Introduction: This dissertation seeks to identify novel, potentially modifiable risk factors that could be used to reduce the risk of prostate cancer (PCa) progression. Aim 1 investigates the effects of obesity and smoking on PCa progression, aim 2 studies the effects of specific medication use on PCa progression, and aim 3 identifies factors associated with faster PCa progression.Methods: Data from 140 subjects from the Watchful Waiting study followed every 3 months for up to 5 years were used. Multiple linear regressions were used to determine associations with baseline PSA. PSA velocity (rate of change of PSA over time) was used as a surrogate marker for PCa progression. Mixed effect models were used to assess the effect of obesity, smoking and medication use on PSA velocity(aim1 and 2). For aim 3, subjects were categorized as slow, intermediate and fast progressors based on tertiles of PSA velocity. In addition to the above variables, age, Gleason score, chromogranin-A, family history, selenium and free PSA were investigated as determinants of faster PCa progression using multiple logistic regressions. Analyses were run using two models, comparing slow progressors to fast progressors (model1) and slow progressors to a combination of fast and intermediate progressors (model2).Results: Aspirin use was negatively associated with baseline PSA (coefficient = -0.39 and 95% confidence interval (CI):-0.612, -0.158). Aspirin effect was statistically significant in never smokers (coefficient = -0.54, 95% CI: -0.916, -0.170) but not in ever smokers (coefficient = -0.22, 95% CI: -0.505, 0.065). Ever smoking was statistically significantly associated with higher PSA velocity compared to never smoking (coefficient = -0.001, 95% CI: 0.0002, 0.002). In aim 3, pack-years of smoking were positively associated whereas aspirin use was negatively associated with high PSA velocity in both models. Odds Ratio and 95% CI for smoking and aspirin use for model1 and 2 respectively; 1.03 (0.92, 1.13), 1.02 (1.00, 1.03), 0.24(0.06, 0.94) and 0.26(0.10, 0.68).Conclusions: Although more studies are needed before recommendations can be made, if these results are borne to be true in other studies these modifiable risk factors can be potentially be used in prevention of PCa progression.

Aim: The aim of the study is to explore the relationships between an adolescent’s weight and parenting style, emotional eating, and emotional regulation and lifestyle behaviours to further develop the understanding of the factors that contribute to the current epidemic of childhood obesity. Design: A cross sectional survey design was used. Method: 112 adolescents, aged between 16 and 18 from three secondary schools in Scotland completed a self-report questionnaire on their mother and father’s parenting style, their own emotional regulation strategies, emotional eating and lifestyle behaviours. Their height and weight was measured by the researcher and used to calculate the adolescents’ BMI. Results: Overall, this study did not find that adolescent’s healthy food habits, exercise and emotional eating predicted BMI. There were no significant relationships found between BMI and parenting style, emotional eating and emotional regulation. Conclusion: These findings suggest that parenting style, emotional eating, emotional regulation and lifestyle behaviours are not related to adolescent weight.

Abstract The aim of this study was to examine lifestyle risk factors for low bone mass, falls and fractures, and to determine the effect of 30-month exercise trial on bone mass, balance, muscle strength and gait in elderly women. Reliability of an inclinometric method for assessing postural sway was evaluated. Data on risk factors, falls and fractures were collected by questionnaires, and calcaneus and radius bone mass were measured from 1,222 women. Lifetime physical activity, low occupational physical activity, type 2 diabetes, hypertension, hormone replacement, thyroid hormone and thiazide use were associated with increased bone mass, while low current physical activity, high coffee intake and late menarche were associated with low bone mass in lean women. Factors associated with fractures were: low lifetime habitual physical activity, diabetes, living alone and calcaneum bone mass. One hundred and sixty women with low femoral neck bone mass were randomly assigned to the exercise group (n = 84) or to the control group (n = 76). The outcomes included radius, proximal femur and calcaneus bone mass, postural sway, muscle strength, gait speed and endurance. Bone mineral density (BMD) at proximal femur decreased in the control group, while no change occurred in the exercise group. Mean trochanter bone mineral content (BMC) decreased more in the control group. The women in the exercise group improved their performance in walking speed and endurance, body sway and leg strength compared to the control group. There were six falls that resulted in fractures in the exercise group and 16 in the control group. The inclinometric method proved to be reliable. In conclusion, lifestyle factors are determinants of bone mass in lean elderly women. Long-term exercise has a site-specific effect on BMC but not on BMD in elderly women. Weight-bearing exercise can modify risk factors for fractures, and may even prevent fall-related fractures in elderly women.

