| 1. |
- Blomstedt, Yulia, et al.
(författare)
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10 years follow-up of deep brain stimulation in the caudal zona incerta/posterior subthalamic area for essential tremor
- 2023
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Ingår i: Movement Disorders Clinical Practice. - : John Wiley & Sons. - 2330-1619. ; 10:5, s. 783-793
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Tidskriftsartikel (refereegranskat)abstract
- Background: Long-term data on the effects of deep brain stimulation (DBS) for essential tremor (ET) is scarce, especially regarding DBS in the caudal Zona incerta (cZi) and the posterior subthalamic area (PSA). Objectives: The aim of this prospective study was to evaluate the effect of cZi/PSA DBS in ET at 10 years after surgery.Methods: Thirty-four patients were included. All patients received cZi/PSA DBS (5 bilateral/29 unilateral) and were evaluated at regular intervals using the essential tremor rating scale (ETRS).Results: One year after surgery, there was a 66.4% improvement of total ETRS and 70.7% improvement of tremor (items 1–9) compared with the preoperative baseline. Ten years after surgery, 14 patients had died and 3 were lost to follow-up. In the remaining 17 patients, a significant improvement was maintained (50.8% for total ETRS and 55.8% for tremor items). On the treated side the scores of hand function (items 11–14) had improved by 82.6% at 1 year after surgery, and by 66.1% after 10 years. Since off-stimulation scores did not differ between year 1 and 10, this 20% deterioration of on-DBS scores was interpreted as a habituation. There was no significant increase in stimulation parameters beyond the first year.Conclusions: This 10 year follow up study, found cZi/PSA DBS for ET to be a safe procedure with a mostly retained effect on tremor, compared to 1 year after surgery, and in the absence of increase in stimulation parameters. The modest deterioration of effect of DBS on tremor was interpreted as habituation.
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| 2. |
- Hariz, Marwan, et al.
(författare)
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Anthropology of deep brain stimulation; the 30th anniversary of STN DBS in 2023
- 2023
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Ingår i: Movement Disorders Clinical Practice. - : John Wiley & Sons. - 2330-1619. ; 10:9, s. 1285-1292
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Forskningsöversikt (refereegranskat)abstract
- Background: The year 2023 marks the 30th anniversary of deep brain stimulation (DBS) of the subthalamic nucleus (STN) for Parkinson’s disease (PD). This procedure prompted a universal interest in DBS for various brain disorders and resulted in a unique expansion of clinical and scientific collaboration between many disciplines, with impact on many aspects of society.Objective: To study the anthropology of DBS, that is, its ethno-geographic origins, its evolution, its impact on clinicians and scientists, and its influence on society at large.Material and Methods: The authors scrutinized the geo-ethnic origins of the pioneers of modern DBS, and they evaluated, based on the literature and on a long-term praxis, the development of DBS and its impact on clinicians, on healthcare, and on society.Results: Scientists and clinicians from various geo-ethnic origins pioneered modern DBS, leading to worldwide spread of this procedure and to the establishment of large multidisciplinary teams in many centers. Neurologists became actively involved in surgery and took on new laborious tasks of programming ever more complicated DBS systems. Publications sky-rocketed and the global spread of DBS impacted positively on several aspects of society, including healthcare, awareness of neurological diseases, interdisciplinary relations, conferences, patient organizations, unemployment, industry, etc.Conclusions: STN DBS has boosted the field of deep brain electrotherapy for many neurological and psychiatric illnesses, and DBS has generated a global benefit on many aspects of society, well beyond its clinical benefits on symptoms of diseases. With the ever-increasing indications for DBS, more positive global impact is expected.
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| 3. |
- Hariz, Marwan, et al.
(författare)
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Serendipity and Observations in Functional Neurosurgery : From James Parkinson's Stroke to Hamani's & Lozano's Flashbacks
- 2022
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Ingår i: Stereotactic and Functional Neurosurgery. - : S. Karger. - 1011-6125 .- 1423-0372. ; 100:4, s. 201-209
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Forskningsöversikt (refereegranskat)abstract
- Background: Serendipity and observations have a noble tradition in medicine, including neurology, and are responsible for many medical treatments (carbamazepine for tic douloureux, amantadine for Parkinson's disease, gabapentin for restless legs...). We aimed at examining the contribution of serendipity and observations to functional neurosurgery. Scholarly publications relevant to the history of functional neurosurgery for movement and psychiatric disorders were reviewed, starting from the pre-stereotactic era. The documents were scrutinized with respect to indications for surgery, surgical methods, and brain targets, in view of determining whether serendipitous discoveries and other observations contributed to various functional neurosurgical procedures. Summary: James Parkinson's observation that tremors disappeared in the arm of a person with shaking palsy after a hemiparetic stroke encouraged neurosurgeons in the first half of the 20th century to perform ablative procedures on central motor pathways. Following a lobotomy performed by Browder that extended too far medially in a psychiatric patient with coexisting Parkinson's disease (PD), it was noted that the Parkinsonian signs improved. This encouraged Russel Meyers to carry out open surgery on the caudate nucleus and basal ganglia in PD. Cooper introduced ligation of the anterior choroidal artery as a treatment for PD following a surgical accident during a pedunculotomy. Cooper later started to perform stereotactic surgery on the ventrolateral thalamus following the pathological finding that an intended pallidal lesion had in fact targeted the thalamus. Leksell discovered the ideal location of a pallidal lesion being in the posteroventral area empirically, long before the advent of the basal ganglia model of PD. Modern Deep Brain Stimulation (DBS) that started in the thalamus for tremor was the result of an observation by Benabid that intraoperative high-frequency stimulation during a thalamotomy reduced tremor. Both the discoveries of the anterior limbic subthalamic nucleus as a DBS target for OCD and the medial forebrain bundle as a DBS target for depression occurred by chance. Hamani and Lozano observed memory flashbacks in a patient who was undergoing DBS for obesity, which led to the discovery of the fornix as a potential DBS target for Alzheimer's disease. Key Messages: In the history of functional neurosurgery, serendipity and observations have resulted in discoveries of several procedures, brain targets for lesioning or DBS as well as new clinical surgical indications. In this era of neuromodulation, this technology should be exquisite in allowing potential serendipitous discoveries, provided that clinicians remain both observant and prepared.
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| 4. |
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| 5. |
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| 6. |
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| 7. |
- Blomstedt, Yulia, et al.
