1.
Jemberie, Wossenseged Birhane, 1985-, et al.
(author)
Substance Use Disorders and COVID-19 : Multi-Faceted Problems Which Require Multi-Pronged Solutions
2020
In: Frontiers in Psychiatry. - : Frontiers Media S.A.. - 1664-0640. ; 11
Journal article (peer-reviewed) abstract
COVID-19 shocked health and economic systems leaving millions of people without employment and safety nets. The pandemic disproportionately affects people with substance use disorders (SUDs) due to the collision between SUDs and COVID-19. Comorbidities and risk environments for SUDs are likely risk factors for COVID-19. The pandemic, in turn, diminishes resources that people with SUD need for their recovery and well-being. This article presents an interdisciplinary and international perspective on how COVID-19 and the related systemic shock impact on individuals with SUDs directly and indirectly. We highlight a need to understand SUDs as biopsychosocial disorders and use evidence-based policies to destigmatize SUDs. We recommend a suite of multi-sectorial actions and strategies to strengthen, modernize and complement addiction care systems which will become resilient and responsive to future systemic shocks similar to the COVID-19 pandemic.
2.
Girma Kebede, Betlehem, et al.
(author)
Communicative challenges among physicians, patients, and family caregivers in cancer care: An exploratory qualitative study in Ethiopia
2020
In: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 15:3
Journal article (peer-reviewed) abstract
Background: Cancer is a growing concern in Ethiopia. Though communication is essential for the treatment process, few studies have looked at communication in Ethiopian cancer care. Due to the large number of patients and scarcity of resources, it is vital to understand how to manage consultations in order to effectively help as many patients as possible in this challenging work environment. Thus, research is needed to analyze and understand the communicative challenges experienced by physicians, patients, and family caregivers, in order to successfully handle patient care in practice. Objective We explore communication in Ethiopian cancer care and present the main challenges faced by physicians, patients, and family caregivers. Methods This explorative qualitative study was conducted at the Oncology Department of the Tikur Anbessa (Black Lion) Specialized Teaching Hospital (TASH) in Addis Ababa, Ethiopia. A triangulation of data collection methods was used: 91 audio-recorded, semi-structured interviews and 21 video-recordings of authentic interactions during hospital rounds. The aim was to obtain as complete a picture as possible of communication from the perspectives of physicians, patients, and family caregivers. The interviews were analyzed using thematic content analysis and the identified themes were supported by excerpts from the transcribed recordings. Results Eight themes emerged from the data. Workload and time pressure, in combination with restricted space for privacy, limited the possibilities for physicians to deliver detailed information and provide emotional support. Furthermore, patient literacy levels, in combination with no or little cancer awareness, financial problems, reliance on traditional and religious treatments, the stigma of cancer, and a fatalistic attitude, resulted in delays in patients seeking care and participating in positive health behaviors, and, subsequently, often resulted in an unwillingness to openly discuss problems with physicians and adhere to treatment. The study also illustrates the paramount role of family in physician-patient communication in Ethiopia. Though family caregivers provide a valuable interpreting support when patients have limited language skills, they can also prevent patients from sharing information with physicians. Another important finding is that family caregivers were often responsible for making decisions about treatment and avoided telling patients about a poor prognosis, believing that conveying bad news may upset them. All of these themes have important implications for the role of ethically acceptable communication in patient-centered care. Conclusions This study has identified a number of serious challenges for successful and ethically acceptable health communication in Ethiopian cancer care. The study contributes to our understanding of the complexity around the role of family, combined with patients’ dependency on family members for communication, support, and access to care, which creates particular ethical dilemmas for the medical staff. The questions raised by this study concern how to organize consultations to achieve patient-centered health communication, while maintaining a constructive alliance with the family and not jeopardizing the patient’s continued access to care. The integration of communication training for medical students in Ethiopia, with a focus on ethical guidelines for family-centered patient consultation suitable for these circumstances, would be an essential step.
