| 1. |
- Bergström, Sten-Erik, et al.
(författare)
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Asthma mortality among Swedish children and young adults, a 10-year study
- 2008
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Ingår i: Respiratory Medicine. - : Elsevier BV. - 0954-6111 .- 1532-3064. ; 102:9, s. 1335-1341
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Previous reports indicate that morbidity and mortality from asthma have increased during the past decades. Here, the mortality rate associated with asthma and possible risk factors in children and young adults in Sweden during the period 1994-2003 were evaluated. METHODS: The medical profession was asked to report suspected cases of death from asthma in individuals 1-34 years of age. All death certificates containing relevant ICD codes were reviewed. Medical records and autopsy reports were assessed and telephone interviews with next-of-kin performed. RESULTS: During the 10-year period 37 deaths due to asthma were identified. The median age at the time of death was 27 years and 6 of the deceased were younger than 15. The overall incidence of death from asthma decreased from 1.54 deaths per million in 1994 to 0.53 per million in 2003. Common risk factors were under-treatment (23/37), poor adherence to prescribed treatment (17/37) and adverse psychosocial situation (19/37). An alarming finding was that 11 of the 37 deaths were probably caused by food allergy and for 8 subjects death was associated with exposure to pet dander. The death certificates were found to contain inaccuracies with 30% of those for whom asthma was reported as the underlying cause having died from other causes. CONCLUSION: Asthma mortality in children and young adults in Sweden decreased between 1994 and 2003. Food allergy and inadequate treatment were the major risk factors for such a death. Recognition and special care of patients with asthma who have shown signs of non-compliance, denial or severe food allergy must be encouraged.
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| 2. |
- Engström, Gunnar, et al.
(författare)
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The Swedish CArdioPulmonary BioImage Study : objectives and design
- 2015
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Ingår i: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 278:6, s. 645-659
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Tidskriftsartikel (refereegranskat)abstract
- Cardiopulmonary diseases are major causes of death worldwide, but currently recommended strategies for diagnosis and prevention may be outdated because of recent changes in risk factor patterns. The Swedish CArdioPulmonarybioImage Study (SCAPIS) combines the use of new imaging technologies, advances in large-scale 'omics' and epidemiological analyses to extensively characterize a Swedish cohort of 30 000 men and women aged between 50 and 64 years. The information obtained will be used to improve risk prediction of cardiopulmonary diseases and optimize the ability to study disease mechanisms. A comprehensive pilot study in 1111 individuals, which was completed in 2012, demonstrated the feasibility and financial and ethical consequences of SCAPIS. Recruitment to the national, multicentre study has recently started.
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| 3. |
- Holmberg, Lars I, 1944-
(författare)
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Health, Risk-Taking Behavior and Sexuality in Swedish Adolescents
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aims of this research were to develop methods of identifying adolescents with unhealthy and/or risk-taking behavior with special reference to sexuality, and to evaluate support measures for young people in need of such interventions. A further aim was to assess strategies for preventing unhealthy and/or risk-taking behavior. Data were obtained by questionnaires (studies I, III, IV and V) and interviews (study II).The results showed that young men involved in unintended pregnancies would benefit from active participation in the decision making regarding continuation or termination of the pregnancy, and from support at Outpatient Clinics for Adolescents in Sweden, including information together with the partner (I).It was also concluded that consideration should be paid to questions and problems, e.g. feelings, apprehensions, moral issues and psychosocial factors, that require individual support from personnel with knowledge and resources to help young men in this difficult situation (II).Among the most important findings regarding young men who had been involved in an unplanned pregnancy were that in this group a high percentage had previously considered suicide and that anabolic steroids were frequently used, compared with young men without experience of pregnancy (III).The finding that unprotected intercourse occurred in a fairly high frequency among 13- to 18-year-olds, despite massive education and easy access to contraceptives, gives reason for further considerations regarding appropriate ways of providing information to young people (IV).Girls and boys in vocational programs in Swedish high schools exhibit more risk-taking behaviors than those in theoretical programs and these two groups differ in clustering and accumulation of these behaviors. This means that preventive interventional strategies need to be elaborated with regard to these differences, with the aim of improving health maintenance among adolescents (V).Child-and-youth centers with a developmental and research capacity need to be established with the broad purpose of drawing up health prevention programs for children and young people.
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| 4. |
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| 5. |
- Jerdén, Lars, et al.
(författare)
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Gender Differences and Predictors of Self-Rated Health Development Among Swedish Adolescents
- 2011
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Ingår i: Journal of Adolescent Health. - : Elsevier BV. - 1054-139X .- 1879-1972. ; 48:2, s. 143-150
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The purpose of the study was to evaluate the development of self-rated health among boys and girls during adolescence. Methods: Longitudinal cohort study, involving 1,046 Swedish adolescents from the seventh (12-13 years old) to the ninth grade. Self-rated health (well-being) and health-related empowerment were measured using a questionnaire. Results: In the seventh as well as in the ninth grade, the proportion of adolescents reporting a good health was lower in girls than in boys. In general, girls showed lower health-related empowerment as compared with boys and this difference remained between both the grades. In boys and girls belonging to both grades, a high empowerment score was related to a high self-rated health. For both boys and girls, self-rated health declined between the seventh and ninth grade. In girls, the proportion rating their health as "very good" declined from 47 % to 30%, and in boys the same proportion declined from 56% to 46%, indicating an increasing gender difference. Only a minor proportion of adolescents (16% of the boys and 13% of the girls) reported an improvement. A high self-rated health in grade nine was, in girls, predicted by positive school experiences in seventh grade and, in boys, by a good mood in the family. Conclusion: During adolescence, girls reported lower self-rated health than boys and this gender difference increased over the years. High empowerment is related to high self-rated health, and positive school experiences and a good mood in the family seem to be important predictors of a positive development of self-rated health.
