Koskenvuo, Markku
Works: | 48 works in 53 publications in 2 languages and 71 library holdings |
---|---|
Roles: | Contributor, Author, Other, Honoree |
4 editions published in 1978 in Finnish and English and held by 5 WorldCat member libraries worldwide
2 editions published in 2012 in English and held by 3 WorldCat member libraries worldwide
Background: Job strain (i.e., high job demands combined with low job control) is a frequently used indicator of harmful work stress, but studies have often used partial versions of the complete multi-item job demands and control scales. Understanding whether the different instruments assess the same underlying concepts has crucial implications for the interpretation of findings across studies, harmonisation of multi-cohort data for pooled analyses, and design of future studies. As part of the 'IPD-Work' (Individual-participant-data meta-analysis in working populations) consortium, we compared different versions of the demands and control scales available in 17 European cohort studies. Methods: Six of the 17 studies had information on the complete scales and 11 on partial scales. Here, we analyse individual level data from 70 751 participants of the studies which had complete scales (5 demand items, 6 job control items). Results: We found high Pearson correlation coefficients between complete scales of job demands and control relative to scales with at least three items (r> 0.90) and for partial scales with two items only (r = 0.76-0.88). In comparison with scores from the complete scales, the agreement between job strain definitions was very good when only one item was missing in either the demands or the control scale (kappa> 0.80); good for job strain assessed with three demand items and all six control items (kappa> 0.68) and moderate to good when items were missing from both scales (kappa = 0.54-0.76). The sensitivity was> 0.80 when only one item was missing from either scale, decreasing when several items were missing in one or both job strain subscales. Conclusions: Partial job demand and job control scales with at least half of the items of the complete scales, and job strain indices based on one complete and one partial scale, seemed to assess the same underlying concepts as the complete survey instruments
1 edition published in 1999 in English and held by 2 WorldCat member libraries worldwide
1 edition published in 2006 in English and held by 2 WorldCat member libraries worldwide
1 edition published in 2018 in English and held by 2 WorldCat member libraries worldwide
1 edition published in 2006 in English and held by 2 WorldCat member libraries worldwide
1 edition published in 2010 in English and held by 2 WorldCat member libraries worldwide
1 edition published in 2005 in English and held by 2 WorldCat member libraries worldwide
1 edition published in 1978 in Undetermined and held by 2 WorldCat member libraries worldwide
2 editions published in 2017 in English and held by 2 WorldCat member libraries worldwide
Background: Although overweight and obesity have been studied in relation to individual cardiometabolic diseases, their association with risk of cardiometabolic multimorbidity is poorly understood. Here we aimed to establish the risk of incident cardiometabolic multimorbidity (ie, at least two from: type 2 diabetes, coronary heart disease, and stroke) in adults who are overweight and obese compared with those who are a healthy weight. Methods: We pooled individual-participant data for BMI and incident cardiometabolic multimorbidity from 16 prospective cohort studies from the USA and Europe. Participants included in the analyses were 35 years or older and had data available for BMI at baseline and for type 2 diabetes, coronary heart disease, and stroke at baseline and follow-up. We excluded participants with a diagnosis of diabetes, coronary heart disease, or stroke at or before study baseline. According to WHO recommendations, we classified BMI into categories of healthy (20·0-24·9 kg/m 2), overweight (25·0-29·9 kg/m 2), class I (mild) obesity (30·0-34·9 kg/m 2), and class II and III (severe) obesity (e"5·0 kg/m 2). We used an inclusive definition of underweight (<20 kg/m 2) to achieve sufficient case numbers for analysis. The main outcome was cardiometabolic multimorbidity (ie, developing at least two from: type 2 diabetes, coronary heart disease, and stroke). Incident cardiometabolic multimorbidity was ascertained via resurvey or linkage to electronic medical records (including hospital admissions and death). We analysed data from each cohort separately using logistic regression and then pooled cohort-specific estimates using random-effects meta-analysis. Findings: Participants were 120 813 adults (mean age 51·4 years, range 35-103; 71 445 women) who did not have diabetes, coronary heart disease, or stroke at study baseline (1973-2012). During a mean follow-up of 10·7 years (1995-2014), we identified 1627 cases of multimorbidity. After adjustment