Background: Antonovsky's salutogenic concept of a sense of coherence (SOC) has proved most influential in the way that health is now perceived. Aim: To (1) describe the distribution of SOC among 40-70-year-old Å landers; (2) examine the distribution of depression in Å land, Finland, and its relationship with SOC; and (3) discuss the findings within a salutogenic framework in a societal context. Design: A cross-sectional study design was adopted. Antonovsky's SOC Questionnaire (13 items) and the Beck Depression Inventory (13 items) were used. In addition, in a separate questionnaire, sociodemographic information about each participant was sought, together with a question specific to this study and designed to measure self-rated health. Setting: Å land, an autonomous island province of Finland. Results: The proportion of respondents reporting good health was high (64%). The overall mean (SD) SOC was 70.7 (11.7) points, whereas for farmers and fishermen it was 73.88 (8.8) and 74.33 (9.2) points, respectively. SOC was significantly and strongly related to the self-rated health score. The higher the SOC, the better was the health of the respondents. Furthermore, the study provided clear evidence of the potential of the SOC concept as a positive mental health indicator. Conclusion: The SOC seems to be a health-promoting resource that supports the development of a positive subjective state of health.

This article reviews different theoretical models concerning the prevention of substance use by adolescents. The models differ in their concepts and in their assumptions. Because the models describe different parts of the substance use problem, they can be combined to provide the basis for the design of information-based prevention programs. For example, in order to understand adolescent development, identity models or attachment models can be used. To understand adolescent norm changes, cultural models or peer system models can be applied. To understand how adolescents cope in specific situations where alcohol and other drugs are available, models that include concepts like self-esteem, drug expectations, existing norms, and perceived control of substance use can be employed. All preventive programs need to be pretested as well as evaluated both during and postprogram. The models mentioned may be used as frameworks in an evaluation, i.e., the variables and the assumptions in the models can be used as hypotheses to establish whether the desired results are achieved as a consequence of the selected strategies and techniques in the preventive program. A greater knowledge of the social and psychological processes preventing substance use will put us in a better position to influence and understand adolescent substance use in the future.

This article takes some preliminary steps towards an integrated analysis of dependency problems e.g., long-term tranquillizer use, alcohol dependence, problematic use of narcotics. It argues for the need to outline important theoretical, epistemological, and methodological prerequisites in the analysis of the complex dynamic developmental processes involved in dependency problems. The dynamic process leading to dependence can be studied by the aid of an artificial science neural network approach in combination with a mixed method strategy including a clarification of a combination of different epistemological positions. It is intended that the empirical output of this complex strategy will provide a starting point for a new theoretical analysis which, in turn, will lead to new and more relevant input variables in the neural network approach that will help us to extend our knowledge of the dynamic processes leading to dependency.

Objective. To determine how knowledgeable pharmacy customers are regarding their own health and information about minor illnesses and over-the-counter medicines.Methods. A written questionnaire was sent in the period of January to April 2003 to a sample of pharmacies in different regions of Estonia. Questionnaires were then distributed to randomly selected pharmacy customers. Of 886 questionnaires given out, 727 were answered and returned; a response rate was 82%.Results. Half of the respondents assessed their health as good or excellent. When minor illnesses occurred, most used home remedies or over-the-counter medicines. Their knowledge of such illnesses was better than that of over-the-counter medicines. In both cases, the pharmacist was the most frequently used information source. Drug administration, which preparation should be chosen for which illness, and the drug price were the three most often asked questions in the pharmacy. The information about over-the-counter medicines given in the pharmacies was regarded as sufficient by 51% of the respondents.Conclusion. Although lay people do know about over-the-counter medicines and especially about minor illnesses, pharmacists play a very important part in providing information about medicines. However, drug communication by healthcare professionals regarding over-the-counter medicines should be given more attention in the future.

The aim of this article is to present a theoretical model of how to undertake evaluations of prevention programs directed at adolescents. Based on the results from metaanalyses of outcome studies of school-based programs, this article concludes that interactive programs tend to be more effective than not only those mainly intended to increase factual knowledge about tobacco, alcohol, and illegal drugs, but also those initiatives aimed at influencing adolescents' attitudes toward those substances. The interactive strategy corresponds to problem-based learning or the interactive educational approach, now widely popular in educational circles. These outcome studies have provided us with important knowledge. However, there are relatively few evaluation investigations that analyze in substantive detail the process by which adolescents change their alcohol, tobacco, and illegal drug-use behavior, and alter their perceptions about these substances. In an ongoing intervention study based on an interaction framework, involving all youngsters in the ninth grade (15-16 year olds, n = 300, undertaken in year 2001-2002) in the Aland Islands, Finland, the students' perceptions regarding the risks involved in illegal drug use could not be altered. Neither was it possible to decrease the alcohol or tobacco consumption during this school year. However, what did occur was that a number of expectations regarding alcohol were changed, which, in turn, might influence the patterns of alcohol use by the target group. The ways students in the Alands celebrate the end of junior high school are culturally embedded, and this may explain the lack of success in decreasing their alcohol consumption and tobacco use at the end of the ninth grade. Based on the analysis, a combination of outcome and process evaluations is recommended in order to reach a better understanding of how school prevention programs may achieve the desired goals.