Mika Kivimaki

University College London, Londinium, England, United Kingdom

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Publications (249)2168.22 Total impact

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    ABSTRACT: We investigated causal effect of completed growth, measured by adult height, on coronary heart disease (CHD), stroke and cardiovascular traits, using instrumental variable (IV) Mendelian randomization meta-analysis. We developed an allele score based on 69 single nucleotide polymorphisms (SNPs) associated with adult height, identified by the IBCCardioChip, and used it for IV analysis against cardiovascular risk factors and events in 21 studies and 60 028 participants. IV analysis on CHD was supplemented by summary data from 180 height-SNPs from the GIANT consortium and their corresponding CHD estimates derived from CARDIoGRAMplusC4D. IV estimates from IBCCardioChip and GIANT-CARDIoGRAMplusC4D showed that a 6.5-cm increase in height reduced the odds of CHD by 10% [odds ratios 0.90; 95% confidence intervals (CIs): 0.78 to 1.03 and 0.85 to 0.95, respectively],which agrees with the estimate from the Emerging Risk Factors Collaboration (hazard ratio 0.93; 95% CI: 0.91 to 0.94). IV analysis revealed no association with stroke (odds ratio 0.97; 95% CI: 0.79 to 1.19). IV analysis showed that a 6.5-cm increase in height resulted in lower levels of body mass index (P < 0.001), triglycerides (P < 0.001), non high-density (non-HDL) cholesterol (P < 0.001), C-reactive protein (P = 0.042), and systolic blood pressure (P = 0.064) and higher levels of forced expiratory volume in 1 s and forced vital capacity (P < 0.001 for both). Taller individuals have a lower risk of CHD with potential explanations being that taller people have a better lung function and lower levels of body mass index, cholesterol and blood pressure. © The Author 2015; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.
    International Journal of Epidemiology 05/2015; DOI:10.1093/ije/dyv074 · 9.20 Impact Factor
  • Médecine du Sommeil 03/2015; 12(1). DOI:10.1016/j.msom.2015.01.112
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    ABSTRACT: Physical activity is critically important for successful aging, but its effect on adiposity markers at older ages is unclear as much of the evidence comes from self-reported data on physical activity. We assessed the associations of questionnaire-assessed and accelerometer-assessed physical activity with adiposity markers in older adults. This was a cross-sectional study on 3940 participants (age range 60-83 years) of the Whitehall II study who completed a 20-item physical activity questionnaire and wore a wrist-mounted accelerometer for 9 days in 2012 and 2013. Total physical activity was estimated using metabolic equivalent hours/week for the questionnaire and mean acceleration for the accelerometer. Time spent in moderate-and-vigorous physical activity (MVPA) was also assessed by questionnaire and accelerometer. Adiposity assessment included body mass index, waist circumference, and fat mass index. Fat mass index was calculated as fat mass/height² (kg/m²), with fat mass estimated using bioimpedance. Greater total physical activity was associated with lower adiposity for all adiposity markers in a dose-response manner. In men, the strength of this association was 2.4 to 2.8 times stronger with the accelerometer than with questionnaire data. In women, it was 1.9 to 2.3 times stronger. For MVPA, questionnaire data in men suggested no further benefit for adiposity markers past 1 hour/week of activity. This was not the case for accelerometer-assessed MVPA where, for example, compared with men undertaking <1 hour/week of accelerometer-assessed MVPA, waist circumference was 3.06 (95% confidence interval 2.06-4.06) cm lower in those performing MVPA 1-2.5 hours/week, 4.69 (3.47-5.91) cm lower in those undertaking 2.5-4 hours/week, and 7.11 (5.93-8.29) cm lower in those performing ≥4 hours/week. The association of physical activity with adiposity markers in older adults was stronger when physical activity was assessed by accelerometer compared with questionnaire, suggesting that physical activity might be more important for adiposity than previously estimated. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
    Journal of the American Medical Directors Association 03/2015; 36(5). DOI:10.1016/j.jamda.2015.01.086 · 4.78 Impact Factor
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    ABSTRACT: Obesity is heritable and predisposes to many diseases. To understand the genetic basis of obesity better, here we conduct a genome-wide association study and Metabochip meta-analysis of body mass index (BMI), a measure commonly used to define obesity and assess adiposity, in up to 339,224 individuals. This analysis identifies 97 BMI-associated loci (P < 5 × 10(-8)), 56 of which are novel. Five loci demonstrate clear evidence of several independent association signals, and many loci have significant effects on other metabolic phenotypes. The 97 loci account for ∼2.7% of BMI variation, and genome-wide estimates suggest that common variation accounts for >20% of BMI variation. Pathway analyses provide strong support for a role of the central nervous system in obesity susceptibility and implicate new genes and pathways, including those related to synaptic function, glutamate signalling, insulin secretion/action, energy metabolism, lipid biology and adipogenesis
    Nature 02/2015; 518(7538). DOI:10.1038/nature14177 · 42.35 Impact Factor
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    ABSTRACT: Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 x 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms.
