Abstract The prevalence of overweight and obesity among adolescents has increased worldwide at the population-level, reflecting inactive lifestyle and excessive energy intake. The comorbidities of obesity, e.g. impaired glucose tolerance and high blood pressure increase the risk for cardiovascular diseases. The first manifestation of cardiovascular diseases can be detected in young adulthood, and prevention should be focused to those at highest risk. This study was aimed to evaluate the changes in body weight and body composition, physical fitness and cardiometabolic risk factors, associated with physical exercise during military service. Furthermore, this study investigated the association of antenatal and lifestyle factors with the body composition and physical fitness among young men. The material of this study consisted of 1046 men (mean age 19.2 years) who began their compulsory military service in the Sodankylä Jaeger Brigade in 2005. The conscripts’ cardiometabolic risk factors, body weight, body composition, fitness, and lifestyle habits were evaluated at baseline and after 6–12 months military service. The data on the participants’ mothers’ antenatal and participants’ childhood period was available for 508 offsprings, who belonged to the 1986 Northern Finland Birth Cohort. During the military service the prevalence of metabolic syndrome decreased in the overall cohort from 6.1% to 3.6%, and the reduction was present among overweight and obese conscripts. The reduction in metabolic syndrome was associated with the reduction in waist circumference, weight loss and improvement in muscle fitness. Some lifestyle factors e.g. maternal smoking during pregnancy and conscripts’ smoking, alcohol consumption and binge drinking were associated with the conscripts’ body composition and fitness test results. Military service was especially beneficial for those reporting weekly binge drinking, who showed the greatest reduction in body weight and fat, and improvements in physical fitness and lifestyle habits. This study shows that unbeneficial lifestyle habits can be seen as detrimental to the body composition and fitness levels of young men. Furthermore, the physical exercise is in important role for reducing the metabolic syndrome, already present in young men. Maternal smoking during pregnancy was associated with reduced aerobic fitness in the subjects, underlining its long-standing consequences on offspring’s health. / Tiivistelmä Väestötutkimusten perusteella nuorten ylipaino ja lihavuus ovat yleistyneet, liittyen inaktiiviseen elämäntapaan ja liialliseen energiansaantiin. Lihavuuden liitännäissairaudet, kuten heikentynyt sokerinsieto ja kohonnut verenpaine lisäävät riskiä sydän- ja verisuonisairauksille. Sydän- ja verisuonisairauksien ensimmäiset ilmentymät voidaan havaita nuorella aikuisiällä ja sairauden ehkäisystrategiat tulisi kohdentaa riskiryhmiin. Tässä tutkimuksessa arvioitiin varusmiespalvelukseen liittyvän liikunnan aikaansaamia muutoksia kehonpainossa, kehonkoostumuksessa, fyysisessä kunnossa sekä sydän- ja verisuonisairauksien riskitekijöissä. Lisäksi tutkimus arvioi äidin raskausaikaan liittyvien tekijöiden ja elintapojen yhteyttä nuorten miesten kehonkoostumukseen ja fyysiseen kuntoon. Tutkimusaineisto koostui 1046 miehestä (keski-ikä 19.2 vuotta), jotka astuivat varusmiespalvelukseen Sodankylän Jääkäriprikaatissa vuonna 2005. Varusmiesten sydän- ja verisuonisairauksien riskitekijät, kehonpaino, kehonkoostumus, kunto ja elintavat arvioitiin palveluksen alussa ja lopussa (seuranta-aika 6–12 kk). Varusmiesten äitien raskaudenaikaiset ja varusmiesten varhaislapsuuden tiedot olivat käytettävissä 508:lta tutkittavalta, jotka kuuluivat Pohjois-Suomen syntymäkohorttiin 1986. Varusmiespalveluksen aikana metabolisen oireyhtymän vallitsevuus väheni koko aineistossa 6.1 %:sta 3.6 %:iin, ja väheneminen oli havaittavissa ylipainoisten ja lihavien joukossa. Metabolisen oireyhtymän väheneminen oli yhteydessä vyötärönympäryksen ja painon laskuun sekä lihaskunnon paranemiseen. Elintavat, kuten äidin raskaudenaikainen tupakointi ja varusmiehen ruokavalio, tupakointi, alkoholin kulutus ja humalahakuinen juominen olivat yhteydessä varusmiehen kehonkoostumukseen ja fyysiseen kuntoon. Varusmiespalveluksesta hyötyivät erityisesti ne, jotka raportoivat viikoittaista humalahakuista juomista; heillä havaittiin myönteisiä muutoksia kehonkoostumuksessa, fyysisessä kunnossa ja elintavoissa. Tämän tutkimuksen perusteella voidaan myös todeta, että äidin raskaudenaikainen tupakointi vaikuttaa jälkeläisen heikompaan aerobiseen kuntoon. Tutkimus osoittaa epäterveellisten elämäntapojen vaikutukset epäedulliseen kehonkoostumukseen ja heikompaan fyysiseen kuntoon nuorilla miehillä. Lisäksi liikunnan merkitys nuorten miesten sydän- ja verisuonisairauksien riskitekjöiden hoidossa on oleellista.

