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- Brännström, Inger, 1945-
(författare)
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Community participation and social patterning in cardiovascular disease intervention
- 1993
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This study addresses health policy and public health in the field of cardiovascular disease (CVD) on the local level in Sweden. The overall aim is to contribute to the assessment of structural and social conditions within public health by analysing participation processes and outcome patterns in a local health programme. The northern Swedish MONICA study served as a reference area. The research strategy has been to integrate quantitative and qualitative methodologies and, thereby, focus on different aspects of the health programme under study.The mortality rate was excessive in the study area of Norsjö relative to both provincial and national figures over a period of more than 10 years. This finding formed the basis for a tenyear comprehensive and community-based health programme towards the prevention of CVD and diabetes.Even in this seemingly homogeneous area it was found that socio-economic circumstances were associated with the public health. Almost half of the study population had hypercholesterolaemia (;>6.5 mmol/1), 19% of men and 25% of women were smokers and 30% and 29%, respectively, had high blood pressure. Age had a strong impact on all outcome measures. After adjustments for age and social factors it was found that the relative risk of having hypercholesterolaemia dropped significantly in both sexes during the six years of intervention. The probability of being a smoker was significantly reduced only in highly educated groups. No statistically significant change over time could be found for the risk of suffering high blood pressure. In the reference area of northern Sweden there were no changes over time for any of the selected risk factors. The likelihood of self-assessed good health decreased with increasing risk factor load, with the exception of hypercholesterolaemia , in all social strata.The authorities, including the health and medical staff, were the main actors on the mediastage. Men in manual occupations were least affected by the media coverage. The actors and the public as well as the media viewed the health programme as orientated towards individual lifestyles. Community participation was mainly defined by the actors based on the medical and health planning approach. Differences in interpretations, social interests, personal conflicts and ideological constraints among the actors at local level were observed. Some critical attitudes towards the organization and management of the health programme were also noted among the citizens. However, a majority of the public wanted the health programme to continue. The present study underlines the importance of considering age, gender and social differences in the planning and evaluation of CVD preventive programmes.
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| 2. |
- Lundkvist, Sven-Olof, 1949-
(författare)
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Evaluation of Road Equipment with Emphasis on Condition Assessment
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This doctoral thesis deals primarily with condition assessment of road equipment. The road equipment concept is defined by five main groups, road lighting, fences and barriers, vertical signs, horizontal signs and traffic signals, respectively. Of these groups, road markings, street lighting and barriers of three-lane roads have been studied more in detail. A state-of-the-art, comprising information obtained by comprehensive literature studies on condition assessment of road equipment is presented. Comparably few fundamental studies were found, which, to some degree, can be explained by the lack of suitable physical measurement methods. However, in the case of road marking retroreflectivity, mobile instruments have been developed, and research published in this area is relatively comprehensive. Furthermore, although not based on mobile measurements, several studies on assessments on performance of road sign sheeting have been published. The experimental part of the thesis is divided into four studies, of which two are dealing with mobile measurement of wet road markings and street lighting, respectively. One of the studies concerns condition assessment of road marking performance accomplished in the Nordic countries. Finally, one study comprises risk analysis related to crashes into the barriers on three-lane roads. At road equipment condition assessment, mobile measurement methods are preferable compared to stationary methods. However, many relevant parameters are tricky to measure at speed. One example in this connection is characterization of performance of wet road markings, which has to be based on one or more parameters obtained by measurements on dry surfaces. Results presented in this thesis indicate that retroreflectivity and skid resistance of wet road markings can be predicted based on retroreflectivity and macro-texture of dry road marking. For traffic safety, street lighting is important. The performance of this type of road equipment is in most cases described in terms of luminance of the illuminated road surface. However, luminance measurements are tricky and time-consuming and not useful for condition assessment. On the contrary, measurement of illuminance is easy to carry out and can be performed at speed. One part of the thesis describes how road surface luminance in street lighting can be estimated based on illuminance and reflection properties of the road surface. With the purpose of comparing road marking performance in the Nordic countries, condition assessment using mobile measurement equipment was accomplished in 2002 and 2003. In each of the five Nordic countries, a number of roads were chosen for measuring retroreflectivity. The study showed that the retroreflectivity of edge, centre and lane lines was poor in some countries, but, at least regarding edge lines, this shortcoming could be compensated by use of wide, continuous lines. In other words, the visibility of longitudinal road markings was approximately equal in the different countries. The purpose of the risk analysis performed on three-lane road barriers was to estimate the influence of the time-period between initial crash and repair on the risk of a secondary accident. The result showed that, especially in winter-time, time-reduction means reduced risk of secondary accidents.
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