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| 6. |
- Jerdén, Lars
(författare)
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Health-promoting health services : personal health documents and empowerment
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In 2003, the Swedish Parliament adopted a national public health policy that included the domain - “A more health-promoting health service”. Strategies and tools are needed in the work to reorient health services. Personal health documents are documents concerning a person’s health, and are owned by the individual. Several studies that have evaluated such documents indicate that they could be of interest in health-promotion work. However, there is insufficient knowledge concerning personal health documents that target adolescents, and little is known about the feasibility of such documents in a Swedish cultural context. The concept of empowerment is gaining increased interest for health services, but the associations between empowerment, self-rated health and health behaviour are sparsely studied. The overall aim of the thesis is to explore a strategy - empowerment - and a tool - personal health documents - that might facilitate the work of the public health goal of a health-promoting health service. Specific aims are to examine the feasibility of using personal health documents in health promotion; to examine professionals’ experiences of working with health promotion and personal health documents; to examine the association between personal health documents and self-reported health behaviour change; and to examine the perception of empowerment in relation to self-rated health and health behaviour among adolescents. Two personal health documents that targeted adults and adolescents were developed and evaluated. Distribution to adults in different settings was compared in a cross-sectional study (n = 1 306). Adolescents received the document in school, and surveys were performed at baseline and after one year (n = 339). Practical use and attitudes by document owners were studied by questionnaires. Teachers (n = 69) answered a questionnaire, and community health nurses were interviewed (n = 12). The interviews also explored nurses’ experiences of working with health promotion in general, and were analysed by qualitative methodology. Adolescents’ empowerment was examined by a questionnaire (n = 1 046). Most participants reported reading in the documents; writing in the documents varied between 16% (distribution in occupational health) and 87% (adolescents). The health document was perceived as useful by 35% of the adolescents. Factors significantly related to personal usefulness were being born outside Sweden, experiencing fair treatment by teachers, being a non-smoker and having a positive school experience. Community health nurses were striving for a balance of being a doer of practical, disease-oriented tasks and a health-promotion communicator. The structural organisation in health care centres was important for their work with health promotion and the health document. Teachers were generally in favour of continued work with the document. In different settings, between 10% and 26% of adults reported changes in their health situations as a result of reading the booklet. Self-reported changes in health situations were less likely using postal distribution, and there were no significant differences between the other types of distribution. Adolescents with low empowerment scores reported poorer self-rated health and more risk-taking behaviours such as smoking and binge drinking. To conclude, personal health documents are feasible to use in different settings. Health promotion in health services needs active support from leaders as well as adequate support systems. Findings suggest that personal health documents can be tools for promoting self-reported lifestyle changes among adults in different settings. There is a close relation among adolescents between low empowerment in the domain of health, low self-rated health and health behaviours such as binge drinking and smoking.
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| 7. |
- Jerdén, Lars, et al.
(författare)
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Personal health documents in school health education : A feasibility study
- 2007
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 35:6, s. 662-665
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To examine the feasibility of a school intervention using a personal health document adapted for adolescents. Methods: The health document was developed in close cooperation with groups of adolescents and tested among seventh-grade students at two junior high schools (n=339). The document was presented to the students by their regular teachers. For evaluation, an adolescent questionnaire was used at baseline and after one year. Results: After one year, 87% of adolescents reported having written in the health document, and 77% reported having had classes with discussions on subjects in the document. The health document was perceived as useful by 35% of the adolescents. Factors significantly related to personal usefulness were being born outside Sweden, experiencing fair treatment by teachers, being a nonsmoker, and having a positive school experience. Conclusions: Implementation of a personal health document in junior high-school health education was feasible and well accepted.
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| 8. |
- Mallipeddi, Dinesh, 1987, et al.
(författare)
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Surface integrity of machined electron beam melted Ti6Al4V alloy manufactured with different contour settings and heat treatment
- 2020
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Ingår i: Procedia CIRP. - : Elsevier BV. - 2212-8271. ; 87:20, s. 327-332
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Konferensbidrag (refereegranskat)abstract
- The powder-bed-fusion-based Electron Beam Melting (EBM) is rapidly gaining interest as a feasible process in the manufacturing industry for producing intricate Ti6Al4V components. However, there is still a challenge of reducing production time and optimizing surface roughness. One way to improve surface roughness is to optimize the melting strategy, i.e. contour setting. This not only influences the obtained surface topographical features, but also the production time. Most industrial applications require subtractive post processing (machining) to obtain a desired functional surface. This paper is concerned with analysing surface and subsurface in turning of Ti6Al4V alloy, manufactured by EBM using different contour settings. Also, the effect of subsequent heat treatment, i.e. Hot Isostatic Pressing (HIP) is studied. The results indicate that avoiding of contours require a machining allowance of 1 mm to obtain surface roughness of about 0.5 µm (Sa). In case of three and five contours the machining allowance can be reduced to 0.25 mm. Microstructural differences originating from the subsequent HIP operation show no effect on machinability. Tensile residual stresses are generated when reaching down to the heat effected zone of contour settings.
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| 9. |
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| 10. |
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| 11. |
- Antonsson, Ann-Beth, et al.
(författare)
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Möjligheter och begränsningar avseende användning av slutningsåtgärder för metallhaltiga vatten
- 1992
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Målsättningen för det här fleråriga projektet är att ta fram ett objektivt tekniskt/ekonomiskt underlag avseende olika separationsteknikers möjligheter och begränsningar att sluta en ytbehandlingsanläggning. Tyngdpunkten ligger på metallbeläggningssidan. I den första delen av projektet har vi på laboratoriet behandlat följande provvattentyper från ytbehandlare. - Sköljvatten från förkromning, förkoppring, förnickling och förzinkning - Totalavlopp efter konventionell fällning. Vi har behandlat vattnen med ett stort antal olika separationstekniker. Jonbyte, omvänd osmos, nanofiltrering, indunstning, elektrolys, elektrodialys, sulfidfällning, aktivt kol. Vad gäller avskiljningen av metall kan man konstatera att det går att producera ett vatten med mycket låga resthalter, framförallt med jonbyte, omvänd osmos och indunstning. Investeringskostnaden för dessa metoder ökar nu i nämnd ordning. Det finns många företag som använder separationstekniker i sina system (framför allt jonbyte). Emellertid används dessa oftast för att återanvända sköljvattnet. De metaller som uppkoncentreras fälls oftast ut som metallhydroxider. För att kunna återföra metaller och andra prestationskemikalier till processbadet krävs det att man uppnår rätt koncentration samtidigt som man inte ska återföra föroreningar till badet. Helst ska dessa blödas ut ur systemet. För de tekniker som studerats var avskiljningsförmågan för metall hög för alla metoder utom aktivt kol. För organiskt material var den hög för omvänd osmos och indunstning. För att kunna bedöma möjligheten att återföra koncentrat till baden krävs det kunskap om korrekt badsammansättning, tolerabla avvikelser samt innehåll i de koncentrat som ska återföras. I den här inledande delen av projektet kan vi konstatera att kunskapen kring dessa frågor många gånger är bristfällig. En genomgång av vilka kemikalier som kan finnas i sköljvattnen och vilka inneboende hälsorisker dessa besitter har sammanställts. Med utgångspunkt från detta har sedan tänkbara hälsorisker som kan uppstå vid slutning diskuterats. I etapp 2 kommer arbetsmiljöaspekterna att belysas ytterligare i samband med pilotkörningarna i fält. Jonbyte, omvänd osmos (RO) och indunstning kommer att utprovas under långvariga och realistiska omständigheter. Dessutom kommer Elektrodialys (ED) och elektrolys att utprovas på mer koncentrerade sparsköljar och koncentrat från de andra metoderna.