(författare)
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Flawed conclusions on the Vasterbotten Intervention Program by San Sebastian et .al
- 2019
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- An evaluation of Vasterbotten Intervention Programme (VIP) was recently conducted by San Sebastian et al. (BMC Public Health 19:202, 2019). Evaluation of health care interventions of this kind require 1) an understanding of both the design and the nature of the intervention, 2) correct definition of the target population, and 3) careful choice of the appropriate evaluation method. In this correspondence, we review the approach used by San Sebastian et al. as relates to these three criteria. Within this framework, we suggest important explanations for why the conclusions drawn by these authors contradict a large body of research on the effectiveness of the VIP.
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| 8. |
- Blomstedt, Yulia, et al.
(författare)
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Impact of a combined community and primary care prevention strategy on all-cause and cardiovascular mortality : a cohort analysis based on 1 million person-years of follow-up in Västerbotten County, Sweden, during 1990-2006
- 2015
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 5:12
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate the impact of the Västerbotten Intervention Programme (VIP) by comparing all eligible individuals (target group impact) according to the intention-to-treat principle and VIP participants with the general Swedish population.DESIGN: Dynamic cohort study.SETTING/PARTICIPANTS: All individuals aged 40, 50 or 60 years, residing in Västerbotten County, Sweden, between 1990 and 2006 (N=101 918) were followed from their first opportunity to participate in the VIP until age 75, study end point or prior death.INTERVENTION: The VIP is a systematic, long-term, county-wide cardiovascular disease (CVD) intervention that is performed within the primary healthcare setting and combines individual and population approaches. The core component is a health dialogue based on a physical examination and a comprehensive questionnaire at the ages of 40, 50 and 60 years.PRIMARY OUTCOMES: All-cause and CVD mortality.RESULTS: For the target group, there were 5646 deaths observed over 1 054 607 person-years. Compared to Sweden at large, the standardised all-cause mortality ratio was 90.6% (95% CI 88.2% to 93.0%): for women 87.9% (95% CI 84.1% to 91.7%) and for men 92.2% (95% CI 89.2% to 95.3%). For CVD, the ratio was 95.0% (95% CI 90.7% to 99.4%): for women 90.4% (95% CI 82.6% to 98.7%) and for men 96.8% (95% CI 91.7 to 102.0). For participants, subject to further impact as well as selection, when compared to Sweden at large, the standardised all-cause mortality ratio was 66.3% (95% CI 63.7% to 69.0%), whereas the CVD ratio was 68.9% (95% CI 64.2% to 73.9%). For the target group as well as for the participants, standardised mortality ratios for all-cause mortality were reduced within all educational strata.CONCLUSIONS: The study suggests that the VIP model of CVD prevention is able to impact on all-cause and cardiovascular mortality when evaluated according to the intention-to-treat principle.
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| 9. |
- Blomstedt, Yulia, et al.
(författare)
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Measuring self-reported health in low-income countries : piloting three instruments in semi-rural Burkina Faso
- 2012
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Ingår i: Global Health Action. - Järfälla : Co-Action Publishing. - 1654-9716 .- 1654-9880. ; 5, s. 8488-
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Tidskriftsartikel (refereegranskat)abstract
- Background: National surveys in low-income countries increasingly rely on self-reported measures of health. The ease, speed, and economy of collecting self-reports of health make such collection attractive for rapid appraisals. However, the interpretation of these measures is complicated since different cultures understand and respond to the same question in different ways. Objective: The aim of this pilot study was to develop a culturally sensitive tool to study the self-reported health (SRH) of the local adult population in Burkina Faso. Design: The study was carried out in the 2009 rainy season. The sample included 27 men and 25 women aged 18 or older who live in semi-urban Nouna, Burkina Faso. Three culturally adapted instruments were tested: a SRH question, a wooden visual analogue scale (VAS), and a drawn VAS. Respondents were asked to explain their answers to each instrument. The narratives were analyzed with the content analysis technique, and the prevalence of poor SRH was estimated from the quantitative data by stratification for respondent background variables (sex, age, literacy, education, marital status, ethnicity, chronic diseases). The correlation between the instruments was tested with Spearman's correlation test. Results: The SRH question showed a 38.5% prevalence of poor SRH and 44.2% prevalence with both VAS. The correlation between the VAS was 0.89, whereas the correlation between the VAS and the SRH question was 0.60-0.64. Nevertheless, the question used as the basis of each instrument was culturally sensitive and clear to all respondents. Analysis of the narratives shows that respondents clearly differentiated between the various health statuses. Conclusion: In this pilot, we developed and tested a new version of the SRH question that may be more culturally sensitive than its non-adapted equivalents. Additional insight into this population's understanding and reporting of health was also obtained. A larger sample is needed to further study the validity and reliability of the SRH question and the VAS and understand which instrument is best suited to study SRH in the low-income setting of semi-rural Burkina Faso.
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| 10. |
- Blomstedt, Yulia, et al.
(författare)
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Mental health of immigrants from the former Soviet Bloc : a future problem for primary health care in the enlarged European Union? A cross-sectional study
- 2007
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Ingår i: BMC Public Health. - : BioMed Central. - 1471-2458. ; 7, s. Article nr 27-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Enlargement of the European Union has caused worries about the possibility of increased migration from its new members, the former Soviet countries, and consequently increased demands on the health care systems of the host countries. This study investigated whether or not earlier immigrants from the former Soviet Bloc have poorer self-reported mental health, measured as self-reported psychiatric illness and psychosomatic complaints, than the host population in Sweden. It also examined the particular factors which might determine the self-reported mental health of these immigrants. METHODS: The cross-sectional national sample included 25-84-year-old Swedish-born persons (n = 35,459) and immigrants from Poland (n = 161), other East European countries (n = 164), and the former Soviet Union (n = 60) who arrived in Sweden after 1944 and were interviewed during 1994-2001. Unconditional multivariate logistic regression was used in the analyses. RESULTS: The findings indicated that the country of birth had a profound influence on self-reported mental health. Polish and other East European immigrants in general had a twofold higher odds ratio of reporting psychiatric illness and psychosomatic complaints, which fact could not be explained by adjustments for the demographic and socioeconomic variables. However, immigrants from the former Soviet Union had odds similar to those of the Swedish-born reference group. Adjustments for migration-related variables (language spoken at home and years in Sweden) changed the association between the country of birth and the outcomes only to a limited extent. CONCLUSION: Since poor mental health may hinder acculturation, the mental health of immigrants from Poland and other East European countries should be acknowledged, particularly with the expansion of the European Union and inclusion of nine former Soviet Bloc countries by 2007.
