published_or_final_version / abstract / toc / Nursing Studies / Master / Master of Philosophy

The aim of this research was to study the correlation between tissue tumor marker expression and HR-HPV infection, smoking, hormonal contraceptive use and sex steroids in women with cervical intraepithelial neoplasia or normal epithelium. The study investigated the expression of 11 tumor markers in cervical biopsies obtained from 228 women with different diagnoses ranging from normal cervical epithelium to various stages of CIN. 188 women were recruited at our colposcopy clinic (out-patient surgery, Department of Obstetrics and Gynecology, Falun Hospital) for laser cervical conization or a directed punch biopsy, either because of a vaginal smear (Pap smear) that showed cytological findings suggesting CIN, or because of repeated findings showing atypical squamous cells of undetermined significance (ASCUS). For 40 volunteers, punch biopsies were taken from the normal cervical epithelium. The time period for this study was 2005-2007. Study I :  228 women, of whom 116 were tested, 64 were positive to HR-HPV. The results showed that Ki67 tumor cell proliferation index was the only marker that independently correlated to both the presence of HR-HPV and the severity of cervical lesions. Study II:  228 women, of whom 83 were smokers (36, 9%). Smokers showed lower expression of p53, FHIT (tumor suppressor markers) and interleukin-10 .Higher expression of Cox-2 and Ki-67 (tumor proliferation markers). Study III:  195 women who were premenopausal. There was increased p53 expression (tumor suppressor) in the progestin-IUD users compared to non-users. Decreased IL-10 expression (immunological marker) was observed in both COC users and any progestin-only users. Study IV: Serum from 80 premenopausal women was available. The main finding was that the increased levels of serum progesterone and estradiol were associated with increased Cox-2 expression (proliferation marker). Serum progesterone and estradiol levels influence cellular and extracellular proteins which have been associated with neoplastic development in normal epithelium and CIN. Conclusion: The results of these studies support previous epidemiological findings on the role of smoking, contraceptive use and sex steroids as co-factors in development of CIN and that tumor marker expression varies in different grades of CIN.

The purpose of this study was to investigate the relationship between cigarette smoking and socio-demographic variables based on the empirical literature and the primitive theories in the field. Two regression approaches, logistic regression and linear multiple regression, were conducted on the two most recent Arizona Adult Tobacco Surveys to test the hypothesized models. The results showed that cigarette smokers in Arizona are mainly residents who have not completed a four-year college degree, who are unemployed, White, non-Hispanic, or young to middle-aged adults. Among the socio-demographic predictors of interest, education is the most important variable in identifying cigarette smokers, even though the predictive power of these socio-demographic variables is small. Practical and methodological implications of these findings are discussed.

