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101.
Sekine M Tatsuse T Kagamimori S Chandola T Cable N Marmot M Martikainen P Lallukka T Rahkonen O Lahelma E 《Social science & medicine (1982)》2011,73(4):595-603
In general, women report more physical and mental symptoms than men. International comparisons of countries with different welfare state regimes may provide further understanding of the social determinants of sex inequalities in health. This study aims to evaluate (1) whether there are sex inequalities in health functioning as measured by the Short Form 36 (SF-36), and (2) whether work characteristics contribute to the sex inequalities in health among employees from Britain, Finland, and Japan, representing liberal, social democratic, and conservative welfare state regimes, respectively. The participants were 7340 (5122 men and 2218 women) British employees, 2297 (1638 men and 659 women) Japanese employees, and 8164 (1649 men and 6515 women) Finnish employees. All the participants were civil servants aged 40-60 years. We found that more women than men tended to have disadvantaged work characteristics (i.e. low employment grade, low job control, high job demands, and long work hours) but such sex differences were relatively smaller among employees from Finland, where more gender equal policies exist than Britain and Japan. The age-adjusted odds ratio (OR) of women for poor physical functioning was the largest for British women (OR = 2.08), followed by for Japanese women (OR = 1.72), and then for Finnish women (OR = 1.51). The age-adjusted OR of women for poor mental functioning was the largest for Japanese women (OR = 1.91), followed by for British women (OR = 1.45), and then for Finnish women (OR = 1.07). Thus, sex differences in physical and mental health was the smallest in the Finnish population. The larger the sex differences in work characteristics, the larger the sex differences in health and the reduction in the sex differences in health after adjustment for work characteristics. These results suggest that egalitarian and gender equal policies may contribute to smaller sex differences in health, through smaller differences in disadvantaged work characteristics between men and women. 相似文献
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Health inequalities according to objective socioeconomic position (SEP), have been well-documented. Yet, in young people the associations are negligible. Recently, research on the association of subjective social status (SSS), and adult health has begun to accumulate. Studies on young people are rare and describe societies with large income inequalities. Here, we investigated the association between SSS and health, while controlling for own and familial SEP. The study population consisted of 15-year-olds (N = 2369) who have grown up in a context of low social inequalities. Data were derived from surveys carried out in 2004 in 29 secondary schools in Helsinki. The SSS was measured with an indicator specific to and validated for adolescents (a societal ladder). Outcome measures were self-rated health, health complaints, presence of limiting longstanding illness (LLI) and GHQ-12 caseness (indicating psychiatric morbidity). The SSS associated strongly with all health measures. Adjusting for objective socioeconomic measures attenuated the associations; although they all remained statistically significant apart from LLI among girls. The subjective assessment contributes to health inequalities in young people largely independent of objective SEP. Subjective ratings most probably capture aspects of social hierarchy that are more subtle and less well represented than in conventional measures. 相似文献
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105.
Riekkinen O Hakulinen MA Timonen M Töyräs J Jurvelin JS 《Ultrasound in medicine & biology》2006,32(7):1073-1083
Ultrasound (US) has been introduced as a promising tool for osteoporosis diagnostics. However, soft tissues overlying the bones affect reliability of the ultrasound (US) techniques. In this in vitro study, the effect of soft tissues on bone US measurements was investigated numerically and experimentally. Particularly, the dependence of the error induced by soft tissues on the applied US frequency (0.3 to 6.7 MHz) was addressed. For these aims, human trabecular bone samples (n = 25) were measured using acoustic, dual energy x-ray absorptiometry (DXA) and mechanical techniques. US attenuation, speed, reflection and backscattering were determined from the through-transmission and pulse-echo measurements. Numerical correction, based on the inclusion of acoustic characteristics of specific soft tissue components, i.e., adipose and lean tissues, was derived for the analysis of experimental measurements. Values of US parameters, interrelationships between the US parameters and mechanical properties, as well as the errors induced by the soft tissues, were significantly dependent on the US frequency. The errors induced by the soft tissues on the US measurement were typically reduced by approximately 50% after introduction of the numerical correction technique. Thereby, the acoustic prediction of mechanical properties of trabecular bone was also improved. We conclude that the numerical correction of the contribution of overlying soft tissues on acoustic measurements can reduce uncertainties related to in vivo US measurements. 相似文献
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Georg?MachareyEmail authorView authors OrcID profile Mika?Gissler Leena?Rahkonen Veli-Matti?Ulander Mervi?V?is?nen-Tommiska Mika?Nuutila Seppo?Heinonen 《Archives of gynecology and obstetrics》2017,295(4):833-838
Purpose
The aim of this study was to estimate whether breech presentation at term was associated with known individual obstetric risk factors for adverse fetal outcome.Methods
This was a retrospective, nationwide Finnish population-based cohort study. Obstetric risks in all breech and vertex singleton deliveries at term were compared between the years 2005 and 2014. A multivariable logistic regression model was used to determine significant risk factors.Results
The breech presentation rate at term for singleton pregnancies was 2.4%. The stillbirth rate in term breech presentation was significantly higher compared to cephalic presentation (0.2 vs 0.1%). The odds ratios (95% CIs) for fetal growth restriction, oligohydramnios, gestational diabetes, a history of cesarean section and congenital fetal abnormalities were 1.19 CI (1.07–1.32), 1.42 CI (1.27–1.57), 1.06 CI (1.00–1.13), 2.13 (1.98–2.29) and 2.01 CI (1.92–2.11).Conclusions
The study showed that breech presentation at term on its own was significantly associated with antenatal stillbirth and a number of individual obstetric risk factors for adverse perinatal outcomes. The risk factors included oligohydramnios, fetal growth restriction, gestational diabetes, history of caesarean section and congenital anomalies.109.