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| 11. |
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| 12. |
- Blomstedt, Yulia
(författare)
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Self-reported health among immigrants from the former Soviet Union : quantitative and qualitative studies in Sweden
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aims: The general aim was to study self-reported health and its determinants in immigrants from the FSU in Sweden. Study I: to analyze (i) whether there is an association between being born in the FSU and other countries of the former Soviet Bloc and poor self-reported general health among immigrants in Sweden and (ii) whether this association persists after adjusting for demographic, socioeconomic, and migration-related variables. Study II: to study (i) whether self-reported mental health (defined as self-reported psychiatric illness and psychosomatic complaints) was poorer among persons born in the FSU and other countries of the former Soviet Bloc currently living in Sweden than among Swedish-born persons and (ii) whether the demographic, socioeconomic, and migration-related characteristics of respondents could explain this. Study III: (i) to explore the self-reported health of Russian-speaking immigrants from the FSU in Sweden and (ii) to describe the influence of the culture of origin and of acculturation into the host country on the selfreporting of health among these immigrants. The aim of Study IV was to explore the immigrants own rating of the extent of their acculturation (self-reported integration) as a source of information in contrast to an external (researchers ) measurement of acculturation. Methods: Both quantitative (Studies I and II) and qualitative (Studies III and IV) research approaches were used. Studies I and II were based on eight pooled, cross-sectional random samples of permanent Swedish residents (including immigrants with permanent residence permits or Swedish citizenship who arrived in Sweden after 1944) interviewed within the Swedish Annual Level of Living Survey. Unconditional multivariate logistic regression was employed to estimate the odds ratios of poor self-reported health (both general and mental) after the stepwise and simultaneous adjustment for demographic, socioeconomic and migration-related variables. Study I included men and women aged 25 to 84 (N = 36,084) born in Sweden (n = 35,711), Poland (n = 158), other East European countries (n= 161), or the FSU (n = 54) interviewed between 1993 and 2000. Study II included men and women (N = 35,844) aged 25 to 84, born in Sweden (n = 35,459), Poland (n = 161), other East European countries (n = 164), or the FSU (n = 60), interviewed between 1994 and 2001. Studies III and IV were based on the data collected in Stockholm and its suburbs in April-June 2005 by means of the semi-structured in-depth interviews. The study sample included 15 Russian-speaking immigrants from the FSU currently living in Sweden (5 men and 10 women), with varying marital and socioeconomic status, a mean age of 47.3 (25 - 70) years and a mean time spent in Sweden of 13.6 (3 - 36) years. The results were validated by means of mini-interviews by telephone with 15 new respondents. Study III utilized the grounded theory approach to analyze the data. Study IV utilized the content analysis technique Framework. Results: Studies I and II showed that while immigrants from the FSU had higher odds of self-reporting poor general health than the Swedish-born host population, they did not have higher odds of reporting poor mental health. This was not true of immigrants from other countries of the former Soviet Bloc (Poland and other East European countries), who had higher odds of self-reporting both poor general health and poor mental health than the Swedish-born individuals. These findings remained after adjustment for demographic and socioeconomic variables. Study III showed that acculturation influenced the way Russianspeaking immigrants from the FSU communicated their health regardless of their actual health status. Their self-reported health (rated from very good to poor ) was associated with their choice of response models for the general health question (explicit, normalized, or implicit). This choice was determined by the extent of their acculturation (Integrated, Assimilated, Separated, or Marginalized) and consequent preference for manner of communication (Swedish or Russian). This suggested that it is essential to account for acculturation in the studies of immigrant health. Study IV described an easy way to measure acculturation by applying a variable called self-reported integration , which might be regarded as a proxy for acculturation. The self-reported integration is determined by the response to the question: In your opinion, have you become integrated in Sweden? The findings showed that the answer to this question given by the immigrants corresponded with the researcher s estimation of the immigrants extent of acculturation and possibly represented a respondent s holistic view of his or her acculturation, based on self-evaluation of both internal and formal criteria of integration. Conclusions In the present thesis we found that being born in the FSU was associated with poorer self-reported general health, but not self-reported mental health, than in the Swedish-born host population. This finding remained after adjustments for demographic and socioeconomic variables. However, it was found that acculturation influenced health communication among Russian-speaking immigrants from the FSU in Sweden. The more acculturated a respondent was, the more his/her response model to the general health question and his/her self-reported health corresponded to the ones traditional of the host country, but did not necessarily correspond to the actual state of the respondent’s health. This suggests that it is essential to account for acculturation in studies of immigrant health and calls for attention when designing studies and interventions targeted at this population group. Self-reported health is widely used in medical and related research practice nowadays and underestimating the influence of culture and acculturation on health communication might have negative consequences in the planning, implementation, and evaluation of health care services. Self-reported integration might be an informative variable for measuring the extent of acculturation. This might have implications in immigrant research, but its use as a proxy for acculturation should be tested primarily in other settings and in a quantitative analysis.
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| 13. |
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| 14. |
- Blomstedt, Yulia, et al.
(författare)
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What about healthy participants? : the improvement and deterioration of self-reported health at a 10-year follow-up of the Västerbotten Intervention Programme
- 2011
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Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 4, s. 5435-
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The Västerbotten Intervention Programme (VIP) addresses cardiovascular disease and diabetes in the middle-aged population of Västerbotten County, Sweden. Self-reported health (SRH) is one of the risk factors for both conditions. The aim of this study was to analyse the development patterns of SRH among the VIP participants.METHODS: Cross-sectional data from 1990 to 2007 were used to analyse the prevalence of poor SRH among 101,396 VIP participants aged 40-60 years. Panel data were used to study the change in SRH among 25,695 persons aged 30-60 years, who participated in the VIP twice within a 10-year interval.RESULTS: Prevalence of poor SRH fluctuated between 1990 and 2007 in Västerbotten County. There was a temporary decline around 2000, with SRH continuously improving thereafter. The majority of panel participants remained in good SRH; over half of those with poor or fair SRH at baseline reported better SRH at follow-up. SRH declined in 19% of the panel participants, mostly among those who had good SRH at the baseline. The decline was common among both women and men, in all educational, age and marital status groups.CONCLUSIONS: The SRH improvement among those with poor and fair SRH at baseline suggests that VIP has been successful in addressing its target population. However, the deterioration of SRH among 21% of the individuals with good SRH at baseline is of concern. From a public health perspective, it is important for health interventions to address not only the risk group but also those with a healthy profile to prevent the negative development among the seemingly healthy participants.