Bakgrund: Policybeslutet att införa Rökfri arbetstid i Motala kommun är ett led i kommunernas och de fackliga organisationernas strävan att skapa en hälsofrämjande miljö. Rökfri arbetstid innebär att ingen ska utsättas för tobaksrök på sitt arbete. I Motala kommun trädde detta beslut i kraft 2007-07-01 och mottogs med olika åsikter bland de kommunanställda. Tidigare forskning har visat samband med engagemang och delaktighet i beslut med empowerment hos de anställda. Syfte: Studiens syfte är att undersöka anställdas reaktioner till Rökfri arbetstid i Motala kommun. Metod: En kvantitativ undersökning i form av fler alternativa och öppna frågor i en enkät som delades ut bland rökande personal på olika enheter i Motala kommun. Även Motala kommuns intranät Kanalen användes, där information om enkäten lades ut och de som ville kunde ta del av den. Resultat: Rökfri arbetstid ger resultat i positiv bemärkelse, de anställda som rökte röker i dag 30 % mindre på arbetstid samt 16 % har slutat. För de som var positivt inställda av deltagarna när beslutet togs visar även en minskning i sitt rökande på fritiden. Då beslutet togs 2007-07-01 var 54 % negativa till detta, i dag är siffran på 32,5 %. Resultatet visar också en stor irritation över att; deltagarna inte fått varit med och tyckt till om Rökfri arbetstid, informationen till de anställda har inte varit bra, cheferna ger inga direktiv och verkar inte veta vilka regler som gäller. I dag följs reglerna olika på olika arbetsplatser. Fortfarande finns det många av studiens deltagare som röker på arbetstid även om de har minskat sin konsumtion. Deltagarna själva vill ha klara regler för vad som gäller när någon trotsar rökförbudet. Diskussion: Mer information, mer empowerment till de anställda i Motala kommun hade gett mer positiva resultat än vi ser idag Låt de rökande få vara med och diskutera fram hur regler ska följas på arbetsplatserna samt vilket stöd de förväntar sig få från kommunen. De anställda måste också ta på sig ansvaret att leta efter information. / Background : The policy decision to introduce non smoking environment in the city of Motala is a part of the city and the unions’ efforts to create a healthy environment. Smoke-free working hours means that no one shall be subjected to tobacco smoke at work. The city of Motala took this decision in full force 2007-07-01 and it was received with different opinions from the city’s employees. Previous research has shown the commitment and involvement is greater if the employee feels empowerment at their work place. Purpose: The purpose of this study is to investigate the employee´s reaction to the decision to introduce non smoking environment in Motala. Method: A quantitative method was used. Questionnaire which included even open-ended questions was distributed among smoking employees in different work areas in the city of Motala. The questionnaire was also laid out on "kanalen" which is a communication platform within the city of Motala. Here could any employee take part of the survey. Results: Smoke free working environment delivers results in a positive way, people smoke 30% less at work and 16% have stopped smoking completely during working hours. For those who were in favor of the decision when it was taken can also show a reduction in their smoking in their free time. When the decision was made 2007-07-01 was 54% negative to this, today the figure is 32.5%. The results also show that irritation over this decision was; the employees had not been involved when it comes to decision around this subject, information has been lousy, directors did not provide any directive for the smokers and does not seem to know clearly what the rules are. Today the rules are followed differently in different workplaces. Still, there are many participants who smoke during working hours although they may have reduced their consumption. Participants themselves would like to have clear rules on what it is that applies. Discussion: More information, more empowerment to the employees in the city of Motala had gotten more positive results than we see today. Where does the information stops? Is it between local government leaders to the directors at different workplaces or is it the director that does not provide the information to the employees. Let the smokers be involved and discuss how the rules should be followed at the workplace and what support they may expect from the city. Employees must also take responsibility to look for information.

The aim of this study was to examine the spread of the dependence on alcohol, smoking and internet and to estimate their connection with psychosocial state among the population of the students of vocational schools. Materials and methods. 395 students between 17-22 years old from Kaunas vocational schools took part in the survey the data of which has been analysed in this study. The habits related to alcohol, smoking and internet were assessed anonymously using the method of frequentative testing and Fagerstrom and AUDIT questionnaire developed for the research of these dependencies. The averages of the sample indications and standard errors of calculations were estimated whilst analysing the data. The criterion of the student (t) was used to compare the average variables of the independent samples. Independency of indications was checked with the help of chi square (x) criterion. Associations are considered to be statistically significant if p < 0,05. Results. After the habits of alcohol consumption had been estimated , it was defined that 89 % of male and 92.1 % of female respondents had tried alcohol and the bigger part of them (40.5%) had used alcohol 1-2 times a month. The most popular drink among girls is champagne ( 33.3 % ) and among boys – wine (50%). The examination of the smoking habits have shown that 79.7 % of girls and 83.8 % of boys have tried to smoke. 15.4% of girls and 33.5 % of boys have smoked 20-29 days during the last month. After examining the habits... [to full text]

Tobacco use is a major preventable cause of morbidity and mortality worldwide. Most smokers initiate smoking in childhood, become addicted, and continue the habit into adulthood. Various factors have been shown to impact smoking behavior. It is important to determine how these factors impact smoking behavior in developing regions of the world, such as in South Africa. This study examines the association between parental smoking status; peer smoking status; exposure to pro-tobacco marketing; and current smoking status among adolescents in South Africa. It also determines which factor is the most significant predictor of current smoking status among the study population and further examines the trends in these factors among survey populations from 1999 – 2008. Secondary analysis was conducted on data obtained from the Global Youth Tobacco Survey. Logistic regression analyses were conducted to determine the association between the independent variables; parental smoking status, peer smoking status, and exposure to pro-tobacco marketing; and the dependent variable, current smoking status, controlling for other factors. Adolescents who had at least a parent or a friend who smoked had greater odds of being current smokers as compared to those who had neither a parent nor a friend who smoked. Similarly, exposure to average and high levels of pro-tobacco marketing was associated with greater odds of an adolescent being a current smoker as compared to exposure to low levels of pro-tobacco marketing. Maternal smoking appeared to have a greater impact on adolescent smoking behavior as compared to paternal smoking. Also, peer smoking had the greatest impact on smoking behavior as compared to the other independent factors. Smoking rates among South African adolescents has decreased from 23% in 1999 to about 17% in 2008. Similarly, the proportion of adolescents who had a parent or a friend who smoked, or had been exposed to average and high levels of pro-tobacco marketing has also decreased over the same period. Programs must be implemented to educate parents on how their smoking behavior is being transmitted to their children, with a special focus on maternal influences. Tobacco use prevention campaigns aimed at the youth should also be implemented, and laws restricting tobacco marketing must be enforced.

