| 1. |
- Nohlert, Eva, et al.
(författare)
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Comparison of a high and a low intensity smoking cessation intervention in a dentistry setting in Sweden : a randomized trial
- 2009
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Ingår i: BMC Public Health. - Stockholm : BioMed Central (BMC). - 1471-2458. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundTobacco is still the number one life style risk factor for ill health and premature death and also one of the major contributors to oral problems and diseases. Dentistry may be a potential setting for several aspects of clinical public health interventions and there is a growing interest in several countries to develop tobacco cessation support in dentistry setting. The aim of the present study was to assess the relative effectiveness of a high intensity intervention compared with a low intensity intervention for smoking cessation support in a dental clinic setting.Methods300 smokers attending dental or general health care were randomly assigned to two arms and referred to the local dental clinic for smoking cessation support. One arm received support with low intensity treatment (LIT), whereas the other group was assigned to high intensity treatment (HIT) support. The main outcome measures included self-reported point prevalence and continuous abstinence (≥ 183 days) at the 12-month follow-up.ResultsFollow-up questionnaires were returned from 86% of the participants. People in the HIT-arm were twice as likely to report continuous abstinence compared with the LIT-arm (18% vs. 9%, p = 0.02). There was a difference (not significant) between the arms in point prevalence abstinence in favour of the HIT-protocol (23% vs. 16%). However, point prevalence cessation rates in the LIT-arm reporting additional support were relatively high (23%) compared with available data assessing abstinence in smokers trying to quit without professional support.ConclusionScreening for willingness to quit smoking within the health care system and offering smoking cessation support within dentistry may be an effective model for smoking cessation support in Sweden. The LIT approach is less expensive and time consuming and may be appropriate as a first treatment option, but should be integrated with other forms of available support in the community. The more extensive and expensive HIT-protocol should be offered to those who are unable to quit with the LIT approach in combination with other support.
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| 2. |
- Kristjansson, Álfgeir L, et al.
(författare)
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Social correlates of cigarette smoking among Icelandic adolescents : a population-based cross-sectional study
- 2008
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Ingår i: BMC Public Health. - Stockholm : Karolinska Institutet, Dept of Public Health Sciences. - 1471-2458.
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Previous research has shown that between 80 and 90 percent of adult smokers report having started smoking before 18 years of age. Several studies have revealed that multiple social factors influence the likelihood of smoking during adolescence, the period during which the onset of smoking usually occurs. To better understand the social mechanisms that influence adolescent smoking, we analyzed the relationship and relative importance of a broad spectrum of social variables in adolescent smoking in Iceland, a Nordic country with high per-capita income. METHODS: We used cross-sectional data from 7,430 14- to 16 year-old students (approximately 81% of all Icelanders in these age cohorts) in the 2006 Youth in Iceland study. The Youth in Iceland studies are designed to investigate the role of several cognitive, behavioral, and social factors in the lives of adolescents, and the data collected are used to inform the design, implementation, and evaluation of substance use prevention programs that are being developed by Icelandic social scientists, policy makers, and practitioners. RESULTS: Our analysis revealed that friends' smoking behavior and attitude toward smoking were strongly associated with adolescent smoking and other tobacco use, as well as alcohol consumption during the previous 30 days. Main protective factors were parent's perceived attitude toward smoking, the quantity of time spent with parents, absence of serious verbal conflict between parents and adolescents, and participation in physical activity. Family structure was related to adolescent smoking to a small extent, but other background factors were not. CONCLUSION: We conclude that multiple social factors are related to adolescent smoking. Parents and other primary preventive agents need to be informed about the complicated nature of the adolescent social world in order to maximize their impact.
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| 3. |
- Skulason, Bragi, et al.
(författare)
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Assessing survival in widowers, and controls : a nationwide, six- to nine-year follow-up
- 2012
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Ingår i: BMC Public Health. - Stockholm : Karolinska Institutet, Dept of Public Health Sciences. - 1471-2458.