    Nature 02/2015; 518(7538-7538):187-96. DOI:10.1038/nature14132 · 42.35 Impact Factor
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    ABSTRACT: A previous report suggested that 88% of individuals in the general population with total cholesterol (TC)>9.3mmol/L have familial hypercholesterolaemia (FH). We tested this hypothesis in a cohort of 4896 UK civil servants, mean (SD) age 44(±6) years, using next generation sequencing to achieve a comprehensive genetic diagnosis. 25(0.5%) participants (mean age 49.2 years) had baseline TC>9.3 mmol/L, and overall we found an FH-causing mutation in the LDLR gene in seven (28%) subjects. The detection rate increased to 39% by excluding eight paticipants with triglyceride levels over 2.3mmol/L, and reached 75% in those with TC>10.4mmol/L. By extrapolation, the detection rate would be ∼25% by including all participants with TC>8.6mmol/L (2.5 standard deviations from the mean). Based on the 1/500 FH frequency, 30% of all FH-cases in this cohort would be missed using the 9.3mmol/L cut-off. Given that an overall detection rate of 25% is considered economically acceptable, these data suggest that a diagnostic TC cut-off of 8.6mmol/L, rather than 9.3mmol/L would be clinically useful for FH in the general population.
    Atherosclerosis 01/2015; 97(2). DOI:10.1016/j.atherosclerosis.2015.01.028 · 3.97 Impact Factor
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    ABSTRACT: Objective: Positive psychological well-being has protective associations with cardiovascular outcomes, but no studies have considered its association with diabetes. This study investigated links between well-being and incident diabetes. Methods: At study baseline (1991-1994), 7,800 middle-aged British men and women without diabetes indicated their life satisfaction, emotional vitality, and optimism. Diabetes status was determined by self-reported physician diagnosis and oral glucose tolerance test (screen detection) at baseline and through 2002-2004. Incident diabetes was defined by physician-diagnosed and screen-detected cases combined and separately. Logistic regression estimated the odds of developing diabetes controlling for relevant covariates (e.g., demographics, depressive symptoms). Models were also stratified by gender and weight status. Results: There were 562 combined cases of incident diabetes during follow-up (up to 13 years). Well-being was not associated with incident diabetes for combined physician-diagnosed and screen-detected cases. However, when examining the 288 physician-diagnosed cases, life satisfaction and emotional vitality were associated with up to a 15% decrease in the odds of physician-diagnosed diabetes, controlling for demographics (results were similar with other covariates). Optimism was not associated with physician-diagnosed diabetes, and no well-being indicator was associated with screen-detected diabetes. Gender and weight status were not moderators. Conclusions: Life satisfaction and emotional vitality, but not optimism, were associated with reduced risk of physician-diagnosed diabetes. These findings suggest that well-being may contribute to reducing risk of a prevalent and burdensome condition, although intervention studies are needed to confirm this. It is unclear why findings differed for physician-diagnosed versus study-screened diabetes. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
    Health Psychology 01/2015; DOI:10.1037/hea0000200 · 3.95 Impact Factor
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    ABSTRACT: Intense interest surrounds the “healthy” obese phenotype, which is defined as obesity in the absence of metabolic risk factor clustering (1). Efforts to understand the cardiovascular consequences of healthy obesity are ongoing (2); however, its conceptual validity and clinical value rest on the assumption that it is a stable physiological state, rather than a transient phase of obesity-associated metabolic deterioration. Therefore, a fundamental question is whether healthy obese adults maintain this metabolically healthy profile over the long term or naturally transition into unhealthy obesity over time. Few studies have examined this; in those that have, durations of follow-up have been modest, with none exceeding 10 years (3,4). Accordingly, we aimed to describe the natural course of healthy obesity over 2 decades in a large population-based study.
