Biomedical subjects

Pekka Virtanen

Publications and source records attributed to Pekka Virtanen.

13 recordsLinked to original sources

PubMed2006

Employment status and differences in the one-year coverage of physician visits: different needs or unequal access to services?

BACKGROUND: The dichotomy employed vs. unemployed is still a relevant, but rather crude measure of status in current labour markets. Also, studies concerning the association of employment status with health have to specify the type of the employment as well as the characteristics of the unemployment. This study aims to reveal differences and potential inequalities in physician visits among seven groups in the core-periphery structures of the labour markets. METHODS: A total of 16,000 Finns responded to a postal survey in 2003. Their visits to physicians in public primary health care, occupational health care, private health services, hospital outpatient clinics and dental care services during previous year were measured as indicators of service utilisation. Participants were classified as employees having a permanent or fixed-term and full-time or part-time contract and as those experiencing short-term, prolonged or long-term unemployment. Differences in the one-year coverage of physician visits between these groups of employees were analysed using logistic regression analyses where differences in the need for services were controlled for by including demographics and self-rated health assessments in the models. RESULTS: Permanently employed respondents had visited a physician most often, and the need-adjusted regression models showed significantly lower odds ratios for a visit among fixed-term employees (OR 0.65, 95% CI 0.53-0.81) and in particular among the long-term unemployed (OR 0.21, 95% CI 0.14-0.31). A stratified analysis according to health care sector showed the lowest odds ratios in occupational health care and private physicians (ORs between 0.05 and 0.73) and also low odds ratios for dentists (ORs between 0.45 and 0.91), whereas visits to public primary health care were more common among non-permanent employees and the unemployed (ORs between 1.46 and 2.39). CONCLUSION: The use of physician services varies according to labour market status, being relatively low among the non-permanently employed and the unemployed. This underuse is emphasised when clinical need is taken into account. The main reasons for the variance evidently lie in the structures of the Finnish health service system. The result may indicate non-optimal health care of the population on the periphery of the labour market, but it may also reflect the importance of employment status as a context for need and the decision to visit a physician.

Adult↗

PubMed2005

Labor market trajectories and health: a four-year follow-up study of initially fixed-term employees.

With the growth of atypical employment, there is increasing concern about the potential health-damaging effects of unstable employment. This prospective study of Finnish public-sector employees in 1998-2002 examined labor market trajectories and changes in health. At entry, all participants had a fixed-term job contract. Trajectories were measured by exposure to unstable employment during follow-up, destination employment status at the end of follow-up, and the way in which these elements were combined. Nonoptimal self-rated health at baseline was associated with high exposure to unstable employment and unemployment as the destination. After adjustment for health and psychological distress at baseline, a trajectory with stable employment as the destination was associated with a decreased risk of psychological distress at follow-up (odds ratio = 0.68, 95% confidence interval: 0.46, 0.98), whereas a trajectory toward the labor market periphery was related to increased risk of nonoptimal health (odds ratio = 2.54, 95% confidence interval: 1.47, 4.39) when compared with remaining in fixed-term employment. A significant dose-response relation was seen between the measure combining exposure to instability with destination employment status and nonoptimal health. This longitudinal study provides evidence of health-related selection into employment trajectories and suggests that the trajectories themselves carry different health risks.

Adult↗

PubMed2005

Temporary employment and health: a review.

OBJECTIVES: We aimed to review evidence on the relationship between temporary employment and health, and to see whether the association is dependent on outcome measure, instability of employment, and contextual factors. METHOD: We systematically searched for studies of temporary employment and various health outcomes and critically appraised 27 studies. RESULTS: The review suggests higher psychological morbidity among temporary workers compared with permanent employees. According to some studies, temporary workers also have a higher risk of occupational injuries but their sickness absence is lower. Morbidity may be higher in temporary jobs with high employment instability and in countries with a lower number of temporary workers and unemployed workers. CONCLUSIONS: The evidence indicates an association between temporary employment and psychological morbidity. The health risk may depend on instability of temporary employment and the context. Confounding by occupation may have biased some of the studies. Additional research to clarify the role of employment instability, hazard accumulation, and selection is recommended.

Absenteeism↗

PubMed2005

Local economy and sickness absence: prospective cohort study.

