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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.

https://arctichealth.org/en/permalink/ahliterature89775
Source
BMC Public Health. 2009;9:74
Publication Type
Article
Date
2009
Author
Nilsson Maria
Weinehall Lars
Bergström Erik
Stenlund Hans
Janlert Urban
Author Affiliation
Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences, Umeå University, Sweden. maria.nilsson@epiph.umu.se
Source
BMC Public Health. 2009;9:74
Date
2009
Language
English
Publication Type
Article
Keywords
Adolescent
Adolescent Behavior
Adolescent Psychology
Cross-Sectional Studies
Female
Health Knowledge, Attitudes, Practice
Humans
Male
Parenting
Parents
Smoking - epidemiology - prevention & control - psychology
Sweden - epidemiology
Tobacco, Smokeless
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.
PubMed ID
19261172 View in PubMed
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Assessment of intervention intensity: experiences from a small-scale Swedish cardiovascular disease prevention programme.

https://arctichealth.org/en/permalink/ahliterature81992
Source
Scand J Public Health. 2006;34(3):279-86
Publication Type
Article
Date
2006
Author
Färnkvist Lisbeth
Weinehall Lars
Author Affiliation
Department of Public Health and Research, Härnösand-Medelpad Medical Service, Sundsvall, Sweden. lisbeth.farnkvist@telia.com
Source
Scand J Public Health. 2006;34(3):279-86
Date
2006
Language
English
Publication Type
Article
Keywords
Adult
Cardiovascular Diseases - prevention & control
Community Health Planning
Cross-Sectional Studies
Female
Health promotion
Humans
Interviews
Male
Middle Aged
Primary Health Care
Primary Prevention
Program Evaluation
Questionnaires
Risk factors
Socioeconomic Factors
Sweden
Abstract
AIMS: To study the context of an intervention programme, including possible competing demands between an intervention and other health service assignments, and to develop a measure of intervention intensity. METHODS: Data used include questionnaires and interviews with intervention staff, protocols, and reports from the intervention programme, and cross-sectional health surveys. A new Intervention Intensity Score (IIS) is used as an indicator of the intensity of the intervention. RESULTS: Initially the intensity of support and activity of the programme was high and some cardiovascular risk factors such as cholesterol and daily smoking declined. There were favourable allocations of resources in the setting and enthusiasm. Later, disturbing changes in the organisation, competing demands within Primary Health Care (PHC), and an incipient decline of the intervention intensity occurred. These changes accelerated and finally the intervention intensity faded out, parallel to unfavourable risk factor changes. The Intervention Intensity Score (IIS) is useful as an indicator in the interpretation of programme effectiveness. CONCLUSIONS: The amount and quality of support, the intervention process itself, and the intervention intensity were determining factors of the achievements of this intervention programme. The IIS measure used in this study provides a feasible way to interpret and understand achievements and shortcomings of the intervention programme.
PubMed ID
16754586 View in PubMed
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Cardiovascular risk factor burden has a stronger association with self-rated poor health in adults in the US than in Sweden, especially for the lower educated.

