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- Lindholm, Lars H, et al.
(författare)
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Relation between drug treatment and cancer in hypertensives in the Swedish Trial in Old Patients with Hypertension 2: a 5-year, prospective, randomised, controlled trial
- 2001
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Ingår i: The Lancet. - 1474-547X. ; 358, s. 539-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Is cancer related to hypertension and blood pressure? Do antihypertensive drugs promote cancer? Do antihypertensive drugs protect against cancer? We previously analysed the frequency of cardiovascular mortality and morbidity in elderly people who participated in the Swedish Trial in Old Patients with Hypertension 2 (STOP-Hypertension-2). We have also looked at the frequency of cancer in these patients. METHODS: We randomly assigned 6614 elderly patients with hypertension (mean age 76 years, median time of follow-up 5.3 years) to one of three treatment strategies: conventional drugs (diuretics or b-blockers), calcium antagonists, or ACE inhibitors. We matched the patients to the Swedish Cancer Registry and compared our findings with expected values based on age, sex, and calendar-year-specific reference frequencies for the general Swedish population. We also compared the number of cancers between the three treatment groups. FINDINGS: At baseline, 607 (9%) patients had previous malignant disease. Diagnoses were closely similar to the distribution of cancer types that might be seen in elderly patients. During follow-up, there were 625 new cases of cancer in 590 patients. The frequency of cancer did not differ significantly between the treatment strategies, including all cancers and those at individual sites. The standardised incidence ratios (SIRs) for all cancers were also close to unity: 0.92 (95% CI 0.80-1.06) for conventional drugs, 0.96 (0.83-1.10) for calcium antagonists, and 0.99 (0.86-1.13) for ACE inhibitors. INTERPRETATIONS: No difference in cancer risk was seen between patients randomly assigned to conventional drugs, calcium antagonists, or ACE inhibitors. Thus, the general message to the practising physician is that more attention should be given to getting the blood pressure down than to the risk of cancer.
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| 2. |
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| 3. |
- Skari, Hans, et al.
(författare)
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Congenital diaphragmatic hernia in Scandinavia from 1995 to 1998: Predictors of mortality.
- 2002
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Ingår i: Journal of Pediatric Surgery. - : Elsevier BV. - 1531-5037 .- 0022-3468. ; 37:9, s. 1269-1275
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND/PURPOSE: There is a lack of large contemporary studies on the management of congenital diaphragmatic hernia (CDH), and the prediction of mortality remains difficult. The aim of this study was to investigate the influence of perinatal factors on mortality rate in a contemporary multicenter study. METHODS: The authors conducted a retrospective multicenter cohort study. Twelve of 13 Scandinavian pediatric surgical centers participated in the study. During a 4-year period (1995 through 1998) 195 children with CDH were included. The main endpoints were hospital mortality rate and total mortality rate (before 2001). Bivariate and multivariate survival analyses were performed using Kaplan-Meier plots, Log-rank test, and Cox regression. RESULTS: Overall hospital mortality rate was 30%. Among 168 neonates with symptoms within 24 hours (early presenters) 35% died before discharge. All 61 deaths occurred in 157 neonates with symptoms within the first 2 hours of life. Among early presenters, 27% had prenatal ultrasound diagnosis, 26% were delivered by cesarean section, and 21% had associated major malformations. Bivariate analysis of early presenters showed increased risk of death in neonates with prenatal diagnosis, associated anomalies, right-sided diaphragmatic hernia (RCDH), low 1-minute and 5-minute Apgar scores, low birth weight, short gestational age, and cesarean delivery. Neonates with prenatal diagnosis were characterized by significantly lower Apgar scores, lower birth weight, and increased frequency of associated anomalies than those diagnosed after birth. Multivariate analysis found that prenatal diagnosis (P =.004), 1-minute Apgar (P =.001), and RCDH (P =.042) were independent predictors of total mortality rate. CONCLUSIONS: In a series of 195 CDH patients, all 61 deaths occurred in the 157 neonates presenting with symptoms within the first 2 hours of life. Prenatal diagnosis, 1-minute Apgar score, and RCDH were significant independent predictors of total mortality. J Pediatr Surg 37:1269-1275. Copyright 2002, Elsevier Science (USA). All rights reserved.