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| 12. |
- Bergström, Erik, 1944-
(författare)
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Cardiovascular risk indicators in adolescents : the Umeå youth study
- 1995
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Atherosclerotic cardiovascular diseases (CVD), particularly coronary heart disease (CHD) and cerebrovascular disease, are today major causes of death in the industrialised parts of the world. There are evidence to suggest that the atherosclerotic process starts in childhood, implying that preventive measures should be implemented already in children and adolescents.The aim of this study was to examine CVD risk indicators and their determinants in healthy Swedish adolescents. The study population comprised 14- and 17-year-old boys and girls (n=1032), in the dty and surroundings of Umeå in northern Sweden.Biochemical, anthropometric, and physiological parameters associated to CVD (s- lipoproteins and s-apolipoproteins, s-insulin, s-ferritin, anthropometric measurements, blood pressure, and physical fitness) were evaluated in relation to family history of CVD, weight and length at birth, infant feeding regimen, physical growth during infancy and childhood, current diet, physical activity, smoking, and educational level and occupation of the parents.The main findings of the study were that, on average, total serum cholesterol (TC) values in boys and girls were at the same level as reported from other European countries. A family history of CVD, short duration of breast feeding, low attained height during infancy and childhood, high body mass index (BMI), and low physical fitness were all associated with an unfavourable serum lipid profile. The findings also showed that features typical of the insulin resistance syndrome are present already in adolescents. In boys, iron stores, estimated by serum ferritin, were related to BMI and physical fitness, in a similar way as well established CVD risk indicators. Compared to previous dietary studies in Sweden, mean relative (energy %) fat intake had decreased substantially although the mean relative intake of saturated fat was still rather high. For both boys and girls, reported relative energy intake (energy intake/estimated energy expenditure) decreased with increasing level of BMI. Furthermore, daily smoking was more common among adolescents from families with low socio-economic status (SES) but was most strongly associated to smoking in peers. Tobacco use was considerably higher among adolescents attending vocational programs at secondary high school as compared to theoretical programs. Daily smokers had a more unfavourable serum lipid profile compared to non-smokers. Low socio-economic status of the parents was related to higher BMI and low educational level to higher dietary fat intake in both boys and girls.In conclusion, the findings of the study show that parameters linked to adult CVD when examined in adolescents, are related to family history, infant nutrition, previous physical growth, current body composition, physical fitness, physical activity, smoking, and social status and educational level of the parents.
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| 13. |
- Bergström, Göran, 1964, et al.
(författare)
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Body weight at age 20 and in midlife is more important than weight gain for coronary atherosclerosis: Results from SCAPIS.
- 2023
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Ingår i: Atherosclerosis. - : Elsevier BV. - 1879-1484 .- 0021-9150. ; 373, s. 46-54
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Tidskriftsartikel (refereegranskat)abstract
- Elevated body weight in adolescence is associated with early cardiovascular disease, but whether this association is traceable to weight in early adulthood, weight in midlife or to weight gain is not known. The aim of this study is to assess the risk of midlife coronary atherosclerosis being associated with body weight at age 20, body weight in midlife and body weight change.We used data from 25,181 participants with no previous myocardial infarction or cardiac procedure in the Swedish CArdioPulmonary bioImage Study (SCAPIS, mean age 57 years, 51% women). Data on coronary atherosclerosis, self-reported body weight at age 20 and measured midlife weight were recorded together with potential confounders and mediators. Coronary atherosclerosis was assessed using coronary computed tomography angiography (CCTA) and expressed as segment involvement score (SIS).The probability of having coronary atherosclerosis was markedly higher with increasing weight at age 20 and with mid-life weight (p<0.001 for both sexes). However, weight increase from age 20 until mid-life was only modestly associated with coronary atherosclerosis. The association between weight gain and coronary atherosclerosis was mainly seen in men. However, no significant sex difference could be detected when adjusting for the 10-year delay in disease development in women.Similar in men and women, weight at age 20 and weight in midlife are strongly related to coronary atherosclerosis while weight increase from age 20 until midlife is only modestly related to coronary atherosclerosis.
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| 14. |
- Bergström, Hannah, et al.
(författare)
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Audio-video recording during laparoscopic surgery reduces irrelevant conversation between surgeons : a cohort study
- 2018
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Ingår i: BMC Surgery. - : BioMed Central. - 1471-2482. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The prevalence of perioperative surgical complications is a worldwide issue: In many cases, these events are preventable. Audio-video recording during laparoscopic surgery provides useful information for the purposes of education and event analyses, and may have an impact on the focus of the surgeons operating. The aim of the present study was to investigate how audio-video recording in the operating room during laparoscopic surgery affects the focus of the surgeon and his/her assistant.METHODS: A group of laparoscopic procedures where video recording only was performed was compared to a group where both audio and video recordings were made. All laparoscopic procedures were performed at Lindesberg Hospital, Sweden, during the period August to September 2017. The primary outcome was conversation not relevant to the ongoing procedure. Secondary outcomes were intra- and postoperative adverse events or complications, operation time and number of times the assistant was corrected by the surgeon.RESULTS: The study included 41 procedures, 20 in the video only group and 21 in the audio-video group. The material comprised laparoscopic cholecystectomies, totally extraperitoneal inguinal hernia repairs and bariatric surgical procedures. Irrelevant conversation time fell from 4.2% of surgical time to 1.4% when both audio and video recordings were made (p = 0.002). No differences in perioperative adverse event or complication rates were seen.CONCLUSION: Audio-video recording during laparoscopic abdominal surgery reduces irrelevant conversation time and may improve intraoperative safety and surgical outcome.TRIAL REGISTRATION: Available at FOU Sweden (ID: 232771) and retrospectively at Clinical trials.gov (ID: NCT03425175 ; date of registration 7/2 2018).
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| 15. |
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| 16. |
- Bergström, Lena, 1973-
(författare)
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Macroalgae in the Baltic Sea : responses to low salinity and nutrient enrichment in Ceramium and Fucus
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The brackish Baltic Sea is a marginal environment for both marine and freshwater species. The rate of ecological differentiation is presumably high due to strong selection pressure from a gradient of decreasing salinity that has been present in its current state for only about 3 000 years. Even more recently, increased nutrient loading due to human activities has affected the growth rate of species, with potential effects on their competitive interactions and responses to other regulating factors. I have investigated the potential effects of low salinity and nutrient enrichment on the distributional ranges of two marine macroalgae with a wide distribution in the Baltic Sea, the red alga Ceramium tenuicorne (Kütz.) Wærn and the brown alga Fucus vesiculosus L. A field study in the northern Baltic Sea indicated a strong relationship between the community structure of macroalgae and abiotic factors even on a small, local scale. The abiotic factors are potentially modulated by eutrophication, which may have a strong effect on the depth distribution and abundance of macroalgae. On a regional scale, laboratory experiments suggested that nutrient enrichment is unlikely to affect the distribution of Ceramium and Fucus along the salinity gradient. Growth in Ceramium from the Baltic Proper was enhanced by nitrate and phosphate, but the response did not override growth constraints due to low salinity. Ceramium from the Gulf of Bothnia had an inherently lower growth rate that was not positively affected by nitrate and phosphate increase. In Fucus vesiculosus, reproductive performance was impaired by nitrate and phosphate levels corresponding to ambient levels in eutrophicated areas of the Baltic Sea, when measured by their effect on zygote attachment, germination, and rhizoid development.The wide distribution of Ceramium in the inner Baltic Sea is probably related to local adaptation, rather than a generalized tolerance of different salinity levels. Ecotypic differences were observed when comparing strains from the Baltic Proper (salinity 7 psu) and the Gulf of Bothnia (4 psu). A high rate of vegetative reproduction was evident, although sexual reproduction was occasionally observed in salinity 4. In Fucus vesiculosus, genetic and morphological analyses of sympatric and allopatric populations of the common, vesicular, morphotype and a dwarf morphotype, characteristic for the Gulf of Bothnia, showed that the dwarf morphotype represents a separate evolutionary lineage. Also, vegetative reproduction was observed in Fucus for the first time, as supported by genetic and experimental data. The results show that the biota of the inner Baltic Sea may have unique adaptive and genetic properties, and that it is highly relevant to consider subspecies diversity in Baltic Sea management.