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this study was to assess if widowers had an increased mortality rate during the first 6 to 9 years after the death of their wife, compared initially to an age-matched control group and also compared to the general population of Iceland. Methods: The study base was comprised of all 371 men born in 1924-1969 who were widowed in Iceland in 1999-2001 and 357 controls, married men, who were matched by age and residence. The widowers and controls were followed through the years 2002-2007 using information from Statistics Iceland. Mortality rates were compared between the groups and also with the general population. The mortality rate comparisons were: study group vs. control group, on the one hand, and study group vs. general population on the other. Causes of death were also compared between widowers and their wives. Results: A statistically significant increase in mortality in the widowers’ group, compared to controls, was observed. Lifestyle-related factors could not be excluded as contributing to cause of death in these cases. Conclusions: Being a widower was related to an increased risk of death for at least 9 years after the death of their wife.
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| 4. |
- Tomson, Tanja, et al.
(författare)
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Are non-responders in a quitline evaluation more likely to be smokers?
- 2005
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Ingår i: BMC Public Health. - Stockholm : Karolinska Institutet, Dept of Public Health Sciences. - 1471-2458.
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In evaluation of smoking cessation programs including surveys and clinical trials the tradition has been to treat non-responders as smokers. The aim of this paper is to assess smoking behaviour of non-responders in an evaluation of the Swedish national tobacco cessation quitline a nation-wide, free of charge service. METHODS: A telephone interview survey with a sample of people not participating in the original follow-up. The study population comprised callers to the Swedish quitline who had consented to participate in a 12 month follow-up but had failed to respond. A sample of 84 (18% of all non-responders) was included. The main outcome measures were self-reported smoking behaviour at the time of the interview and at the time of the routine follow-up. Also, reasons for not responding to the original follow-up questionnaire were assessed. For statistical comparison between groups we used Fischer's exact test, odds ratios (OR) and 95% confidence intervals (CI) on proportions and OR. RESULTS: Thirty-nine percent reported to have been smoke-free at the time they received the original questionnaire compared with 31% of responders in the original study population. The two most common reasons stated for not having returned the original questionnaire was claiming that they had returned it (35%) and that they had not received the questionnaire (20%). Non-responders were somewhat younger and were to a higher degree smoke-free when they first called the quitline. CONCLUSION: Treating non-responders as smokers in smoking cessation research may underestimate the true effect of cessation treatment.
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| 5. |
- Gustafsson, Per E, et al.
(författare)
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Is body size at birth related to circadian salivary cortisol levels in adulthood? Results from a longitudinal cohort study.
- 2010
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 10:346
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe hypothesis of fetal origins of adult disease has during the last decades received interest as an explanation of chronic, e.g. cardiovascular, disease in adulthood stemming from fetal environmental conditions. Early programming and enduring dysregulations of the hypothalamic-pituitary-adrenal (HPA axis), with cortisol as its end product, has been proposed as a possible mechanism by which birth weight influence later health status. However, the fetal origin of the adult cortisol regulation has been insufficiently studied. The present study aims to examine if body size at birth is related to circadian cortisol levels at 43 years.MethodsParticipants were drawn from a prospective cohort study (n = 752, 74.5%). Salivary cortisol samples were collected at four times during one day at 43 years, and information on birth size was collected retrospectively from delivery records. Information on body mass during adolescence and adulthood and on health behavior, medication and medical conditions at 43 years was collected prospectively by questionnaire and examined as potential confounders. Participants born preterm or < 2500 g were excluded from the main analyses.ResultsAcross the normal spectrum, size at birth (birth weight and ponderal index) was positively related to total (area under the curve, AUC) and bedtime cortisol levels in the total sample. Results were more consistent in men than in women. Descriptively, participants born preterm or < 2500 g also seemed to display elevated evening and total cortisol levels. No associations were found for birth length or for the cortisol awakening response (CAR).ConclusionsThese results are contradictory to previously reported negative associations between birth weight and adult cortisol levels, and thus tentatively question the assumption that only low birth weight predicts future physiological dysregulations.
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| 6. |
- Nilsson, Kerstin, 1947, et al.
(författare)
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Pride and confidence at work: potential predictors of occupational health in a hospital setting.