Background: Many of today’s young adults suffer from impaired psychological well-being and report suffering from psycho-somatic symptoms related to stress. Lifestyle factors, such as smoking, risky alcohol consumption, lack of physical activity and poor diet are known predictors of ill health and may have long lasting impacts on young people’s lives. Aim: The aim of this thesis was to 1: measure adult high school students’ social capital and 2: examine the association between their social capital and psychological well-being as well as the association between social capital and the lifestyle factors; smoking, alcohol consumption, physical activity, diet and academic achievement. Methods: Questionnaires were used to measure high school students’ social capital self- rated psychological health, lifestyle factors and academic achievement. Participants were high school students 18 years and older (n=124) enrolled in Nacka Enskilda Gymnasium and Mörby Gymnasium, two high schools in counties with similar demographic backgrounds, measured in annual salaries, on the outskirts of Stockholm, Sweden. Results: Total social capital was significantly associated with no less than 6 factors of health; self-rated mental health, self-rated stress, psycho-somatic symptoms, intensive physical exercise, consumption of fruit and membership to a club. In addition, consumption of vegetables and expected grade point average (Grade point average (GPA): final GPA’s in Sweden range from 0-20) were significantly associated with individual factors of social capital. Conclusion: The results of this study support the findings of many earlier studies; that social capital appears to be significantly associated with young peoples’ health and well-being. The findings lend weight to earlier studies and contribute to the multitude of voices that lobby for investing in the further development of policies and interventions that aim to increase young peoples’ social capital.

Bakalauro darbe vertinama 8 klasės moksleivių laikysena stovint sagitalinėje ir frontalinėje plokštumose ir stuburo mobilumas/paslankumas. Tyrime dalyvavo vienos Šiaulių progimnazijos 26 aštuntos klasės moksleiviai. Iš jų 10 merginų ir 16 vaikinų. Tyrimas vyko 2013 metų lapkričio 11 – 15 dienomis. Tyrimu buvo siekiama: 1) įvertinti paauglių statinę laikyseną ir stuburo mobilumą naudojant ZEBRIS CM10 WinSpine Pointer diagnostinę įrangą; 2) atskleisti paauglių subjektyvaus sveikatos vertinimo ir fizinio aktyvumo aspektus. Duomenims įvesti ir rezultatams apdoroti buvo naudotas specializuotas duomenų įvedimo ir statistinės analizės programinis paketas SPSS (20 versija). Atlikta statistinė (vidurkių, Mann – Whitney ir Kruskal – Wallis kriterijai) duomenų analizė. Vertinant paauglių laikyseną buvo remtasi mokslininkų (Arcinavičius, 2004; Muckus, 2006; Neumann, 2010; Saniukas, 2007) nurodytomis normomis. Anketa buvo siekiama atskleisti paauglių subjektyvų sveikatos vertinimą ir fizinį aktyvumą, laisvalaikio pomėgius, kurie buvo lyginami su gautais laikysenos vertinimo duomenimis. Taip buvo siekiama atskleisti gyvensenos veiksnių įtaką paauglių laikysenai. Vertinant paauglių laikyseną statinėje padėtyje nustatyta, kad visiems tiriamiesiems yra pečių ir dubens asimetrija. Tyrimo metu buvo nustatyta, kad dviem paaugliams yra skoliozinė deformacija į dešinę pusę ir dviem paaugliams – į kairę pusę. Nustatyta, kad septynių paauglių krūtininė kifozė yra per daug išreikšta. Tai reiškia, kad... [toliau žr. visą tekstą] / In the Bachelor's work is evaluating 8 class pupils’ standing posture in the sagittal and frontal planes and the spine mobility. In the investigation participated 26 eighth class teenagers one of Šiauliai progymnasium, 10 girls and 16 boys. The investigation took place 11 th – 15 th of November, 2013. When conducting the investigation goal was: 1) to evaluate static posture and spine mobility of teenager using ZEBRIS CM10 WinSpine Pointer diagnostic equipment; 2) reveal teenager‘s subjective assessment of health and physical activity aspects. Statistical analysis of results was implemented (means, Mann-Whitney and Kruskal-Wallis criterions). Evaluating of teenager posture was based on scientists (Arcinavičius, 2004; Muckus, 2006; Neumann, 2010; Saniukas, 2007) specified rate. Using questionnaire the aim was to reveal teenager‘s subjective assessment of health and physical activity, hobies of leisure witch was correlated with postural data assessment. Thus, it was intended to reveal lifestyle factors on teenagers posture. In evaluating the situation in the static position of teenagers posture found that all teenagers have the asymmetry of shoulder and pelvic. Two teenagers have scoliotic deformation of right side and two teenagers have left side scoliotic deformation. In the investigation was found that seven teenagers have too big thoracic kyphosis that exceed the rate. It means that these pupils have kyphotic posture. The analysis of lateral flexion revealed that no one of... [to full text]

