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1.
  • Baggens, Christina, 1952- (författare)
  • Nurses' Work with Empowerment during Encounters with Families in Health Care
  • 2002
  • Ingår i: Critical Public Health. - : Informa UK Limited. - 0958-1596 .- 1469-3682. ; 12:4, s. 351-363
  • Tidskriftsartikel (refereegranskat)abstract
    • One goal of Swedish child healthcare work is to empower parents, and thereby reinforce them in their parental roles. It may, however, be difficult to put this ideology into practice because the concept of empowerment is abstract, and because it is unclear what this concept means in practice. The overall aim of this article is to examine critically and discuss empowerment in nurses' work, in their everyday encounters with families in child healthcare. An empirical study was conducted at three child health centres in medium-sized towns in Sweden. Data collection consisted of audiotapes of 44 visits by families to nurses at these centres. The tape-recorded conversations were transcribed verbatim and have been used as data. Data were analysed qualitatively by examining the advice-giving sequences, to see the extent to which the nurse tried to involve and encourage parents to participate actively in problem solving, and how frequently the nurse enquired about the parents' opinions and ideas. It was revealed that the nurses dominated advice giving in these visits to the extent that they took the initiative in the majority of the advisory sequences that occurred, and that they decided both when advice should be given and the nature of the advice. Furthermore, there were remarkably few examples that could be called empowering or have an empowering function in the advice giving. The nurse instead gave standard solutions and answers in response to various questions from the parents, reinforcing her own role as an expert.
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2.
  • Bradby, Hannah, 1966-, et al. (författare)
  • Universalism, diversity and norms : gratitude, healthcare and welfare chauvinism
  • 2020
  • Ingår i: Critical Public Health. - : Taylor & Francis Group. - 0958-1596 .- 1469-3682. ; 30:2, s. 166-178
  • Tidskriftsartikel (refereegranskat)abstract
    • Access to universal healthcare is a normative expectation of citizens in European welfare states. As part of a comparative study of healthcare in diverse European neighbourhoods, we met women who described failures of the public healthcare system, together with gratitude for that system. Challenges to European welfare states of ageing populations, the retraction of resources available for healthcare, and globalised migration streams have been linked to xenophobic ‘welfarist’ attempts to restrict access to services for new arrivals and those seen as failing to contribute sufficiently. Stories of healthcare systems’ failure to treat symptoms, pain, and suffering in a timely and caring fashion came from eight women of non-European migrant backgrounds as part of a wider interview study in four European cities (Birmingham, Uppsala, Lisbon, Bremen). These accounts suggest that a normative aspect of welfare provision has been reproduced – that is, the expression of gratitude – despite inadequate services. Where welfarist attitudes to migration meet normative aspects of healthcare, suffering may be compounded by an expectation of gratitude. The regrettable unmet healthcare need of the eight women whose cases are presented suggests that other marginalised healthcare users may also be under-served in apparently universal healthcare systems.
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3.
  • Ekendahl, Mats, 1971-, et al. (författare)
  • Fixed and fluid at the same time : how service providers make sense of relapse prevention in Swedish addiction treatment
  • 2023
  • Ingår i: Critical Public Health. - : Informa UK Limited. - 0958-1596 .- 1469-3682. ; 33:1, s. 105-115
  • Tidskriftsartikel (refereegranskat)abstract
    • This article explores how professionals within Swedish addiction treatment (n = 18) describe and make sense of relapse prevention (RP). RP is known as a self-control programme for maintaining behavioural change, helping people deal with high-risk situations. However, since self-control techniques have been incorporated widely in the addiction treatment field, the specificities of RP have become vague. To grasp what RP ‘is’, we draw on John Law’s and Annemarie Mol’s thoughts on how logics enact objects and realities. We thus follow critical scholarship in Science and Technology Studies and view treatment as a local knowledge-making practice that may depart from how it was originally designed. A key question is how RP is potentially transformed and made-to-matter when moved from the controlled settings of theorising and experimental studies to practice. The professionals used a logic of fixity to make RP stable, structured and evidence-based, easily distinguishable from other interventions. They also used a logic of fluidity to explain how and why they tinkered with it and adapted it to the preferences of both staff and attendees. The two logics enacted two different realities of addiction treatment: one in which RP is standardised, temporally demarcated and can solve most addiction problems, and another where interventions must be individualised, continuous and adapted to local settings and needs. It did not appear contradictory to ‘make up’ RP as both fixed and fluid; the two realities exist side by side, but with different material effects.
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4.