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| 15. |
- Byass, Peter, et al.
(författare)
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Beyond 2015 : time to reposition Scandinavia in global health?
- 2013
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Ingår i: Global Health Action. - Järfälla, Sweden : CoAction Publishing. - 1654-9716 .- 1654-9880. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- Global health currently finds itself in an exciting, almost bewildering, state of flux. A plethora of initiatives, statements, high-level meetings, and other activities are generating a continuous flow of new ideas, with the impetus at least partly driven by the advent of the 2015 target date set for the Millennium Development Goals that were adopted in 2000. Whatever shape the post-2015 global health landscape may eventually take, it is already clear that there will be new targets of some kind as the world tries to make further progress on some of the less tractable health issues.
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| 16. |
- Friberg, Peter, et al.
(författare)
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Public and global engagement with global health
- 2013
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Ingår i: The Lancet. - : Elsevier. - 0140-6736 .- 1474-547X. ; 381:9883, s. 2066-2066
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Tidskriftsartikel (refereegranskat)abstract
- Global health is widely regarded as being grounded in public and global engagement. But much of the process of global health is dominated by Northern institutions, expert groups, think-tanks, high-level meetings, and the like. Indeed, the exponential growth of global health in the past decade may soon turn into terminal decline unless truly global and broad-based ownership of the concept can be achieved.
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| 17. |
- Haafkens, Joke, et al.
(författare)
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Training needs for research in health inequities among health and demographic researchers from eight African and Asian countries
- 2014
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: To support equity focussed public health policy in low and middle income countries, more evidence and analysis of the social determinants of health inequalities is needed. This requires specific know how among researchers. The INDEPTH Training and Research Centres of Excellence (INTREC) collaboration will develop and provide training on the social determinants of health approach for health researchers from the International Network for the Demographic Evaluation of Populations and Their Health in Low- and Middle-Income Countries (INDEPTH) in Africa and Asia. To identify learning needs among the potential target group, this qualitative study explored what INDEPTH researchers from Ghana, Tanzania, South Africa, Kenya, Indonesia, India, Vietnam, and Bangladesh feel that they want to learn to be able to conduct research on the causes of health inequalities in their country.METHODS: Using an inductive method, online concept-mapping, participants were asked to generate statements in response to the question what background knowledge they would need to conduct research on the causes of health inequalities in their country, to sort those statements into thematic groups, and to rate them in terms of how important it would be for the INTREC program to offer instruction on each of the statements. Statistical techniques were used to structure statements into a thematic cluster map and average importance ratings of statements/clusters were calculated.RESULTS: Of the 150 invited researchers, 82 participated in the study; 54 from Africa; 28 from Asia. Participants generated 59 statements and sorted them into 6 broader thematic clusters: "assessing health inequalities"; "research design and methods"; "research and policy"; "demography and health inequalities"; "social determinants of health" and "interventions". African participants assigned the highest importance to further training on methods for assessing health inequalities. Asian participants assigned the highest importance to training on research and policy.CONCLUSION: The identified thematic clusters and statements provide a detailed understanding of what INDEPTH researchers want to learn in order to be able to conduct research on the social determinants of health inequalities. This offers a framework for developing capacity building programs in this emerging field of public health research.
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| 18. |
- Hedlund, Christina, et al.
(författare)
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Association of climatic factors with infectious diseases in the Arctic and subarctic region : a systematic review
- 2014
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Ingår i: Global Health Action. - : Global Health Action. - 1654-9716 .- 1654-9880. ; 7, s. 1-16
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Forskningsöversikt (refereegranskat)abstract
- Background:The Arctic and subarctic area are likely to be highly affected by climate change, with possible impacts on human health due to effects on food security and infectious diseases.Objectives:To investigate the evidence for an association between climatic factors and infectious diseases, and to identify the most climate-sensitive diseases and vulnerable populations in the Arctic and subarctic region.Methods:A systematic review was conducted. A search was made in PubMed, with the last update in May 2013. Inclusion criteria included human cases of infectious disease as outcome, climate or weather factor as exposure, and Arctic or subarctic areas as study origin. Narrative reviews, case reports, and projection studies were excluded. Abstracts and selected full texts were read and evaluated by two independent readers. A data collection sheet and an adjusted version of the SIGN methodology checklist were used to assess the quality grade of each article.Results:In total, 1953 abstracts were initially found, of which finally 29 articles were included. Almost half of the studies were carried out in Canada (n = 14), the rest from Sweden (n = 6), Finland (n = 4), Norway (n = 2), Russia (n = 2), and Alaska, US (n = 1). Articles were analyzed by disease group: food-and waterborne diseases, vector-borne diseases, airborne viral-and airborne bacterial diseases. Strong evidence was found in our review for an association between climatic factors and food-and waterborne diseases. The scientific evidence for a link between climate and specific vector-and rodent-borne diseases was weak due to that only a few diseases being addressed in more than one publication, although several articles were of very high quality. Air temperature and humidity seem to be important climatic factors to investigate further for viral-and bacterial airborne diseases, but from our results no conclusion about a causal relationship could be drawn.Conclusions:More studies of high quality are needed to investigate the adverse health impacts of weather and climatic factors in the Arctic and subarctic region. No studies from Greenland or Iceland were found, and only a few from Siberia and Alaska. Disease and syndromic surveillance should be part of climate change adaptation measures in the Arctic and subarctic regions, with monitoring of extreme weather events known to pose a risk for certain infectious diseases implemented at the community level.
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| 19. |
- Henschke, Nicholas, et al.
