymistä. Tässä tutkimuksessa tarkastellaan, kuinka usein terveyskeskuslääkärin työtehtävät keskeytyvät, miksi ne keskeytyvät ja miten lääkäri reagoi tehtävien keskeytymiseen. Tutkimuksessa havainnoitiin viittä terveyskeskuslääkäriä yhteensä 117 tuntia. Aineistoksi poimittiin kaikki ne tilanteet, joissa lääkärin työtehtävä keskeytyi. Keskeytyksiä löytyi yhteensä 102. Aineisto koodattiin Atlas.ti ohjelmalla ja analyysissä käytettiin sekä laadullisia että määrällisiä menetelmiä. Tulokset osoittavat, että terveyskeskuslääkärin työ keskeytyy noin kerran tunnissa vaihdellen 0.4 keskeytyksestä 1.9 keskeytykseen tunnissa. Kolme neljästä keskeytyksestä johtuu työn organisointitavasta kuten lääkäri-hoitaja työparimallista tai lääkärin tuutorointivastuusta. Loput ovat ennakoimattomia keskeytyksiä kuten tietokoneongelmia. Keskeytykset kumuloituvat niin, että niitä tulee useita peräkkäin tai myös keskeytyksen jälkeen aloitettu uusi tehtävä keskeytyy. Lähes kaikissa tapauksissa lääkäri keskeyttää sen hetkisen tehtävänsä ja siirtyy uuteen työtehtävään. Terveyskeskustyössä keskeytysten ennakoitavuus auttaa sopeutumaan niihin. Kuitenkin lääkärin työssä on myös tehtäviä, kuten vaativien lausuntojen laatiminen, jotka edellyttävät keskeytymätöntä työaikaa. Työhyvinvoinnin näkökulmasta kestävä tapa olisi järjestää lääkärille hiljaista työaikaa tai muuttaa esimerkiksi lausuntoja sellaisiksi, että niihin on mahdollisen keskeytyksenkin jälkeen helppo palata.

Tutkimuksessa analysoitiin perusterveydenhuollossa työskentelevien esimiesten (ylilääkärien ja osastonhoitajien) kokemuksia ulkomaalaistaustaisesta terveydenhuoltohenkilöstöstään. Aineisto koostui kymmenestä teemahaastattelusta, jotka analysoitiin laadullisella sisällönanalyysillä. Tutkimuksessa nousi esille neljä ulkomaalaistaustaisiin työntekijöihin liittyvää teemaa – kielitaito, ammattitaito, kulttuurierot ja suomalaisten suhtautuminen – jotka eri näkökulmista tarkasteltuina näyttäytyivät esimiesten mukaan toisaalta etuina ja toisaalta uhkina suomalaiselle perusterveydenhuollolle. Tulokset tukivat voimavarojen säilyttämisteorian (Hobfoll 2001) periaatteita, kuten menetysten korostumista, voimavarojen investointia ja jatkuvaa kulumista. Perusterveydenhuollon niukkenevat resurssit ja ulkomaalaistaustaisten terveydenhuollon ammattilaisten määrän kasvu saattavat yhdessä vaikeuttaa perusterveydenhuollon esimiesten mahdollisuuksia havaita ja hyödyntää monikulttuurisen työyhteisön etuja.

Artikkelin otsikkoa on täsmennetty siten, että kyseessä on "etenevä kohorttitutkimus vuosina 1955, 1960 ja 1965 syntyneistä miehistä". Tutkimuksen taustaa ja tavoitetta selvitettäessä todetaan, että "Armeija kouluttaa varusmiespalveluksessa eriasteisiin johtamistehtäviin vuosittain lähes 10 000 ihmistä.… Puolustusvoimien johtamiskoulutus pyrkii tarjoamaan johtamisvalmiuksia erityisesti ihmisten ja joukkojen johtamiseen taisteluissa ja erilaisissa kriisinhallintatehtävissä. Johtamiskoulutukselle on kuitenkin asetettu tavoitteeksi myös se, että koulutuksen läpikäynyt voisi käyttää saavuttamiaan valmiuksia siviiliorganisaatioissakin." Artikkelin mukaan sitä kuinka puolustusvoimien antaman johtamiskoulutuksen saaneet ovat sijoittuneet yhteiskuntaa, ei ole riittävästi tutkittu. "Tässä tutkimuksessa selvitettiin, onko puolustusvoimien varusmiespalvelussa tarjoamalla johtamiskoulutuksella ja siinä menestymisellä yhteyttä varusmiespalvelunjälkeiseen sijoittumiseen ja pärjäämiseen työelämässä." Menetelmiä käsittelevässä luvussa selvitetään tutkimukseen valittujen valinnan perusteet, mitä tietoja kerättiin ja miten niitä hyödynnettiin sekä käytettyjä tilastollisia analyysimenetelmiä. Seuraavassa luvussa tulkitaan tuloksia ja esitellään analyysiin liittyviä taulukoita. Lopussa pohditaan saatuja tuloksia ja niiden yleistämisen mahdollisuutta. There is summary in English at the end of the article.