This diploma thesis deals with ethnic differences in the incidence of colorectal cancer. One of the primary aims is to analyze the influence of selected socio-demographic factors, health factors and lifestyle factors on the incidence of colorectal cancer. Another main aim is to find out if there are ethnic differences in the incidence of colorectal cancer in the United States to determine the contribution of the influence of selected socio-demographic and lifestyle factors using the data from the PLCO database. PLCO is a case-control study which includes individual data collected from approximately 155,000 respondents in the United States. The main finding is a significant influence of respondents' age structure, gender, ethnicity, education, family history of colorectal cancer as well as diabetes on the incidence of colorectal cancer. It has also been suggested that alcohol consumption, smoking and obesity increase the risk of colorectal cancer. On the contrary, an increased intake of vitamin D and drugs containing acetylsalicylic acid (in this case aspirin) reduces the risk of colorectal cancer. The influence of age structure and gender on the risk of developing colorectal cancer has been determined as statistically significant in African Americans, Caucasians and others (including the remaining...

This diploma thesis deals with the topic of health literacy level in the Czech population and its association with sociodemographic and lifestyle factors. The aim was to describe this association in the stages of health information processing, which are the stages of finding, understanding, judging and application of health information. The data from the Czech modification of the HLS-EU survey from 2014 was used. Lower level of health literacy was associated with older age, lower level of education, as well as lower self-assessed social status at all stages of health information processing. Lower self- assessed health condition was also associated with lower level of health literacy, especially in the phases of understanding and application of health information. Regarding the lifestyle factors, the association was determined in case of physical activity, most notably in the phases of understanding and application of health information. The association was also determined in the case of body mass index, but only in phases understanding and judging. Differences in health literacy levels between smoking categories as well as between gender were not been determined. Regarding the difference between phases of health information processing, the judging of health information seems to be the most risk.

Obesity is a serious metabolic disease that often occurs in childhood. Up to 55 % of obese children continue to be obese until adolescence and then 80 % of these obese adolescents remain obese in adulthood. This diploma thesis follows the results of the first round of the study Childhood Obesity Prevalence and Treatment (COPAT). Analyzes the data found in 2009-2010 in relation with the results from 2018. The aim of this work was to determine the prevalence of overweight, obesity, metabolic syndrome, hidden (normal-weight) obesity and to examine the factors potentially contributing to the development of excessive body weight in the participants in the second round of COPAT study. After eight years, 12 % of the original sample, ie 246 probands (150 women and 96 men), were repeatedly examined within the diploma thesis. The examinations took place at the Institute of Endocrinology in Prague and consisted of fasting blood, clinical examination (blood pressure and pulse measurement; determination of body composition by bioimpedance analysis) and anthropometric examination. All participants also completed an on-line questionnaire consisting of three parts (personalized questionnaire; Eating inventory questionnaire; Baecke questionnaire of habitual physical activity). The obtained data were processed using...