  • Haukenes, Inger, et al. (författare)
  • Inequity in disability pension: an intersectional analysis of the co-constitution of gender, education and age. The Hordaland Health Study
  • 2019
  • Ingår i: Critical Public Health. - : Informa UK Limited. - 0958-1596 .- 1469-3682. ; 29:3, s. 302-313
  • Tidskriftsartikel (refereegranskat)abstract
    • © 2018 Informa UK Limited, trading as Taylor & Francis Group Social position, education, gender and increasing age are all identified as important risk factors for disability pension. This study takes an intersectionality approach and examines their co-constitution, in relation to inequity in disability pension. The population included 22,203 middle-aged men and women participating in the community-based Hordaland Health Study, Western Norway (1997–1999). The participants were categorised in four exposure groups: higher educated men, higher educated women, lower educated men and lower educated women. The outcome was disability pension from 1992 to end of 2007, from a national registry. Using recommendations for intersectionality-informed quantitative research, we estimated the main effects of gender and educational attainment on disability pension, and potential statistical multiplicative interactions between gender and education in relation to cause-specific and all-cause disability pension. For all-cause disability pension, men with higher education had the lowest risk for disability pension (rate per 1000 person-years: 2.01) during the course of working life (from age 35 to 57), followed by higher educated women (rate 3.56), and lower educated men (rate 4.59). Finally, women with lower education had a substantially increased risk already in early middle age (rate 8.39). We found a statistical multiplicative effect of lower education and female gender on all-cause disability pension and disability pension with musculoskeletal disorders compared with men with higher education. The discussion highlights that inequity in disability pension is not only about defining vulnerable groups, but also about understanding how privileges and disadvantages are unequally distributed.
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5.
  • Hellman, Matilda, et al. (författare)
  • What’s the story on addiction? Popular myths in the USA and Finland
  • 2015
  • Ingår i: Critical Public Health. - : Informa UK Limited. - 0958-1596 .- 1469-3682. ; 25:5, s. 582-598
  • Tidskriftsartikel (refereegranskat)abstract
    • The study inquires into popular myths on addiction in two countries: Finland and the USA. It provides evidence of the manners in which the typical media narratives incorporate basic value traits from their context of origin. We distinguish some main features in the narrative set-ups that support different solution repertoires for dealing with addiction. Belief and hope are crucial story elements associated with the US emphasis on group formation and local empowerment. The individual is assigned obligations and can be morally condemned. In the Finnish journalistic prose, there seems to be an inherent belief that the agenda-setting in itself will propel the question into the institutionalised welfare state solution machinery. The occurrence of a story resolution was customary in the US stories, whereas the Finnish stories were typically left pending. The evidence produced has implications for the ongoing debate regarding the mainstreaming of both definitions of and solutions to addiction problems.
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6.
  • Klarare, Anna, et al. (författare)
  • Social rights in relation to digitalization, mobile phone, and internet use – experiences of women in homelessness : A qualitative study
  • 2024
  • Ingår i: Critical Public Health. - : Informa UK Limited. - 0958-1596 .- 1469-3682. ; 34:1, s. 1-16
  • Tidskriftsartikel (refereegranskat)abstract
    • Given the fact that women in homelessness face considerable health inequities, the question of how digitalization can be understood in relation to social rights and right to health surfaces. The objective of this qualitative interview study was to explore the use of mobile phones and internet for women experiencing homelessness. Women (n = 26) shared experiences of healthcare access by using a mobile phone or internet. Data were analyzed using NVivo software. The results are presented in two themes: Conditions and circumstances of having a mobile phone; and Structural and intrapersonal challenges affecting social rights. The results show that digitalization actively influenced everyday life for women experiencing homelessness. Whether women wanted it to or not, digitalization presents a line of demarcation for participation and inclusion or exclusion, in health- and social-care services.
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7.
  • Lucivero, Federica, et al. (författare)
  • Normative positions towards COVID-19 contact-tracing apps : findings from a large-scale qualitative study in nine European countries
  • 2022
  • Ingår i: Critical Public Health. - : Taylor & Francis. - 0958-1596 .- 1469-3682. ; 32:1, s. 5-18
  • Tidskriftsartikel (refereegranskat)abstract
    • Mobile applications for digital contact tracing have been developed and introduced around the world in response to the COVID-19 pandemic. Proposed as a tool to support ‘traditional’ forms of contact-tracing carried out to monitor contagion, these apps have triggered an intense debate with respect to their legal and ethical permissibility, social desirability and general feasibility. Based on a large-scale study including qualitative data from 349 interviews conducted in nine European countries (Austria, Belgium, France, Germany, Ireland, Italy, the Netherlands, German-speaking Switzerland, the United Kingdom), this paper shows that the binary framing often found in surveys and polls, which contrasts privacy concerns with the usefulness of these interventions for public health, does not capture the depth, breadth, and nuances of people’s positions towards COVID-19 contact-tracing apps. The paper provides a detailed account of how people arrive at certain normative positions by analysing the argumentative patterns, tropes and (moral) repertoires underpinning people’s perspectives on digital contact-tracing. Specifically, we identified a spectrum comprising five normative positions towards the use of COVID-19 contact-tracing apps: opposition, scepticism of feasibility, pondered deliberation, resignation, and support. We describe these stances and analyse the diversity of assumptions and values that underlie the normative orientations of our interviewees. We conclude by arguing that policy attempts to develop and implement these and other digital responses to the pandemic should move beyond the reiteration of binary framings, and instead cater to the variety of values, concerns and expectations that citizens voice in discussions about these types of public health interventions.