Sosiaali- ja terveyspalvelujen saatavuus on monitahoinen käsite, vaikka sitä on usein mitattu palvelujen käytöllä. Tutkimuksen tavoitteena on selvittää aikuisväestön palveluiden saatavuutta käyttäen itse arvioitua tyydyttämätöntä avoterveydenhuollon lääkäripalvelujen tarvetta saatavuuden mittarina. Samalla arvioimme palvelutarpeen yhteyttä sosiodemografisiin tekijöihin. Aineistona käytetään vuoden 2010 Alueellinen hyvinvointi ja terveys-kyselyaineistoa Turusta, Oulun seudulta ja Kainuun seutukunnasta (n = 26 000, vastausprosentti n. 55). Ne, joilla ei palvelutarvetta ollut, poistettiin aineistosta ja analysoitavaksi jäi 6042 henkilön aineisto. Analyysimenetelmänä käytettiin logistista regressioanalyysiä. Tyydyttämätöntä palvelutarvetta oli erityisesti taloudellista uhkaa kokevilla, työttömillä työikäisillä sekä huonon terveydentilan omaavilla. Aiemmin avoterveydenhuollon palvelujen käytössä on todettu sosiaaliryhmittäisiä eroja. Tämän tutkimuksen tulokset viittaavat siihen, että käytön tarkastelu aliarvioi sosiaaliryhmittäisiä eroja palvelujen saatavuudessa.

International audience; In this study, the health-related selection hypothesis (that health predicts social mobility) and the social causation hypothesis (that socioeconomic status influences health) were tested in relation to cardiometabolic factors. The authors screened 8,312 United Kingdom men and women 3 times over 10 years between 1991 and 2004 for waist circumference, body mass index, systolic and diastolic blood pressure, fasting glucose, fasting insulin, serum lipids, C-reactive protein, and interleukin-6; identified participants with the metabolic syndrome; and measured childhood health retrospectively. Health-related selection was examined in 2 ways: 1) childhood health problems as predictors of adult occupational position and 2) adult cardiometabolic factors as predictors of subsequent promotion at work. Social causation was assessed using adult occupational position as a predictor of subsequent change in cardiometabolic factors. Hospitalization during childhood and lower birth weight were associated with lower occupational position (both P's ≤ 0.002). Cardiometabolic factors in adulthood did not consistently predict promotion. In contrast, lower adult occupational position predicted adverse changes in several cardiometabolic factors (waist circumference, body mass index, fasting glucose, and fasting insulin) and an increased risk of new-onset metabolic syndrome (all P's ≤ 0.008). These findings suggest that health-related selection operates at younger ages and that social causation contributes to socioeconomic differences in cardiometabolic health in midlife.

