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- Johansson, Anna
(author)
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Tjock och vacker - kvinnlighet och kroppsstorlek bland nicaraguanska kvinnor
- 1996
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In: Sociologisk forskning. - : Sveriges Sociologförbund. - 0038-0342 .- 2002-066X. ; 33:2-3, s. 51-70
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Journal article (peer-reviewed)abstract
- Fat and beautiful - femininity and body size among Nicaraguan womenThis article aims to illuminate and discuss body size as a central element in the social construction of a feminine body. It also emphases the variations in the social definitions and experiences of womens body size; historical and social as well as cultural ones. The dominant body ideal today in Western culture is the slender and fat free body. Women are to a higher extent then men subdued to the disciplinary practices of fat reduction, to what some feminist researchers call ”the tyranny of slenderess”. These ideals and practices are historically rooted in a Western discourse and are formed within a culture of affluence and mass consumption. At the same time they are also influencing (or colonizing?) the so called Third World, as part ofthe cultural flows of global modernity. This is true also for Nicaragua, a country where I have carried out fieldwork during the latest years. Still, among the Nicaraguan lower class mestizo women with whom I have lived, fatness is defined as beautiful and as a sign of health, while slenderness is considered a sign of suffering. As I am disciplined within the Western ”fat is bad” discourse, the ethnographic situation of fieldwork involved both a meeting and confrontation of different ideals and practices of the feminine body. Finally, in highlighting definitions and significance of bodysize which are different from the Western ones there might lie a possibility of challenge and resistance of the discourses which are dominating our definitions and experiences of our own and others bodies.
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| 2. |
- Bergström, Anna, et al.
(author)
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Health system context and implementation of evidence-based practices-development and validation of the Context Assessment for Community Health (COACH) tool for low- and middle-income settings
- 2015
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In: Implementation Science. - : Springer Science and Business Media LLC. - 1748-5908. ; 10
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Journal article (peer-reviewed)abstract
- Background: The gap between what is known and what is practiced results in health service users not benefitting from advances in healthcare, and in unnecessary costs. A supportive context is considered a key element for successful implementation of evidence-based practices (EBP). There were no tools available for the systematic mapping of aspects of organizational context influencing the implementation of EBPs in low- and middle-income countries (LMICs). Thus, this project aimed to develop and psychometrically validate a tool for this purpose. Methods: The development of the Context Assessment for Community Health (COACH) tool was premised on the context dimension in the Promoting Action on Research Implementation in Health Services framework, and is a derivative product of the Alberta Context Tool. Its development was undertaken in Bangladesh, Vietnam, Uganda, South Africa and Nicaragua in six phases: (1) defining dimensions and draft tool development, (2) content validity amongst in-country expert panels, (3) content validity amongst international experts, (4) response process validity, (5) translation and (6) evaluation of psychometric properties amongst 690 health workers in the five countries. Results: The tool was validated for use amongst physicians, nurse/midwives and community health workers. The six phases of development resulted in a good fit between the theoretical dimensions of the COACH tool and its psychometric properties. The tool has 49 items measuring eight aspects of context: Resources, Community engagement, Commitment to work, Informal payment, Leadership, Work culture, Monitoring services for action and Sources of knowledge. Conclusions: Aspects of organizational context that were identified as influencing the implementation of EBPs in high-income settings were also found to be relevant in LMICs. However, there were additional aspects of context of relevance in LMICs specifically Resources, Community engagement, Commitment to work and Informal payment. Use of the COACH tool will allow for systematic description of the local healthcare context prior implementing healthcare interventions to allow for tailoring implementation strategies or as part of the evaluation of implementing healthcare interventions and thus allow for deeper insights into the process of implementing EBPs in LMICs.
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| 3. |
- Johansson, Sverker
(author)
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All you need is love... or what?
