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40-Year CHD Mortality Trends and the Role of Risk Factors in Mortality Decline: The North Karelia Project Experience.

https://arctichealth.org/en/permalink/ahliterature289324
Source
Glob Heart. 2016 06; 11(2):207-12
Publication Type
Journal Article
Review
Date
06-2016
Author
Pekka Jousilahti
Tiina Laatikainen
Veikko Salomaa
Arto Pietilä
Erkki Vartiainen
Pekka Puska
Author Affiliation
National Institute for Health and Welfare, Department of Health, Helsinki, Finland. Electronic address: pekka.jousilahti@thl.fi.
Source
Glob Heart. 2016 06; 11(2):207-12
Date
06-2016
Language
English
Publication Type
Journal Article
Review
Keywords
Cardiovascular Diseases - mortality - prevention & control
Finland - epidemiology
Forecasting
Public Health
Risk Assessment - methods
Risk factors
Survival Rate - trends
Abstract
In the 1960s and early 1970s, coronary heart disease (CHD) mortality in Finland was the highest in the world, and within Finland, mortality was particularly high in the eastern part of the country. The North Karelia Project, the first large community-based cardiovascular diseases prevention program was established in 1972 to reduce the extremely high CHD mortality through behavioral change and reduction of the main cardiovascular disease risk factors among the whole population of North Karelia, the easternmost province of Finland. During the 40-year period from 1972 to 2012, smoking prevalence, serum total cholesterol, and systolic blood pressure declined markedly, except a small increase in serum cholesterol levels between 2007 and 2012. From the early 1970s to 2012, CHD mortality decreased by 82% (from 643 to 118 per 100,000) among working-age (35 to 64 years) men. Among working-age women, the decline was 84% (from 114 to 17 per 100,000). During the first 10 years, changes in these 3 target risk factors explained nearly all of the observed mortality reduction. Since the mid-1980s, the observed reduction in mortality has been larger than the predicted reduction. In the early 1970s, premature CHD mortality (35 to 74 years) was about 37% higher among Eastern Finnish men and 23% higher among Eastern Finnish women, compared with men and women in Southwestern Finland. During the last 40 years, premature CHD mortality declined markedly in both areas, but the decline was larger in Eastern Finland and the mortality gap between the two areas nearly disappeared.
PubMed ID
27242088 View in PubMed
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An update on risk communication in the Arctic.

https://arctichealth.org/en/permalink/ahliterature289269
Source
Int J Circumpolar Health. 2016; 75:33822
Publication Type
Journal Article
Review
Date
2016
Author
Eva-Maria Krümmel
Andrew Gilman
Author Affiliation
Inuit Circumpolar Council, Ottawa, Canada; ekruemmel@scientissime.com.
Source
Int J Circumpolar Health. 2016; 75:33822
Date
2016
Language
English
Publication Type
Journal Article
Review
Keywords
Arctic Regions
Communicable Disease Control - organization & administration
Environmental Exposure - prevention & control
Environmental monitoring
Environmental Pollutants - analysis
Food Contamination
Health Communication
Humans
Inuits
Needs Assessment - organization & administration
Public Health
Abstract
Arctic residents can be exposed to a wide range of contaminants through consumption of traditional (country) foods (i.e. food from wild animals and plants that are hunted, caught or collected locally in the Arctic). Yet these foods provide excellent nutrition, promote social cohesion, meet some spiritual needs for connectedness to the land and water, reinforce cultural ties, are economically important and promote overall good health for many. The risk and benefit balance associated with the consumption of traditional Arctic foods is complicated to communicate and has been referred to as the "Arctic Dilemma". This article gives an update on health risk communication in the Arctic region. It briefly summarizes some research on risk communication methodologies as well as approaches to an evaluation of the outcomes of risk communication initiatives. It provides information on specific initiatives in several Arctic countries, and particularly those that were directed at Indigenous populations. This article also summarizes some international versus local risk communication activities and the complexity of developing and delivering messages designed for different audiences. Finally, the potential application of social media for risk communication and a summary of "best practices" based on published literature and a survey of Inuit in a few Arctic countries are described.
Several of the risk communication initiatives portrayed in this article indicate that there is only limited awareness of the outcome of risk communication messages. In some cases, risk communication efforts appear to have been successful, at least when effectiveness is measured in an indirect way, for example, by lower contaminant levels. However, due to missing effectiveness evaluation studies, uncertainty remains as to whether a specific risk communication method was successful and could be clearly linked to behavioural changes that resulted in decreased contaminant exposure.
Notes
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PubMed ID
27974140 View in PubMed
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APPROACHES TO THE EVALUATION OF CULTURAL ADAPTATIONS OF HOME VISITING IN TRIBAL COMMUNITIES.