International audience; In this study, the health-related selection hypothesis (that health predicts social mobility) and the social causation hypothesis (that socioeconomic status influences health) were tested in relation to cardiometabolic factors. The authors screened 8,312 United Kingdom men and women 3 times over 10 years between 1991 and 2004 for waist circumference, body mass index, systolic and diastolic blood pressure, fasting glucose, fasting insulin, serum lipids, C-reactive protein, and interleukin-6; identified participants with the metabolic syndrome; and measured childhood health retrospectively. Health-related selection was examined in 2 ways: 1) childhood health problems as predictors of adult occupational position and 2) adult cardiometabolic factors as predictors of subsequent promotion at work. Social causation was assessed using adult occupational position as a predictor of subsequent change in cardiometabolic factors. Hospitalization during childhood and lower birth weight were associated with lower occupational position (both P's ≤ 0.002). Cardiometabolic factors in adulthood did not consistently predict promotion. In contrast, lower adult occupational position predicted adverse changes in several cardiometabolic factors (waist circumference, body mass index, fasting glucose, and fasting insulin) and an increased risk of new-onset metabolic syndrome (all P's ≤ 0.008). These findings suggest that health-related selection operates at younger ages and that social causation contributes to socioeconomic differences in cardiometabolic health in midlife.

Tämän tutkimuksen tarkoituksena oli tutkia työsuhteen laadun (määräaikainen/jatkuva) vaikutuksia sairaanhoitajien ja lääkärien kokemukseen työn stressitekijöistä. Tutkimuksen aineisto sisälsi 2364 lääkäriä (58 % naisia) ja 1732 naissairaanhoitajaa. Kovarianssianalyysein tutkittiin työsuhteen laadun yhteyttä kiireeseen, ryhmätyöongelmiin ja potilaisiin liittyvään rasitukseen, kun demografisia muuttujia ja työhön liittyviä tekijöitä vakioitiin. Vakituiset sairaanhoitajat ja lääkärit kokivat pääosin enemmän työn stressitekijöitä kuin määräaikaiset ja tulokset selittyivät paljolti työhön liittyvillä tekijöillä. Sairaanhoitajat kokivat lääkäreitä enemmän ryhmätyöongelmia ja potilaisiin liittyvää rasitusta, kun taas lääkärit rasittuivat hieman enemmän kiireestä kuin sairaanhoitajat. Tulostemme perusteella näyttäisi siltä, että varsinkin vakituisten sairaanhoitajien ja lääkärien työperäiseen stressiin tulisi kiinnittää huomiota.

International audience; BACKGROUND: Cognitive and physical functions are closely linked in old age, but less is known about this association in midlife. Whether cognitive function predicts physical function and whether physical function predicts cognitive function were assessed in middle-aged men and women. METHODS: Data were from Whitehall II, an ongoing large-scale, prospective occupational cohort study of employees from 20 London-based white-collar Civil Service departments. The participants, 3446 men and 1274 women aged 45-68 years at baseline (1995-1997), had complete data on cognitive performance and physical function at both baseline and follow-up (2002-2004). A composite cognitive score was compiled from the following tests: verbal memory, inductive reasoning (Alice Heim 4-I), verbal meaning (Mill Hill), phonemic and semantic fluency. Physical function was measured using the physical composite score of the short form (SF-36) scale. Average follow-up was 5.4 years. RESULTS: Poor baseline cognitive performance predicted poor physical function at follow-up (beta = 0.08, p

Lääkärien ja sairaanhoitajien vaativa työ johtaa helposti vaikeuksiin työn ja perhe-elämän yhteensovittamisessa. Tämän tutkimuksen aineisto kerättiin kyselytutkimuksena. Kyselyyn vastasi 2 841 lääkäriä ja 2 152 sairaanhoitajaa. Regressioanalyysein tutkittiin työn ominaisuuksien, työkyvyn ja työn psykososiaalisten riskitekijöiden (oikeudenmukaisuus ja vaikutusmahdollisuudet) yhteyttä työ- ja perhe-elämän yhteensovittamisen vaikeuksiin. Voimakkaimmin työn ja perheen yhteensovittamisen vaikeuksiin olivat yhteydessä sekä lääkäreillä että sairaanhoitajilla työhön käytetty aika, työkyky ja organisaation epäoikeudenmukaisuus. Vaikeuksia yhteensovittamisessa oli myös lääkäreillä, jotka olivat johtavassa asemassa, päivystivät, olivat erikoistuneet tai erikoistumassa ja joilla oli paljon lapsia. Sairaanhoitajilla kolmivuorotyön tekeminen ja lasten suuri lukumäärä lisäsivät todennäköisyyttä kokea vaikeuksia yhdistää työ- ja perhe-elämä. Tutkimuksemme perusteella näyttäisi siltä, että työn suuri määrä ja työpaikan epäoikeudenmukaisuus ovat voimakkaasti yhteydessä työn ja perheen yhteensovittamisen vaikeuksiin, vaikka työn ominaisuudet, työkyky ja lasten lukumäärä otettaisiin huomioon.