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| 17. |
- Ekman, Simon, et al.
(författare)
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A novel oral insulin-like growth factor-1 receptor pathway modulator and its implications for patients with non-small cell lung carcinoma : A phase I clinical trial
- 2016
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Ingår i: Acta Oncologica. - 0284-186X .- 1651-226X. ; 55:2, s. 140-148
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A phase Ia/b dose-escalation study was performed to characterize the safety, efficacy and pharmacokinetic properties of the oral small molecule insulin-like growth factor-1-receptor pathway modulator AXL1717 in patients with advanced solid tumors.MATERIAL AND METHODS: This was a prospective, single-armed, open label, dose-finding phase Ia/b study with the aim of single day dosing (phase Ia) to define the starting dose for multi-day dosing (phase Ib), and phase Ib to define and confirm recommended phase II dose (RP2D) and if possible maximum tolerated dose (MTD) for repeated dosing.RESULTS AND CONCLUSION: Phase Ia enrolled 16 patients and dose escalations up to 2900 mg BID were successfully performed without any dose limiting toxicity (DLT). A total of 39 patients were treated in phase Ib. AXL1717 was well tolerated with neutropenia as the only dose-related, reversible, DLT. RP2D dose was found to be 390 mg BID for four weeks. Some patients, mainly with NSCLC, demonstrated signs of clinical benefit, including four partial tumor responses (one according to RECIST and three according to PET). The 15 patients with NSCLC with treatment duration longer than two weeks with single agent AXL1717 in third or fourth line of therapy showed a median progression-free survival of 31 weeks and overall survival of 60 weeks. Down-regulation of IGF-1R on granulocytes and increases of free serum levels of IGF-1 were seen in patients treated with AXL1717. AXL1717 had an acceptable safety profile and demonstrated promising efficacy in this heavily pretreated patient cohort, especially in patients with NSCLC. RP2D was concluded to be 390 mg BID for four weeks. Trial number is NCT01062620.
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| 18. |
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| 19. |
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| 20. |
- Engström, Gunnar, et al.
(författare)
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Pulmonary function and atherosclerosis in the general population : causal associations and clinical implications
- 2024
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Ingår i: European Journal of Epidemiology. - : Springer Nature. - 0393-2990 .- 1573-7284. ; 39:1, s. 35-49
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Tidskriftsartikel (refereegranskat)abstract
- Reduced lung function is associated with cardiovascular mortality, but the relationships with atherosclerosis are unclear. The population-based Swedish CArdioPulmonary BioImage study measured lung function, emphysema, coronary CT angiography, coronary calcium, carotid plaques and ankle-brachial index in 29,593 men and women aged 50–64 years. The results were confirmed using 2-sample Mendelian randomization. Lower lung function and emphysema were associated with more atherosclerosis, but these relationships were attenuated after adjustment for cardiovascular risk factors. Lung function was not associated with coronary atherosclerosis in 14,524 never-smokers. No potentially causal effect of lung function on atherosclerosis, or vice versa, was found in the 2-sample Mendelian randomization analysis. Here we show that reduced lung function and atherosclerosis are correlated in the population, but probably not causally related. Assessing lung function in addition to conventional cardiovascular risk factors to gauge risk of subclinical atherosclerosis is probably not meaningful, but low lung function found by chance should alert for atherosclerosis.
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| 21. |
- Flacking, Renée, 1964-, et al.
(författare)
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'In or Out'-On the Dynamic between Acceptance and Rejection and its Influence on Health in Adolescent Girls
- 2014
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Ingår i: Young - Nordic Journal of Youth Research. - : SAGE Publications India. - 1103-3088 .- 1741-3222. ; 22:3, s. 291-303
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Tidskriftsartikel (refereegranskat)abstract
- Adolescent girls' subjective health, or well-being, is of international concern as the frequency of psychological and psychosomatic complaints is continuously increasing in several countries world-wide. The causes of this development are still obscure. The aim of this study was to explore well-being and strategies for increased well-being among adolescent girls. Grounded Theory method was used, in which in-depth interviews were held with 18 adolescent girls, 17-18 years of age. Results showed that striving for acceptance and avoiding rejection were central for their well-being. When rejection was experienced, emotions of stress-shame were recognized, a phenomena we call the stress-shame cycle. In the struggle to prevent rejection and to become accepted, the girls strived to boost their social attractiveness by impression management.
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| 22. |
- Gustafsson, Michael, et al.
(författare)
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Significant Gamma Lines from Inert Higgs Dark Matter
- 2007
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Ingår i: Physical Review Letters. - : American Physical Society. ; 99:041301
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Tidskriftsartikel (refereegranskat)abstract
- One way to unambiguously confirm the existence of particle dark matter and determine its mass would be to detect its annihilation into monochromatic gamma-rays in upcoming telescopes. One of the most minimal models for dark matter is the inert doublet model, obtained by adding another Higgs doublet with no direct coupling to fermions. For a mass between 40 and 80 GeV, the lightest of the new inert Higgs particles can give the correct cosmic abundance of cold dark matter in agreement with current observations. We show that for this scalar dark matter candidate, the annihilation signal of monochromatic γγ and Zγ final states would be exceptionally strong. The energy range and rates for these gamma-ray line signals make them ideal to search for with the soon upcoming GLAST satellite.
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| 23. |
- Helgesen, Fred, et al.