Waste management is an integral part of sustainable urban development. In the modern world, when attitude to waste is being shifted towards “waste as resource” and “waste as income generator”, ensuring separation of hazardous waste from the general waste stream becomes increasingly important. Sorting hazardous waste is critical in light of the whole recycling idea. Hazardous elements, while bearing a certain value if properly handled, can negate the costs of the recyclable materials if found in their stream. They present enormous long-term losses, if introduced into the environment, and can negatively influence our ability to benefit from recycling. Convenience is one of the most effective tools in increasing recycling rates (Carlson 2001, p.1275). It is a personally defined concept, and often depends on the users’ lifestyle-related factors. This thesis explores users’ understanding and habits of handling hazardous waste, as well as the challenges they encounter and their views and suggestions on convenience of hazardous waste recycling systems. The main method used in this comparative case study research is qualitative interviews conducted with a variety of people with different lifestyles living in Malmo. First, the thesis develops a list of lifestyle-related factors which lower the perceived convenience of recycling. People consider recycling to be effort demanding or easy not just because they are women or men, young or old, live in a dense area or not. But this perception is influenced by having or not having access to a transporting vehicle and time available, their household’s waste producing rates, time spent living in a certain place, available space for storing waste; physical constraints or difficulties with self-organization at home; established or not recycling habits or level of environmental concern. People’s recycling behavior is determined by these personal lifestyle-related factors. Second, aspects of convenience are being presented as the focus areas which planners should consider in increasing recycling rates. The convenience aspects are developed with regards to the challenges people with different lifestyles experience in recycling. While lifestyle-related factors cannot be influenced directly, aspects of convenience can be employed in ensuring efficiency of hazardous waste collection system. It is important that the hazardous waste collection system design takes them into the full account. Detailed descriptions of the aspects of perceived convenience are presented. They are grouped into convenience of access to information and convenience through facilities and services. The final conclusion of the thesis is that involving users would assist in addressing key aspects of recycling systems’ perceived convenience and increase their efficiency. It is hoped that the information can be helpful in designing successful hazardous waste collection systems with increased capability to reach national goals in recycling and reduce the amounts of hazardous substances in general waste. / Master Programme: Sustainable Urban Management, 2011-2012Thesis: On the Way to the Convenient Hazardous Waste Collection System in Malmo, Sweden. Users’ PerspectiveAuthor: Olga Belorusova (OB)Tutor: Peter ParkerDate of Submission: 24 May, 2012.

This study explores how socioeconomic status influences lifestyle choices and chronicdiseases in Sweden. It investigates prevalent chronic diseases across different socio economicgroups and assesses policy interventions to address disparities. Theoretical frameworks suchas chronic disease prevention, health lifestyle and fundamental causes theories inform theanalysis. The method of this study is used to gather and analyse sensory data for the study. Itdescribed the systematic search for relevant articles, inclusion and exclusion criteria, dataextraction and thematic analysis. Ethical considerations are also addressed and maintained.The results highlighted socioeconomic disparities in lifestyle and chronic disease burden inSweden and other countries. The results show varying impacts in health behaviours andoutcomes based on socioeconomic status, emphasising on the need for targeted interventionwhich address preventable health conditions. The discussion of the study provides a detailedinterpretation of the results by linking theories and methods used.

Souvent diagnostiqué à un stade avancé, le cancer du pancréas (CP) est un cancer particulièrement létal pour lequel il n’y a, à ce jour, que très peu de possibilités de traitement et de diagnostic anticipé. L’identification de facteurs de risque modifiables pourrait fournir des données épidémiologiques nécessaires au soutien de la mise en place de mesures préventives. Cette thèse a pour but d’étudier l’étiologie du CP en évaluant le rôle de la consommation d’alcool et du mode de vie dans l’étude prospective européenne sur le cancer et la nutrition (EPIC), cohorte multicentrique de plus de 500,000 sujets provenant de 10 pays européens. La consommation d’alcool a d’abord été évaluée en regard du risque de CP. Les rôles des différents types d’alcools ainsi que du tabagisme dans la relation entre l’alcool et le CP ont été examinés. Cette évaluation a montré qu’une consommation d’alcool élevée était associée à une augmentation du risque de CP. Ensuite, la relation entre le Healthy Lifestyle Index, un indicateur combinant le passé tabagique, la consommation d’alcool, l’alimentation, l’anthropométrie et l’activité physique, et le risque de CP a été étudiée. Pour quantifier l’impact de l’amélioration de ces facteurs, des fractions de CP attribuables ont été estimées en considérant des scénarios hypothétiques où les participants adopteraient des modes de vie plus sains. L’adhérence à des habitudes saines était fortement et inversement associée au risque de CP. Ces travaux ont apporté des connaissances informatives sur l’étiologie du CP, et soutiennent le développement de mesures de santé publique promouvant la prévention du CP par l’adoption de modes de vie sains / Commonly diagnosed at late stage, pancreatic cancer (PC) is a highly fatal cancer with limited opportunities for early detection and effective treatment. The identification of modifiable risk factors may offer relevant scientific evidence for PC prevention. This doctoral research program investigated PC etiology through a comprehensive examination of the role of alcohol consumption and other lifestyle determinants in the occurrence of PC within the European Prospective Investigation into Cancer and nutrition (EPIC) study, a multi-center cohort involving more than 500,000 participants from 10 European countries. Alcohol intake was evaluated with respect to the risk of PC. The role of different alcoholic beverages and potential effect modification by smoking habits on PC risk were also examined. Findings from this evaluation provided epidemiological evidence that large intakes of alcohol were associated with an increased risk of PC.The association between the healthy lifestyle index, a score combining information on smoking history, alcohol intake, diet, obesity, and physical activity and the risk of PC was examined. To quantify the impact of modifying several lifestyle factors, population attributable fractions were estimated assuming counterfactual scenarios whereby study participants hypothetically moved towards healthier behaviors. Adherence to healthy lifestyle habits was strongly inversely related to PC. This comprehensive evaluation provides informative insights on the etiology of PC and supports the development and implementation of public health guidelines to promote individuals’ adoption of healthy lifestyle habits for PC prevention