3.
Ahlstrand, Inger, et al.
(author)
Health-promoting factors among students in higher education within health care and social work : a cross-sectional analysis of baseline data in a multicentre longitudinal study
2022
In: BMC Public Health. - London : BioMed Central. - 1471-2458. ; 22:1
Journal article (peer-reviewed) abstract
Background: Educational environments are considered important in strengthening students’ health status and knowledge, which are associated with good educational outcomes. It has been suggested to establish healthy universities based on a salutogenic approach – namely, health promotion. The aim of this study was to describe health-promoting resources and factors among first-semester students in higher education in healthcare and social work.Methods: This cross-sectional study is based on a survey distributed among all students in seven healthcare and social work programmes at six universities in southern Sweden. The survey was carried out in 2018 using a self-reported, web-based questionnaire focussing on general health and well-being, lifestyle factors together with three validated instruments measuring health-promoting factors and processes: the Sense of Coherence (SOC) scale, Salutogenic Health Indicator Scale (SHIS) and Occupational Balance Questionnaire (OBQ).Results: Of 2283 students, 851 (37.3%) completed the survey, of whom 742 (87.1%) were women; 722 (84.8%) were enrolled on healthcare programmes, and 129 (15.2%) were enrolled on social work programmes. Most reported good general health and well-being (88.1% and 83.7%, respectively). The total mean scores for the SOC scale, SHIS and OBQ were, respectively, 59.09 (SD = 11.78), 44.04 (SD = 9.38) and 26.40 (SD = 7.07). Well-being and several healthy lifestyles were related to better general health and higher SOC, SHIS and OBQ scores. Multiple linear and logistic regressions showed that perceived well-being and no sleeping problems significantly predicted higher general health and higher SOC, SHIS and OBQ scores. Being less sedentary and non-smoking habits were significant predictors of higher SOC.Conclusions: Swedish students in higher education within the healthcare and social work sector report good general health and well-being in the first semester, as well as health-promoting resources (i.e. SOC, SHIS and OBQ), and in some aspects, a healthy lifestyle. High-intensity exercise, no sleeping problems and non-smoking seem to be of importance to both general health and health-promotive resources. This study contributes to knowledge about the health promotive characteristics of students in the healthcare and social work fields, which is of importance for planning universities with a salutogenic approach.
4.
Nijsingh, Niels, 1977, et al.
(author)
Managing pollution from antibiotics manufacturing: charting actors, incentives and disincentives
2019
In: Environmental health. - : Springer Science and Business Media LLC. - 1476-069X. ; 18
Journal article (peer-reviewed) abstract
Background Emissions of high concentrations of antibiotics from manufacturing sites select for resistant bacteria and may contribute to the emergence of new forms of resistance in pathogens. Many scientists, industry, policy makers and other stakeholders recognize such pollution as an unnecessary and unacceptable risk to global public health. An attempt to assess and reduce such discharges, however, quickly meets with complex realities that need to be understood to identify effective ways to move forward. This paper charts relevant key actor-types, their main stakes and interests, incentives that can motivate them to act to improve the situation, as well as disincentives that may undermine such motivation. Methods The actor types and their respective interests have been identified using research literature, publicly available documents, websites, and the knowledge of the authors. Results Thirty-three different actor-types were identified, representing e.g. commercial actors, public agencies, states and international institutions. These are in complex ways connected by interests that sometimes may conflict and sometimes pull in the same direction. Some actor types can act to create incentives and disincentives for others in this area. Conclusions The analysis demonstrates and clarifies the challenges in addressing industrial emissions of antibiotics, notably the complexity of the relations between different types of actors, their international dependency and the need for transparency. The analysis however also suggests possible ways of initiating incentive-chains to eventually improve the prospects of motivating industry to reduce emissions. High-resource consumer states, especially in multinational cooperation, hold a key position to initiate such chains.
5.