Benskörhet (osteoporos) och frakturer orsakade av osteoporos är ett stort globalt problem. Syftet med det tioåriga projektet ”Vadstena en benhård kommun” var att utvärdera om man med en befolkningsinriktad interventionsstrategi kunde minska osteoporos och osteoporosrelaterade frakturer i en kommun. Ett representativt urval av befolkningen i åldern 20-79 år, 15% av en population på 7800 personer, blev tillfrågade om att delta vid fyra undersökningstillfällen som innebar att fylla i en enkät och att bentäthetsmätas. Vid första tillfället deltog 70%, första uppföljningen 69%, andra uppföljningen 79% och vid den tredje uppföljningen 65%.Syftet med denna MPH-uppsats är att beskriva det praktiska interventionsarbetet utifrån dagboksanteckningar och att presentera befolkningens upplevelser av interventionsarbetet.Vi nådde uppskattningsvis 5000 personer (65%) av befolkningen med direkt information.De personer som fick individuella riskprofiler baserade på angivna svar i frågeformulär och bentäthetsvärden var de som gav mest positiv respons och kan tillskrivas en lyckad individuell intervention.Den grupp som varit med en eller flera gånger tidigare (interventionsgruppen) var de som vid sista undersökningen 1999, hade fått ökad kunskap om osteoporos (P&lt;0,001). Den gruppen kände även bäst till projektet (P&lt;0, 001), men även den nya gruppen (befolkningsgruppen) kände i hög grad till projektet (75 %). På frågan om deltagarna ville förändra sina vanor var båda grupperna lika villiga (65 % respektive 64 %), vilken kan tillskrivas en lyckad generell intervention.Sjukdomen osteoporos och dess följder tar lång tid att utveckla. Det tar därför även lång tid att mäta effekt av att projekt som detta, som dessutom innefattar en hel befolkning. Nu, 18 år efter projektets start görs en uppföljning av projektet där delar av de mål som sattes upp i början av projektet mäts, bland annat frakturincidens och kunskap om osteoporos hos befolkningen.Nyckelord / Osteoporosis and fractures due to osteoporosis are an increasing global health problem. The aim ofthe ten-years Vadstena Osteoporosis Prevention Project (VOPP) was to evaluate if it was possible toreduce osteoporosis and osteoporotic-related fractures with a community-based prevention programA representative sample aged 20-79 years (Vadstena population of 7800) was invited to participatein the study comprising four measurements including questionnaire and bone mineral densitymeasurement. At baseline 70% participated, at first follow-up 69%, second follow-up 70% and at thethird follow-up 65 %.The aim with this MPH- essay is to describe the intervention from a diary and to present thepopulations experience of the VOPP.We met approximately 5000 persons (65%) of the citizens directly with our intervention. Theparticipators who received individual feedback letters on their answers in the questionnaire and theresults from the bone measurement gave us the best response.The group that participated once or more had the best knowledge about osteoporosis (p&lt; 0.001)and were to an high extent familiar with the project (p&lt;0.001). Even the single participating grouphad god knowledge about the project (75 %). Both groups stated that they wanted to change lifestyle(65 % vs. 64 %) showing a successful general intervention.Osteoporosis is a disease that is present for a long period without signs, before resulting in theclinical sign, fractures. Therefore results of a preventive program towards a whole population isexpected to be found not until after several years. Now eighteen years later a follow up is planned inorder to measure the incidence of osteoporotic fractures and the knowledge about osteoporosis in thepopulation. / <p>ISBN 978-91-85721-45-0</p>