(författare)
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Trends in prostate cancer survival in Sweden, 1960 through 1988 : Evidence of increasing diagnosis of nonlethal tumors
- 1996
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Ingår i: Journal of the National Cancer Institute. - 0027-8874 .- 1460-2105. ; 88:17, s. 1216-1221
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The incidence of prostate cancer has increased during the past 30 years but has been paralleled by increases in survival rates from this disease, despite the absence of documented major improvement in curative treatment. Since a high prevalence of microscopic prostate cancer has been observed in autopsied men and because many prostate cancers may never surface clinically, increased diagnostic activities might have led to increased detection of less aggressive tumors. PURPOSE: This study was conducted to elucidate whether the trends in prostate cancer incidence and patient survival may be due to increasing diagnoses of nonlethal tumors. METHODS: We analyzed a population-based cohort comprising all cases of prostate cancer (n = 80,901) detected in Sweden during the period of 1960 through 1988. Five hundred eighteen patients (0.64% of the total number) who could not be followed because of emigration or an incomplete national registration number were excluded. Observed and relative survival rates were calculated for the entire cohort of 80,383 assessable patients per 5-year age group in 5-year periods of diagnosis and according to diagnostic method and were compared between geographic areas with differences in incidence rates. To estimate the independent effects of these determinants, multivariate analyses were performed. RESULTS: For the 80,383 patients with complete follow-up, the 10- and 20-year observed survival rates were 17.5% (95% confidence interval [CI] = 17.2%-17.9%) and 3.5% (95% CI = 3.2%-3.7%), and the relative survival rates were 41.1% (95% CI = 40.3%-41.9%) and 28.6% (95% CI = 26.5%-30.1%), respectively. Relative survival rates improved markedly over time; 10-year relative survival rates increased from 29% (95% CI = 27%-31%) among case patients diagnosed in 1960 through 1964 to 45% (95% CI = 43%-46%) among those diagnosed in 1975 through 1979. Relative survival rates leveled off after about 18 years at 18% (95% CI = 15%-20%) among patients diagnosed in 1960 through 1964 and at 31% (95% CI = 28%-34%) among those diagnosed in 1970 through 1974. An even more favorable outlook was observed in those case patients diagnosed later. In areas with a high or low incidence of prostate cancer, the 10-year relative survival rates were 45% (95% CI = 44%-47%) and 36% (95% CI = 34%-38%), respectively. In the early 1960s, the calculated loss of life expectancy after diagnosis varied from about 68% (95% CI = 61%-75%) of the expected length of life in the youngest age group to about 48% (95% CI = 46%-50%) in the oldest age group. From 1960 through 1964 to 1985 through 1988, the loss of life expectancy decreased by more than 50% in all age groups. The differences in relative survival rates between age groups were small, with a gradual decrease in age groups more than 60-64 years of age. CONCLUSIONS: Most of the great temporal improvement and geographic variation in survival rates are quantitatively consistent, with likely increases in the rate of detection of nonlethal tumors. IMPLICATIONS: The increase in relative survival rates must be taken into consideration when evaluating the outcome of treatment of prostate cancer, since nonrandomized comparisons may be confounded by time trends. Diagnosis of nonlethal tumors raises concerns because the individual would suffer from the psychologic burden of a cancer diagnosis without any therapeutic benefit.
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| 24. |
- Henriksson, Roger, et al.
(författare)
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High-grade astrocytoma treated concomitantly with estramustine and radiotherapy.
- 2006
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Ingår i: Journal of neuro-oncology. - : Springer Science and Business Media LLC. - 0167-594X .- 1573-7373. ; 78:3, s. 321-6
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Tidskriftsartikel (refereegranskat)abstract
- Experimental and early clinical investigations have demonstrated encouraging results for estramustine in the treatment of malignant glioma. The present study is an open randomized clinical trial comparing estramustine phosphate (Estracyt) in addition to radiotherapy with radiotherapy alone as first line treatment of astrocytoma grade III and IV. The 140 patients included were in a good clinical condition with a median age of 55 years (range 22-87). Estramustine was given orally, 280 mg twice daily, as soon as the diagnosis was established, during and after the radiotherapy for a period of in total 3 months. Radiotherapy was delivered on weekdays 2 Gy daily up to 56 Gy. Eighteen patients were excluded due to misclassification, leaving 122 patients eligible for evaluation. Overall the treatment was well tolerated. Mild or moderate nausea was the most common side effect of estramustine. The minimum follow-up time was 5.2 years for the surviving patients. For astrocytoma grade III the median survival time was 10.6 (1.3-92.7) months for the radiotherapy only group and 17.3 (0.4-96.9+) months for the estramustine + radiotherapy group. In grade IV the corresponding median survival time was 12.3 (2.1-89.2) and 10.3 (0.3-91.7+) months, respectively. Median time to progress for radiotherapy only and radiotherapy and estramustin group in grade III tumours was 6.5 and 10.1 months, respectively. In grade IV tumours the corresponding figures were 5.1 and 3.3 months, respectively. Although there was a tendency for improved survival in grade III, no statistical significant differences were found between the treatment groups. No differences between the two treatment groups were evident with respect to quality of life according to the EORTC QLQ-protocol. In conclusion, this first randomized study did not demonstrate any significant improvement of using estramustine in addition to conventional radiotherapy, however, a trend for a positive response for the estramustine group was found in patients with grade III glioma.
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| 25. |
- Jacobsson, Lars, et al.
(författare)
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Tillfällig avstängning av plaströrsledningar genom sammanklämning - kunskapsläge
- 2014
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Rapport (refereegranskat)abstract
- Temporary closure of plastic pipes by squeeze-off - state of the art State of the art and present use of squeeze-off methods for temporary closure of polymer pipelines for water and gas was investigated by an enquiry and a literature study. A limited, supplementary series of tests was also performed. The aim was to find, if possible, general limitations for use in terms of temperature at squeezing, pipe dimensions and materials, and to identify important problems that have to be analysed before guidelines can be issued regarding the use of the method. Some producers, suppliers and users in Sweden, were interviewed by the aid of a questionnaire. Although the investigation was limited, the answers are so homogeneous that they are considered representative. The belief is that the technique is harmful. It is used mostly for PE 80 and PE 100 materials and when necessary, e. g. when no valves are available. Decisions and risk assessments are mostly made ad hoc. The performance is according to manuals from producers and suppliers. Design of equipment, geometry, and recommended squeeze rates varies among suppliers. The literature on pipes consists mainly of papers from the 80-ies and 90-ies and from some research groups in the USA. There is a heuristic knowledge about formation and appearance of damage, and to some extent about the influence on service life. Newer research on general damage and fracture in polymers is available that is not related to the specific conditions in squeezed pipes. Such models are lacking, which may be due to the complexity of the area and its hands-on character. The commonly used PE 80 and PE 100 materials are clearly damaged by squeezing, particularly so for high compression levels, but the pipes still fulfil the requirements for use. Stronger and more crystalline materials, and larger pipe sizes, seem to be more severely damaged. It is not known how the damages influence slow crack growth and life. Squeeze-off on PE pipes with external longitudinal scratches should strictly be avoided. Also squeeze-off on PE pipes with PP coating at low temperature should be conducted with precaution until the opposite have been proven as some damage cases were reported. Removing the PP coating is recommended by some in this case. The experiments, on one old PE 80 pipe and two new PE 100 pipes with dimensions from 315 to 355 mm confirm the picture of damage. Commercial equipment was used and according to the supplier’s manual. All the pipes show similar damage, with crack formation and unevenness. Those are less significant for thinner pipe walls than for thicker ones. There is no apparent difference between new and old pipes. A few pressure tests were carried out on the squeezed pipes as well as the untouched pipes. The results show that no significant reduction of the lifetime could be proven regardless when an interrelated comparison between a squeezes and not squeezed pipe was made or when the lifetimes were compared with those obtained in earlier available material classification tests for the actual materials.
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| 26. |
- Joffer, Junia, et al.
(författare)
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Predictors of smoking among Swedish adolescents
- 2014
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 14, s. 1296-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Smoking most often starts in adolescence, implying that understanding of predicting factors for smoking initiation during this time period is essential for successful smoking prevention. The aim of this study was to examine predicting factors in early adolescence for smoking in late adolescence. Methods: Longitudinal cohort study, involving 649 Swedish adolescents from lower secondary school (12-13 years old) to upper secondary school (17-18 years old). Tobacco habits, behavioural, intra-and interpersonal factors and socio-demographic variables were assessed through questionnaires. Descriptive statistics, univariable and multivariable logistic regression were used to identify predicting factors. Results: Smoking prevalence increased from 3.3% among 12-13 year olds to 25.1% among 17-18 year olds. Possible predictors of smoking were: female sex, lower parental education, poorer family mood, poorer self-rated health, poorer self-esteem, less negative attitude towards smoking, binge drinking, snus use and smoking. In a multivariable logistic regression analysis, female sex (OR 1.64, CI 1.08-2.49), medium and low self-esteem (medium: OR 1.57, CI 1.03-2.38, low: 2.79, CI 1.46-5.33), less negative attitude towards smoking (OR 2.81, CI 1.70-4.66) and ever using snus (OR 3.43, CI 1.78-6.62) remained significant independent predicting factors. Conclusions: The study stresses the importance of strengthening adolescents' self-esteem, promoting anti-smoking attitudes in early adolescence, as well as avoidance of early initiation of snus. Such measures should be joint efforts involving parents, schools, youth associations, and legislating authorities.