    Journal of the American College of Cardiology 01/2015; 65(1):101-102. DOI:10.1016/j.jacc.2014.09.077 · 15.34 Impact Factor
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    ABSTRACT: We developed a 65-T2D variant weighted gene score to examine the impact on T2D risk assessment in a UK-based consortium of prospective studies, initially free from type 2 diabetes (T2D) (N=13,294; 37.3% women; mean age 58.5 (38-99) years). We compared the performance of the gene score with the phenotypically-derived Framingham Offspring Study T2D risk model, and then the two in combination. Over the median 10 years follow-up, 804 participants developed T2D. The odds ratio for T2D (top vs. bottom quintiles of gene score) was 2.70 (95%CI 2.12-3.43). With a 10% false positive rate, the genetic score alone detected 19.9% incident cases, the Framingham risk model 30.7%, and together, 37.3%. The respective area under the receiver operator characteristic curves were 0.60 (95% CI: 0.58-0.62), 0.75 (95% CI: 0.73 to 0.77) and 0.76 (95% CI: 0.75 to 0.78). The combined risk scores Net Reclassification Improvement (NRI) was 8.1% (5.0 to 11.2) p=3.31x10(-7). While BMI stratification into tertiles influenced the NRI (95% CI) (BMI<24.5kg/m(2) (27.6% (17.7 to 37.5) p=4.82x10(-8)); 24.5-27.5kg/m(2) (11.6% (5.8 to 17.4) p=9.88x10(-5)); >27.5kg/m(2) (2.6% (-1.4 to 6.6) p=0.20), age categories did not. The addition of the gene score to a phenotypic risk model leads to a potentially clinically important improvement in discrimination of incident T2D. © 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.
    Diabetes 12/2014; 64(5). DOI:10.2337/db14-1504 · 8.47 Impact Factor
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    ABSTRACT: The QT interval, an electrocardiographic measure reflecting myocardial repolarization, is a heritable trait. QT prolongation is a risk factor for ventricular arrhythmias and sudden cardiac death (SCD) and could indicate the presence of the potentially lethal mendelian long-QT syndrome (LQTS). Using a genome-wide association and replication study in up to 100,000 individuals, we identified 35 common variant loci associated with QT interval that collectively explain ∼8-10% of QT-interval variation and highlight the importance of calcium regulation in myocardial repolarization. Rare variant analysis of 6 new QT interval-associated loci in 298 unrelated probands with LQTS identified coding variants not found in controls but of uncertain causality and therefore requiring validation. Several newly identified loci encode proteins that physically interact with other recognized repolarization proteins. Our integration of common variant association, expression and orthogonal protein-protein interaction screens provides new insights into cardiac electrophysiology and identifies new candidate genes for ventricular arrhythmias, LQTS and SCD.
    Nature Genetics 12/2014; DOI:10.1038/ng.3014 · 29.65 Impact Factor
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    ABSTRACT: We previously used a single nucleotide polymorphism (SNP) in the CHRNA5-A3-B4 gene cluster associated with heaviness of smoking within smokers to confirm the causal effect of smoking in reducing body mass index (BMI) in a Mendelian randomisation analysis. While seeking to extend these findings in a larger sample we found that this SNP is associated with 0.74% lower body mass index (BMI) per minor allele in current smokers (95% CI -0.97 to -0.51, P = 2.00×10-10), but also unexpectedly found that it was associated with 0.35% higher BMI in never smokers (95% CI +0.18 to +0.52, P = 6.38×10-5). An interaction test confirmed that these estimates differed from each other (P = 4.95×10-13). This difference in effects suggests the variant influences BMI both via pathways unrelated to smoking, and via the weight-reducing effects of smoking. It would therefore be essentially undetectable in an unstratified genome-wide association study of BMI, given the opposite association with BMI in never and current smokers. This demonstrates that novel associations may be obscured by hidden population sub-structure. Stratification on well-characterized environmental factors known to impact on health outcomes may therefore reveal novel genetic associations.