Visame pasaulyje grėsmingai auga turinčių antsvorio ir nutukusių vaikų skaičius. Nustatyta, kad vienas iš penkių vaikų Europoje turi antsvorio. Vaikų antsvorio ir nutukimo priežastys įvairios. Tai gali būti susiję su mitybos ir fizinio aktyvumo įpročių pokyčiais, taip pat su ekonominės, socialinės aplinkos įtaka gyvensenai. Vaikų fizinio išsivystymo tyrimai yra vieni svarbiausių stebint jų sveikatos būklę ir augimą. Disertacinis darbas atliktas dalyvaujant tarptautiniame PSO Europos vaikų nutukimo stebėsenos iniciatyvos projekte (COSI), kurio tikslas – rutiniškai stebėti pradinių klasių mokinių (6–9 m.) antsvorio ir nutukimo tendencijas bei sukurti standartizuotą ir Europos mastu suderintą stebėsenos sistemą. / The prevalence of overweight and obesity is growing all over the world and is evaluated as an epidemic. One of five kids in Europe is overweight. The reasons for childhood obesity are of various origins. It might be related to dietary habits and changes in physical activity. The prevalence of obesity also depends on social and economical inequalities. The survey was performed as a part of WHO European Childhood Obesity Surveillance Initiative (COSI). This initiative aimed to measure routinely trends in overweight and obesity in primary school children (6-9 yr.), and to harmonize the collection of anthropometric data across Europe among primary school aged children, based on a common protocol and measurement procedures.

Bakgrund   Fertilitet beskrivs som kvinnans biologiska natur och definieras ofta som förmågan att kunna bli gravid. Fertilitet kan även ses som ett tecken på hälsa och att kroppen är i balans. Idag är det många kvinnor som lider av nedsatt fertilitet. Det finns flera olika faktorer som kan påverka en kvinnas fertilitet varav vissa av dessa kan vara livsstilsfaktorer som kvinnan själv skulle kunna påverka om hon får tillgång till rätt kunskap. Syfte  Syftet var att belysa livsstilsfaktorer som kan förbättra kvinnans fertilitet med hjälp av sjuksköterskans informativa roll.   Metod  En icke-systematisk litteraturöversikt utfördes baserad på 15 vetenskapliga artiklar där majoriteten var av kvantitativ design. Inkluderade artiklar eftersöktes i databaserna CINAHL och PubMed med hjälp av relevanta sökord för föreliggande syfte. Kvaliteten på de valda artiklar granskades och innehållet analyserades för att sammanställas i tre huvudkategorier: livsstilsfaktorer, kost och sjuksköterskans hälsofrämjande arbete. Resultat Från huvudkategorierna skapades subkategorier gällande livsstilsfaktorer; vikt och träning, stress och sömn, mikronäringsämnen, jod, Omega-3, D-vitamin, koffein samt gällande  sjuksköterskans hälsofrämjande arbete; behov och utbildning. Samtliga livsstilsfaktorer visade sig inverka på fertiliteten. Ett behov gällande utbildning och information kring detta framhålls som betydelsefullt för kvinnor och det framgick att redan aktuella sjuksköterskor efterfrågar utbildning för att kunna tillgodose kvinnor med detta. Slutsats Det finns livsstilsfaktorer som har en direkt påverkan på kvinnans fertilitet och som kvinnor själva kan påverka så länge de har kunskapen. Att sjuksköterskor utbildar kvinnor gällande livsstilsfaktorer och fertilitetsförståelse skulle vara värdefullt för kvinnor för resten av livet, inte enbart för att gynna fertilitet men även för varje kvinnas allmänna hälsa eftersom ägglossning inte enbart är ett tecken på fertilitet utan även kan ses som ett hälsotecken. / Background Fertility is described as the biological nature of a woman and is often defined as the ability to conceive. Fertility means more than the ability to get pregnant, it can also be seen as a sign of health and that the body is in balance. Nowadays many women suffer from infertility. There are several factors that can affect a woman's fertility where some of them are lifestyle factors that the woman may be able to affect if she gets the right information. Aim The aim of this study was to describe how lifestyle factors can improve a woman's fertility with help from information provided by a nurse.  