- 2005
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Ingår i: BMC public health. - : Springer Science and Business Media LLC. - 1471-2458. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: This study focuses on determinants of a healthy work environment in two departments in a Swedish university hospital. The study is based on previously conducted longitudinal studies at the hospital (1994-2001), concerning working conditions and health outcomes among health care personnel in conjunction with downsizing processes. Overall, there was a general negative trend in relation to mental health, as well as long-term sick leave during the study period. The two departments chosen for the current study differed from the general hospital trend in that they showed stable health development. The aim of the study was to identify and analyse experiential determinants of healthy working conditions. METHODS: Thematic open-ended interviews were carried out with seventeen managers and key informants, representing different groups of co-workers in the two departments. The interviews were transcribed verbatim and an inductive content analysis was made. RESULTS: In the two studied departments the respondents perceived that it was advantageous to belong to a small department, and to work in cooperation-oriented care. The management approaches described by both managers and co-workers could be interpreted as transformational, due to a strain of visionary, delegating, motivating, confirmative, supportive attitudes and a strongly expressed solution-oriented attitude. The daily work included integrated learning activities. The existing organisational conditions, approaches and attitudes promoted tendencies towards a work climate characterised by trust, team spirit and professionalism. In the description of the themes organisational conditions, approaches and climate, two core determinants, work-pride and confidence, for healthy working conditions were interpreted. Our core determinants augment the well-established concepts: manageability, comprehensiveness and meaningfulness. These favourable conditions seem to function as a buffer against the general negative effects of downsizing observed elsewhere in the hospital, and in the literature. CONCLUSION: Research illuminating health-promoting aspects is rather unusual. This study could be seen as explorative. The themes and core dimensions we found could be used as a basis for further intervention studies in similar health-care settings. The result could also be used in future health promotion studies in larger populations. One of the first steps in such a strategy is to formulate relevant questions, and we consider that this study contributes to this.
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| 7. |
- Sundblad, Gunilla M Brun, et al.
(författare)
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Child-parent agreement on reports of disease, injury and pain.
- 2006
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 6, s. 276-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Studies on school students are indicating that somatic complaints and pain have increased during the past decades. Throughout this period there has been a change in methodology from proxy reports by parents to having the students themselves act as the respondents, possible explaining some of the increase in prevalence. The aim of this study was to compare the agreement of answers from students with answers given by their parents regarding the students' medical background and subjective rating of perceived health with specific focus on frequency of headache, musculoskeletal pain and tiredness. METHODS: The participating students came from eleven different schools in Sweden. The schools were a sub sample of randomly selected schools originally participating in a larger multidisciplinary base study. Those 8th grade students present at school on the test date became the subjects of the investigation. A total of 232 students answered, assisted by the test leader, a specially designed self-complete questionnaire at school. Their parents were, at the same time, contacted and 200 answered a similar mailed-out questionnaire. One hundred and eighty-six (186) corresponding student-same parent questionnaires were registered for which comparisons of answers could be made and analysis conducted. RESULTS: When a child is in good health, in absence of diseases, pain and injuries, his or her assessment matches up with their parent. Children and parents also showed agreement in cases of severe injuries and frequent (daily) complaints of knee pain. Less frequent headaches, back- and musculoskeletal pain and other complaints of minor injuries and less wellbeing, such as students' tiredness, were all under-reported and under-rated by their parents. CONCLUSION: When assessing the perceived health and wellbeing of students, their own expressions should be the basis for the data collection and analysis rather than relying entirely on parental reports.
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| 8. |
- Toomingas, Allan, et al.
(författare)
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Variation between seated and standing/walking postures among male and female call centre operators
- 2012
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Ingår i: BMC Public Health. - London : Springer Science and Business Media LLC. - 1471-2458. ; 12, s. 154-
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of the present study was to assess variation in gross body posture amongst male and female call centre operators using whole-day registrations of seated and standing/walking periods, analyzed and described by a number of novel variables. Methods: Body postures, identified as either seated or standing/walking, were recorded using inclinometers throughout an entire work shift for 43 male and 97 female call centre operators at 16 call centres. Data were analyzed using an extensive set of variables describing occurrence of postures, switches between postures, posture similarities across the day, and compliance with posture recommendations. Results: The majority of the operators, both male and female, spent more than 80% of the shift in a seated posture. The average number of switches between seated and standing/walking or vice versa was 10.4 per hour. Female operators spent, on average, 11% of the day in periods of sustained sitting longer than 1 hour; male operators only 4.6% of the day (p=0.013). Only 38% of the operators followed current standard recommendations of having an uninterrupted break from seated work, lasting a minimum of 5minutes within a one hour of work and only 11% of operators had a 10 minute (or longer) uninterrupted break. Substantial variation between operators was observed in many variables. Since work tasks were essentially similar across operators and were expected to be similar across days, this indicates individual differences in working technique. Conclusions: The dominance of seated work for extended periods indicates that efforts should be made at call centres to introduce more gross physical variation during the work day. Appropriate and effective initiatives for realizing this intervention need to be identified
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| 9. |
- Ahnquist, Johanna, et al.