for sociodemographic and lifestyle factors, compared with individuals with a healthy weight, the risk of developing cardiometabolic multimorbidity in overweight individuals was twice as high (odds ratio [OR] 2·0, 95% CI 1·7-2·4; p<0·0001), almost five times higher for individuals with class I obesity (4·5, 3·5-5·8; p<0·0001), and almost 15 times higher for individuals with classes II and III obesity combined (14·5, 10·1-21·0; p<0·0001). This association was noted in men and women, young and old, and white and non-white participants, and was not dependent on the method of exposure assessment or outcome ascertainment. In analyses of different combinations of cardiometabolic conditions, odds ratios associated with classes II and III obesity were 2·2 (95% CI 1·9-2·6) for vascular disease only (coronary heart disease or stroke), 12·0 (8·1-17·9) for vascular disease followed by diabetes, 18·6 (16·6-20·9) for diabetes only, and 29·8 (21·7-40·8) for diabetes followed by vascular disease. Interpretation: The risk of cardiometabolic multimorbidity increases as BMI increases; from double in overweight people to more than ten times in severely obese people compared with individuals with a healthy BMI. Our findings highlight the need for clinicians to actively screen for diabetes in overweight and obese patients with vascular disease, and pay increased attention to prevention of vascular disease in obese individuals with diabetes. Funding: NordForsk, Medical Research Council, Cancer Research UK, Finnish Work Environment Fund, and Academy of Finland
1 edition published in 2018 in English and held by 2 WorldCat member libraries worldwide
1 edition published in 2016 in English and held by 2 WorldCat member libraries worldwide
1 edition published in 2003 in English and held by 2 WorldCat member libraries worldwide
1 edition published in 2015 in English and held by 2 WorldCat member libraries worldwide
Objective: To quantify the association between long working hours and alcohol use. Design: Systematic review and meta-analysis of published studies and unpublished individual participant data. Data sources: A systematic search of PubMed and Embase databases in April 2014 for published studies, supplemented with manual searches. Unpublished individual participant data were obtained from 27 additional studies. Review methods: The search strategy was designed to retrieve cross sectional and prospective studies of the association between long working hours and alcohol use. Summary: estimates were obtained with random effects meta-analysis. Sources of heterogeneity were examined with meta-regression. Results: Cross sectional analysis was based on 61 studies representing 333 693 participants from 14 countries. Prospective analysis was based on 20 studies representing 100 602 participants from nine countries. The pooled maximum adjusted odds ratio for the association between long working hours and alcohol use was 1.11 (95\% confidence interval 1.05 to 1.18) in the cross sectional analysis of published and unpublished data. Odds ratio of new onset risky alcohol use was 1.12 (1.04 to 1.20) in the analysis of prospective published and unpublished data. In the 18 studies with individual participant data it was possible to assess the European Union Working Time Directive, which recommends an upper limit of 48 hours a week. Odds ratios of new onset risky alcohol use for those working 49-54 hours and>=55 hours a week were 1.13 (1.02 to 1.26; adjusted difference in incidence 0.8 percentage points) and 1.12 (1.01 to 1.25; adjusted difference in incidence 0.7 percentage points), respectively, compared with working standard 35-40 hours (incidence of new onset risky alcohol use 6.2\%). There was no difference in these associations between men and women or by age or socioeconomic groups, geographical regions, sample type (population based v occupational cohort), prevalence of risky alcohol use in the cohort, or sample attrition rate. Conclusions Individuals whose working hours exceed standard recommendations are more likely to increase their alcohol use to levels that pose a health risk
1 edition published in 1999 in English and held by 2 WorldCat member libraries worldwide
1 edition published in 2017 in English and held by 2 WorldCat member libraries worldwide
1 edition published in 2010 in English and held by 2 WorldCat member libraries worldwide
1 edition published in 2016 in English and held by 2 WorldCat member libraries worldwide
1 edition published in 1997 in English and held by 2 WorldCat member libraries worldwide
1 edition published in 2004 in English and held by 2 WorldCat member libraries worldwide


0 |
![]() |
1 | ||
General | Special |

- SpringerLink (Online service) Other
- Kaprio, Jaakko Other Contributor
- Kivimäki, Mika Author Contributor
- Vahtera, Jussi Contributor
- Virtanen, Marianna Author
- Nyberg, Solja T. Contributor
- Pentti, Jaana
- Oksanen, Tuula
- Knutsson, Anders Contributor
- Ferrie, Jane E. Author