Method A non-systematic literature review was conducted based on 15 scientific articles where the majority were of quantitative study design. The database searches were performed inCINAHL and PubMed, using relevant keywords for the aim of the study. The quality of the selected articles were reviewed and the content was analyzed to be grouped into three main categories: lifestyle habits, diet and the nurse's health promotion work. Results The main categories were divided into subcategories. Lifestyle factors into; weight and exercise, stress and sleep, micronutrients, iodine, Omega-3, vitamin D, caffeine and the nurse's health promotion work into; needs and education. All lifestyle factors were shown to affect fertility. A need regarding education and information about this was shown to be important for women and it appears that nurses already request an education about fertility and lifestyle factors to provide women with this knowledge.  Conclusions There are lifestyle factors that have a direct impact on a woman's fertility and that women themselves can influence as long as they have the knowledge. If nurses were able to educate women regarding these lifestyle factors and fertility awareness it would benefit women for the rest of their lives - not only to prevent infertility but also for each woman's general health since ovulation is both a sign of fertility and a sign of health.

Around 10% of women in fertile age have endometriosis, despite this there is little known about its origin. It can take years from the first experienced symptoms to an established diagnosis, which is done using invasive methods. A database from the Lucy application containing 11720 questionnaires with up to 41 questions each was examined for signs of associations between lifestyle factors and health indicators with endometriosis. The database was restructured and unusable questionnaires were pruned, leaving 5719 questionnaires for analysis. Questionnaires were assigned a label depending on whether the respondent had an endometriosis diagnosis, some other diagnosis or no diagnosis. Histograms were created for 36 questions to visualize answer distributions among the labels while wordclouds were created for 3 questions to determine commonly used words. Pearson’s chi-square test was performed on 24 questions to determine whether there were statistically significant differences in how respondents answered with regards to their diagnosis. Then, 26 questions were divided between seven question groups based on their similarities. The relative prevalence of endometriosis for every answer alternative was determined and compared withthe average for that group. This was then followed up by a multi-correspondence analysis for every question group. It was found that there are associations between endometriosis and 12 health indicators. These being: affected by infertility, always being tired, regarding own health as bad, having more than 100 birthmarks, severe chronic pelvic pain, dysmenorrhea, regularly whole-body pain, muscle stiffness, neck and shoulder tension, forgetfulness, concentration difficulties, regularly experiencing that stress worsens physical symptoms. No statistically significant association between lifestyle factors and endometriosis could be found in the survey database. There were findings of socioeconomic differences between respondents with endometriosis and those without a diagnosis which may have affected the result. / Runt 10% av kvinnor i fertil ålder har endometrios, trots detta är lite känt om dess ursprung. Det kan gå flera år från första upplevda symptom till en etablerad diagnos, som kräver invasiva metoder. En databas från Lucy applikationen med 11 720 enkäter upp till 41 frågor vardera undersöktes efter tecken på kopplingar mellan livsstilsfaktorer och hälsoindikatorer med endometrios. Som ett första steg omstrukturerades databasen och oanvändbara enkäter sållades bort, vilket lämnar 5719 enkäter för analys. Enkäterna blev tilldelad en etikett baserad på huruvida respondenten hade en endometriosdiagnos, någon annan diagnos eller ingen diagnos. Histogram skapades för 36 frågor för att visualisera svarsfördelningen mellan etiketter medan ordmoln skapades för 3 frågor för att bestämma vanligt förekommande ord. Pearsons chi-kvadrattest utfördes på 24 frågor för att bestämma huruvida det fanns signifikanta statistiska skillnader i hur respondenter svarade med avseende på deras diagnos. 26 frågor blev uppdelade i 7 olika grupper baserade på deras liknelser och den relativa utbredningen av endometrios bestämdes för varje grupp och jämfördes med snittet i varje grupp. Slutligen följdes detta upp med multikorrespondensanalys för varje grupp av frågor. Det hittades associationer mellan endometrios och 12 hälsofaktorer. Dessa var: infertilitet, alltid vara trött, betrakta sin egna hälsa som dålig, ha fler än 100 födelsemärken, uppleva allvarlig kronisk bäckensmärta, dysmenorré, regelbunden helkroppssmärta, muskelstelhet, spändhet i nacke och axlar, glömskhet, koncentrationssvårigheter, regelbundet uppleva att stress förvärrar fysiska symptom. Ingen statistisk signifikant association kunde hittas mellan livsstilsfaktorer och endometrios från undersökningsdatabasen. Det hittades socioekonomiska skillnader mellan respondenter med endometrios och de utan diagnos vilket kan ha påverkat resultatet. / FEMaLe