https://arctichealth.org/en/permalink/ahliterature299178
Source
Infant Ment Health J. 2018 05; 39(3):347-357
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Review
Date
05-2018
Author
Aleta Meyer
Erin Geary
Debra Heath
Vanessa Hiratsuka
Melina Salvador
Jenae Sanchez
Nancy Whitesell
Author Affiliation
U.S. Department of Health & Human Services, Administration for Children and Families.
Source
Infant Ment Health J. 2018 05; 39(3):347-357
Date
05-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Review
Keywords
Adult
Alaska
Alaska Natives
Child Health Services
Child, Preschool
Culturally Competent Care - methods
Female
Health Services, Indigenous
House Calls
Humans
Indians, North American
Infant
Infant, Newborn
Male
Maternal health services
Needs Assessment
New Mexico
Pregnancy
Washington
Young Adult
Abstract
The research that underlies evidence-based practices is often based on relatively homogenous study samples, thus limiting our ability to understand how the study findings apply in new situations as well as our understanding of what might need to be adapted. In a preliminary effort to address those gaps, the requirements for the Tribal Maternal Infant and Early Childhood Home Visiting Program (MIECHV) included the expectation that grantees design and implement rigorous evaluations to address local priorities and to help build the knowledge base regarding the use of evidence-based home-visiting programs in tribal communities. A priority that emerged across many Tribal MIECHV grantees was to determine the added benefit of the cultural adaptations that they were making to their home-visiting programs. While there is literature to describe recommended processes for making cultural adaptations to evidence-based programs themselves, there are very few guidelines for evaluating these adaptations. In this article, we review the varied evaluation approaches utilized by Tribal MIECHV grantees and provide three case examples of how evaluators and tribal communities worked together to articulate evaluation questions and choose appropriate and feasible evaluation designs. The lessons derived from these Tribal MIECHV evaluation experiences have implications for the role of the evaluator in diverse communities across the country evaluating home visiting and other evidence-based practices in settings characterized by unique cultural contexts.
PubMed ID
29767435 View in PubMed
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The Arctic's sea ice cover: trends, variability, predictability, and comparisons to the Antarctic.

https://arctichealth.org/en/permalink/ahliterature292049
Source
Ann N Y Acad Sci. 2018 May 28; :
Publication Type
Journal Article
Review
Date
May-28-2018
Author
Mark C Serreze
Walter N Meier
Author Affiliation
National Snow and Ice Data Center, Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, Colorado.
Source
Ann N Y Acad Sci. 2018 May 28; :
Date
May-28-2018
Language
English
Publication Type
Journal Article
Review
Abstract
As assessed over the period of satellite observations, October 1978 to present, there are downward linear trends in Arctic sea ice extent for all months, largest at the end of the melt season in September. The ice cover is also thinning. Downward trends in extent and thickness have been accompanied by pronounced interannual and multiyear variability, forced by both the atmosphere and ocean. As the ice thins, its response to atmospheric and oceanic forcing may be changing. In support of a busier Arctic, there is a growing need to predict ice conditions on a variety of time and space scales. A major challenge to providing seasonal scale predictions is the 7-10 days limit of numerical weather prediction. While a seasonally ice-free Arctic Ocean is likely well within this century, there is much uncertainty in the timing. This reflects differences in climate model structure, the unknown evolution of anthropogenic forcing, and natural climate variability. In sharp contrast to the Arctic, Antarctic sea ice extent, while highly variable, has increased slightly over the period of satellite observations. The reasons for this different behavior remain to be resolved, but responses to changing atmospheric circulation patterns appear to play a strong role.
PubMed ID
29806697 View in PubMed
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Assessment of Cardiac Autonomic Function in Relation to Methylmercury Neurotoxicity.