https://arctichealth.org/en/permalink/ahliterature82538
Source
Scand J Public Health. 2006;34(2):140-9
Publication Type
Article
Date
2006
Author
Emmelin Maria
Nafziger Anne N
Stenlund Hans
Weinehall Lars
Wall Stig
Author Affiliation
Epidemiology and Public Health Sciences, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. maria.emmelin@epiph.umu.se
Source
Scand J Public Health. 2006;34(2):140-9
Date
2006
Language
English
Publication Type
Article
Keywords
Adult
Aged
Cardiovascular Diseases - epidemiology - etiology
Cross-Sectional Studies
Educational Status
Female
Health Surveys
Humans
Life Style
Male
Middle Aged
Questionnaires
Risk Assessment - methods
Risk factors
Self Concept
Socioeconomic Factors
Sweden - epidemiology
United States - epidemiology
Abstract
BACKGROUND: There is an ongoing debate about the importance of biomedical and sociodemographic risk factors in the prediction of self-rated health. OBJECTIVES: To compare the association of sociodemographic and cardiovascular risk factors and self-rated health in Sweden and the US. DESIGN: Data from two population-based cross-sectional health surveys, one in Sweden and one in the US. SUBJECTS: The surveys included questionnaire and measured data from 5,461 adults in Sweden and 7,643 in the US. Participants were between 35 and 65 years of age. RESULTS: The odds ratios for poor self-rated health for the included cardiovascular risk factors were greater in the US. Low education was significantly more prevalent among those with self-rated poor health in the US, but not in Sweden. Using Swedes with high education as reference group (OR = 1), adults in the US with low education and 2+ risk factors had a greater than threefold risk (OR = 6.3) of self-rated poor health compared with Swedish low-educated adults with the same risk factor burden (OR = 1.9). The better-educated US adults with 2+ risk factors were significantly more likely to report poor health (OR = 3.4) compared with their Swedish counterparts (OR = 2.4). CONCLUSIONS: The interaction between risk factors, education, and self-rated health suggests a frightening picture, especially for the US. Public health interventions for reducing cardiovascular risk factors need to include both population and individual measures. Taking people's overall evaluation of their health into account when assessing total health risk is important.
PubMed ID
16581706 View in PubMed
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Changes in plasma C-reactive protein and hemostatic factors prior to and after a first myocardial infarction with a median follow-up time of 8 years.

https://arctichealth.org/en/permalink/ahliterature89367
Source
Blood Coagul Fibrinolysis. 2009 Jul;20(5):340-6
Publication Type
Article
Date
Jul-2009
Author
Thøgersen Anna M
Nilsson Torbjörn K
Weinehall Lars
Boman Kurt
Eliasson Mats
Hallmans Göran
Jansson Jan-Håkan
Author Affiliation
Department of Public Health and Clinical Medicine, Umeå University Hospital, Umeå, Sweden. anmat@rn.dk
Source
Blood Coagul Fibrinolysis. 2009 Jul;20(5):340-6
Date
Jul-2009
Language
English
Publication Type
Article
Abstract
The objective of this study was to determine whether a first myocardial infarction leads to increased plasma levels of hemostatic factors and high sensitive C-reactive protein (hs-CRP) and whether the association between theses biomarkers and myocardial infarction was greater at follow-up compared with baseline. Of more than 36,000 persons screened in northern Sweden, 78 developed a first myocardial infarction (on average 18 months after sampling) in a population-based, prospective, nested patient-referent study. Fifty of these had participated in a follow-up health survey (on average 8 and a half years between surveys) and were sex-matched and age-matched with 56 referents. The mean increases in hs-CRP, tissue plasminogen activator (tPA) mass, plasminogen activator inhibitor-1 mass, and tPA/plasminogen activator inhibitor-1 complex concentration and von Willebrand factor among patients and referents were comparable during follow-up. Conditional logistic regression indicated that hs-CRP was not significantly associated with first myocardial infarction in a univariate analysis, whereas high plasma levels of tPA and creatinine were significantly associated with outcome at baseline and follow-up. tPA/plasminogen activator inhibitor-1 complex was not superior to tPA as a risk marker in this study. A first myocardial infarction did not in this study induce significantly different changes in plasma levels of hs-CRP and hemostatic factors among patients compared with referents during follow-up.
PubMed ID
19357504 View in PubMed
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Contribution of Swedish moist snuff to the metabolic syndrome: a wolf in sheep's clothing?