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| 27. |
- Joffer, Junia, et al.
(författare)
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Self-rated health, subjective social status in school and socioeconomic status in adolescents: a cross-sectional study
- 2019
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- Background: Social position, traditionally measured by objective data on socioeconomic status (SES), is linked to health status in adults. In adolescents, the association is more uncertain and there are some studies suggesting that subjective social status (SSS) might be more adequate in relation to health. This study aimed to examine associations between SSS in school, SES and self-rated health (SRH) in adolescent boys and girls.Methods: A descriptive cross-sectional research design with quantitative survey data was used. The study involved 705 Swedish adolescents in upper secondary school (17–18-year-olds). SRH was measured with a single-item question and SSS by a question where adolescents were asked to assess their social position within their school. Formal education level of the parents was used as a proxy for objective SES. Univariable and multivariable ordinal regression analyses were conducted to assess the associations between SRH and SSS in school and SES.Results: In the multivariable analysis, SSS in school was positively associated with SRH, whereas no significant association between SES and SRH was found. The proportion of adolescents with high SRH increased with higher steps on the SSS ladder. Significant gender differences were found in that boys rated their SRH and SSS in school higher than girls did.Conclusions: The study shows that self-rated health in adolescents is related to perceived social position in school. Subjective social status in school seems to be a useful health-related measure of social position in adolescents.
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| 28. |
- Johansson, Jan-Erik, et al.
(författare)
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Fifteen-year survival in prostate cancer : a prospective, population-based study in Sweden
- 1997
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Ingår i: Journal of the American Medical Association (JAMA). - : American Medical Association (AMA). - 0098-7484 .- 1538-3598. ; 277:6, s. 467-471
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To describe the natural history of initially untreated early-stage prostate cancer. A key secondary objective was to calculate long-term survival rates by stage, grade, and age at diagnosis. DESIGN: Prospective cohort study. SETTING: Population-based in 1 county of Sweden, without screening for prostate cancer. PATIENTS: A group of 642 patients with prostate cancer of any stage, consecutively diagnosed between 1977 and 1984 at a mean age of 72 years with complete follow-up to 1994. MAIN OUTCOME MEASURES: Proportion of patients who died from prostate cancer, and 15-year survival (with 95% confidence interval [CI]), corrected for causes of death other than prostate cancer. RESULTS: In the entire cohort, prostate cancer accounted for 201 (37%) of all 541 deaths. Among 300 patients with a diagnosis of localized disease (T0-T2), 33 (11%) died of prostate cancer. In this group, the corrected 15-year survival rate was similar in 223 patients with deferred treatment (81%; 95% CI, 72%-89%) and in 77 who received initial treatment (81%; 95% CI, 67%-95%). The corrected 15-year survival was 57% (95% CI, 45%-68%) in 183 patients with locally advanced cancer (T3-T4) and 6% (95% CI, 0%-12%) in those 159 who had distant metastases at the time of diagnosis. CONCLUSION: Patients with localized prostate cancer have a favorable outlook following watchful waiting, and the number of deaths potentially avoidable by radical initial treatment is limited. Without reliable prognostic indicators, an aggressive approach to all patients with early disease would entail substantial overtreatment. In contrast, patients with locally advanced or metastatic disease need trials of aggressive therapy to improve their poor prognosis.
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| 29. |
- Lind, Lars, et al.
(författare)
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Obesity is associated with coronary artery stenosis independently of metabolic risk factors : the population-based SCAPIS study
- 2022
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Ingår i: Atherosclerosis. - : Elsevier. - 0021-9150 .- 1879-1484. ; 362, s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: Previous studies reported divergent results on whether metabolically healthy obesity is associated with increased coronary artery calcium and carotid plaques. We investigated this in a cross-sectional fashion in a large, well-defined, middle-aged population using coronary CT angiography (CCTA) and carotid ultrasound. Methods: In the SCAPIS study (50–65 years, 51% female), CCTA and carotid artery ultrasound were performed in 23,674 individuals without clinical atherosclerotic disease. These subjects were divided into six groups according to BMI (normal weight, overweight, obese) and the presence of metabolic syndrome (MetS) according to the NCEP consensus criteria. Results: The severity of coronary artery stenosis was increased in individuals with obesity without MetS compared to normal-weight individuals without MetS (OR 1.47, 95%CI 1.34–1.62; p < 0.0001), even after adjusting for non-HDL-cholesterol and several lifestyle factors. Such difference was not observed for the presence of carotid artery plaques (OR 0.94, 95%CI 0.87–1.02; p = 0.11). Obese or overweight individuals without any MetS criteria (except the waist criterion) showed significantly more pronounced stenosis in the coronary arteries as compared to the normal-weight individuals, while one criterion was needed to show increased plaque prevalence in the carotid arteries. High blood pressure was the most important single criterion for increased atherosclerosis in this respect. Conclusions: Individuals with obesity without MetS showed increased severity of coronary artery stenosis, but no increased occurrence of carotid artery plaques compared to normal-weight individuals without MetS, further emphasizing that obesity is not a benign condition even in the absence of MetS.
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| 30. |
- Lundholm, Thomas, et al.
(författare)
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NEW TECHNIQUES APPLIED TO ADAPTIVE CONTROLLED MACHINING
- 1992
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Ingår i: Robotics and Computer-Integrated Manufacturing. - 0736-5845 .- 1879-2537. ; 9:4-5, s. 383-389
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Tidskriftsartikel (refereegranskat)abstract
- The future capital intensive CIM and FMS systems will demand adaptive controlled (AC) machine tools. At the Department of Production Engineering of the Royal Institute of Technology in Stockholm (IMT/KTH) we are continuing the development of an advanced AC turning center. Our approach is to design and use sophisticated sensor systems to measure several features both on-line and off-line in order to obtain sufficient information on the cutting process and make adaptive feedback feasible. The AC system operates at three different levels: advanced process monitoring adaptive control constraint (ACC) adaptive control optimization (ACO). In this paper we give an overview of practical progress and improvements that have been achieved since our contribution to MSTF '87 in Cambridge.1 This includes: a new flexible sensor installation for optical tool wear measurements on-line tool wear estimation based upon a dynamic force sensor applied time series analysis for on-line chatter control real-time control of maching conditions with respect to cutting forces distributed real-time computer system solution.