https://arctichealth.org/en/permalink/ahliterature293409
Source
Toxics. 2018 Jul 20; 6(3):
Publication Type
Journal Article
Review
Date
Jul-20-2018
Author
Kanae Karita
Toyoto Iwata
Eri Maeda
Mineshi Sakamoto
Katsuyuki Murata
Author Affiliation
Department of Hygiene and Public Health, Kyorin University School of Medicine, Mitaka, Tokyo 181-8611, Japan. kanae@ks.kyorin-u.ac.jp.
Source
Toxics. 2018 Jul 20; 6(3):
Date
Jul-20-2018
Language
English
Publication Type
Journal Article
Review
Abstract
After the European Food Safety Authority reviewed reports of methylmercury and heart rate variability (HRV) in 2012, the panel concluded that, although some studies of cardiac autonomy suggested an autonomic effect of methylmercury, the results were inconsistent among studies and the implications for health were unclear. In this study, we reconsider this association by adding a perspective on the physiological context. Cardiovascular rhythmicity is usually studied within different frequency domains of HRV. Three spectral components are usually detected; in humans these are centered at
PubMed ID
30036985 View in PubMed
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Association between prescribed antidepressants and other prescribed drugs differ by gender: a nationwide register-based study in Sweden.

https://arctichealth.org/en/permalink/ahliterature300034
Source
Nord J Psychiatry. 2019 Jan; 73(1):73-79
Publication Type
Journal Article
Review
Date
Jan-2019
Author
Lena Thunander Sundbom
Kerstin Hedborg
Author Affiliation
a Faculty of Health and Occupational Studies, Department of Health and Caring Sciences , University of Gävle , Gävle , Sweden.
Source
Nord J Psychiatry. 2019 Jan; 73(1):73-79
Date
Jan-2019
Language
English
Publication Type
Journal Article
Review
Keywords
Adult
Aged
Aged, 80 and over
Antidepressive Agents - therapeutic use
Comorbidity
Cross-Sectional Studies
Depressive Disorder - drug therapy - epidemiology
Drug Prescriptions - statistics & numerical data
Female
Humans
Logistic Models
Male
Middle Aged
Polypharmacy
Registries
Sex Factors
Sweden
Abstract
People with depression are prescribed more drugs than people in general, partly due to comorbidity with other conditions. However, little research has been done on depression-related drug use from a gender perspective.
Examine the association between antidepressants, other types of prescribed drugs, and polypharmacy, by gender.
Data on drugs dispensed October to December 2016 to all Swedish citizens aged 18-84 years were collected from the Swedish prescribed drug register. Logistic regression analyses were performed to examine the associations between antidepressants and other drugs, by gender.
For both men and women, associations were found between antidepressants and drugs for alimentary tract problems, respiratory problems, blood, nervous system, analgesics, and polypharmacy. However, for women, but not men, associations were also found for drugs for diabetes, musculoskeletal problems, dermatological problems, and systemic hormones.
Associations were found between antidepressants and many other types of drugs for both men and women; indicating comorbidity between depression and other conditions. Further, some of the associations between antidepressants and other drugs were found to be specific among women. Whether this indicates that men and women differ in comorbidity between depression and other conditions cannot be concluded based on this cross-sectional study. However, comorbidity impairs the possibility of recovery; in the somatic condition as well as the depression. Thus, physicians need to be aware that the association between antidepressants and other types of drugs are more common among women than men.
PubMed ID
30661437 View in PubMed
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Atopic Dermatitis: Racial and Ethnic Differences.