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8.
  • Mulinari, Shai, et al. (författare)
  • Categorical and anti-categorical approaches to US racial/ethnic groupings: revisiting the National 2009 H1N1 Flu Survey (NHFS)
  • 2018
  • Ingår i: Critical Public Health. - : Informa UK Limited. - 0958-1596 .- 1469-3682. ; 28:2, s. 177-189
  • Tidskriftsartikel (refereegranskat)abstract
    • Intersectionality theory calls for the understanding of race/ ethnicity, sex/ gender and class as interlinked. Intersectional analysis can contribute to public health both through furthering understanding of power dynamics causing health disparities, and by pointing to heterogeneities within, and overlap between, social groups. The latter places the usefulness of social categories in public health under scrutiny. Drawing on McCall we relate the first approach to categorical and the second to anti-categorical intersectionality. Here, we juxtapose the categorical approach with traditional between-group risk calculations (e.g. odds ratios) and the anticategorical approach with the statistical concept of discriminatory accuracy (DA), which is routinely used to evaluate disease markers in epidemiology. To demonstrate the salience of this distinction, we use the example of racial/ ethnic identification and its value for predicting influenza vaccine uptake compared to other conceivable ways of organizing attention to social differentiation. We analyzed data on 56,434 adults who responded to the NHFS. We performed logistic regressions to estimate odds ratios and computed the area under the receiver operating characteristic curve (AU-ROC) to measure DA. Above age, the most informative variables were education and household poverty status, with race/ ethnicity providing minor additional information. Our results show that the practical value of standard racial/ ethnic categories for making inferences about vaccination status is questionable, because of the high degree of outcome variability within, and overlap between, categories. We argue that, reminiscent of potential tension between categorical and anti-categorical perspectives, between-group risk should be placed and understood in relationship to measures of DA, to avoid the lure of misguided individual-level interventions.
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9.
  • Persmark, Anna, et al. (författare)
  • Intersectional inequalities and the U.S. opioid crisis : challenging dominant narratives and revealing heterogeneities
  • 2019
  • Ingår i: Critical Public Health. - : Taylor & Francis. - 0958-1596 .- 1469-3682. ; 30:4, s. 398-414
  • Tidskriftsartikel (refereegranskat)abstract
    • Dominant narratives of prescription opioid misuse (POM) in the U.S. have portrayed it as an issue primarily affecting White communities. In this study we explore POM as reported in data from the 2015 National Survey on Drug Use and Health, using an intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA). We map the risk of POM through a series of multilevel models with individuals (N = 43,409) nested within strata formed by the intersections of gender, race/ethnicity, income, and age. We find meaningful heterogeneity between and within strata. The ten strata with the greatest risk for POM were comprised of individuals identifying as White, African American, and non-White Hispanic, and included individuals of low, medium, and high income. We uncover intersections of social position with high risk for POM that are often excluded from dominant narratives, including young high-income African American women. Intersectional approaches are essential for advancing our understanding of health inequalities and unfolding epidemics such as that of POM in the U.S.
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10.
  • Room, Robin (författare)
  • Addiction and personal responsibility as solutions to the contradictions of neoliberal consumerism
  • 2011
  • Ingår i: Critical Public Health. - London : Taylor & Francis Group. - 0958-1596 .- 1469-3682. ; 21:2, s. 141-151
  • Tidskriftsartikel (refereegranskat)abstract
    • The article analyses the idealization of moderate alcohol consumption and of personal responsibility for controlling drinking behaviour as a sociocultural solution for a central contradiction in modern consumer societies. The application of neoliberal ideals of consumer sovereignty, free market access at any hour of the day or night and unrestrained market promotion tends to push upward the population's alcohol consumption. But in many aspects of daily life – for instance, when at work, when driving a car, when minding children – modern societies require sobriety. The ideological solution to this societal dilemma is to individualize the responsibility for handling it, apotheosizing the ideal of the moderate drinker, at the cultural level as a dream to reach for and at the individual level as an ideal of a secular pilgrim's progress.
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