64 research outputs found
Identifying obstacles to participation in a questionnaire survey on widowers' grief
Background: The aim of this study was to determine if Icelandic widowers might foresee obstacles to responding to a
questionnaire on bereavement. Also, we sought to compare the proportion of men reporting obstacles in a telephone
interview to the actual response rate in the questionnaire survey.
Methods: The study was part of a nation-wide survey of widowers who lost their wives in 1999, 2000, and 2001. This
included all widowers born in Iceland 1924-1969 (aged 30-75 years) who were alive, and residing in Iceland at the time
of the study. A telephone poll was conducted prior to sending out a questionnaire to determine if the widowers would
be interested in responding, or if they could see obstacles, which could affect their willingness to respond to a
subsequent questionnaire survey. The telephone poll was repeated five years later with a random sample of the
original study base to determine if views initially expressed towards the questionnaire survey, had changed over time.
Results: Of the 357 eligible widowers, 11 had died prior to the first telephone interview, yielding a study population of
346 widowers. Of those, 296 (86%) were reachable and all of these (100%) were willing to participate in the telephone
survey. Of them, 55% identified obstacles to participation in the questionnaire survey. Men under 60 years were less
likely to identify obstacles. Years from loss (second through fourth years) were not associated with reporting obstacles
to participation. The response rate in the epidemiological questionnaire survey following the telephone interview was
62% (216/346).
Of those who did identify obstacles 23%, did not did not identify any particular obstacle, but 33% stated that "they
felt bad" or that it would be "a painful experience" or that they felt "uncomfortable" talking about their grief. About
18% stated their grief was "a private matter"; 6% stated that they did not want to be "stuck with their grief"; 9% said
that it was "too late" to talk about their grief or that they "wanted to look towards their future". Additionally, 11%
stated "other reasons", including responses like: "it's too early to talk about it", and "I have started another relationship
- don't want complications."
Conclusions: The willingness to participate in the telephone interview was high and indicates a strong interest in the
subject. Also, exposure to the study appeared to increase willingness to participate, since many men who initially could
see obstacles to participation, actually participated in the epidemiological questionnaire survey. However,
approximately one third of the men who initially identified obstacles to participation remained negative toward
participation throughout the study period.NonePublishe
Social correlates of cigarette smoking among Icelandic adolescents: A population-based cross-sectional study
BACKGROUND: Previous research has shown that between 80 and 90 percent of adult
smokers report having started smoking before 18 years of age. Several studies
have revealed that multiple social factors influence the likelihood of smoking
during adolescence, the period during which the onset of smoking usually occurs.
To better understand the social mechanisms that influence adolescent smoking, we
analyzed the relationship and relative importance of a broad spectrum of social
variables in adolescent smoking in Iceland, a Nordic country with high per-capita
income.
METHODS: We used cross-sectional data from 7,430 14- to 16 year-old
students (approximately 81% of all Icelanders in these age cohorts) in the 2006
Youth in Iceland study. The Youth in Iceland studies are designed to investigate
the role of several cognitive, behavioral, and social factors in the lives of
adolescents, and the data collected are used to inform the design,
implementation, and evaluation of substance use prevention programs that are
being developed by Icelandic social scientists, policy makers, and practitioners.
RESULTS: Our analysis revealed that friends' smoking behavior and attitude toward
smoking were strongly associated with adolescent smoking and other tobacco use,
as well as alcohol consumption during the previous 30 days. Main protective
factors were parent's perceived attitude toward smoking, the quantity of time
spent with parents, absence of serious verbal conflict between parents and
adolescents, and participation in physical activity. Family structure was related
to adolescent smoking to a small extent, but other background factors were not.
CONCLUSION: We conclude that multiple social factors are related to adolescent
smoking. Parents and other primary preventive agents need to be informed about
the complicated nature of the adolescent social world in order to maximize their
impact.Icelandic Alcohol and Drug Prevention CommitteeIcelandic Red CrossCity of ReykjavikSports and Recreational Committee of Reykjavik to the Icelandic Centre for Social Research and AnalysisIcelandic Centre for Research (RANNĂŤS)Publishe
Death talk: gender differences in talking about one's own impending death.