https://arctichealth.org/en/permalink/ahliterature290693
Source
Dermatol Clin. 2017 Jul; 35(3):395-402
Publication Type
Journal Article
Review
Date
Jul-2017
Author
Adeline Mei-Yen Yong
Yong-Kwang Tay
Author Affiliation
Department of Dermatology, National University Health System, 5 Lower Kent Ridge Road, Singapore 119074, Singapore.
Source
Dermatol Clin. 2017 Jul; 35(3):395-402
Date
Jul-2017
Language
English
Publication Type
Journal Article
Review
Keywords
Age Factors
China - epidemiology
Dermatitis, Atopic - diagnosis - ethnology - genetics - pathology
Health Status Disparities
Humans
Malaysia - epidemiology
Phenotype
Prevalence
Singapore - epidemiology
Socioeconomic Factors
Sweden - epidemiology
Abstract
Atopic dermatitis (AD) is a common, chronic inflammatory skin condition affecting up to 20% of children and 3% of adults worldwide. There is wide variation in the prevalence of AD among different countries. Although the frequency of AD is increasing in developing countries, it seems to have stabilized in developed countries, affecting approximately 1 in 5 schoolchildren. Adult-onset AD is not uncommon and is significantly higher, affecting between 11% and 13% of adults in some countries, for example, Singapore, Malaysia, and Sweden. AD is thus associated with significant health care economic burden in all age groups.
PubMed ID
28577807 View in PubMed
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Attitudes toward surrogacy among doctors working in reproductive medicine and obstetric care in Sweden.

https://arctichealth.org/en/permalink/ahliterature299028
Source
Acta Obstet Gynecol Scand. 2018 Sep; 97(9):1114-1121
Publication Type
Journal Article
Review
Date
Sep-2018
Author
Camilla Stenfelt
Gabriela Armuand
Kjell Wånggren
Agneta Skoog Svanberg
Gunilla Sydsjö
Author Affiliation
Fertilitetscentrum Stockholm, Stockholm, Sweden.
Source
Acta Obstet Gynecol Scand. 2018 Sep; 97(9):1114-1121
Date
Sep-2018
Language
English
Publication Type
Journal Article
Review
Keywords
Adult
Attitude of Health Personnel
Cross-Sectional Studies
Female
Humans
Physicians - psychology
Pregnancy
Reproductive Medicine
Surrogate Mothers
Surveys and Questionnaires
Sweden
Abstract
The aim of this study was to investigate attitudes and opinions towards surrogacy among physicians working within obstetrics and reproductive medicine in Sweden.
Physicians working within medically assisted reproduction (MAR), antenatal care and obstetrics were invited to participate in a cross-sectional nationwide survey study. The study-specific questionnaire measured attitudes and experiences in three domains: attitudes towards surrogacy, assessment of prospective surrogate mothers, and antenatal and obstetric care for surrogate mothers.
Of the 103 physicians who participated (response rate 74%), 63% were positive or neutral towards altruistic surrogacy being introduced in Sweden. However, only 28% thought that it should be publicly financed. Physicians working at fertility clinics were more positive towards legalization as well as public financing of surrogacy compared than were those working within antenatal and delivery care. The majority of the physicians agreed that surrogacy involves the risk of exploitation of women's bodies (60%) and that there is a risk that the commissioning couple might pay the surrogate mother "under the table" (82%). They also expressed concerns about potential surrogate mothers not being able to understand fully the risks of entering pregnancy on behalf of someone else.
There is a relatively strong support among physicians working within obstetrics and reproductive medicine for the introduction of surrogacy in Sweden. However, the physicians expressed concerns about the surrogate mothers' health as well as the risk of coercion. Further discussions about legalization of surrogacy should include views from individuals within a wide field of different medical professions and laymen.
PubMed ID
29512820 View in PubMed
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Avoiding a crisis of motivation for ocean management under global environmental change.