(författare)
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Strengthening capacity to research the social determinants of health in low-and middle-income countries : lessons from the INTREC programme
- 2017
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Ingår i: BMC Public Health. - : BioMed Central. - 1471-2458. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Background: The INDEPTH Training & Research Centres of Excellence (INTREC) collaboration developed a training programme to strengthen social determinants of health (SDH) research in low-and middle-income countries (LMICs). It was piloted among health-and demographic researchers from 9 countries in Africa and Asia. The programme followed a blended learning approach and was split into three consecutive teaching blocks over a 12month period: 1) an online course of 7 video lectures and assignments on the theory of SDH research; 2) a 2-week qualitative and quantitative methods workshop; and 3) a 1-week data analysis workshop. This report aims to summarise the student evaluations of the pilot and to suggest key lessons for future approaches to strengthen SDH research capacity in LMICs. Methods: Semi-structured interviews and questionnaires with 24 students from 9 countries in Africa and Asia were used to evaluate each teaching block. Information was collected about the students' motivation and interest in studying SDH, any challenges they faced during the consecutive teaching blocks, and suggestions they had for future courses on SDH. Results: Of the 24 students who began the programme, 13 (54%) completed all training activities. The students recognised the need for such a course and its potential to improve their skills as health researchers. The main challenges with the online course were time management, prior knowledge and skills required to participate in the course, and the need to get feedback from teaching staff throughout the learning process. All students found the face-to-face workshops to be of high quality and value for their work, because they offered an opportunity to clarify SDH concepts taught during the online course and to gain practical research skills. After the final teaching block, students felt they had improved their data analysis skills and were better able to develop research proposals, scientific manuscripts, and policy briefs. Conclusions: The INTREC programme has trained a promising cadre of health researchers who live and work in LMICs, which is an essential component of efforts to identify and reduce national and local level health inequities. Time management and technological issues were the greatest challenges, which can inform future attempts to strengthen research capacity on SDH.
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| 20. |
- Hirve, Siddhivinayak, et al.
(författare)
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Does self-rated health predict death in adults aged 50 years and above in India? Evidence from a rural population under health and demographic surveillance.
- 2012
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Ingår i: International Journal of Epidemiology. - : Oxford University Press (OUP). - 0300-5771 .- 1464-3685. ; 41:6, s. 1719-1727
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Tidskriftsartikel (refereegranskat)abstract
- Background The Study on Global Ageing and Adult Health (SAGE) aims to improve empirical understanding of health and well-being of adults in developing countries. We examine the role of self-rated health (SRH) in predicting mortality and assess how socio-demographic and other disability measures influence this association.Methods In 2007, a shortened SAGE questionnaire was administered to 5087 adults aged >= 50 years under the Health Demographic Surveillance System in rural Pune district, India. Respondents rated their own health with a single global question on SRH. Disability and well-being were assessed using the WHO Disability Assessment Schedule Index, Health State Score and quality-of-life score. Respondents were followed up every 6 months till June 2011. Any change in spousal support, migration or death during follow-up was updated in the SAGE dataset.Results In all, 410 respondents (8%) died in the 3-year follow-up period. Mortality risk was higher with bad/very bad SRH [hazard ratio (HR) in men: 3.06, 95% confidence interval (CI): 1.93-4.87; HR in women: 1.64, 95% CI: 0.94-2.86], independent of age, disability and other covariates. Disability measure (WHO Disability Assessment Schedule Index) and absence of spousal support were also associated with increased mortality risk.Conclusion Our findings confirm an association between bad/very bad SRH and mortality for men, independent of age, socio-demographic factors and other disability measures, in a rural Indian population. This association loses significance in women when adjusted for disability. Our study highlights the strength of nesting cross-sectional surveys within the context of the Health Demographic Surveillance System in studying the role of SRH and mortality.
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| 21. |
- Hirve, Siddhivinayak, et al.
(författare)
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Evaluating reporting heterogeneity in self-rated health among adults aged 50 years and above in India : an anchoring vignettes analytic approach
- 2014
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Ingår i: Journal of Aging and Health. - : Sage Publications. - 0898-2643 .- 1552-6887. ; 26:6, s. 1015-1031
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To use anchoring vignettes to evaluate reporting heterogeneity (RH) in self-rated mobility and cognition in older adults.Method: We analyzed vignettes and self-rated mobility and cognition in 2,558 individuals aged 50 years and above. We tested for assumptions of vignette equivalence (VE) and response consistency (RC). We used a joint hierarchical ordered probit (HOPIT) model to evaluate self-rating responses for RH.Results: The assumption of VE was met except for "learning" vignettes. Higher socioeconomic status (SES) and education significantly lowered thresholds for cognition ratings. After correction for RH, women, lower SES, and older respondents were significantly more likely to report greater difficulty in mobility. The influence of age, SES, and education on thresholds was less apparent for cognition.Discussion: Our study provides strong evidence of RH in self-rated mobility and cognition. We highlight the need to formally test basic assumptions before using vignettes to adjust self-rating responses for RH.
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| 22. |
- Hirve, Siddhivinayak, 1961-
(författare)
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"In general, how do you feel today?" Self-rated health in the context of aging in India
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Most aging research comes from the developed world. Aging research in India is focused on disease states and risk factors. Evidence on elderly health, physical performance and disability to understand the psycho-social or socio-behavioral risk is limited in India. Self-rated health (SRH) is used often in survey settings to quickly assess health status and is known to predict morbidity and mortality. The first wave of the Study on global AGEing and adult health (SAGE) survey provides an opportunity to explore the complex construct of SRH in the context of the aging process in its various key life domains of health, disability, cognition, activities of daily life, work, family, security and well-being in low and middle income settings.Objectives: This research aims to (a) understand pathways through which the social environment, functional disability, health behaviour and chronic disease experience influence SRH, (b) examine the role of SRH in predicting mortality, (c) validate SRH to improve its interpersonal comparability, and (d) assess how well estimates of SRH derived directly from a ‘small area’ survey compare with ‘small area’ estimates derived indirectly from a ‘large area’ survey.Methods: The Vadu Health and Demographic Surveillance System (HDSS) monitor health and demographic trends in a rural population of more than 100 000 in 22 villages in India since 2002. The full and short version of the SAGE survey was implemented in Vadu in 2007-09 among 321 and 5432 individuals aged 50 years and above, respectively. A structural equation model tested pathways through which social and biological factors influenced SRH. A Cox proportional hazard model examined the role of SRH as a predictor for mortality. Anchoring vignettes were used to evaluate SRH for reporting heterogeneity. The Hierarchical Ordered Probit model adjusted SRH for reporting heterogeneity. The SRH prevalence estimates for Vadu derived indirectly (indirect synthetic estimate, empirical Bayes estimate, Hierarchical Bayes estimate) from the national SAGE survey were compared with estimates derived directly from the Vadu SAGE survey, using different design and model-based techniques.Results: Older individuals reported poor SRH compared to those younger. Women rated their quality of life and SRH poorer than men. The effect of age on SRH was mediated through functional disability. Higher socioeconomic status and higher quality of life was in turn associated with better SRH but this relationship lacked statistical significance. Smoking or consumption of tobacco was associated with at least one chronic illness which in turn was associated with poor SRH and quality of life. However the association between chronic illness and SRH and quality of life was not statistically significant. Mortality risk was higher among individuals who reported bad/very bad SRH, disability and lack of spousal support independent of age and sex. There was strong evidence of reporting heterogeneity in SRH that was influenced by age, sex, education and socioeconomic status. The prevalence of ‘good / very good’ SRH was estimated to be 50%. This direct survey estimate compared well with the prevalence estimate of about 45% derived indirectly from model-based small area estimation methods. The indirect synthetic estimate for Vadu (23.2%) was a poor approximation to the direct survey or modelbased estimate.Conclusion: This research establishes the value and utility of SRH as a simple measure of health and predictor of mortality in an aging context. It provides evidence to formulate programs and policies towards an enabling social environment and an ability to function in key life domains of health and well-being. It highlights the need to identify and adjust self-rated responses for interpersonal incomparability prior to making comparisons across individuals or groups of individuals. It highlights the potential of using information from large national surveys by district level managers for planning and evaluation of policies and programs at the district or sub-district level. Finally, this research provides the basis for integrating SRH and related questions into routine HDSS.