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| 4. |
- Wester-Herber, Misse, et al.
(författare)
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Did they get it? : Examining the goals of risk communication within the Seveso II Directive in a Swedish context
- 2004
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Ingår i: Journal of Risk Research. - : Informa UK Limited. - 1366-9877 .- 1466-4461. ; 7:5, s. 495-506
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Tidskriftsartikel (refereegranskat)abstract
- In this article, the success of a risk communication programme conducted in two municipalities in Sweden is evaluated. The communication efforts were initiated in order to comply with the Seveso II Directive, passed as a national law in July 1999. Data from two different questionnaires are used. Between the distribution of the two questionnaires, an information campaign took place in the communities. The first questionnaire was aimed at measuring the public's opinion and understanding of the risks related to chemical industries in their communities, as well as the public's knowledge of emergency behaviour in the event of an accident. The second was aimed at measuring the effects or impact of the risk communication programme on the public. A total of 346 respondents participated in the study by answering two questionnaires. An evaluation of the risk communication efforts was focused around three dimensions: comprehension, audience evaluation and communication failures. The results showed differences between the two campaigns that gave significantly different results in the two communities. In the community with the multimedia channel campaign, the respondents showed greater knowledge of the production process at the local industry, they also judged the health threats for that industry to be less after the campaign, and they saved the information material to a greater extent. However, the overall effects of the information campaigns were weak. Future research is needed to explore the relation between people's emergency behaviour and risk communication.
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| 5. |
- Wester-Herber, Misse, et al.
(författare)
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Gender and regional differences in risk perception : results from implementing the Seveso II directive in Sweden
- 2002
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Ingår i: Journal of Risk Research. - : Informa UK Limited. - 1366-9877 .- 1466-4461. ; 5:1, s. 69-81
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Tidskriftsartikel (refereegranskat)abstract
- This paper attempts to investigate whether there are gender and regional specific differences in risk perception in three municipalities in Sweden. It focuses on differences between gender and region with regard to risk perception, issues of trust and credibility as well as attitudes towards local industry and emergency response behaviour. This study is based on results from a larger study investigating the Seveso II Directive in Sweden. The aim of this paper is to investigate how gender and regional differences appear and in what way they should be taken into consideration when it comes to implementing national laws that deal with information to the public. The results show that there are differences between gender consistent with earlier findings, and also that there are regional differences which may influence the risk communication effort. Men tend to report having more knowledge of the industrial activities in their community and estimate the possible effect of an accident to be smaller than do women. Regional comparisons show that there are local variations with regard to estimated knowledge and the credibility of a source. Attempts are made to explain the gender differences from a power/influence perspective, and attribute the local variations to specific cultural contexts.
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| 6. |
- Wester-Herber, Misse, 1969-
(författare)
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Talking to me? : Risk communication to a diverse public
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis focuses on the process of communication of environmental risks. A basic assumption in this thesis is that even though ambitious risk communication efforts can take place, the intended recipients are left with a feeling of alienation: Talking to me? The thesis presents a review of theories developed in the field of risk communication research and theories concerning risk perception. Results in this thesis are based on the findings in four papers. The first two papers report results from traditional risk communication strategies that have taken place in Sweden in accordance with the Seveso II Directive. The third paper looks at how industry and organizations view participatory strategies that include stakeholders in risk debates. The fourth paper attempts to fuse together placeidentity and risk perception in order to broaden the understanding of environmental conflicts. The main results of this thesis can be summarized under three headings. First that there is no homogenous public in a risk communication context. Instead there seems to be a number of publics that differ in risk perception or have different environmental concerns. Second, strategies that tend to incorporate parts of the concerned public or stakeholders seem to work better than traditional risk communication efforts. Third, if discussion about risk are to be fruitful, the concept of risk needs to be broadened to include concerns that are not directly or apparently linked to issues of health or safety. Instead concerns such as local culture or local attachment need to be included. The purpose of this thesis is to suggest methods for communicating about environmental risks in order to make the affected public feel: Yes, you are talking to me.
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