https://arctichealth.org/en/permalink/ahliterature79621
Source
Scand J Public Health. 2006;34(6):576-83
Publication Type
Article
Date
2006
Author
Norberg Margareta
Stenlund Hans
Lindahl Bernt
Boman Kurt
Weinehall Lars
Author Affiliation
Epidemiology and Public Health Sciences, Umeå University, Umeå, Sweden. margareta.norberg@epiph.umu.se
Source
Scand J Public Health. 2006;34(6):576-83
Date
2006
Language
English
Publication Type
Article
Keywords
Adult
Cohort Studies
Female
Follow-Up Studies
Health Surveys
Humans
Life Style
Longitudinal Studies
Male
Metabolic Syndrome X - blood - complications - etiology
Middle Aged
Prospective Studies
Questionnaires
Risk factors
Socioeconomic Factors
Sweden - epidemiology
Tobacco, Smokeless - adverse effects
Abstract
AIM: Combined effects of genetic and environmental factors underlie the clustering of cardiovascular risk factors in the metabolic syndrome (MetSy). The aim was to investigate associations between several lifestyle factors and MetSy, with a focus on the possible role of smokeless tobacco in the form of Swedish moist snuff (snus). METHODS: A population-based longitudinal cohort study within the Västerbotten Intervention Programme in Northern Sweden. All inhabitants at the ages of 30, 40, 50, and 60 are invited to participate in a health survey that includes a questionnaire on psychosocial conditions and lifestyle and measurement of biological variables. Individuals examined in 1990-94 (n = 24,230) and who also returned for follow-up after 10 years were included (total of 16,492 individuals: 46.6% men and 53.4% women). Regression analyses were performed. MetSy was the outcome and analyses were adjusted for age, sex, alcohol abuse, and family history of CVD and diabetes. RESULTS: Ten-year development of MetSy was associated with high-dose consumption of snus at baseline (OR 1.6 [95% CI 1.26-2.15]), low education (2.2 [1.92-2.63]), physical inactivity (1.5 [1.22-1.73]) and former smoking (1.2 [1.06-1.38]). Snus was associated with separate components of MetSy, including triglycerides (1.6, 1.30-1.95), obesity (1.7 [1.36-2.18]) but not hypertension, dysglycemia and low HDL cholesterol. CONCLUSIONS: MetSy is independently associated with high consumption of snus, even when controlling for smoking status. The finding is of public health interest in societies with widespread use of snus. More research is needed to better understand the mechanisms underlying this effect.
PubMed ID
17132590 View in PubMed
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Cost-effectiveness of a personal health document in different distribution settings.

https://arctichealth.org/en/permalink/ahliterature92742
Source
Health Promot J Austr. 2008 Aug;19(2):125-31
Publication Type
Article
Date
Aug-2008
Author
Jerdén Lars
Lindholm Lars
Weinehall Lars
Author Affiliation
Epidemiology and Public Health Sciences, Department of Public Health and Clinical Medicine, Umeå University, S-901 85 Umeå, Sweden. lars.jerden@ltdalarna.se
Source
Health Promot J Austr. 2008 Aug;19(2):125-31
Date
Aug-2008
Language
English
Publication Type
Article
Keywords
Adult
Cost-Benefit Analysis
Female
Health Behavior
Health Promotion - economics - methods
Humans
Male
Medical Records
Middle Aged
Patient Education as Topic - economics - methods
Primary Health Care
Abstract
ISSUE ADDRESSED: The aim was to compare the cost-effectiveness of different ways to distribute a personal health document that was primarily aimed at supporting behaviour change. Personal health documents have been widely used in health-promoting efforts but their effective use is rather sparsely studied. METHODS: Four types of distribution were tested in Sweden: primary health care centres (n=418); work site meetings (n=164); at an occupational health examination (n=279); by mail (n=445). Participant behaviour changes were measured by a questionnaire. Cost calculations were made based on the results of the study. RESULTS: Between 10% and 26% of participants reported behaviour changes as a result of reading the booklet. A change in health situation was less likely using postal distribution. There were no significant differences between the other types of distribution. Cost-effective distribution at work sites and in occupational health was superior to distribution in primary health care when direct costs were used. Distribution at work sites was the least cost-effective when indirect costs, i.e. productivity losses of participants, were included. CONCLUSIONS: Cost-effectiveness analyses support distribution of personal health documents in occupational health. In primary health care, high training costs in combination with low distribution rates might be problematic. Providing information during distribution at work sites is time-consuming and might therefore be a problem if productivity losses are taken into account.
PubMed ID
18647126 View in PubMed
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The effects of commuting activity and occupational and leisure time physical activity on risk of myocardial infarction.