(författare)
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Institutional trust and alcohol consumption in Sweden: The Swedish National Public Health Survey 2006
- 2008
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Background: Trust as a measure of social capital has been documented to be associated with health. Mediating factors for this association are not well investigated. Harmful alcohol consumption is believed to be one of the mediating factors. We hypothesized that low social capital defined as low institutional trust is associated with harmful alcohol consumption. Methods: Data from the 2006 Swedish National Survey of Public Health were used for analyses. The total study population comprised a randomly selected representative sample of 26.305 men and 30.584 women aged 16-84 years. Harmful alcohol consumption was measured using a short version the Alcohol Use Disorders Identification Test (AUDIT), developed and recommended by the World Health Organisation. Low institutional trust was defined based on trust in ten main welfare institutions in Sweden. Results: Independent of age, country of birth and socioeconomic circumstances, low institutional trust was associated with increased likelihood of harmful alcohol consumption (OR (men) = 1.52, 95% CI 1.34-1.70) and (OR (women) = 1.50, 95% CI 1.35-1.66). This association was marginally altered after adjustment for interpersonal trust. Conclusion: Findings of the present study show that lack of trust in institutions is associated with increased likelihood of harmful alcohol consumption. We hope that findings in the present study will inspire similar studies in other contexts and contribute to more knowledge on the association between institutional trust and lifestyle patterns. This evidence may contribute to policies and strategies related to alcohol consumption.
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| 10. |
- Elgan, Tobias H., et al.
(författare)
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Design of a Web-based individual coping and alcohol-intervention program (web-ICAIP) for children of parents with alcohol problems: study protocol for a randomized controlled trial
- 2012
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Background: It has been estimated that approximately 20% of all Swedish children grow up with parents having alcohol problems, which may result in negative outcomes among these children. Therefore, most Swedish municipalities provide resources for support, but at the same time figures reveal that not even 2% receive support, mainly due to difficulties in identifying and recruiting these children into support programs. Delivering intervention programs to children and adolescents via the Internet seems a promising strategy, but to date, the number of web-based interventions aimed at this target group is very scarce. We have therefore developed a novel internet-delivered therapist assisted self-management intervention called the web-ICAIP (Individual Coping and Alcohol Intervention Program) for adolescents having parents with alcohol problems. The purpose of the program is to strengthen adolescents' coping behavior, improve their mental health, and postponing the onset or decreasing risky alcohol consumption. This paper describes the web-ICAIP and the design of a randomized controlled trial (RCT) to measure the efficacy of this intervention. Methods/Design: The RCT will include at least 183 adolescents (15-19 year old) who will be randomly allocated to two conditions where one group has access to the web-ICAIP and the other is a waiting list control group. Participants will be recruited from websites containing information and facts for adolescents about alcohol and other drugs. Possible participants will be screened using the short version of the Children of Alcoholics Screening Test (CAST-6). The assessment consists of a baseline and two follow-up measurements taking place after two and six months, respectively. The primary outcomes include the Center for Epidemiological Studies Depression Scale (CES-DC), a coping behavior scale, and also the short version of the Alcohol Use Disorders Identification Test (AUDIT-C). Additional outcomes include the "Ladder of life" which measures overall life satisfaction and questions concerning program adherence. Discussion: There is an urgent need for developing and evaluating web-based intervention programs which target children having parents with alcohol problems. This study will therefore make an important contribution to this novel field of research.
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