Background: It has been proved that bystander cardiopulmonary resuscitation (CPR) saves lives; however, which training method in CPR is most instructive and whether survival is affected by the training level of the bystander have not yet been fully described. Aim: To identify the factors that may affect 7th grade students’ acquisition of CPR skills during CPR training and their willingness to act, and to describe 30-day survival from outof- hospital cardiac arrest (OHCA) after bystander CPR and the actions performed by laymen versus off-duty medically educated personnel. Methods: Studies I–III investigate a CPR training intervention given to students in 7th grade during 2013–2014. The classes were randomized to the main intervention: the mobile phone application (app) or DVD-based training. Some of the classes were randomized to one or several additional interventions: a practical test with feedback, reflection, a web course, a visit from elite athletes and automated external defibrillator (AED) training. The students’ practical skills, willingness to act and knowledge of stroke symptoms, symptoms of acute myocardial infarction (AMI) and lifestyle factors were assessed directly after training and at 6 months using the Laerdal PC SkillReporting system (and entered into a modified version of the Cardiff test scoring sheet) and a questionnaire. The Cardiff test resulted in a total score of 12–48 points, and the questionnaire resulted in a total score of 0–7 points for stroke symptoms, 0–9 points for symptoms of AMI and 0– 6 points on lifestyle factors. Study IV is based on retrospective data from the national quality register, the Swedish registry of cardiopulmonary resuscitation, 2010-2014. Results: A total of 1339 students were included in the CPR training intervention. The DVD-based group was superior to the app-based group in CPR skills, with a total score of 35 (SD 4.o) vs 33 (SD 4.2) points directly after training (p<0.001) and 33 (SD 4.0) vs 31 (SD 4.2) points at six months (p<0.001). Of the additional interventions, the practical test with feedback had the greatest influence regarding practical skills: at six months the intervention group scored 32 (SD 3.9) points and the control group (CPR only) scored 30 (SD 4.0) points (p<0.001). Reflection, the web course, visits from elite athletes and AED training did not further increase the students’ acquisition of practical CPR skills. The students who completed the web course Help-Brain-Heart received a higher total score for theoretical knowledge in comparison with the control group, directly after training: stroke 3.8 (SD 1.8) vs 2.7 (SD 2.0) points (p<0.001); AMI 4.0 (SD 2.0) vs 2.5 (SD 2.0) points (p<0.001); lifestyle factors 5.4 (SD 1.2) vs 4.5 (SD 2.0) points p<0.001. Most of the students (77% at 6 months), regardless of the intervention applied, expressed that they would perform both chest compressions and ventilations in a cardiac arrest (CA) situation involving a relative. If a stranger had CA, a significantly lower proportion of students (32%; p<0.001) would perform both compressions and ventilations. In this case, however, many would perform compressions only. In most cases of bystander-witnessed OHCA, CPR was performed by laymen. Off-duty health care personnel bystanders initiated CPR within 1 minute vs 2 minutes for laymen (p<0.0001). Thirty-day survival was 14.7% among patients who received CPR from laymen and 17.2% (p=0.02) among patients who received bystander CPR from off-duty health care personnel. Conclusions: The DVD-based method was superior to the app-based method in terms of teaching practical CPR skills to 7th grade students. Of the additional interventions, a practical test with feedback was the most efficient intervention to increase learning outcome. The additional interventions, reflection, web course, visit from elite athletes and AED did not increase CPR skills further. However, the web course Help-Brain-Heart improved the students’ acquisition of theoretical knowledge regarding stroke, AMI and lifestyle factors. For OHCA, off-duty health care personnel bystanders initiated CPR earlier and 30-day survival was higher compared with laymen bystanders.