STUDY OBJECTIVE: To investigate the effect of the local economy, as measured by municipal revenue and local unemployment rate, on sickness absence among the employed. DESIGN: A prospective cohort study of 60 160 public sector employees (46 081 women, 14 079 men) with ecological measures of municipal revenue and local unemployment rate 1999-2000 and individual measures of sickness absence at baseline 1999 and at follow up 2000-2001. RESULTS: Among men and women, constantly poor local economy, as shown by low municipal revenue and high unemployment rate, was related to decreased self certified sickness absence rates. Local unemployment rate was a stronger predictor of self certified sickness absence than municipal revenue and the effect was stronger among men than among women. High unemployment rate predicted increased medically certified sickness absence among women. CONCLUSIONS: Working in areas of poor local economy is associated with increased long term sickness absence but decreased probability to take a short term sick leave. Unemployment rate may have an effect on the threshold to take a sick leave in relation to minor illnesses even when area deprivation poses health risk to its residents. To prevent adverse health effects of presenteeism, working while ill, and to reduce medically certified sickness absence, potential benefits may be attained by improving economic conditions and re-employment in deprived areas.

Adult↗

PubMed2004

Organisational downsizing, sickness absence, and mortality: 10-town prospective cohort study.

OBJECTIVE: To examine whether downsizing, the reduction of personnel in organisations, is a predictor of increased sickness absence and mortality among employees. DESIGN: Prospective cohort study over 7.5 years of employees grouped into categories on the basis of reductions of personnel in their occupation and workplace: no downsizing (< 8% reduction), minor downsizing (8-18%), and major downsizing (> 18%). SETTING: Four towns in Finland. PARTICIPANTS: 5909 male and 16 521 female municipal employees, aged 19-62 years, who kept their jobs. MAIN OUTCOME MEASURES: Annual sickness absence rate based on employers' records before and after downsizing by employment contract; all cause and cause specific mortality obtained from the national mortality register. RESULTS: Major downsizing was associated with an increase in sickness absence (P for trend < 0.001) in permanent employees but not in temporary employees. The extent of downsizing was also associated with cardiovascular deaths (P for trend < 0.01) but not with deaths from other causes. Cardiovascular mortality was 2.0 (95% confidence interval 1.0 to 3.9) times higher after major downsizing than after no downsizing. Splitting the follow up period into two halves showed a 5.1 (1.4 to 19.3) times increase in cardiovascular mortality for major downsizing during the first four years after downsizing. The corresponding hazard ratio was 1.4 (0.6 to 3.1) during the second half of follow up. CONCLUSION: Organisational downsizing may increase sickness absence and the risk of death from cardiovascular disease in employees who keep their jobs

Absenteeism↗

PubMed2004

Social capital in working life and the health of employees.

It is commonly assumed that social capital influences health, but only few studies have examined this hypothesis in the context of the workplace. The present prospective cohort study of 6028 public sector employees in Finland investigated social capital as a workplace characteristic which potentially affects employee health. The two indicators of social capital were trust in the labour market, measured by security of the employment contract, and trust in co-worker support. Self-rated health status and psychological distress were used as indicators of health. The combination of subsidised job contract and low co-worker support (i.e. the lowest category of social capital) was associated with poorer health prospects than the combination of permanent employment and high support (the highest social capital category) in an age-adjusted model, but this association disappeared in logistic regression analysis adjusted by sociodemographic background factors and baseline health. Fixed-term employment predicted better self-rated health and less psychological distress when compared with permanent employment. Co-worker support was most common in permanent and least common in subsidised employees and it was associated with better self-rated health in women. Our findings suggest only partial support for the hypothesis of work-related social capital as a health resource.

Adult↗

PubMed2004

Is fixed-term employment a new risk for adverse physical working conditions?

Relationships between employment type and the physical work environment were studied among blue-collar workers (n = 1,127). Based on survey data, we set out to compare the evaluations of environmental load and physical strain at work given by fixed-term (17% of all) and permanent workers. The type of employment was not related to environmental load. However, working on a fixed-term basis increased the risk of physical strain at work. Analyses revealed that this connection was evident only among fixed-term construction workers. The results did not support the much-cited view that the disintegration of standard employment has given rise to a new series of work environment problems. Such problems are concentrated in an area with a long tradition of work environment problems, that is, in the construction industry.

Adolescent↗

PubMed2004

Work and family as constituents of sense of coherence.

In this article, the authors focus on the intersection of the sense of coherence (SOC) and professional career in the light of qualitative data. They analyze the career descriptions written by young physicians in response to an open question in a survey questionnaire. In these narrative accounts, respondents who scored high on the SOC scale did not always orientate to work in a predictable way. Visiting narrative theoretization and feminist critique, the authors suggest a reflective survey style that seeks in the research process not so much an endeavor to reach a preexisting truth but, rather, a dialogue aimed at explaining the phenomenon at hand in a meaningful, agency-enabling way.