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| 31. |
- Lundström, Erik, 1980-
(författare)
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Phenomenology of Inert Scalar and Supersymmetric Dark Matter
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- While the dark matter has so far only revealed itself through the gravitational influence it exerts on its surroundings, there are good reasons to believe it is made up by WIMPs – a hypothetical class of heavy elementary particles not encompassed by the Standard Model of particle physics. The Inert Doublet Model constitutes a simple extension of the Standard Model Higgs sector. The model provides a new set of scalar particles, denoted inert scalars because of their lack of direct coupling to matter, of which the lightest is a WIMP dark matter candidate. Another popular Standard Model extension is that of supersymmetry. In the most minimal scenario the particle content is roughly doubled, and the lightest of the new supersymmetric particles, which typically is a neutralino, is a WIMP dark matter candidate. In this thesis the phenomenology of inert scalar and supersymmetric dark matter is studied. Relic density calculations are performed, and experimental signatures in indirect detection experiments and accelerator searches are derived. The Inert Doublet Model shows promising prospects for indirect detection of dark matter annihilations into monochromatic photons. It is also constrained by the old LEP II accelerator data. Some phenomenological differences between the Minimal Supersymmetric Standard Model and a slight extension, the Beyond the Minimal Supersymmetric Standard Model, can be found. Also, supersymmetric dark matter models can be detected already within the early LHC accelerator data.
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| 32. |
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| 33. |
- Nilsson, Maria, 1957-, et al.
(författare)
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Adolescent´s perceptions and expectations of parental action on children´s smoking and snus use : national cross sectional data from three decades
- 2009
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Ingår i: BMC Public Health. - : BioMed Central. - 1471-2458. ; 9:74
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Tidskriftsartikel (refereegranskat)abstract
- Background: Parents play a vital role as children develop tobacco behaviours. Many parents feel unsure about their possibility to influence their teenager's lifestyle. Knowledge about young people's acceptance for parental intervention could increase parental involvement. The overall objective of this study was to explore adolescents' perceptions and expectations of parental action regarding children's smoking and snus use, and whether they have changed over time. To see if there were differences whether the adolescent was a tobacco user or not the adolescents' tobacco use was followed; and described to put the findings on their perceptions and expectations of parental action in a context.Methods: The study used a repeated cross-sectional design, reporting Swedish national data from three decades. Data were collected in 1987, 1994 and 2003 by a questionnaire mailed to homes, in total to 13500 persons. The annual samples, which were random and national representative, consisted of 4500 young people aged 13, 15 and 17 yr, 1500 individuals per age group. The sampling and data collection procedures were done the same way during each survey. Chi2- tests were used to evaluate differences in distributions.Results: Adolescents in all age groups became more positive toward parental action over time. In 2003, more then 86% of the adolescents, including both smokers and non-smokers, strongly supported parental action on their children's smoking by trying to persuade them not to smoke (94%), by not smoking themselves (87%) and by not allowing their children to smoke at home (86%). Both non-smokers and smokers supported the idea of parental action in a similar way. Reduced pocket money had a weak support (42%), especially from girls. Eighty-nine percent of the adolescents expected their parents to act against smoking and 85% against snus use.Smoking was stable at 8% in 1987 and 1994 but decreased to 4% in 2003. In 1987 the snus use prevalence was 4% and in 2003 it was 3%. Snus users were mostly boys while few girls had done more than tried snus. More young people in all age groups had never tried smoking compared to the previous studies. In 2003 57% stated that they had never tried smoking.Conclusion: Adolescent smoking in Sweden has decreased and the proportion who never tried smoking has increased. The results of this study show that a growing majority of adolescents support strong parental intervention to help them refrain from tobacco, but preferably not in a punitive manner. This finding dismisses the notion that adolescents ignore or even disdain parental practices concerning tobacco. Prevention strategies and interventions addressing adolescent tobacco use that involve parents can be improved by using these findings to encourage parents to intervene against their children's tobacco use.
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| 34. |
- Nilsson, Maria, 1957-, et al.
(författare)
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“I would do anything for my child, even quit tobacco” : bonus effects from an intervention that target adolescent tobacco use
- 2009
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Ingår i: Scandinavian Journal of Psychology. - : John Wiley & Sons. - 0036-5564 .- 1467-9450. ; 50:4, s. 341-345
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Tidskriftsartikel (refereegranskat)abstract
- This paper aims to assess program bonus effects on adult tobacco use from a long term intervention that targeted adolescent tobacco use. The school-based community intervention started in Västerbotten County in Sweden in 1993 and adults were invited to support adolescents to stay tobacco-free. It was combined with repeated cross-sectional surveys in schools annually 1994-1999 among grades 7-9 and after 1999 every second year. Participating schools were randomly selected before the first survey representing both rural and urban settings. Out of 4,055 students, 1,008 (24.8%) reported that their supporting adult had been a tobacco user who quit tobacco in order to be allowed to participate. Out of these, 13.2% used tobacco daily before joining. The remaining 2,997 students’ adult partners were not tobacco users. Engaging tobacco using adults as partners in interventions targeting adolescent tobacco use seem to have a considerable tobacco-reducing bonus effect in the adults.
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| 35. |
- Nilsson, Maria, 1957-, et al.
(författare)
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It takes two: reducing adolescent smoking uptake through sustainable adolescent-adult partnership
- 2006
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Ingår i: Journal of Adolescent Health. - : Elsevier BV. - 1054-139X .- 1879-1972. ; 39:6, s. 880-886
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Tidskriftsartikel (refereegranskat)abstract
- Purpose To assess the effects of a long-term intervention for tobacco use prevention that targets adolescents (Tobacco Free Duo). Methods School-based community intervention combined with repeated cross-sectional surveys over 7 years. The intervention was performed in the County of Västerbotten, Sweden, where survey data were collected in grade seven to nine schools on an annual basis for 7 years. Data for comparison were collected in grade nine on the national level in Sweden. In the intervention area, the annual number of seventh to ninth grade students participating in the study varied between 1300 and 1650. In the reference data, the number of participating ninth grade students approximated 4500 annually. Results A significant decrease of nearly 50% was seen in smoking prevalence in the intervention area. The decrease was evident in grades eight and nine (ages 14–15 years) in both boys and girls. At the start of the intervention, smoking prevalence in grade nine was 16.1% in the intervention area and 23% in the national reference group. Although the prevalence in the national sample remained stable, there was a decrease to 9.0% in the intervention area at the end of the study period. Conclusions These results suggest that the Tobacco Free Duo program contributed to a reduction in adolescent smoking among both boys and girls. Using a multi-faceted intervention that includes adolescent–adult partnership can reduce adolescent smoking uptake, and the intervention has been proven to be sustainable within communities.