https://arctichealth.org/en/permalink/ahliterature294930
Source
Glob Chang Biol. 2017 11; 23(11):4483-4496
Publication Type
Journal Article
Review
Research Support, Non-U.S. Gov't
Date
11-2017
Author
Peter J Mumby
James N Sanchirico
Kenneth Broad
Michael W Beck
Peter Tyedmers
Megan Morikawa
Thomas A Okey
Larry B Crowder
Elizabeth A Fulton
Denny Kelso
Joanie A Kleypas
Stephan B Munch
Polita Glynn
Kathryn Matthews
Jane Lubchenco
Author Affiliation
Marine Spatial Ecology Lab & ARC Centre of Excellence for Coral Reef Studies, School of Biological Sciences, University of Queensland, St Lucia, Qld, Australia.
Source
Glob Chang Biol. 2017 11; 23(11):4483-4496
Date
11-2017
Language
English
Publication Type
Journal Article
Review
Research Support, Non-U.S. Gov't
Keywords
Animals
Climate change
Conservation of Natural Resources
Coral Reefs
Ecosystem
Fishes
Humans
Motivation
Oceans and Seas
Abstract
Climate change and ocean acidification are altering marine ecosystems and, from a human perspective, creating both winners and losers. Human responses to these changes are complex, but may result in reduced government investments in regulation, resource management, monitoring and enforcement. Moreover, a lack of peoples' experience of climate change may drive some towards attributing the symptoms of climate change to more familiar causes such as management failure. Taken together, we anticipate that management could become weaker and less effective as climate change continues. Using diverse case studies, including the decline of coral reefs, coastal defences from flooding, shifting fish stocks and the emergence of new shipping opportunities in the Arctic, we argue that human interests are better served by increased investments in resource management. But greater government investment in management does not simply mean more of "business-as-usual." Management needs to become more flexible, better at anticipating and responding to surprise, and able to facilitate change where it is desirable. A range of technological, economic, communication and governance solutions exists to help transform management. While not all have been tested, judicious application of the most appropriate solutions should help humanity adapt to novel circumstances and seek opportunity where possible.
PubMed ID
28447373 View in PubMed
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Background, Principles, Implementation, and General Experiences of the North Karelia Project.

https://arctichealth.org/en/permalink/ahliterature289329
Source
Glob Heart. 2016 06; 11(2):173-8
Publication Type
Journal Article
Review
Date
06-2016
Author
Pekka Puska
Erkki Vartiainen
Aulikki Nissinen
Tiina Laatikainen
Pekka Jousilahti
Author Affiliation
Department of Health, National Institute for Health and Welfare (THL), Helsinki, Finland. Electronic address: Pekka.Puska@thl.fi.
Source
Glob Heart. 2016 06; 11(2):173-8
Date
06-2016
Language
English
Publication Type
Journal Article
Review
Keywords
Cardiovascular Diseases - epidemiology - prevention & control
Finland
Health promotion
Humans
Morbidity - trends
Public Health
Survival Rate - trends
Abstract
The extremely high mortality of cardiovascular diseases in the 1960s in Finland, particularly in the Eastern Province of North Karelia and especially that of coronary heart disease in men, caused great concern among the local population. Action to reduce the problem was demanded in a petition signed in 1971 by the representatives of the population. In response, the North Karelia Project was launched in 1972 to carry out a comprehensive preventive project, first only in North Karelia as a national pilot (1972 to 1977), and thereafter continuing in North Karelia but at the same time transferring the experiences to a national level. The intervention was based on the at-that-time relatively new scientific information on the main causal risk factors. A comprehensive population-based intervention was carried out, aiming especially at the reduction of the high levels of serum cholesterol, blood pressure, and tobacco use, emphasizing general dietary changes and smoking reduction. A comprehensive monitoring and evaluation program was designed and implemented to learn from the experience in preparation for national and international use. Presented here are the background, principles, and general experiences of this project, which has made major contributions both to the contemporary public health work for the prevention and control of heart disease and noncommunicable diseases and for research in the area.
PubMed ID
27242083 View in PubMed
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213 records – page 1 of 22.