To access publisher's full text version of this article. Please click on the hyperlink in Additional Links field.According to common practice based on a generally agreed interpretation of Icelandic law on the rights of patients, health care professionals cannot discuss prognosis and treatment with a patient's family without that patient's consent. This limitation poses ethical problems, because research has shown that, in the absence of insight and communication regarding a patient's impending death, patient's significant others may subsequently experience long-term psychological distress. It is also reportedly important for most dying patients to know that health care personnel are comfortable with talking about death and dying. There is only very limited information concerning gender differences regarding death talk in terminal care patients.This is a retrospective analysis of detailed prospective "field notes" from chaplain interviews of all patients aged 30-75 years receiving palliative care and/or with DNR (do not resuscitate) written on their charts who requested an interview with a hospital chaplain during a period of 3 years. After all study patients had died, these notes were analyzed to assess the prevalence of patient-initiated discussions regarding their own impending death and whether non-provocative evocation-type interventions had facilitated such communication.During the 3-year study period, 195 interviews (114 men, 81 women) were conducted. According to the field notes, 80% of women and 30% of men initiated death talk within the planned 30-minute interviews. After evoking interventions, 59% (67/114) of men and 91% (74/81) of women engaged in death talk. Even with these interventions, at the end of the first interview gender differences were still statistically significant (p = 0.001). By the end of the second interview gender difference was less, but still statistically significant (p = 0.001).Gender differences in terminal care communication may be radically reduced by using simple evocation methods that are relatively unpretentious, but require considerable clinical training.Men in terminal care are more reluctant than women to enter into discussion regarding their own impending death in clinical settings. Intervention based on non-provocative evocation methods may increase death talk in both genders, the relative increase being higher for men.National University Hospital
Icelandic Centre for Research (RANNIS), Iceland
Stockholm County Council, Health Services, Swede
Symptoms in smokers trying to quit
AIMS: To describe the prevalence and intensity of different symptoms in relation
to tobacco abstinence. To explore latent dimensions between symptoms in smokers
trying to quit.
DESIGN: A cross sectional study using a questionnaire to
retrospectively assess symptoms over a period of 12 months.
SETTING: Swedish
telephone quitline, a nationwide free of charge service.
PARTICIPANTS: All 741
individuals who had called the quitline and signed up for smoking cessation
treatment between February 2000 to November 2001 and reported to have been smoke
free for at least 24 hours during the previous 12 month period from first
contact.
MEASUREMENTS: Assessments were made by self-report, and abstinence was
defined as "not a single puff of smoke during the last week". A factor analysis
approach where individual items aggregate into factors was used to explore the
relationship between the different symptoms.
FINDINGS: High intensity of symptoms
related to unsuccessful quitting attempts and included craving, irritability,
apprehension/anxiety, difficulties concentrating, restlessness,
depression/depressed mood, and insomnia. The factor loadings of all 17 symptoms
resulted in three factors with factor 1, psychological being the most important.
High scores on this factor relates to unsuccessful quitting attempts. Using
Nicotine Replacement Therapy (NRT) for 5 weeks or longer, reduced symptoms
included in factor 1. The other two factors were factor 2 physiological and
factor 3 neurological.
CONCLUSION: Symptoms that are psychological and/or
neurological in nature are interrelated and appear to be the most significant
obstacles for successful quitting attempts in a population-based setting. These
symptoms may be successfully treated with NRT.NonePublishe
The national alcohol helpline in Sweden: an evaluation of its first year
There are no direct competing financial interests between the authors and the Swedish Alcohol Helpline. However, during the time of the data collection the authors KA and LN salaries were partly financed by the same unit at Stockholm County Council Health Services (SCCHS) responsible for the development of the Swedish Alcohol Helpline, while author ARH was founded by another unit at SCCHS during the same period.Background: Telephone helplines are easily available and can offer anonymity. Alcohol helplines may be a potential gateway to a more advanced support protocol, and they may function as a primary support option for some. However, although telephone helplines (quitlines) make up an established evidence-based support arena for smoking cessation, few studies have described such telephone-based alcohol counseling.
Methods: This study describes the basic characteristics of callers (n = 480) to the Swedish Alcohol Helpline during its first year of operation, and assesses aspects of change in alcohol behavior in a selected cohort of clients (n = 40) willing to abstain from anonymity and enter a proactive support protocol.
Results: During the study period, 50% of callers called for consultation regarding their own alcohol use (clients), a third called about relatives with alcohol problems, and the others called for information. The clients’ average age was 49 years, and half were females. The clients’ average AUDIT score at baseline was 21 (std. dev. =7.2). Approximately a quarter had scores indicating hazardous alcohol use at baseline, while the others had higher
scores. In a follow-up pilot study, the average AUDIT score had decreased from 21 to 14. While clients reporting more severe alcohol use showed a significant decrease at follow-up, hazardous users exhibited no change during the study period.