Roos E Talala K Laaksonen M Helakorpi S Rahkonen O Uutela A Prättälä R 《European journal of clinical nutrition》2008,62(7):823-833
BACKGROUND: Studies from different time periods have shown that consumption of vegetables is more common in higher socioeconomic groups and among women. However, there are only few studies of changes of socioeconomic differences in vegetable consumption over time. Our aim was to determine whether socioeconomic differences, measured by educational level and household income, in daily vegetable consumption have increased, decreased or been stable over the last two decades among Finnish men and women. METHODS: Data on daily consumption of fresh vegetables were derived from repeated annual cross-sectional surveys performed among representative samples of Finnish working aged (15-64 years) population. Data from the years 1979-2002 were linked with data on education and household income from Statistics Finland. Those under 25 years and all students were excluded, giving a total of 69 383 respondents. The main analyses were conducted with logistic regression. RESULTS: Daily consumption of fresh vegetables became overall more prevalent during the study period. Daily consumption of fresh vegetables was more common among those with higher education and higher income during the whole study period. Both educational level and household income differences in daily vegetable consumption slightly narrowed since 1979 among men and women. CONCLUSIONS: Women with high socioeconomic position have been initial trend setters, but the prevalence of daily consumers of vegetables in these groups has not increased since the early 1990s. The prevalence of daily consumption of fresh vegetables has increased more in lower educational and income groups during the 1980s and 1990s along with narrowing socioeconomic differences. 相似文献
110.
Langer I Guller U Berclaz G Koechli OR Moch H Schaer G Fehr MK Hess T Oertli D Bronz L Schnarwyler B Wight E Uehlinger U Infanger E Burger D Zuber M;Swiss Multicenter Study Group Sentinel Lymph Node in Breast Cancer 《Breast cancer research and treatment》2009,113(1):129-136
Objective To assess the accuracy of sentinel lymph node (SLN) frozen section in a prospective multicenter study of early-stage breast
cancer patients. Summary background data The decision to perform an immediate completion axillary node dissection (ALND) is based on results of SLN frozen section.
However, SLN frozen sections are not routinely performed in all centers. Moreover, the accuracy of SLN frozen section remains
a matter of great debate. Methods Prospective multicenter trial analyzing 659 early stage breast cancer patients (pT1 and pT2 ≤ 3 cm, cN0) enrolled between
January 2000 and December 2003. SLN were intraoperatively examined by frozen section. Final histopathology consisted in performing
step sectioning as well as staining with H&E and immunohistochemistry. Results SLN were identified in 98.3% (648/659) of all patients. The accuracy of frozen section was 90.1% (584/648), the sensitivity
for SLN macro-metastases 98% (142/145), and the specificity 100%. A total of 47 patients with SLN micro-metastases (n = 36) or isolated tumor cells (n = 11) underwent a delayed completion ALND. In 96% (45/47) of these patients the ALND specimens were free of macro-metastases. Conclusions
SLN frozen section provides highly accurate information regarding identification of SLN macro-metastases, a delayed completion
ALND can be avoided in 98% of these patients. More importantly, in the present investigation the vast majority (96%) of patients
with SLN micro-metastases or isolated tumor cells undergoing delayed completion ALND did not benefit from the second operation
as ALND specimens were free of macro-metastases. We strongly recommend the routine use of SLN frozen section in early stage
breast cancer patients. 相似文献