Visame pasaulyje susirūpinimą kelia vis prastėjanti jaunų žmonių sveikata. Šiandien studentų kūno kultūra ir sportas patiria krizę. Aukštosiose mokyklose gerokai sumažinus privalomų kūno kultūros pratybų, sumažėjo daugumos studentų fizinis aktyvumas. Tik pradėjus studijuoti, jau pirmaisiais studijų metais studentai praranda galimybę išsiugdyti reguliarių fizinių pratimų poreikį, kurį turėjo iki studijų. Visa tai sąlygoja studentų prastą mitybą, mažą fizinį aktyvumą, nemigą, nuovargį ir kt. (Genevičius, 1991). Hipotezė: Lietuvos sporto universiteto (toliau – LSU) studentų, studijuojančių su sveikatinimu susijusiose studijų programose, studijų metu didėja fizinis aktyvumas ir formuojasi nesveikos mitybos įpročiai. Darbo objektas: LSU studentų, studijuojančių su sveikatinimu susijusiose studijų programose, gyvensenos pokyčiai studijų metu. Darbo tikslas: Išsiaiškinti studentų, studijuojančių su sveikatinimu susijusiose studijų programose, gyvensenos pokyčius studijų metu. Darbo uždaviniai: 1. Įvertinti LSU pirmo ketvirto kurso studentų, studijuojančių su sveikatinimu susijusiose studijų programose, fizinį aktyvumą lyties aspektu. 2. Įvertinti LSU pirmo ketvirto kurso studentų, studijuojančių su sveikatinimu susijusiose studijų programose, mitybą ir mitybos įpročius lyties aspektu. 3. Įvertinti LSU pirmo ketvirto kurso studentų, studijuojančių su sveikatinimu susijusiose studijų programose, žalingų įpročių paplitimą lyties aspektu. 4. Įvertinti studentų gyvensenos pokyčių... [toliau žr. visą tekstą] / The actual concern in the worldwide is the continued deterioration of the young people’s health. It could be said that today students’ physical education and sport is in crisis at certain aspects. In the higher education institutions there were significantly reduced the physical education subjects and as a matter of fact the physical activity of the majority of the students were decreased. Starting their studies students at the very first year of the study are deprived of the opportunity to develop a regular exercises. Students’ nutrition becomes not well balanced also. It all leads to the poor diet, low physical activity, insomnia, fatigue and other (Genevičius, 1991). Hypothesis: Lithuanian Sports University (LSU) students, studying the health relating study programs, are facing increase physical activity and having unhealthy eating habits. The object of the research: The lifestyle changes during the studies of the LSU students, studying the health relating study programs. The aim of the research: To find out the lifestyle changes during the studies of the LSU students of the health relating study programs. The tasks of the research: 1. To evaluate LSU’s first-fourth year students’, studying the health relating study programs, physical activity by gender. 2. To evaluate LSU’s first-fourth year students’, studying the health relating study programs, diet and nutritional habits by gender. 3. To evaluate LSU’s first-fourth year students’ studying the health relating study... [to full text]