Terveyskeskuslääkärien työhön ja työhyvinvointiin on kiinnitetty entistä enemmän huomiota terveyskeskuksien pahenevan lääkärivajeen vuoksi. Tämän tutkimuksen tarkoituksena oli arvioida lääkärien työhön sitoutumiseen ja työpaikan vaihtoaikeisiin yhteydessä olevia lääkärin työn riskitekijöitä sekä psykososiaalisia tekijöitä. Aineistona oli 585 Lääkärien työolot ja terveys 2006-kyselyyn vastannutta terveyskeskuslääkäriä. Terveyskeskuslääkärien työstälähtöaikeisiin olivat yhteydessä heikentynyt työtyytyväisyys ja epäoikeudenmukaisuuden kokemukset, jotka molemmat keskeisimmin yhdistyivät ryhmätyö- ja ihmissuhdeongelmiin. Työtyytyväisyyteen olivat yhteydessä myös työn yksinäisyys ja konsultaatiomahdollisuuksien heikkoudet sekä lääkärien kokema kiire ja resurssipula. Lääkärit, joiden työtyytyväisyys oli heikentynyt tai jotka kokivat ryhmätyö- ja ihmissuhdeongelmia, olivat muita huonommin sitoutuneita organisaatioonsa. Työvoimapulan tilanteessa lääkärien työstälähtöaikeisiin voitaneen vaikuttaa puuttumalla työtyytyväisyyteen ja oikeudenmukaisuuden kokemuksiin keskeisesti liittyviin tekijöihin.

BackgroundIn occupational life, a mismatch between high expenditure of effort and receiving few rewards may promote the co-occurrence of lifestyle risk factors, however, there is insufficient evidence to support or refute this hypothesis. The aim of this study is to examine the extent to which the dimensions of the Effort-Reward Imbalance (ERI) model – effort, rewards and ERI – are associated with the co-occurrence of lifestyle risk factors.MethodsBased on data from the Finnish Public Sector Study, cross-sectional analyses were performed for 28,894 women and 7233 men. ERI was conceptualized as a ratio of effort and rewards. To control for individual differences in response styles, such as a personal disposition to answer negatively to questionnaires, occupational and organizational -level ecological ERI scores were constructed in addition to individual-level ERI scores. Risk factors included current smoking, heavy drinking, body mass index ≥25 kg/m2, and physical inactivity. Multinomial logistic regression models were used to estimate the likelihood of having one risk factor, two risk factors, and three or four risk factors. The associations between ERI and single risk factors were explored using binary logistic regression models.ResultsAfter adjustment for age, socioeconomic position, marital status, and type of job contract, women and men with high ecological ERI were 40% more likely to have simultaneously ≥3 lifestyle risk factors (vs. 0 risk factors) compared with their counterparts with low ERI. When examined separately, both low ecological effort and low ecological rewards were also associated with an elevated prevalence of risk factor co-occurrence. The results obtained with the individual-level scores were in the same direction. The associations of ecological ERI with single risk factors were generally less marked than the associations with the co-occurrence of risk factors.ConclusionThis study suggests that a high ratio of occupational efforts relative to rewards may be associated with an elevated risk of having multiple lifestyle risk factors. However, an unexpected association between low effort and a higher likelihood of risk factor co-occurrence as well as the absence of data on overcommitment (and thereby a lack of full test of the ERI model) warrant caution in regard to the extent to which the entire ERI model is supported by our evidence.

Objectives: To investigate the association between effort-reward imbalance (ERI) at work and sedentary lifestyle.Methods: Cross-sectional data from the ongoing Finnish Public Sector Study related to 30 433 women and 7718 men aged 17-64 were used (n = 35 918 after exclusion of participants with missing values in covariates). From the responses to a questionnaire, an aggregated mean score for ERI in a work unit was assigned to each participant. The outcome was sedentary lifestyle defined as

Figure S2. Correlations between original CCCHP- scales. (DOCX 90 kb)