    PLoS Genetics 12/2014; DOI:10.1371/journal.pgen.1004799 · 8.52 Impact Factor
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    ABSTRACT: Background Accelerometers, initially waist-worn but increasingly wrist-worn, are used to assess physical activity free from reporting-bias. However, its acceptability by study participants is unclear. Our objective is to assess factors associated with non-consent to a wrist-mounted accelerometer in older adults. Methods Data are from 4880 Whitehall II study participants (1328 women, age range = 60–83), requested to wear a wrist-worn accelerometer 24 h every day for 9 days in 2012/13. Sociodemographic, behavioral, and health-related factors were assessed by questionnaire and weight, height, blood pressure, cognitive and motor function were measured during a clinical examination. Results 210 participants had contraindications and 388 (8.3%) of the remaining 4670 participants did not consent. Women, participants reporting less physical activity and less favorable general health were more likely not to consent. Among the clinical measures, cognitive impairment (Odds Ratio = 2.21, 95% confidence interval: 1.22–4.00) and slow walking speed (Odds Ratio = 1.38, 95% confidence interval: 1.02–1.86) were associated with higher odds of non-consent. Conclusions The rate of non-consent in our study of older adults was low. However, key markers of poor health at older ages were associated with non-consent, suggesting some selection bias in the accelerometer data.
    PLoS ONE 10/2014; 9(10):e110816. DOI:10.1371/journal.pone.0110816 · 3.53 Impact Factor
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    ABSTRACT: The extent to which social relationships influence cognitive aging is unclear. In this study, we investigated the association of midlife quality of close relationships with subsequent cognitive decline. Participants in the Whitehall II Study (n = 5,873; ages 45-69 years at first cognitive assessment) underwent executive function and memory tests 3 times over a period of 10 years (1997-1999 to 2007-2009). Midlife negative and positive aspects of close relationships were assessed twice using the Close Persons Questionnaire during the 8 years preceding cognitive assessment. Negative aspects of close relationships, but not positive aspects, were associated with accelerated cognitive aging. Participants in the top third of reported negative aspects of close relationships experienced a faster 10-year change in executive function (-0.04 standard deviation, 95% confidence interval: -0.08, -0.01) than those in the bottom third, which was comparable with 1 extra year of cognitive decline for participants aged 60 years after adjustment for sociodemographic and health status. Longitudinal analysis found no evidence of reverse causality. This study highlights the importance of differentiating aspects of social relationships to evaluate their unique associations with cognitive aging.
    American Journal of Epidemiology 10/2014; 180(11). DOI:10.1093/aje/kwu236 · 4.98 Impact Factor
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    ABSTRACT: Study Objectives To assess whether sleep complaints - rather than clinically-defined sleep disturbances - were associated with the metabolic syndrome (MetS) and each of its components in an elderly population. Design and Setting: Cross sectional analyses of data from the French Three City Study - a large multicentre cohort of elderly community-dwellers-. Participants 6354 participants (56.4 % women, median age 73; range 65-97 years). Measure ments: Frequency of insomnia complaints (difficulty in initiating sleep, difficulty in maintaining sleep (DMS), and early morning awakening) and excessive daytime sleepiness (EDS) were self reported. MetS was assessed using National Cholesterol Education program Adult Treatment Panel III criteria. Results A total of 977 participants had MetS. After adjustment for a large range of potential confounders, we reported an association between the number of insomnia complaints and MetS. Among insomnia complaints only DMS was consistently associated with MetS (OR=1.23, 95 % CI: 1.06 to 1.43). Our results showed that EDS independently increased the risk of MetS (OR=1.46, 95%CI: 1.18 to 1.81 for frequently, OR=1.99, 95%CI: 1.49 to 1.67 for often). The EDS-MetS association was independent of 1) past-history of cardiovascular disease, 2) insomnia complaints and 3) obesity and loud snoring. Conclusion We report significant independent associations between frequent sleep complaints (EDS and to a lesser extent DMS) and MetS in the elderly with potential implications in terms of management and cardiovascular prevention in general geriatric practice. Prospective studies are required to clarify the direction of the association between sleep complaints and MetS.