Adaptation, Psychological↗

PubMed2003

A real-time analysis of QacR-regulated multidrug resistance in Staphylococcus aureus.

Here we describe the construction and characterization of a biosensing reporter where luxCDABE genes from Photorhabdus luminescens, engineered for expression in Gram-positive organisms, are under the transcriptional control of QacR repressor from Staphylococcus aureus. In non-pathogenic S. aureus model system we analyzed the activity of the regulatory region acting as multidrug-resistance mediator in wild type strains. The use of full-length bacterial luciferase and the measurement of real-time light emission from intact, living cells make the present system suitable to follow the short term activity of different inducers. Among the tested molecules, tetracyclines showed a peculiar behavior by giving very high induction in a fashion seemingly more related to a general stress condition of the culture than to the direct binding and displacement of QacR from its operator. Temperature shocks confirmed that active transcription from qacA promoter is started in response to unspecific conditions where cell growth is strongly inhibited.

Anti-Infective Agents, Local↗

PubMed2003

Employment status passages and psychosocial well-being.

Medical students entering the labor market were studied to find out whether the improvement of psychosocial well-being depends on characteristics of their careers. Psychosocial well-being was described on the basis of psychosomatic stress symptoms, psychological distress (General Health Questionnaire), and strain resistance resources (Sense of Coherence). The 3-year follow-up showed that among women the improvement of strain resistance resources was delayed in the group with several entries into work. Among men the findings suggested associations between stress symptoms and career characteristics. Most of the results, however, did not support the hypothesis about the division of the participants into those with a stable career and improving well-being and those with a fragmented career and low well-being.

Adaptation, Psychological↗

PubMed2003

Further improvement of broad specificity hapten recognition with protein engineering.

Sulfa-antibiotics (sulfonamides) are widely used in veterinary medicine. Meat and milk from treated animals can be contaminated with sulfa residues. Current sulfonamide assays are unfit for screening of food, because they are either too laborious, insensitive or specific for a few sulfa compounds only. An immunoassay for detection of all sulfas in a single reaction would be useful for screening. Previously we have improved the broad specificity sulfa binding of antibody 27G3 with random mutagenesis and phage display. In order to improve the properties of this antibody further, mutants from the previous study were recombined and more mutations introduced. These new libraries were enriched with phage display and several different mutant antibodies were isolated. The cross-reaction profile of the best mutant was better than that of the wild-type antibody and the mutants of the previous study: it was capable of binding 10 of the tested 13 sulfonamides within a narrow concentration range and also bound the rest of the sulfas 5- to 11-fold better than the mutants of the previous study.

Amino Acid Sequence↗

PubMed2002

Improving broad specificity hapten recognition with protein engineering.

Sulfa antibiotics (sulfonamides) are derivatives of p-aminobenzenesulfonamide that are widely used in veterinary medicine. Foods derived from treated animals may be contaminated with these drugs. However, current immunobased sulfonamide detection methods are unfit for screening of products because they are either too insensitive or specific for a few compounds only. An immunoassay capable of detecting all sulfas in a single reaction would be ideal for screening. For development of a binder capable of binding all sulfas, a protein engineering approach was chosen and the properties of monoclonal antibody 27G3 were improved with mutagenesis followed by selection with phage display. Several different mutant antibodies were isolated. The cross-reaction profile of the best mutant antibody was significantly improved over that of the wild-type antibody: it was capable of binding 9 of the tested 13 sulfonamides within a narrow concentration range and also bound the rest of the sulfas, albeit within a wider concentration range.

Antibodies, Monoclonal↗

PubMedDate not supplied

Discarding multidrug resistance inducers, the possible role of a biosensing reporter in antimicrobial discovery.

The aim of the present work was to determine whether the luminescence-based reporter plasmid pQacLux could be applied to drug discovery in order to discard compounds with defined properties. Non-pathogenic Staphylococcus aureus RN4220 cells bearing pQacLux were incubated with different concentrations of a disinfectant of common use in hospitals. The in vivo light emission response of the plasmid to the given stimuli was then quantified and compared to a negative control for the construction of dose-response curves. The selected disinfectant provided a convenient model for the activity of quaternary ammonium compounds. In spite of the use of a raw model solution, the system revealed high levels of sensitivity. According to the results obtained, pQacLux could be conveniently used in the first steps of drug development in order to discard all possible multidrug resistance inducers.

Biosensing Techniques↗