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- Brännström, Inger, 1945-, et al.
(författare)
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Towards a framework for outcome assessment of health intervention : Conceptual and methodological considerations
- 1994
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Ingår i: European Journal of Public Health. - : Oxford University Press. - 1101-1262 .- 1464-360X. ; 4:2, s. 125-130
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Tidskriftsartikel (refereegranskat)abstract
- We provide a framework for assessing the outcome of community-based intervention programmes for the promotion of cardiovascular health at local level. Particular attention is therefore given to conceptual components connected with community participation in health programmes and to methodological approaches in the evaluation of cardiovascular disease (CVD)-prevention programmes. In a search of the literature covering more than 20 years (1966–1988) in 2 databases (MEDLINE and SOCA), we found that the concepts of ‘community participation’ and ‘community involvement’ have mainly been used during the latter half of the study period. The concepts were often used interchangeably and with no statement as to their precise meanings. The methodological examination of 2 well-known community-based CVO-preventive programmes revealed that most of the scientific papers from these programmes dealt with health behavioural and/or medical effects. The suggested framework presented in this study is designed as a longitudinal process analysis focusing on critical key steps along the path from input to output. The suggested research strategy is problem-orientated, inter-disciplinary and based on a multi-method approach.
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| 2. |
- Forsberg, Bertil, et al.
(författare)
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Air pollution levels, meteorological conditions and asthma symptoms
- 1993
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Ingår i: European Respiratory Journal. - 0903-1936 .- 1399-3003. ; 6:8, s. 1109-1115
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Tidskriftsartikel (refereegranskat)abstract
- We wanted to assess relations between the daily occurrence of asthma symptoms and fluctuations of air pollution concentrations and meteorological conditions. In a panel of 31 asthmatic patients residing in the town of Piteå in northern Sweden, severe symptoms of shortness of breath, wheeze, cough and phlegm were recorded in an asthma diary together with suspected causes. Sulphur dioxide, nitrogen dioxide, black smoke, relative humidity and temperature were used to evaluate the relationship to the environment. By using multivariate analyses, we found that daily variations in the particulate pollution levels, indicated by black smoke levels below the criteria limits, had significant effects on the risk of developing severe symptoms of shortness of breath. This association was stronger among 10 subjects, who had at least five incident days with severe shortness of breath. Meteorological conditions were not significant in the multivariate models. Cough and phlegm did not show significant relationships to any environmental condition that was evaluated. Only one-third of the subjects reported, at least once during the study, symptoms believed to be related to air pollutants, although we found significant correlations between the pollution levels and the frequency of pollution-related symptoms. We conclude that an association has been established for black smoke as pollutant and shortness of breath as respiratory symptom, and that in certain asthmatics, effects were occurring at lower particulate levels than suggested previously.
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| 3. |
- Landin-Olsson, Mona, et al.
(författare)
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Immunoreactive trypsin(Ogen) in the sera of children with recent-onset insulin-dependent diabetes and matched controls
- 1990
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Ingår i: Pancreas. - : Ovid Technologies (Wolters Kluwer Health). - 0885-3177. ; 5:3, s. 241-247
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Tidskriftsartikel (refereegranskat)abstract
- To evaluate the exocrine pancreatic function at the time of diagnosis of insulin-dependent diabetes mellitus, we determined immunoreactive an-odal and cathodal trypsin(ogen) levels in sera from almost all children (n = 375) 0-14 years of age in Sweden in whom diabetes developed during 1 year, and in sex-, age-, and geographically matched control subjects (n = 312). The median level of anodal trypsin(ogen) was 5 (quartile range, 3-7) µg/L in children with newly diagnosed diabetes, compared with a median level of 7 (quartile range, 4-8) µg/L in control subjects (p < 0.0001). Similarly, the median level of cathodal trypsin(ogen) was 8 (quartile range, 4-10) µg/L in children with diabetes, compared with a median level of 11 (quartile range, 7-15) µg/L in control subjects (p < 0.0001). The median of the individual ratios between cathodal and anodal trypsin(ogen) was 1.4 in the diabetic patients and 1.7 in the control children (p < 0.001). In a multivariate test, however, only the decrease in cathodal trypsin(ogen) concentration was associated with diabetes. The levels of trypsin(ogen)s did not correlate with levels of islet cell antibodies, present in 81% of the diabetic children. Several mechanisms may explain our findings, for example, similar pathogenetic factors may affect both the endocrine and exocrine pancreas simultaneously, a failing local trophic stimulation by insulin on the exocrine cells may decrease the trypsinogen production, and there may be an increased elimination of trypsin(ogen) because of higher filtration through the kidneys in the hyperglycemic state.
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