    American Journal of Geriatric Psychiatry 10/2014; DOI:10.1016/j.jagp.2014.10.001 · 3.52 Impact Factor
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    ABSTRACT: Inflammation plays an important role in the aetiology of cardiovascular diseases and may contribute to the association linking unhealthy diet to chronic age-related diseases. However to date the long-term associations between diet and inflammation have been poorly described. Our aim was to assess the extent to which adherence to a healthy diet and dietary improvements over a 6-year exposure period prevented subsequent chronic inflammation over a 5-year follow-up in a large British population of men and women.
    The American Journal of Medicine 10/2014; 128(2). DOI:10.1016/j.amjmed.2014.10.002 · 5.30 Impact Factor
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    ABSTRACT: Using genome-wide data from 253,288 individuals, we identified 697 variants at genome-wide significance that together explained one-fifth of the heritability for adult height. By testing different numbers of variants in independent studies, we show that the most strongly associated approximately 2,000, approximately 3,700 and approximately 9,500 SNPs explained approximately 21%, approximately 24% and approximately 29% of phenotypic variance. Furthermore, all common variants together captured 60% of heritability. The 697 variants clustered in 423 loci were enriched for genes, pathways and tissue types known to be involved in growth and together implicated genes and pathways not highlighted in earlier efforts, such as signaling by fibroblast growth factors, WNT/beta-catenin and chondroitin sulfate-related genes. We identified several genes and pathways not previously connected with human skeletal growth, including mTOR, osteoglycin and binding of hyaluronic acid. Our results indicate a genetic architecture for human height that is characterized by a very large but finite number (thousands) of causal variants.
    Nature Genetics 10/2014; DOI:10.1038/ng.3097 · 29.65 Impact Factor
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    ABSTRACT: Objectives To investigate whether associations of smoking with depression and anxiety are likely to be causal, using a Mendelian randomisation approach.Design Mendelian randomisation meta-analyses using a genetic variant (rs16969968/rs1051730) as a proxy for smoking heaviness, and observational meta-analyses of the associations of smoking status and smoking heaviness with depression, anxiety and psychological distress.Participants Current, former and never smokers of European ancestry aged ≥16 years from 25 studies in the Consortium for Causal Analysis Research in Tobacco and Alcohol (CARTA).Primary outcome measures Binary definitions of depression, anxiety and psychological distress assessed by clinical interview, symptom scales or self-reported recall of clinician diagnosis.Results The analytic sample included up to 58 176 never smokers, 37 428 former smokers and 32 028 current smokers (total N=127 632). In observational analyses, current smokers had 1.85 times greater odds of depression
    BMJ Open 10/2014; 4. DOI:10.1136/bmjopen-2014-006141 · 2.06 Impact Factor
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    ABSTRACT: Objectives To examine cumulative associations between midlife health behaviors and walking speed and upper-limb strength in early old age.DesignProspective cohort study.SettingWhitehall II Study.ParticipantsIndividuals (mean age 49.1 ± 5.9 in 1991–93) with health behavior data for at least two of the three assessments (1991–93, 1997–99, 2002–04) and physical functioning measures in 2007–09 (mean age 65.9 ± 5.9) (N = 5,671).MeasurementsA trained nurse assessed walking speed and upper-limb strength. Unhealthy behaviors were defined as current or recent smoking, nonmoderate alcohol consumption (abstinence or heavy drinking), fruit and vegetable consumption less than twice per day, and physical inactivity (<1 h/wk of moderate and <1 h/wk of vigorous physical activity). For each unhealthy behavior, a cumulative score was calculated as the number of times a person reported the behavior over the three assessments divided by 3. The score ranged between 0 (never) and 1 (all three times).ResultsIn linear regression models adjusted for age, sex, education, marital status, and height, all unhealthy behaviors in 1991–93 were associated with slower walking speed in 2007–09, with differences ranging from 0.10 (nonmoderate alcohol consumption) to 0.25 (physical inactivity) of a standard deviation between participants with and without the unhealthy behavior (Pt-test<.001). For walking speed, the accumulation-of-risk model provided the best fit for unhealthy diet (β for a 1-point increment in the low fruit and vegetable consumption score = −0.29, 95% confidence interval (CI) = −0.36 to −0.22) and physical inactivity (β = −0.37, 95% CI = −0.45 to −0.29). For smoking and nonmoderate alcohol consumption, a cumulative effect was also observed, but partial F-tests did not suggest that it provided a better fit than models with behaviors in 1991–93, 1997–99, or 2002–04. All behavioral scores except smoking were associated with grip strength, but F-tests supported the accumulation-of-risk hypothesis only for physical inactivity.Conclusion These findings highlight the importance of duration of unhealthy behaviors, particularly for diet and physical activity, when examining associations with physical functioning.