Conclusion: The study indicates that telephone helplines addressing the general public can be a primary-care option to reduce risky alcohol use. A randomized controlled study is needed to control for the effect of spontaneous recovery.
Keywords: Quitline, Helpline, Alcohol, AUDIT, Treatment, CounselingPeer Reviewe
Motivational Interviewing in an ordinary clinical setting: A controlled clinical trial at the Swedish National Tobacco Quitline
AbstractIntroductionThe present study aimed to assess the effect of adding Motivational Interviewing (MI) to the first session of an effective smoking cessation treatment protocol in an ordinary clinical setting: the Swedish National Tobacco Quitline (SNTQ).MethodThe study was designed as a controlled clinical trial. Between September 2005 and October 2006, 772 clients accepted the invitation to participate in the study and were semi-randomised to either standard treatment (ST) or MI. The primary outcome measures were self-reported 7-day point prevalence abstinence and 6-month continuous abstinence.ResultsAt 12-month follow-up, the 772 clients were included in an intention to treat analysis. Of the clients allocated to MI, 57/296 (19%) reported 6-month continuous abstinence compared to 66/476 (14%) of the clients allocated to ST (OR 1.48, 95% CI 1.00–2.19; P=.047).ConclusionsIntegrating MI into a cognitive behavioural therapy-based smoking cessation counselling in an ordinary clinical setting at a tobacco quitline increased client 6-month continuous abstinence rates by 5%
Non-response bias and hazardous alcohol use in relation to previous alcohol-related hospitalization: comparing survey responses with population data
Publisher's version (Ăştgefin grein)Background: This study examines whether alcohol-related hospitalization predicts survey non-response, and
evaluates whether this missing data result in biased estimates of the prevalence of hazardous alcohol use and
abstinence.
Methods: Registry data on alcohol-related hospitalizations during the preceding ten years were linked to two
representative surveys. Population data corresponding to the surveys were derived from the Stockholm County
registry. The alcohol-related hospitalization rates for survey responders were compared with the population data,
and corresponding rates for non-responders were based on the differences between the two estimates. The
proportions with hazardous alcohol use and abstinence were calculated separately for previously hospitalized and
non-hospitalized responders, and non-responders were assumed to be similar to responders in this respect.
Results: Persons with previous alcohol-related admissions were more likely currently to abstain from alcohol
(RR=1.58, p<.001) or to have hazardous alcohol use (RR=2.06, p<.001). Alternatively, they were more than twice as
likely to have become non-responders. Adjusting for this skewed non-response, i.e., the underrepresentation of
hazardous users and abstainers among the hospitalized, made little difference to the estimated rates of hazardous
use and abstinence in total. During the ten-year period 1.7% of the population were hospitalized.
Conclusions: Few people receive alcohol-related hospital care and it remains unclear whether this group’s
underrepresentation in surveys is generalizable to other groups, such as hazardous users. While people with severe
alcohol problems – i.e. a history of alcohol-related hospitalizations – are less likely to respond to population surveys,
this particular bias is not likely to alter prevalence estimates of hazardous use.
Keywords: Non-response bias, Missing data, Attrition, Hazardous alcohol use, Abstainers, AbstinenceThe study was made possible by Stockholm County Council and the Swedish National Institute of Public Health.Peer Reviewe
Insertion of an SVA-E retrotransposon into the CASP8 gene is associated with protection against prostate cancer
To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files.
This article is open access.Transcriptional and splicing anomalies have been observed in intron 8 of the CASP8 gene (encoding procaspase-8) in association with cutaneous basal-cell carcinoma (BCC) and linked to a germline SNP rs700635. Here, we show that the rs700635[C] allele, which is associated with increased risk of BCC and breast cancer, is protective against prostate cancer [odds ratio (OR) = 0.91, P = 1.0 Ă— 10(-6)]. rs700635[C] is also associated with failures to correctly splice out CASP8 intron 8 in breast and prostate tumours and in corresponding normal tissues. Investigation of rs700635[C] carriers revealed that they have a human-specific short interspersed element-variable number of tandem repeat-Alu (SINE-VNTR-Alu), subfamily-E retrotransposon (SVA-E) inserted into CASP8 intron 8. The SVA-E shows evidence of prior activity, because it has transduced some CASP8 sequences during subsequent retrotransposition events. Whole-genome sequence (WGS) data were used to tag the SVA-E with a surrogate SNP rs1035142[T] (r(2) = 0.999), which showed associations with both the splicing anomalies (P = 6.5 Ă— 10(-32)) and with protection against prostate cancer (OR = 0.91, P = 3.8 Ă— 10(-7)).National Cancer Research Institute (NCRI)
G0500966/75466
Department of Health, Medical Research Council
Cancer Research UK
University of Cambridge
NIHR
Department of Health
Anniversary Fund of the Austrian National Bank
15079
Medical and Scientific Fund of the Mayor of the City of Vienna
10077
Common Fund of the Office of the Director of the National Institutes of Health
NCI
NHGRI
NHLBI
NIDA
NIMH
NINDS
NCI\SAIC-Frederick, Inc. (SAIC-F)
10XS170
Roswell Park Cancer Institute
10XS171
Science Care, Inc.