Mackay, Heather, 1976-
(author)
Food Sources and Access Strategies in Ugandan Secondary Cities : An Intersectional Analysis
2019
In: Environment & Urbanization. - : SAGE Publications. - 0956-2478 .- 1746-0301. ; 31:2, s. 375-396
Journal article (peer-reviewed) abstract
This article arises from an interest in African urbanization and in the food, farming and nutritional transitions that some scholars present as integral to urban life. The paper investigates personal urban food environments, food sources and access strategies in two secondary Ugandan cities, Mbale and Mbarara, drawing on in-depth interviews and applying an intersectional lens. Food sources were similar across dimensions of difference but food access strategies varied. My findings indicate that socioeconomic circumstance (class) was the most salient influence shaping differences in daily food access strategies. Socioeconomic status, in turn, interacted with other identity aspects, an individual’s asset base and broader structural inequalities in influencing urban food environments. Rural land and rural connections, or multispatiality, were also important for food-secure urban lives. The work illuminates geometries of advantage and disadvantage within secondary cities, and highlights similarities and differences between food environments in these cities and Uganda’s capital, Kampala.
6.
Nijsingh, Niels, 1977, et al.
(author)
Ethics of Screening
2017
In: International Encyclopedia of Public Health, 2nd Edition, Volume 3. Stella R.Quah (ed.). - Oxford, U.K. : Academic Press (Elsevier). - 9780128037089 ; , s. 28-35
Book chapter (peer-reviewed)
7.
Mackay, Heather, 1976-
(author)
A feminist geographic analysis of perceptions of food and health in Ugandan cities
2019
In: Gender, Place and Culture. - : Routledge. - 0966-369X .- 1360-0524. ; 26:11, s. 1519-1543
Journal article (peer-reviewed) abstract
This article contributes to a feminist geographic analysis of how urban food and health environments and non-communicable disease experience may be being constructed, and contested, by healthcare professionals (local elites) in two secondary Ugandan cities (Mbale and Mbarara). I use thematic and group interaction analysis of focus group data to explore material and discursive representations. Findings make explicit how healthcare professionals had a tendency to prescribe highly classed and gendered assumptions of bodies and behaviours in places and in daily practices. The work supports the discomfort some have felt concerning claims of an African nutrition transition, and is relevant to debates regarding double burden malnutrition. I argue that a feministic analysis, and an intersectional appreciation of people in places, is advantageous to food and health-related research and policy-making. Results uncover and deconstruct a dominant patriarchal tendency towards blaming women for obesity. Yet findings also exemplify the co-constructed and malleable nature of knowledge and understandings, and this offers encouragement.
8.
Dymitrow, Mirek, et al.
(author)
Nutrition, health and climate : What have we learned so far?
2019
In: Conference on Food Science and Nutrition: “Forum for food science and nutrition for a better tomorrow”, 25–26 February 2019, Rome, Italy.
Conference paper (peer-reviewed) abstract
Food and meals are central elements in our lives: a source of pleasure, a social activity and a bearer of culture. Our eating habits are also very important to health, which implies that the organization and content of meals is a prerequisite for well-being and learning. Schools, in particular, have unique opportunities to promote healthy lifestyles, help develop good eating habits and raise environmental and climate awareness among children and youths by embedding food in a wider context. Unsurprisingly, there is also an increasing interest in school meals and food-related education among researchers, many of whom agree that the quality of school meals can be seen as one of the most accurate indicators of the cities’ sustainability potential. Systematic quality work, however, requires shared targets and ambitions, regular quality checks and discussions on development and improvement. In that vein, the City of Gothenburg has launched the project Urban Rural Gothenburg, which assembles, develops, tests and implements new solutions for the city’s public kitchens. This involves climate-smart and environmentally sound perspectives and programs regarding meal planning, food procurement, food preparation and food-related teaching and learning. One important approach deals with the normalization of increased vegetarian consumption and greater awareness of food’s origins and travel from farm to table. Another approach deals with conscious choices of raw materials that are beneficial for both the environment and health. A third notable approach focuses on new ways of handling food waste to reduce climate impact. In line with the third Sustainable Development Goal, this presentation captures and reaffirms the fundamental assumptions and methods involved in Gothenburg’s work with food sustainability in public kitchens, with an emphasis on health and climate as cross-cutting issues that matter to us all.