Astma-lėtinė kvėpavimo takų liga, pasireiškianti dusulio ar kosulio epizodais bei padidėjusiu bronchų reaktyvumu. Eksperimentiniai bei klinikiniai tyrimai parodė, kad lėtinis neinfekcinis kvėpavimo takų uždegimas- svarbiausia astmos patogenezės grandis, lemianti šios ligos klinikinę eigą, sunkumą bei skiriamo gydymo efektyvumą. Nėra aišku, ar alerginė bei nealerginė astma skiriasi ne tik klinikiniu pasireiškimu, bet ir patomorfologiniais bei patofiziologiniai kvėpavimo takų pakitimais. Rūkymas- svarbus veiksnys, sukeliantis reikšmingus pokyčius kvėpavimo takų gleivinėje. Tačiau kaip rūkymas įtakoja lėtinį neinfekcinį kvėpavimo takų uždegimą ir ar skiriasi rūkymo poveikis sergant fenotipiškai skirtingomis astmos formomis- nėra žinoma. Todėl šio tyrimo tikslas- nustatyti rūkymo sąlygotus imuninio atsako ypatumus sergant alergine ir nealergine astma. Ištirti alergine ir nealergine astma sergantys pacientai, kurie pagal rūkymo įpročius suskirstyti į grupes: rūkorius ir nerūkančiuosius. Įvertinti rūkymo sąlygoti skreplių, bronchoalveolinio lavažo skysčio ląstelių sudėties skirtumai, eotaksinų, IL-5 bei IL-9 koncentracijų ypatumai, jų ryšys su svarbiausiais klinikiniais pacientų duomenimis. Nustatyta, kad alerginė ir nealerginė astma skiriasi patofiziologinėmis savybėmis, o rūkymas sukelia nevienodus imuninių lėtinio kvėpavimo takų uždegimo žymenų pakitimus pacientams, sergantiems skirtingomis astmos formomis. / Asthma is a chronic disorder of the airways, which is characterized by the presence of chronic airway inflammation. Experimental and clinical studies have showed that chronic airway inflammation is the most important part of asthma pathogenesis, which determines the clinical picture and severity of this disease. The data about differences and similarities of allergic and non-allergic asthma are questionable. It was considered that smoking might cause significant changes of bronchial mucosa. It is unclear whether smoking impairs immune response in patients with allergic and non-allergic asthma similarly. The aim of this study was to evaluate tobacco smoke-induced features of immune response in patients with allergic and non-allergic asthma. Subjects, with allergic and non-allergic asthma were investigated. According to their smoking habits, patients were divided into the groups: smokers and non-smokers. Tobacco smoke-induced changes of sputum and BAL fluid cellular composition were evaluated and features of inflammatory mediators (eotaxins, IL-5 and IL-9) were investigated. This study showed pathomorphological and pathophysiological differences between allergic and non-allergic asthma. Smoking impairs lung function and changes the pattern of chronic airway inflammation by decreasing production of cytokines and increasing production of chemokines.

Aleksitimiški žmonės pasižymi silpnu gebėjimu kognityviai apdoroti ir reguliuoti emocijas, dėl to jiems yra sunku emocijas ir jausmus atskirti nuo kūno pojūčių, sunku jomis bendrauti, tokie žmonės pasižymi į išorę orientuotu mąstymu ir silpna vidine introspekcija. Šio tyrimo tikslas - nustatyti vyresnių klasių moksleivių aleksitimiškumo sąsajas su tabako rūkymu, alkoholinių gėrimų vartojimu ir požiūriu į juos bei šias medžiagas vartojančius asmenis. Tyrime dalyvavo 236 dviejų Jurbarko mokyklų vyresnių klasių moksleiviai (16-19 metų amžiaus) iš kurių rūkė 138 (42,30 %) moksleiviai, alkoholinius gėrimus vartojo 196 (60,1 %) moksleiviai. Tyrimo metu moksleiviai pildė savižinos klausimyną, sudarytą iš TAS-20 skalės, skirtos aleksitimiškumui matuoti, klausimų apie tabako rūkymo ir alkoholio vartojimo ypatybes ir skalių, skirtų požiūriui į tabako rūkymą, alkoholio vartojimą ir šias medžiagas vartojančius asmenis nustatyti. Tyrimo rezultatai parodė, kad rūkymas su aleksitimiškumu nesisieja, tačiau dažnesnis ir didesnio kiekio alkoholinių gėrimų vartojimas statistiškai reikšmingai siejasi su labiau išreikštu aleksitimiškumu berniukų tarpe. Taip pat nustatyta, kad anksčiau alkoholinius gėrimus pradedantys vartoti moksleiviai (berniukai iki 13 metų, mergaitės iki 14 metų) pasižymi labiau išreikštu alekstimiškumu ir prastesniu gebėjimu atpažinti emocijas ir jausmus. Aleksitimiškumas su požiūriu nesisiejo. / Alexithimics are described as having poor cognitive emotion processing and regulation. For that reason, alexithimics have difficulty identifying feelings and distinguishing between feelings and the bodily sensations of emotional arousal, difficulty in communicating emotions, and have external oriented thinking style and weak introspection. The aim of the study was to assess alexithymia associations with tobacco smoking, alcohol consumption and attitudes towards them and towards persons who consume these substances. The subjects of the study were 236 upperclassmen (age 16-19) from two schools in Jurbarkas. 138 (42,30 %) subjects smoked tobacco and 196 (60,1 %) consumed alcohol. Participants filled in a questionnaire composed of TAS-20 scale, questions about tobacco smoking, an evaluation of alcohol consumption, and an attitude scale towards tobacco and alcohol consumption and people who use these materials. The results of the study showed that there is no association between alexithymia and tobacco smoking. However, alcohol consumption has significant associations between alexithymia and frequent and larger quantities of alcohol consumption in the boy's sample. Also found was a significant association between alexithymia and early alcohol drinkers (for boys by 13 years old and for girls by 13 years old). These early alcohol drinkers also showed difficulty identifying feelings. This study showed no associations between alexithymia and the attitudes toward tobacco smoking... [to full text]

