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Biomedical subjects

K Koskela

Publications and source records attributed to K Koskela.

At least 55 records · Page 3Linked to original sources
PubMed1989

The North Karelia project: 15 years of community-based prevention of coronary heart disease.

The North Karelia Project - a community-wide health intervention programme - was launched in 1972 as response to the local petition to reduce the heavy toll of heart disease in North Karelia. The strategy of community-based prevention was based on the previous pioneering international work on epidemiology of cardiovascular diseases and prevention in which Finland had in many ways participated. Comprehensive scientific evaluation of the programme was carefully designed. The effects of the programme on risk factor reduction and on prevention of cardiovascular diseases are assessed by large population surveys every five years and by data on incidence of cardiovascular diseases and mortality rates. The authors present the 15 years' results and some of the most recent findings of the North Karelia Project, and discuss the overall experience and its national an international implications.

Adult↗
PubMed1988

Results of a one-year worksite and mass media based intervention on health behaviour and chronic disease risk factors.

The North Karelia Worksite Intervention Study was carried out to assess the effectiveness of worksite-based innovative intervention on chronic disease risk factors. The one-year intervention combined use of mass media, worksite opinion leaders, risk assessment and counselling and other health education measures. The study used eight medium sized intervention worksites (IW) and eight matched reference worksites (RW). Of the 715 workers 91% participated in the initial survey, and out of these 89% in the one-year follow-up survey. The proportion of current smokers changed from 39% to 30% (p less than 0.05) at the IWs while no change took place at the RWs (33%). The effect on smoking was confirmed by serum thiocyanate analyses. An additive score of the three main CHD risk factors changed from 3.1 to 2.7 at the IWs and from 3.2 to 3.0 at the RWs (p less than 0.05 for the net change). The results and experiences showed the feasibility of the intervention and significant, although modest, effects on risk factors and health behaviour, notably smoking.

Chronic Disease↗
PubMed1988

Allogeneic bone marrow transplantation in multiple myeloma: a report of four cases.

Allogeneic bone marrow transplantation offers a new and promising form for treatment of multiple myeloma incurable with chemotherapy. We present four cases of advanced multiple myeloma given bone marrow transplantation from HLA-identical and MLC-negative sibling donors. One patient had a recurrent plasmacytoma 8 months later and one died 12 days after the transplantation whereas the other two are in good clinical remission 15 and 19 months post-transplantation.

Adult↗
PubMed1986

Effects of smoking and stopping smoking on serum high-density lipoprotein cholesterol levels in a representative population sample.

Serum high-density lipoprotein (HDL) cholesterol levels were assessed in a random sample of 939 men and 853 women ages 14-65 years in eastern Finland. Amount of daily smoking measured by serum thiocyanate concentration was negatively and independently associated with serum HDL cholesterol level and HDL/total cholesterol ratio in men. This negative association seemed largely to be due to low HDL cholesterol levels in heavy smokers. Both male and female current smokers had lower HDL cholesterol levels and HDL/total cholesterol ratios than those who had never smoked. This difference was found even after adjustment for age, body mass index, and beer drinking. The reduction of HDL cholesterol level seemed to be reversible, because those who had recently stopped smoking had higher HDL cholesterol levels and higher HDL/total cholesterol ratios than current smokers.

Adolescent↗
PubMed1986

Four-year follow-up results of the smoking prevention program in the North Karelia Youth Project.

The North Karelia Youth Project was a 2-year intervention study aimed at preventing cardiovascular diseases risk factors among 13-year-old adolescents at the project's start. It was carried out during the years 1978 to 1980 in the county of North Karelia, Finland. The smoking prevention portion of the program was aimed at teaching children skills necessary to handle the social and psychological pressures associated with starting to smoke. During the 2-year program, 10 sessions were carried out in two schools by the project team and by specially trained peer leaders. In about half of the remaining 22 schools in North Karelia, a five-session program was carried out voluntarily by the teachers. After the program, 20% of the children in the two schools where the direct intervention was carried out reported smoking at least once a month. The same rate also was observed in two matched schools representative of the rest of the schools in North Karelia. In two other matched control schools in another county, 30% of the pupils reported to be smokers by the same criteria. Two years after the program (4 years after the beginning of the program), the reported smoking rates in the different school groups were 27, 26, and 37%, respectively. The results of this pilot study indicate that it is possible to reduce smoking onset by this kind of innovative program and that the beneficial effect can last several years.

Adolescent↗
PubMed1983

Change in risk factors for coronary heart disease during 10 years of a community intervention programme (North Karelia project).

A comprehensive community based programme to control cardiovascular diseases was started in North Karelia, Finland, in 1972. Reductions in smoking, serum cholesterol concentrations, and blood pressure were among the central intermediate objectives. The effect of the programme during the 10 year period 1972-82 was evaluated by examining independent random population samples at the outset (1972) and five (1977) and 10 (1982) years later both in the programme and in a matched reference area. Over 10 000 subjects were studied in 1972 and 1977 (participation rate about 90%) and roughly 8000 subjects in 1982 (participation rate about 80%). Analyses were conducted of the estimated effect of the programme on the risk factor population means by comparing the baseline and five year and 10 year follow up results in the age range 30-59 years. The effect of the programme (net reduction in North Karelia) at 10 years among the middle aged male population was estimated to be a 28% reduction in smoking (p less than 0.001), a 3% reduction in mean serum cholesterol concentration (p less than 0.001), a 3% fall in mean systolic blood pressure (p less than 0.001), and a 1% fall in mean diastolic blood pressure (p less than 0.05). Among the female population the reductions were respectively, 14% (NS), 1% (NS), 5% (p less than 0.001), and 2% (p less than 0.05). During the first five years of the project (1972-7) the programme effectively reduced the population mean values of the major coronary risk factors. At 10 years the effects had persisted for serum cholesterol concentrations and blood pressure and were increased for smoking.

Adult↗
PubMed1983

Effect of two years of educational intervention on adolescent smoking (the North Karelia Youth Project).

A two-year educational intervention programme was carried out to try to prevent the onset of smoking among 13-15-year-olds in the county of North Karelia in eastern Finland. The aim of the programme was to teach the children skills to resist social pressures towards smoking. Older students (peer leaders) were trained to conduct the programme, which was directly managed in two schools and voluntarily implemented by the staff of about half of the remaining 23 schools in the county. Both types of intervention were associated with a significant reduction in self-reported onset rates of smoking. It is concluded that this type of innovative approach, based on modern psychosocial principles, is needed to control the smoking epidemic among adolescents.

Adolescent↗
PubMed1982

Theory and action for health promotion illustrations from the North Karelia Project.

The North Karelia Project in Finland illustrates the fundamental goals of health promotion. Specific activities of the project serve as examples of how concepts from the social and behavioral sciences can be applied to achieve estimated reductions in predicted risk of disease. The results in North Karelia are not conclusive, but they are encouraging, and the investigations conducted there is an essential reference for future research in health promotion and disease prevention.

Cardiovascular Diseases↗