Accounts of self-perceptions of oral health have hitherto been rare, although they are of great interest for strategies in health promotion. The objective of this study was to increase our knowledge of adolescents' perceptions of oral health and influencing factors. Semi-structured interviews of 17 Swedish adolescents were performed. Criteria for strategic sampling were age (15, 18 years), gender (male, female), and dental health (healthy, unhealthy). Data were analyzed according to the constant comparative method. Areas of focus were general oral health, personal oral health, dental care, and life-style issues. Oral health awareness was generally low among the informants. Two categories of oral health were identified: action (the physical things we do to effect the condition of our mouths) and condition (the physical status of the mouth). Conditional aspects were most frequent in evaluations of personal oral health. The informants considered their possibilities to influence oral health limited. Perceptions of influences on oral health were related to personal and professional care, social support and impact, and external factors. 'Concern for oral health' was derived as the core category in perceived influence on oral health. The study indicates that it is important to find factors that enhance adolescents' awareness of their own resources and to seek mechanisms that govern internalization. There is a need to find strategies to convey such knowledge to the intermediaries: dental personnel and parents.
We here study antibodies against phosphorylcholine (anti-PC) which we reported to be inversely associated with atherosclerosis, cardiovascular disease (CVD), and autoimmune conditions. In previous studies, we determined that this inverse association is more pronounced at low levels with high risk and at high levels, with decreased risk. We compare individuals from Kitava, New Guinea (with low risk of these conditions), with Swedish controls.
We studied a group of 178 individuals from Kitava (age 20-86), and compared those above age 40 (n = 108) with a group of age- and sex-matched individuals from a population based cohort in Sweden (n = 108). Traditional risk factors for CVD and fatty acids were determined. IgM, IgG, and IgA anti-PC were tested by enzyme-linked immunosorbent assay (ELISA).
All anti-PC measures were significantly lower among Swedish controls as compared to Kitavans (p
PURPOSE: To describe and compare the pattern of antihypertensive drug prescriptions during different time periods. METHODS: Antihypertensive prescriptions were registered in all patients who underwent an annual follow-up during 1998 (n = 984), 1992-1993 (n = 924), and 1981 (n = 689), at the hypertension outpatient clinic in primary health care, Skara, Sweden. RESULTS: From 1981 to 1998 the total prescriptions of thiazides declined from 61 to 10% (p
To investigate gender differences in the association between self-rated health (SRH) and impaired glucose tolerance (IGT) in subjects unaware of their glucose tolerance.
A cross-sectional population-based study.
The two municipalities of Vara and Skövde in south-western Sweden.
A total of 2502 participants (1301 women and 1201 men), aged 30-75, were randomly selected from the population.
IGT was regarded as the outcome measure and SRH as the main risk factor.
The prevalence of IGT was significantly higher in women (11.9%) than in men (10.1%), (p = 0.029), as was the prevalence of low SRH (women: 35.4%; men: 22.1%, p = 0.006). Both men and women with low SRH had a poorer risk factor profile than those with high SRH, and a statistically significant crude association between SRH and IGT was found in both men (OR = 2.8, 95% CI 1.8-4.4) and women (OR = 1.5, 95% CI 1.0-2.2, p = 0.033). However, after controlling for several lifestyle factors and biomedical variables, the association was attenuated and remained statistically significant solely in men (OR = 2.3, 95% CI 1.2-4.3).
The gender-specific associations found between SRH and IGT suggest that SRH may be a better indicator of IGT in men than in women. Future studies should evaluate the utility of SRH in comparison with objective health measures as a potential aid to health practitioners when deciding whether to screen for IGT and T2DM.
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The increased incidence of impaired glucose tolerance (IGT), are serious public health issues, and several studies link sleeping disorders with increased risk of developing type 2 diabetes, impaired glucose tolerance and insulin resistance (IR). This study explore how self-reported lack of sleep and low vitality, are associated with IGT in a representative Swedish population.
A cross-sectional survey conducted in two municipalities in South-western Sweden. Participants aged 30-75 were randomly selected from the population in strata by sex and age. Altogether, 2,816 participants were surveyed with a participation rates at 76%. Participants with normal glucose tolerance (n=2,314), and those with IGT (n=213) were retained for analyses. The participants answered a questionnaire before the oral glucose tolerance test (OGTT). Associations for questions concerning sleeping disorders, vitality and IGT were analysed using logistic regression and were expressed as odds ratios (OR) with 95% CI.
In men a statistically significant age-adjusted association was found between self-reported lack of sleep and IGT: OR 2.4 (95% CI: 1.1-5.4). It did not weaken after further adjustment for body mass index (BMI), smoking, education, and leisure time physical activity 2.3 (1.0-5.5, p=0.044). No such associations were found in females. Corresponding age-adjusted associations between low vitality and IGT in both men 2.8 (1.3-5.8), and women 2.0 (1.2-3.4) were successively lost with increasing adjustment.
Insufficient sleep seems independently associated with IGT in men, while low vitality was not independently associated with IGT neither in men nor women, when multiple confounders are considered. IGT should be considered in patients presenting these symptoms, and underlying mechanisms further explored.