Darbo tikslas. Ištirti Lietuvos aukštųjų mokyklų pagrindinių studijų 2 kurso studentų nuomonę apie jų pačių, savo universiteto/aukštosios mokyklos bendruomenės ir visos šalies gyventojų sveikatos ir gyvensenos problemas bei įvertinti studentų pasiūlymus, kaip šias problemas išspręsti. Tyrimo metodika. Buvo tiriami Lietuvos universitetų antro kurso studentai – iš viso 1412 studentai (atsako dažnis 88,3 proc.). Pagrindinis tyrimo metodas – anoniminė anketinė apklausa. Jai panaudota originali anketa, susidedanti iš šių dalių: 1) Ką darote, kad būtumėte sveikas (-a); 2) Svarbiausios sveikatos problemos; 3) Ką reiktų daryti, kad Lietuvos gyventojai taptų sveikesni. Statistinė duomenų analizė atlikta taikant programų paketą SPPS 15.0. Rezultatai. Tyrimo rezultatai parodė, kad, studentų nuomone, tiek universitetuose, tiek ir visoje Lietuvoje svarbiausios sveikatos problemos yra rūkymas ir alkoholio vartojimas. Studentų gyvensena yra nesveika: nepakankamas fizinis aktyvumas, paplitę žalingi įpročiai (rūkymas, alkoholio vartojimas), nesveika mityba. Studentų nuomone, įvairios sveikatinimo priemonės yra vykdomos žymiai mažiau bei prasčiau negu turėtų būti. Deja, šiose priemonėse patys studentai nepakankamai dalyvauja. Jie supranta, kad tai svarbu daryti, bet prisipažįsta, kad daro mažiau negu reikia. Išvados. Studentai sugeba įžvelgti aktualias savo ir šalies visuomenės sveikatos ir gyvensenos problemas, tačiau jiems reikalinga visokeriopa pagalba (sveikatos ugdymas, gerbūvio ir... [toliau žr. visą tekstą] / Aim of the study. To investigate Lithuanian bachelor level second year students’ attitude towards their lifestyle, university and public health problems in Lithuania and to consider students’ suggestions as possible solutions to these problems. Medhods. Lithuanian universities were analyzed second-year students – in total 1412 students (response rate 88.3 percent). The main method of the research was anonymous questionnaires. For this purpose the original questionnaire was used that consisted of the following parts: 1) What are you doing to be healthy; 2) Principal health problems; 3) What should be done to make Lithuanian residents healthier. The statistical package SPPS version 15.0 for Windows was used to conduct data analysis. Results. The results of the survey showed that smoking and alcohol consumption are the most important problems both in Lithuanian universities and in the whole country. The lifestyle of the students is not healthy: insufficient physical activity, popular bad habits (smoking, alcohol consumption), or unhealthy nutrition. The students consider that various healthiness tools are used less and worse than it is needed. However, the students themselves are not participating enough. They understand that it is important to do so, but they acknowledge that they do less than needed. Conclusions. The students are able to see the topical their and national public health and lifestyle problems, but they need all the possible help (health education, securing of... [to full text]