https://arctichealth.org/en/permalink/ahliterature79552
Source
Eur J Cardiovasc Prev Rehabil. 2006 Dec;13(6):924-30
Publication Type
Article
Date
Dec-2006
Author
Wennberg Patrik
Lindahl Bernt
Hallmans Göran
Messner Torbjörn
Weinehall Lars
Johansson Lars
Boman Kurt
Jansson Jan-Håkan
Author Affiliation
Bureå Health Centre, Bureå, Sweden. patrik.wennberg@medforskskelet.se
Source
Eur J Cardiovasc Prev Rehabil. 2006 Dec;13(6):924-30
Date
Dec-2006
Language
English
Publication Type
Article
Keywords
Chi-Square Distribution
Female
Humans
Leisure Activities
Logistic Models
Male
Middle Aged
Motor Activity
Myocardial Infarction - epidemiology
Occupations
Prospective Studies
Risk factors
Statistics, nonparametric
Sweden - epidemiology
Transportation
Abstract
BACKGROUND: Risk reduction of myocardial infarction has been shown for leisure time physical activity. The results of studies on occupational physical activity and risk of myocardial infarction are incongruous and studies on commuting activity are scarce. The aim of this study was to investigate how commuting activity, occupational physical activity and leisure time physical activity were associated with risk of future first myocardial infarction. DESIGN: We used a prospective incident case-referent study design nested in Västerbotten Intervention Program and the Northern Sweden MONICA study. METHODS: Commuting habits, occupational physical activity, leisure time physical activity and cardiovascular risk factors were assessed at baseline screening and compared in 583 cases (20% women) with a first myocardial infarction and 2098 matched referents. RESULTS: Regular car commuting was associated with increased risk of myocardial infarction versus commuting by bus, cycling or walking [odds ratio (OR) 1.74; 95% confidence interval (CI), 1.20-2.52] after multivariate adjustment. High versus low leisure time physical activity was associated with reduced risk of myocardial infarction (OR 0.69; 95% CI, 0.50-0.95) after adjustment for occupational physical activity and commuting activity, but the association was not statistically significant after further multivariate adjustment. After multivariate adjustment we observed a reduced risk for myocardial infarction in men with moderate (OR 0.70; 95% CI, 0.50-0.98) or high (OR 0.67; 95% CI, 0.42-1.08) versus low occupational physical activity. CONCLUSIONS: We found a clear association between car commuting and a first myocardial infarction and a corresponding inverse association with leisure time physical activity, while the impact of occupational physical activity on the risk of myocardial infarction was weaker.
PubMed ID
17143124 View in PubMed
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Experiences of Swedish community health nurses working with health promotion and a patient-held health record.

https://arctichealth.org/en/permalink/ahliterature79746
Source
Scand J Caring Sci. 2006 Dec;20(4):448-54
Publication Type
Article
Date
Dec-2006
Author
Jerdén Lars
Hillervik Charlotte
Hansson Ann-Christin
Flacking Renée
Weinehall Lars
Author Affiliation
Epidemiology, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. lars.jerden@ltdalarna.se
Source
Scand J Caring Sci. 2006 Dec;20(4):448-54
Date
Dec-2006
Language
English
Publication Type
Article
Keywords
Adult
Community Health Nursing
Female
Health Promotion - methods - organization & administration
Humans
Medical Records
Middle Aged
Nurse-Patient Relations
Patient Care Team - organization & administration
Patient Participation
Sweden
Abstract
Community health nurses have a tradition of preventive care, and might therefore be a key group in the introduction of new health-promotion methods. The aim of this study was to describe Swedish community health nurses' experiences in working with health promotion and a patient-held record as an integrated tool in their health-promotion work. Interviews were performed with 12 nurses at primary healthcare centres in the county of Dalarna, Sweden. A qualitative content analysis applying aspects of the grounded theory approach was performed. Central to the analysis was the nurses' struggle for balance, in being both a doer of practical disease-oriented tasks and a health-promotion communicator. Descriptions of the nurses' struggles to balance their work were grouped into three themes: (i) working alone and as a part of a team; (ii) nurse-related and patient-related interests; and (iii) patient's responsibility and shared responsibility between patient and nurse. The findings indicated that the structural organization in the primary healthcare centres was important for the community health nurses' means to work with health promotion and the patient-held record. In addition, the community health nurses' cognitive and emotional needs also affected this balance. In conclusion, the struggle of community health nurses to find a balance between being doers and health-promotion communicators is valuable in understanding health promotion in primary health care. The study indicates that it is not enough to develop health-promotion methods acceptable to community health nurses. A comprehensive examination of working conditions and the content of daily work is needed to ensure an emphasis on health promotion, including long-term usage of patient-held records.
PubMed ID
17116154 View in PubMed
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Fewer deaths from cardiovascular disease than expected from the Systematic Coronary Risk Evaluation chart in a Swedish population.