X10S172
SAIC-F
10ST1035
HHSN261200800001E
deCODE genetics/AMGEN
HHSN268201000029C
DA006227
DA033684
N01MH000028
MH090941
MH101814
MH090951
MH090937
MH101820
MH101825
MH090936
MH101819
MH090948
MH101782
MH101810
MH10182
Clinician acquisition and retention of Motivational Interviewing skills: a two-and-a-half-year exploratory study
<p>Abstract</p> <p>Background</p> <p>Motivational interviewing (MI) is a collaborative, client-centred counselling style aimed at eliciting and strengthening clients' intrinsic motivation to change. There is strong research evidence supporting the efficacy of MI, notably in its application among alcohol and drug abuse populations. MI interventions in smoking cessation may yield modest but significant increases in quitting. The present study sought to assess the acquisition and retention of MI skills in counsellors at the Swedish National Tobacco Quitline.</p> <p>Methods</p> <p>Three audio-recorded sessions from each of three counsellors were assessed using the Motivational Interviewing Treatment Integrity (MITI) Code Version 3.0 over 11 assessment periods at fixed intervals in a two-and-a-half year period during which counsellors received ongoing supervision.</p> <p>Results</p> <p>The mean skill for all counsellors improved throughout the study period in most MITI variables. However, great variations in MI skill between counsellors were observed, as well as fluctuations in performance in counsellors over time.</p> <p>Conclusion</p> <p>The present exploratory study covers a longer time period than most evaluations of MI training, and has several advantages with regard to study design. It may provide a basis for (larger sample) replication to test MI skill (as measured by the MITI) in relation to behaviour change in clients, to evaluate MI training, and to assess the acquisition and retention of MI skill over time. Difficulties in acquiring and retaining MI skill may raise the issue of a selection policy for MI training. Moreover, fluctuations in MI skill over time emphasise the greater importance of continuous feedback and supervision over initial MI training, and the need for the use of validated treatment integrity assessment instruments in ordinary clinical implementations of MI.</p
New basal cell carcinoma susceptibility loci.
To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files.
This article is open access.In an ongoing screen for DNA sequence variants that confer risk of cutaneous basal cell carcinoma (BCC), we conduct a genome-wide association study (GWAS) of 24,988,228 SNPs and small indels detected through whole-genome sequencing of 2,636 Icelanders and imputed into 4,572 BCC patients and 266,358 controls. Here we show the discovery of four new BCC susceptibility loci: 2p24 MYCN (rs57244888[C], OR=0.76, P=4.7 Ă— 10(-12)), 2q33 CASP8-ALS2CR12 (rs13014235[C], OR=1.15, P=1.5 Ă— 10(-9)), 8q21 ZFHX4 (rs28727938[G], OR=0.70, P=3.5 Ă— 10(-12)) and 10p14 GATA3 (rs73635312[A], OR=0.74, P=2.4 Ă— 10(-16)). Fine mapping reveals that two variants correlated with rs73635312[A] occur in conserved binding sites for the GATA3 transcription factor. In addition, expression microarrays and RNA-seq show that rs13014235[C] and a related SNP rs700635[C] are associated with expression of CASP8 splice variants in which sequences from intron 8 are retained.NCI\SAIC-Frederick, Inc. (SAIC-F) 10XS170
Roswell Park Cancer Institute 10XS171
Science Care Inc. X10S172
Laboratory, Data Analysis and Coordinating Center (LDACC)
HHSN268201000029C
SAIC-F
10ST1035
HHSN261200800001E
Brain Bank
DA006227
DA033684
N01MH000028
University of Geneva
MH090941
MH101814
University of Chicago
MH090951
MH090937
MH101820
MH101825
University of North Carolina-Chapel Hill
MH090936
MH101819
Harvard University
MH090948
Stanford University
MH101782
Washington University St Louis
MH101810
University of Pennsylvania
MH10182
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