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Apnea hypopnea index (AHI) is used to study the association between obstructive sleep apnea (OSA) and hypertension, but the independent contributions of total sleep time (TST) and apnea/hypopnea event count to hypertension have not been previously investigated. We studied the relationship between polysomnographically assessed TST and hypertension in a sex-balanced community-dwelling cohort of hypertensive patients and normotensive controls (Skara Sleep Cohort).
Participants (n = 344, men 173, age 61.2 ± 6.5 years, BMI 28.6 ± 4.8 kg/m, mean ± SD) underwent ambulatory home polysomnography. Hypertension was defined according to contemporary Swedish national guidelines. A multivariate logistic regression model was used to predict hypertension status from TST and apnea/hypopnea count (total events/night) adjusting for sex, age and BMI.
OSA was highly prevalent in this population (AHI 26 ± 4 events/h). Hypertensive patients had shorter TST than normotensive patients (353 ± 81 vs. 389 ± 65 min, P
AIMS: To investigate associations between CVD risk factors and socio-economic status (SES) in middle-age men during a period of economic changes. METHODS: Crossectional surveys at age 37, 40 and 43 in a birth cohort of men in Helsingborg, Sweden. All male residents born 1953-4 (n = 1460) were invited; participation rates were 68% (n = 991) at baseline. Of these enrolled, 78% (n = 770) were re-examined after three years and 71% (n = 702) again after six years follow-up. Main outcome measures were body mass index (BMI), S-cholesterol, HDL-cholesterol, systolic and diastolic blood pressure (SBP, DBP), smoking and leisure time physical activity (LTPA), education, employment, ethnicity. RESULTS: Baseline unemployment rate was low, n = 23 (2.4%), but three and six years later it had increased to 61 (8.2%) and 51 (7.5%) respectively. At baseline, BMI and S-cholesterol were significantly higher in unemployed than in employed men (deltaBMI 1.6 kg/m2, CI: 0.2; 2.9, delta S-cholesterol 0.6 mmol/L, CI: 0.1; 1.0), and in men with short versus long education (delta BMI 0.9 kg/m2, CI: 0.4; 1.4, delta S-cholesterol 0.2 mmol/L, CI: 0.03: 0.4), independent of other SES factors. Over the study period crossectional associations with employment status disappeared for BMI, but remained between short education and BMI. Short education was also associated with a significant increase in BMI (delta = 0.4 kg/m2, CI: 0.1; 0.7) during 6-year follow-up. CONCLUSIONS: This study shows that associations between unemployment and CVD risk factors were lost when unemployment rates increased. When the attributable risk of unemployment associated with CVD risk factors is estimated, it is vital to consider the general unemployment rates in society.
AIM: To investigate the development of blood pressure (BP) determinants over a period of 6 years in a birth cohort of middle-aged Swedish men. METHODS: Men born 1953 and 1954 living in Helsingborg, Southern Sweden, were surveyed at 37, 40 and 43 years of age. Baseline participation rate was 68% (n = 991). S-Cholesterol, HDL-Cholesterol, systolic and diastolic blood pressure (SBP and DBP) and anthropomorphic measurements were collected and a questionnaire covering ethnicity, smoking, leisure time physical activity (LTPA) and alcohol consumption was completed. RESULTS: At these surveys, SBP means were: 131, 132, 135 mm Hg and DBP were 83, 83 and 85 mm Hg respectively. Body mass index (BMI), waist hip ratio (WHR), S-Cholesterol and alcohol consumption consistently showed cross-sectional positive associations with SBP and DBP. One mmol/L higher S-Cholesterol at baseline predicted an increase in SBP by 1.16 mm Hg (confidence interval, CI: 0.25; 2.07) over 6 years. At age 40, there was a 4.4 mm Hg (p
The vasoconstricting peptide endothelin-1 has been proposed to be a marker of cardiovascular disease. Our aim was to investigate whether circulating endothelin-1 levels predict coronary heart disease (CHD) in Sweden.
In 2002-2005, 2816 adult participants (30-74 years) were randomly selected from two municipalities in south-western Sweden. Cardiovascular risk factors and endothelin-1 levels were assessed at baseline, and incident CHD was followed-up in all participants through 2011. After exclusion of 50 participants due to known CHD at baseline and 21 participants because of unsuccessful analysis of endothelin-1, 2745 participants were included in the study. In total, 72 CHD events (52 in men and 20 in women) were registered during the follow-up time.
We showed that baseline circulating endothelin-1 levels were higher in women with incident CHD than in women without CHD (3.2?pg/ml, SE: 0.36 vs 2.4?pg/ml, SE: 0.03, p?=?0.003) whereas this difference was not observed in men (2.3?pg/ml, SE: 0.16 vs 2.3?pg/ml, SE: 0.04, p?=?0.828). An age-adjusted Cox proportional regression analysis showed an enhanced risk of CHD with increasing baseline endothelin-1 levels in women (hazard ratio (HR)?=?1.51, 95?% CI?=?1.1-2.1, p?=?0.015) but not in men (HR?=?0.98, 95?% CI?=?0.8-1.2, p?=?0.854). Furthermore, the predictive value of endothelin-1 for incident CHD in women was still significant after adjustments for age, HOMA-IR, apolipoprotein (apo)B/apoA1 and smoking (HR?=?1.53, CI?=?1.1-1.2, p?=?0.024).
Circulating endothelin-1 levels may predict CHD in women.