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| 23. |
- Hirve, Siddhivinayak, et al.
(författare)
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Self-rated health : small area large area comparisons amongst older adults at the state, district and sub-district level in India
- 2014
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Ingår i: Health and Place. - : Elsevier. - 1353-8292 .- 1873-2054. ; 26C, s. 31-38
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Tidskriftsartikel (refereegranskat)abstract
- We compared prevalence estimates of self-rated health (SRH) derived indirectly using four different small area estimation methods for the Vadu (small) area from the national Study on Global AGEing (SAGE) survey with estimates derived directly from the Vadu SAGE survey. The indirect synthetic estimate for Vadu was 24% whereas the model based estimates were 45.6% and 45.7% with smaller prediction errors and comparable to the direct survey estimate of 50%. The model based techniques were better suited to estimate the prevalence of SRH than the indirect synthetic method. We conclude that a simplified mixed effects regression model can produce valid small area estimates of SRH.
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| 24. |
- Hirve, Siddhivinayak, et al.
(författare)
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Unpacking self-rated health and quality of life in older adults and elderly in India : a structural equation modelling approach
- 2014
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Ingår i: Social Indicators Research. - : Springer. - 0303-8300 .- 1573-0921. ; 117:1, s. 105-119
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Tidskriftsartikel (refereegranskat)abstract
- The Study on global AGEing and adult health (SAGE) aims at improving empirical understanding of the health and well-being of older adults in low- and middle-income countries. A total of 321 adults aged 50 years and older were interviewed in rural Pune district, India, in 2007. We used Structural Equation Modelling (SEM) to examine the pathways through which social factors, functional disability, risk behaviours, and chronic disease experience influence self-rated health (SRH) and quality of life (QOL) amongst older adults in India. Both SRH and QOL worsened with increased age (indirect effect) and limitations in functional ability (direct effect). QOL, socio-economic status (SES), and social networking had no significant effect on SRH. Smoking was associated with the presence of at least one chronic illness, but this did not have a statistically significant effect on SRH. Higher social networking was seen amongst the better educated and those with regular income, which in turn positively affected the QOL rating. QOL had a direct, but statistically not significant, effect on SRH. In conclusion, the indirect effects of age on SRH mediated through functional ability, and the effects of SES on QOL mediated through social networking, provide new understanding of how age and socio-economic status affect SRH and QOL. By allowing for measurement errors, solving for collinearity in predictor variables by integrating them into measurement models, and specifying causal dependencies between the underlying latent constructs, SEM provides a strong link between theory and empirics.
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| 25. |
- Hirve, Siddhivinayak, et al.
(författare)
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Use of anchoring vignettes to evaluate health reporting behavior amongst adults aged 50 years and above in Africa and Asia : testing assumptions
- 2013
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Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 6, s. 1-15
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Tidskriftsartikel (refereegranskat)abstract
- Background: Comparing self-rating health responses across individuals and cultures is misleading due to different reporting behaviors. Anchoring vignettes is a technique that allows identifying and adjusting self-rating responses for reporting heterogeneity (RH). Objective: This article aims to test two crucial assumptions of vignette equivalence (VE) and response consistency (RC) that are required to be met before vignettes can be used to adjust self-rating responses for RH. Design: We used self-ratings, vignettes, and objective measures covering domains of mobility and cognition from the WHO study on global AGEing and adult health, administered to older adults aged 50 years and above from eight low-and middle-income countries in Africa and Asia. For VE, we specified a hierarchical ordered probit (HOPIT) model to test for equality of perceived vignette locations. For RC, we tested for equality of thresholds that are used to rate vignettes with thresholds derived from objective measures and used to rate their own health function. Results: There was evidence of RH in self-rating responses for difficulty in mobility and cognition. Assumptions of VE and RC between countries were violated driven by age, sex, and education. However, within a country context, assumption of VE was met in some countries (mainly in Africa, except Tanzania) and violated in others (mainly in Asia, except India). Conclusion: We conclude that violation of assumptions of RC and VE precluded the use of anchoring vignettes to adjust self-rated responses for RH across countries in Asia and Africa.
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| 26. |
- Hofman, Karen, et al.