- 2017
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Conference paper (peer-reviewed)abstract
- All you need is love… or what?Language is essentially always present in groups of modern humans. Even in the exceptional groups that for some reason are formed without language, language will invariably emerge in short order. Examples of language emergence in recent times include deaf communities in e.g. Nicaragua and Israel. Such newly-formed languages converge within a few generations towards the same general form and features as mainstream human languages.Language is essentially never present in groups of non-human primates. Even in the exceptional groups that are heavily exposed to language and explicitly trained in language use, progress in language acquisition is invariably modest at best. Language never emerges spontaneously in non-human groups.What’s special with humans? It is sometimes argued that “all you need is merge” (e.g. Berwick 2007), that a small genetic change provided a language-ready brain and the rest is history. This saltational view of language evolution is wrong for many reasons (e.g. Tallerman 2014), but I would add here another one.A language-ready brain is not an all-or-nothing affair, nor is it sufficient for language emergence. The results of language training in apes are modest, but not nil. Apes do learn to connect symbols with referents and use them communicatively. One may quibble about whether to call this “language”, and it is far from full human language, notably lacking in syntax. But it does show the presence of some language-relevant abilities in apes, and it is a functional communication tool at some protolinguistic level.But if ape brains are protolanguage-ready, why doesn’t protolanguage emerge in the wild among apes, as it does among humans? Clearly, some extra-linguistic key factor is lacking. A language-ready brain is not all you need for language emergence. In a group of hypothetical creatures with a human language faculty (narrow sense) but otherwise ape-like in psychology and behavior, language would not emerge.Human prosociality and shared intentionality are likely key ingredients in language emergence (e.g. Tomasello 2010), but are not the whole story. In this talk, I will explore the minimal extra-linguistic requirements for protolanguage emergence to get off the ground in protohumans. References:Berwick, R C (2011) All you Need is Merge: Biology, Computation, and Language from the Bottom-up. In di Sciullo & Boeckx The Biolinguistic Enterprise OUP.Tallerman M. (2014) No syntax saltation in language evolution. Language Sciences 46, 207-219.Tomasello, M (2010) Origins of human communication. MIT Press.
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| 4. |
- Hay, S. I., et al.
(author)
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Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2016 : A systematic analysis for the Global Burden of Disease Study 2016
- 2017
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In: The Lancet. - : Lancet Publishing Group. - 0140-6736 .- 1474-547X. ; 390:10100, s. 1260-1344
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Journal article (peer-reviewed)abstract
- Background: Measurement of changes in health across locations is useful to compare and contrast changing epidemiological patterns against health system performance and identify specific needs for resource allocation in research, policy development, and programme decision making. Using the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we drew from two widely used summary measures to monitor such changes in population health: disability-adjusted life-years (DALYs) and healthy life expectancy (HALE). We used these measures to track trends and benchmark progress compared with expected trends on the basis of the Socio-demographic Index (SDI). Methods: We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2016. We calculated DALYs by summing years of life lost and years of life lived with disability for each location, age group, sex, and year. We estimated HALE using age-specific death rates and years of life lived with disability per capita. We explored how DALYs and HALE difered from expected trends when compared with the SDI: the geometric mean of income per person, educational attainment in the population older than age 15 years, and total fertility rate. Findings: The highest globally observed HALE at birth for both women and men was in Singapore, at 75·2 years (95% uncertainty interval 71·9-78·6) for females and 72·0 years (68·8-75·1) for males. The lowest for females was in the Central African Republic (45·6 years [42·0-49·5]) and for males was in Lesotho (41·5 years [39·0-44·0]). From 1990 to 2016, global HALE increased by an average of 6·24 years (5·97-6·48) for both sexes combined. Global HALE increased by 6·04 years (5·74-6·27) for males and 6·49 years (6·08-6·77) for females, whereas HALE at age 65 years increased by 1·78 years (1·61-1·93) for males and 1·96 years (1·69-2·13) for females. Total global DALYs remained largely unchanged from 1990 to 2016 (-2·3% [-5·9 to 0·9]), with decreases in communicable, maternal, neonatal, and nutritional (CMNN) disease DALYs ofset by increased DALYs due to non-communicable diseases (NCDs). The exemplars, calculated as the fve lowest ratios of observed to expected age-standardised DALY rates in 2016, were Nicaragua, Costa Rica, the Maldives, Peru, and Israel. The leading three causes of DALYs globally were ischaemic heart disease, cerebrovascular disease, and lower respiratory infections, comprising 16·1% of all DALYs. Total DALYs and age-standardised DALY rates due to most CMNN causes decreased from 1990 to 2016. Conversely, the total DALY burden rose for most NCDs; however, age-standardised DALY rates due to NCDs declined globally. Interpretation: At a global level, DALYs and HALE continue to show improvements. At the same time, we observe that many populations are facing growing functional health loss. Rising SDI was associated with increases in cumulative years of life lived with disability and decreases in CMNN DALYs ofset by increased NCD DALYs. Relative compression of morbidity highlights the importance of continued health interventions, which has changed in most locations in pace with the gross domestic product per person, education, and family planning. The analysis of DALYs and HALE and their relationship to SDI represents a robust framework with which to benchmark location-specific health performance. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform health policies, health system improvement initiatives, targeted prevention eforts, and development assistance for health, including fnancial and research investments for all countries, regardless of their level of sociodemographic development. The presence of countries that substantially outperform others suggests the need for increased scrutiny for proven examples of best practices, which can help to extend gains, whereas the presence of underperforming countries suggests the need for devotion of extra attention to health systems that need more robust support. © The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
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