    Journal of the American Geriatrics Society 10/2014; 62(10). DOI:10.1111/jgs.13071 · 4.22 Impact Factor
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    ABSTRACT: While cohort studies have revealed a range of risk factors for coronary heart disease and stroke, the extent to which the strength of these associations varies according to duration of follow-up in studies with extended disease surveillance is unclear. This was the aim of the present study.
    European Journal of Preventive Cardiology 09/2014; DOI:10.1177/2047487314547659 · 2.68 Impact Factor
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    ABSTRACT: Recent experimental evidence suggests that socioeconomic characteristics of neighbourhoods influence cardiovascular health, but observational studies which examine deprivation across a wide range of cardiovascular diseases (CVDs) are lacking.
    PLoS ONE 08/2014; 9(8):e104671. DOI:10.1371/journal.pone.0104671 · 3.53 Impact Factor

Publication Stats

6k Citations
2,168.22 Total Impact Points

Institutions

  • 2008–2015
    • University College London
      • Department of Epidemiology and Public Health
      Londinium, England, United Kingdom
  • 2005–2014
    • University of Helsinki
      • Department of Psychology
      Helsinki, Uusimaa, Finland
  • 2013
    • Queen Mary, University of London
      • Centre for Psychiatry
      Londinium, England, United Kingdom
    • UCL Eastman Dental Institute
      Londinium, England, United Kingdom
    • Uppsala University
      Uppsala, Uppsala, Sweden
    • Harvard Medical School
      • Department of Medicine
      Boston, Massachusetts, United States
  • 2008–2013
    • French Institute of Health and Medical Research
      • Center for Research in Epidemiology and Population Health CESP
      Lutetia Parisorum, Île-de-France, France
  • 2012
    • University Hospital of Lausanne
      Lausanne, Vaud, Switzerland
    • McGill University
      • Department of Epidemiology, Biostatistics and Occupational Health
      Montréal, Quebec, Canada
  • 2007–2012
    • University of Turku
      • Division of Psychology
      Turku, Varsinais-Suomi, Finland
    • University of Glasgow
      • MRC/CSO Social and Public Health Sciences Unit
      Glasgow, SCT, United Kingdom
    • University of Nottingham
      • Institute of Work, Health and Organisations
      Nottigham, England, United Kingdom
  • 2011
    • The University of Western Ontario
      London, Ontario, Canada
  • 2010–2011
    • Research Institute of the Finnish Economy, Finland, Helsinki
      Helsinki, Uusimaa, Finland
  • 2007–2011
    • London School of Hygiene and Tropical Medicine
      • Faculty of Epidemiology and Population Health
      Londinium, England, United Kingdom
  • 2006–2010
    • Finnish Institute of Occupational Health
      • Centre of Expertise for Work Organizations
      Helsinki, Southern Finland Province, Finland
  • 2009
    • University of Southampton
      • MRC Lifecourse Epidemiology Unit
      Southampton, England, United Kingdom
    • Stockholm University
      • Stress Research Institute
      Stockholm, Stockholm, Sweden
  • 1999
    • University of Jyväskylä
      Jyväskylä, Province of Western Finland, Finland