(författare)
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Addressing research capacity for health equity and the social determinants of health in three African countries : the INTREC programme
- 2013
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Ingår i: Global Health Action. - : CoAction Publishing. - 1654-9716 .- 1654-9880. ; 6, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The importance of tackling economic, social and health-related inequities is increasingly accepted as a core concern for the post-Millennium Development Goal framework. However, there is a global dearth of high-quality, policy-relevant and actionable data on inequities within populations, which means that development solutions seldom focus on the people who need them most. INTREC (INDEPTH Training and Research Centres of Excellence) was established with this concern in mind. It aims to provide training for researchers from the INDEPTH network on associations between health inequities, the social determinants of health (SDH), and health outcomes, and on presenting their findings in a usable form to policy makers.OBJECTIVE: As part of a baseline situation analysis for INTREC, this paper assesses the current status of SDH training in three of the African INTREC countries - Ghana, Tanzania, and South Africa - as well as the gaps, barriers, and opportunities for training.METHODS: SDH-related courses from the three countries were identified through personal knowledge of the researchers, supplemented by snowballing and online searches. Interviews were also conducted with, among others, academics engaged in SDH and public health training in order to provide context and complementary material. Information regarding access to the Internet, as a possible INTREC teaching medium, was gathered in each country through online searches.RESULTS: SDH-relevant training is available, but 1) the number of places available for students is limited; 2) the training tends to be public-health-oriented rather than inclusive of the broader, multi-sectoral issues associated with SDH; and 3) insufficient funding places limitations on both students and on the training institutions themselves, thereby affecting participation and quality. We also identified rapidly expanding Internet connectivity in all three countries, which opens up opportunities for e-learning on SDH, though the current quality of the Internet services remains mixed.CONCLUSIONS: SDH training is currently in short supply, and there is a clear role for INTREC to contribute to the training of a critical mass of African researchers on the topic. This work will be accomplished most effectively by building on pre-existing networks, institutions, and methods.
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| 27. |
- Nahar, Nazmun, et al.
(författare)
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Increasing the provision of mental health care for vulnerable, disaster-affected people in Bangladesh
- 2014
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 14:1, s. 708-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Bangladesh has the highest natural disaster mortality rate in the world, with over half a million people lost to disaster events since 1970. Most of these people have died during floods or cyclones, both of which are likely to become more frequent due to global climate change. To date, the government's post-disaster response strategy has focused, increasingly effectively, on the physical needs of survivors, through the provision of shelter, food and medical care. However, the serious and widespread mental health consequences of natural disasters in Bangladesh have not yet received the attention that they deserve. This Debate article proposes a practical model that will facilitate the provision of comprehensive and effective post-disaster mental health services for vulnerable Bangladeshis on a sustainable basis.DISCUSSION: A series of socially determined factors render the women and the poor of Bangladesh particularly vulnerable to dying in natural disasters; and, for those who survive, to suffering from some sort of disaster-related mental health illness. For women, this is largely due to the enforced gender separation, or purdah, that they endure; while for the poor, it is the fact that they are, by definition, only able to afford to live in the most climatically dangerous, and under-served parts of the country. Although the disasters themselves are brought by nature, therefore, social determinants increase the vulnerability of particular groups to mental illness as a result of them. While deeply entrenched, these determinants are at least partially amenable to change through policy and action.SUMMARY: In response to the 2004 Indian Ocean tsunami, the World Health Organisation developed a framework for providing mental health and psychosocial support after major disasters, which, we argue, could be adapted to Bangladeshi post-cyclone and post-flood contexts. The framework is community-based, it includes both medical and non-clinical components, and it could be adapted so that women and the poor are actively sought out and provided for. After training, these services could be run by Bangladesh's pre-existing 50,000-strong Cyclone Preparedness Programme workforce, alongside the country's extensive network of community-based health workers.
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| 28. |
- Norberg, Margareta, et al.
(författare)
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Community participation and sustainability : evidence over 25 years in the Vasterbotten Intervention Programme
- 2012
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Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 5, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Background: Selection bias and declining participation rates are of concern in many long-term epidemiological studies. The Vasterbotten Intervention Programme (VIP) was launched in 1985 as a response to alarming reports on elevated cardiovascular disease (CVD) mortality in Vasterbotten County in Northern Sweden. The VIP invites women and men to a health examination and health counselling during the year of their 40th, 50th, and 60th birthdays. Objective: To evaluate trends in participation rates and determinants of participation in the VIP from 1990 to 2006. Design: Registry data on socio-economic status from Statistics Sweden, and mortality and hospitalisation data from the National Board of Health and Welfare, both covering the whole Swedish population, were linked to the VIP and analysed for participants and non-participants. Results: During 1990 - 2006, 117,710 individuals were eligible to participate in the VIP, and 40,472 of them were eligible to participate twice. There were 96,560 observations for participants and 61,622 for non-participants. The overall participation rate increased from 56 to 65%. Participants and non-participants had minimal differences in education and age. Initial small differences by sex and degree of urban residence decreased over time. Despite an increasing participation rate in all groups, those with low income or who were single had an approximately 10% lower participation rate than those with high or medium-income or who were married or cohabitating. Conclusion: Sustainability of the VIP is based on organisational integration into primary health care services and targeting of the entire middle-aged population. This enables the programme to meet population expectations of health promotion and to identify high-risk individuals who are then entered into routine preventive health care services. This has the potential to increase participation rates, to minimise social selection bias, and to reinforce other community-based interventions.
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| 29. |
- Nyagwui, Asonganyi Edwin, et al.
(författare)
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Motorcycle injury among secondary school students in the Tiko municipality, Cameroon
- 2016
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Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 24
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: injury from motorcycle is a considerable cause of disability and death in the world and especially in low and middle-income countries; it is one of the most serious public health problems. In Cameroon, motorcycle is commonly used for transportation particularly among students. The aim of this paper is to study the risk-factors of the motorcycle-related accidents and injuries among secondary school students’ in the Tiko municipality, Cameroon.Methods: a cross sectional study was conducted in January 2012 on 391 students age 16-24 from public and private schools in the Tiko Municipality. Logistic regression was used to estimate the association between risk factors and injuries. A closed-ended and few open-ended questionnaire was used to collect data.Results: the study showed that over 70% of students used motorcycles always or often. Few had undergone any formal training for driving a motorcycle. The vast majority reported not wearing protective gear while driving or riding a motorcycle. Usage of protective gear was particularly low among girls. Over 16% reported using a motorbike always or occasionally under the influence of alcohol or drugs. Over 58% of respondents reported having an accident and over 35% were injured when driving or riding a motorcycle. Those who lived at the Tiko-Douala road have three times higher probability to sustain accidents and injuries than students residing elsewhere (OR 3.19 (1.20-8.46).Conclusion: it is deeply alarming that every second respondent in the study reported having been in an accident and every third motorcycle user was somehow injured. We therefore call for an immediate attention and a deeper investigation into the highlighted situation, particularly at Tiko-Douala road.
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| 30. |
- Padyab, Mojgan, et al.