Age, male sex, hypertension, smoking, diabetes, dyslipidaemia, and obesity are considered as established risk factors for cardiovascular diseases. Several of these established cardiovascular risk factors are strongly influenced by lifestyle. Novel biomarkers from different mechanistic pathways have been associated with cardiovascular risk, but their clinical utility is still uncertain. The overall objective of the thesis was to evaluate the associations between certain lifestyle factors (physical activity and snuff use), biomarkers reflecting the haemostatic and the inflammatory systems and risk of a future first-ever myocardial infarction.  A prospective incident nested case-control study design was used with a total of 651 cases of myocardial infarction and 2238 matched controls from the population-based Northern Sweden Health and Disease Study.  The effects of commuting activity, occupational and leisure time physical activity on risk of myocardial infarction were studied. A clearly increased risk of myocardial infarction was found for car commuting compared to active commuting (walking, cycling or going by bus). High versus low leisure time physical activity was associated with decreased risk of myocardial infarction. Low occupational physical activity was associated with risk of myocardial infarction in men.  The risk of myocardial infarction or sudden cardiac death was studied in male snuff users compared to non-tobacco users. No increased risk was found for myocardial infarction or sudden cardiac death among snuff users without a previous history of smoking. However, for sudden cardiac death the study did not have statistical power to detect small differences in risk.  Plasma levels of haemostatic markers have previously shown to be associated with risk of myocardial infarction, but as haemostatic markers are also acute-phase reactants, it is not clear if their association with myocardial infarction is independent of inflammatory markers. In the present study, the haemostatic markers D-dimer, von Willebrand factor (VWF), tissue plasminogen activator (t-PA), and tissue plasminogen activator/plasminogen activator inhibitor-1 complex (t-PA/PAI-1 complex) were associated with risk of myocardial infarction after adjustment for established risk factors and the inflammatory markers C-reactive protein (CRP) and interleukin 6 (IL-6). Furthermore, the addition of eight haemostatic and inflammatory markers could improve the predictive ability for future myocardial infarction beyond that of a model utilizing only established risk factors.  Established risk factors and novel biomarkers were explored as potential mediators of the reduced risk of myocardial infarction related to active commuting. A combination of established risk factors, haemostatic and inflammatory markers appeared to explain a substantial proportion (40%) of the difference in risk for myocardial infarction between active commuters and car commuters. IL-6, t-PA, t-PA/PAI-1 complex, apo B/apo A-1 ratio, and BMI seemed to be the largest potential mediators when tested individually. In conclusion, regular physical activity such as active commuting is associated with reduced risk of a first-ever myocardial infarction. This effect could in part be mediated through a beneficial influence on haemostasis and inflammation, as well as a positive impact on established risk factors. Several haemostatic markers are associated with risk of myocardial infarction independent of established risk factors and inflammatory markers. The combination of haemostatic and inflammatory markers may enhance predictive ability beyond established risk factors. Our findings do not support the hypothesis that snuff use increases the risk of myocardial infarction.