9.
Larsson, Matz, et al.
(author)
Exposure to environmental tobacco smoke and health effects among hospitality workers in Sweden : before and after the implementation of a smoke-free law
2008
In: Scandinavian Journal of Work, Environment and Health. - Helsingfors : Institutet för arbetshygien. - 0355-3140 .- 1795-990X. ; 34:4, s. 267-277
Journal article (peer-reviewed) abstract
Objectives This study attempted to identify changes in exposure to environmental tobacco smoke, as well as symptoms and attitudes among hospitality workers after the introduction of extended smoke-free workplace legislation.Methods A total of 37 volunteers working in bingo halls and casinos (gaming workers) and 54 bars and restaurant employees (other workers) in nine Swedish communities participated in the study. Altogether 71 of 91 persons (14 daily smokers and 57 nonsmokers) participated in both the preban baseline survey and the follow-up 12 months after the ban. Exposure to environmental tobacco smoke, smoking habits, respiratory and sensory symptoms, and attitudes towards the ban were recorded, and spirometry was carried out.Results The frequency of reported respiratory and sensory symptoms was approximately halved among the nonsmokers in both occupational groups after the introduction of the ban. Initially 87% had exposure to environmental tobacco smoke that was over the nicotine cut-off level chosen to identify possible health risk (<0.5 µg/m3), while, after the ban, it was only 22%, a relative risk of 0.25 (95% confidence interval 0.15–0.41). The risk decreased in both occupational groups, but gaming workers experienced the highest preban exposure levels. Attitudes towards the legislation were largely positive, particularly after the ban. However, there was no notable change in lung function, and there was no notable reduction in the number of cigarettes consumed by smokers.Conclusions The introduction of smoke-free legislation was associated with a substantial reduction in respiratory and sensory symptoms, as well as reduced exposure to environmental tobacco smoke at work, particularly among gaming workers.
10.
Svedbo Engström, Maria, 1980, et al.
(author)
A disease-specific questionnaire for measuring patient-reported outcomes and experiences in the Swedish National Diabetes Register: Development and evaluation of content validity, face validity, and test-retest reliability
2018
In: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 101:1, s. 139-146
Journal article (peer-reviewed) abstract
Objective: To describe the development and evaluation of the content and face validity and test-retest reliability of a disease-specific questionnaire that measures patient-reported outcomes and experiences for the Swedish National Diabetes Register for adult patients who have type 1 or type 2 diabetes. Methods: In this methodological study, a questionnaire was developed over four phases using an iterative process. Expert reviews and cognitive interviews were conducted to evaluate content and face validity, and a postal survey was administered to evaluate test-retest reliability. Results: The expert reviews and cognitive interviews found the disease-specific questionnaire to be understandable, with relevant content and value for diabetes care. An item-level content validity index ranged from 0.6-1.0 and a scale content validity/average ranged from 0.7-1.0. The fourth version, with 33 items, two main parts and seven dimensions, was answered by 972 adults with type 1 and type 2 diabetes (response rate 61%). Weighted Kappa values ranged from 0.31-0.78 for type 1 diabetes and 0.27-0.74 for type 2 diabetes. Conclusions: This study describes the initial development of a disease-specific questionnaire in conjunction with the NDR. Content and face validity were confirmed and test-retest reliability was satisfactory. Practice implications: With the development of this questionnaire, the NDR becomes a clinical tool that contributes to further understanding the perspectives of adult individuals with diabetes. (c) 2017 Elsevier B.V. All rights reserved.