(författare)
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Life course socioeconomic position and mortality : A population register-based study from Sweden
- 2013
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 41:8, s. 785-791
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Adverse social circumstances during one’s life course have been related to an increased risk of mortality. This article extends the literature by focusing on adversity at each phase of, and cumulatively at midlife in the Swedish population.Methods: Data on socioeconomic indicators from 1970, 1980 and 1990 were linked to death registrations from 2000 to 2009. Relative indices of inequalities were computed for socioeconomic indicators, in order to measure the cumulative impact of inequality on mortality.Results: A significant cumulative effect of being in the worst-off socioeconomic groups was found. For men, almost all indicators had a significant independent impact on risk of death. Among women, significant independent impacts were found for education in 1990 and for socioeconomic index in the two census years of 1970 and 1980.Conclusions: Being disadvantaged during longer period in midlife has a significant negative impact on health. Policies targeted to reduce health inequality should focus on every stage of the midlife course.
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| 31. |
- Padyab, Mojgan, et al.
(författare)
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No association found between cardiovascular mortality, and job demands and decision latitude : experience from the Västerbotten Intervention Programme in Sweden
- 2014
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Ingår i: Social Science and Medicine. - : Elsevier. - 0277-9536 .- 1873-5347. ; 117, s. 58-66
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Tidskriftsartikel (refereegranskat)abstract
- The current prospective study with the longest follow-up period in Northern Sweden aims to investigate the association between job demands and decision latitude and cardiovascular disease (CVD) mortality. Further, we aim to assess the effect of conventional risk factors (i.e., body mass index, alcohol consumption, physical activity, marital status, education and smoking) on the association between job demands and decision latitude and CVD mortality. The data originated from the Linnaeus database, available at the Center for Population Studies, Umeå University, Sweden. A cohort of men and women aged 40, 50 and 60 years were recruited from the Västerbotten Intervention Programme. Deaths due to stroke and myocardial infarction at the end of the follow up are considered the outcome. Baseline job characteristics were defined by the Swedish version of the Karasek demand/control model. Statistical methods include proportional Cox hazard modeling and Relative Excess Risk due to Interaction (RERI) to assess interactions. The findings from this study did not support the association between job demands and decision latitude and CVD mortality. Instead, conventional risk factors were found stronger predictors, most evidently education differentials were associated with CVD mortality. We know from previous research that the greater the attenuation of the gradient after adjustment for a given risk factor, the greater the potential to reduce educational inequality via interventions that target this factor. Based on the present findings of the experience in Västerbotten, further research is needed to identify other risk factors besides job strain and its components that would reduce the socioeconomic gradient in CVD mortality.
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| 32. |
- Preet, Raman, et al.
(författare)
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Assessing dental professionals' understanding of tobacco prevention and control : a qualitative study in Västerbotten County, Sweden
- 2016
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Ingår i: BDJ Open. - : Springer Science and Business Media LLC. - 2056-807X. ; :2, s. 1-6
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To assess dental professionals’ understanding of tobacco prevention and control.Materials and methods: In Sweden dental hygienists receive training in tobacco prevention and control. The study setting is Västerbotton County in the north of Sweden where a number of successful tobacco control initiatives have been established. A purposeful sample comprising five male and four female dental professionals and trainees was selected. Data were collected through in-depth semi-structured individual interviews and analysed using content analysis.Results: Informants acknowledged limited adherence to tobacco prevention. They were not confident of their knowledge of tobacco and non-communicable disease prevention and had limited awareness of global oral health policies. Reasons for poor adherence included professional fragmentation, lack of training, and the absence of reimbursement for time spent on prevention activities.Discussion: The success of efforts to reduce smoking in Västerbotton County is attributed to the network of local public health initiatives with very limited involvement by local dental professionals.Conclusions: The findings highlight the need to more actively engage the dental workforce in tobacco control and prevention. Moreover, it is important to recognise that dental professionals can be public health advocates for tobacco control and prevention at global, national and local levels.
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| 33. |
- Rönnlund, Michael, et al.
(författare)
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Secular trends in cognitive test performance : Swedish conscript data 1970–1993
- 2013
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Ingår i: Intelligence. - : Elsevier BV. - 0160-2896 .- 1873-7935. ; 41:1, s. 19-24
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Tidskriftsartikel (refereegranskat)abstract
- We investigated time-related patterns in levels of cognitive performance during the period from 1970 to 1993 based on data from Swedish draft boards. The conscripts, including more than a million 18–19-year old men, had taken one of two versions of the Swedish enlistment battery (SEB67; 1970–1979 or SEB80; 1980–1993), each composed of four subtests. The results revealed significant Flynn effects, with estimated gains of 1.2–1.5 IQ-units per decade. The effect seem to hold across ability levels, even though tendencies of more pronounced effects in the lower half of the ability distribution was observed. The largest gains were for visuospatial tests (Paper Form Board and Metal Folding), with little change, even slight losses during the second sub-period, for tests of verbal knowledge (Concept Discrimination and Synonyms) and a mixed pattern for a test of technical comprehension (losses followed by gains). Finally, comparisons of trends in cognitive performance and in standing height show that the gains in cognitive performance over the years from 1980 to 1993 occurred in the absence of overall gains in height, which speaks against nutrition as the cause of the Flynn effects.
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| 34. |
- Sörlin, Ann, et al.
(författare)
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Measuring the gender gap in organizations
- 2011
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Ingår i: Gender in Management. - Bingley : Emerald. - 1754-2413 .- 1754-2421. ; 26:4, s. 275-288
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this paper is to present a register‐based index that could provide a practical tool for gathering information and increasing our knowledge on gender equality at organizational level.Design/methodology/approachBased on Swedish gender policy and information available in public registers, six variables were chosen. For each variable, a gender gap was calculated as the ratio between the sexes, with the larger figure always treated as numerator. The study population consisted of 11,471 persons in 46 companies working in the computer sector, and 32,151 individuals in 77 companies employed in the grocery production sector.FindingsThe results show indices of 1.43‐2.09 for the computer sector and of 1.13‐2.14 for the grocery production sector, both with a normal distribution (one is considered fully gender equal and three least gender equal). Added together, the selected variables provide results that are sufficiently different to enable ranking. The variables vary in importance in the two sectors compared. The smallest index variation was for education and salaries; the largest was for parental leave and the number of men and women employed at the companies.Originality/valueThe index is based on public registers, treats men and women symmetrically, and the results generated by the index are easy to communicate to all stakeholders. This research could provide a useful tool for investigating the extent to which men and women differ in certain variables at company level.
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