https://arctichealth.org/en/permalink/ahliterature89365
Source
Eur J Cardiovasc Prev Rehabil. 2009 Jun;16(3):321-4
Publication Type
Article
Date
Jun-2009
Author
Stenlund Hans
Lönnberg Göran
Jenkins Paul
Norberg Margareta
Persson Mats
Messner Torbjörn
Boman Kurt
Pearson Thomas
Wall Stig
Nyström Lennarth
Weinehall Lars
Author Affiliation
Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences, Umeå University, Umeå, Sweden. hans.stenlund@epiph.umu.se
Source
Eur J Cardiovasc Prev Rehabil. 2009 Jun;16(3):321-4
Date
Jun-2009
Language
English
Publication Type
Article
Abstract
INTRODUCTION: Numerous equations to predict cardiovascular risk have been developed, but they differ in their ability to identify high-risk groups. In particular, concerns have been expressed that the Systematic Coronary Risk Evaluation (SCORE) equation may overestimate the risk of fatal myocardial infarction and stroke in certain European populations. METHODS: The SCORE guidelines were applied to a sample of 10,476 male and 11,874 female participants from the Västerbotten Intervention Program (VIP) of northern Sweden who were screened between 1990 and 1994, at the age of 40, 50, or 60 years, and followed up for at least 10 years or until death. RESULTS: The cohort experienced a total of 229 fatal cardiovascular events, 169 for men and 60 for women, during the course of follow-up, whereas 359 (266 for men and 93 for women) were predicted through application of the Swedish SCORE risk chart. CONCLUSION: Application of the SCORE guidelines resulted in substantial overestimation of the expected number of deaths from cardiovascular disease in a population from northern Sweden.
PubMed ID
19357519 View in PubMed
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High obesity incidence in northern Sweden: how will Sweden look by 2009?

https://arctichealth.org/en/permalink/ahliterature81899
Source
Eur J Epidemiol. 2006;21(5):377-82
Publication Type
Article
Date
2006
Author
Nafziger Anne N
Stenlund Hans
Wall Stig
Jenkins Paul L
Lundberg Vivan
Pearson Thomas A
Weinehall Lars
Author Affiliation
Clinical Pharmacology Research Center, Bassett Healthcare, One Atwell Road, Cooperstown, NY 13326-1394, USA. anafziger@ordwayresearch.org
Source
Eur J Epidemiol. 2006;21(5):377-82
Date
2006
Language
English
Publication Type
Article
Keywords
Adult
Body mass index
Female
Humans
Male
Middle Aged
Obesity - epidemiology
Sex Distribution
Sweden - epidemiology
Time Factors
Abstract
The study objective was to evaluate the incidence of overweight and obesity in two rural areas of Sweden and the U.S. Previously collected data were used from 1990 to 1999 Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) studies in northern Sweden. Health censuses of adults in Otsego County, New York were collected in 1989 and 1999. Adults aged 25-64 year in 1989 with reports from both surveys were included. The 10-year change in body mass index (BMI), overweight (BMI 25-29.9 kg/m2) and obesity (BMI>or=30) were obtained from panel studies. Incidences of overweight and obesity were calculated and compared between countries. The 10-year incidence of obesity was 120/1000 in Sweden and 173/1000 in the U.S. (p
PubMed ID
16763883 View in PubMed
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21 records – page 1 of 3.