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| 36. |
- Nilsson, Maria, 1957-
(författare)
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Promoting health in adolescents : preventing the use of tobacco
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- There is a robust evidence base for the negative health effects from smoking. Smoking is linked to severe morbidity and to mortality, and kills up to half of its regular users. Tobacco use and production also bring other negative consequences such as economic loss for countries, poverty for individuals, child labour, deforestation and other environmental problems in tobacco growing countries. A combination of comprehensive interventions at different levels is needed to curb the tobacco epidemic. Tobacco control strategies at national levels in the western world often include components of information/education, taxation, legislative measures and influencing public opinion. Two approaches have dominated at the meso and micro levels: cessation support for tobacco users and prevention activities to support young people refraining from tobacco use. Smoking uptake is a complex process that includes factors at the societal level as well as social and individual characteristics. At national level, taxation and legislation can contribute to a societal norm opposing tobacco and creating a context for primary prevention aimed at tobacco free youth. There is no magic bullet in primary prevention. At the meso and micro levels, a continued development of knowledge on the underlying mechanisms and primary prevention methods is essential to prevent young people from starting to use tobacco. The overall aim of this thesis was to gain knowledge about factors that influence young people’s use of tobacco and of preventive mechanisms. The specific aims included to study the relation between Tobacco Free Duo, an intervention program targeting youth in Västerbotten County, and tobacco use prevalence. A specific interest was to explore the role adults can play in supporting young people to refrain from tobacco use. The thesis is based on four studies with three separate sets of data, two were quantitative and one was qualitative. The studies were conducted among adolescents (aged 13-15 yr) in Västerbotten County and on national level in Sweden (aged 13, 15 and 17 yr). Tobacco Free Duo is a school-based community intervention that started in 1993. An essential component of the intervention was to involve adults in supporting adolescents to stay tobacco free. Results showed decreased smoking in adolescents among both boys and girls in the intervention area during the study period of seven years. There was no change in a national reference group during the same time period. A bonus effect was a decrease in adult tobacco use in the intervention area. One out of four adults who supported a young person taking part in the intervention stopped using tobacco. In a qualitative assessment of young smokers, starting to smoke was described as a means of gaining control of their feelings and their situation during early adolescence. They expected adults to intervene against their smoking and claimed that close relations with caring adults could be a reason for smoking less or trying to quit smoking. In a quantitative study that used three decades of national data, over time adolescents became more positive toward parental action on children’s smoking. The adolescents strongly supported the idea of parental action, regardless of whether or not they themselves smoked. Adolescents preferred that actions from parents were dissuading their children from smoking, not smoking themselves, and not allowing their children to smoke at home. These results suggest that the Tobacco Free Duo program contributed to a reduction in adolescent smoking among both boys and girls. Using a multi-faceted intervention that includes an adolescent-adult partnership can decrease adolescent smoking uptake. Engaging adults as partners in tobacco prevention interventions that target adolescents has an important tobacco reducing bonus effect in the adults. The intervention has proven sustainable within communities. A growing majority of adolescents support parental interventions to help them refrain from tobacco. The findings dismiss the notion that adolescents ignore or even disdain parental practices concerning tobacco. A common and consequent norm against tobacco from both schools and parents using a supportive attitude can prevent tobacco use in young people.
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| 37. |
- Nilsson, Maria, et al.
(författare)
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The Authors reply
- 2007
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Ingår i: Journal of Adolescent Health. - : Elsevier BV. - 1054-139X. ; 41:2, s. 214-215
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 38. |
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| 39. |
- Reizenstein, Johan A., et al.
(författare)
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Impact of age at diagnosis on prognosis and treatment in laryngeal cancer
- 2010
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Ingår i: Head and Neck. - : Wiley. - 1043-3074 .- 1097-0347. ; 32:8, s. 1062-1068
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND.: The aims of this study were to analyze how age affects treatment and treatment outcome, and to determine whether tumor characteristics differ between different age groups with laryngeal cancer. METHODS.: Patients with laryngeal cancer during 1978-2004 in the Uppsala-Orebro region in Sweden were retrospectively studied. RESULTS.: There were no significant differences in the 945 cases between age groups concerning major patient and tumor characteristics, such as male/female ratio, distribution of glottic/supraglottic tumors, stage, or site of recurrence. Overall survival (OS) and disease-specific survival (DSS) were worse among the oldest, although a significant proportion was cured. Relapse risk was lower among the oldest (12%) compared with the youngest (23%). The risk of never becoming tumor-free was 25% among the oldest and 7% in the youngest. Among the most elderly, only 1 late recurrence occurred. CONCLUSION.: Elderly patients with laryngeal carcinoma cope well with treatment. Undertreatment may determine outcome more than age. The oldest group should be followed for a minimum of 2 years.
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| 40. |
- Reizenstein, Johan A, et al.
(författare)
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Time trends in T3 to T4 laryngeal cancer : a population-based long-term analysis.
- 2014
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Ingår i: Head and Neck. - : Wiley. - 1043-3074 .- 1097-0347. ; 36:12
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A decline in laryngectomies and survival in laryngeal cancer has been reported, especially among patients with advanced tumors.METHODS: Of 1058 patients with laryngeal cancer diagnosed from 1978 to 2007 in the Uppsala-Örebro region in Sweden, 263 T3 to T4 tumors treated with curative intent were studied retrospectively. Two time periods were defined, 1978 to 1992 and 1993 to 2007.RESULTS: Glottic tumors decreased constituting 68.6% of cases in 1978 to 1992 and 47.9% in 1993 to 2007. Laryngectomies were performed in 38.8% and 34.5% in the corresponding time periods. The use of laryngectomy was not strongly prognostic. A decline in overall survival (OS) over time could only be identified for the first year of follow-up. Chemotherapy was only used in a minority of cases.CONCLUSION: The marked decrease of glottic site may mark a shift in etiology. Laryngectomy was not strongly associated with improved survival. The absence of improved survival calls for intensified research.
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| 41. |
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| 42. |
- Sundström, Johan, Professor, 1971-, et al.
(författare)
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Weight gain and blood pressure
- 2020
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Ingår i: Journal of Hypertension. - : Lippincott Williams & Wilkins. - 0263-6352 .- 1473-5598. ; 38:3, s. 387-394
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Although the causality of the obesity—hypertension association is established, the potential for prevention is not. We hypothesized that weight gain between early adulthood and mid-life is associated with higher mid-life blood pressure.METHODS: We investigated the hypothesis using a large contemporaneous population-based mid-life cohort of men and women aged 50-64 years. Recalled body weight at age 20 years was self-reported, and mid-life body weight and office blood pressures were measured in accordance with a detailed protocol.RESULTS: On average, men had gained 14.9 (95% CI 14.6-15.2) kg of weight, and women 14.6 (95% CI 14.4-14.9) kg, between age 20 years and the mid-life examination, corresponding to 0.40 (95% CI 0.39-0.41) kg/year for men and women. Both weight at age 20 years and weight at the mid-life examination were associated with mid-life blood pressures. On average, a 10 kg weight increase between age 20 years and mid-life was associated with 2.2 (95% CI 0.9-3.5) mmHg higher systolic and 1.7 (95% CI 0.9-2.5) mmHg higher diastolic mid-life blood pressure in men, and 3.2 (2.5-4.0) mmHg higher systolic and 2.4 (1.9-2.9) mmHg higher diastolic mid-life blood pressure in women. Mid-life weight was more closely associated than weight at age 20 years with mid-life blood pressure. For a given mid-life weight, blood pressure was higher in persons with higher weight gain from age 20 years.CONCLUSION: In sum, weight gain between early adulthood and mid-life was associated with higher mid-life blood pressure. The magnitude of the association indicates a potentially great public health impact of strategies to prevent weight gain throughout adulthood.
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| 43. |
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