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- Berggren, Vanja, et al.
(författare)
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An explorative study of Sudanese midwives' motives, perceptions and experiences of re-infibulation after birth
- 2004
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Ingår i: Midwifery. - : Churchill Livingstone. - 0266-6138 .- 1532-3099. ; 20:4, s. 299-311
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: to explore Sudanese midwives' motives for and perceptions and experiences of re-infibulation after birth and to elucidate its context and determinants. DESIGN: triangulation of methods, using observational techniques and open-ended interviews. SETTING AND PARTICIPANTS: two government hospitals in Khartoum/Omdurman, Sudan, for the observations and in-depth interviews with 17 midwives. FINDINGS: midwives are among the major stakeholders in the performance of primary female genital cutting (FGC) as well as re-infibulation. Focusing on re-infibulation after birth, midwives were trying to satisfy differing, and sometimes contradictory, perspectives. The practice of re-infibulation (El Adel) represented a considerable source of income for the midwives. The midwives integrated the practice of re-infibulation into a greater whole of doing well for the woman, through an endeavour to increase her value by helping her to maintain her marriage as well as striving for beautification and completion. They were also trying to meet socio-cultural requests, dealing with pressure from the family while balancing on the edge of the law. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: the findings confirm that midwives are important stakeholders in perpetuating re-infibulation, and indicate that the motives are more complex than being only economic. The constant balancing between demands from others puts the midwives in a difficult position. Midwives' potential role to influence views in the preventative work against FGC and re-infibulation should be acknowledged in further abolition efforts.
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| 4. |
- Bergström, Anna
(författare)
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Hur kommunerna i Stockholms län arbetar med cykeltrafikfrågor : en enkätstudie
- 2002
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Under hösten 2001, påbörjade Vägverket Region Stockholm arbetet med att ta fram ett regionalt cykelprogram. Programarbetet utgår från Vägverkets nationella strategi för ökad och säker cykeltrafik. Det regionala programmet ska visa Vägverket Region Stockholms mål, strategier och åtgärder inom cykeltrafikområdet under åren 2002-2006. VTI arbetar på uppdrag av Vägverket Region Stockholm med att kartlägga och sammanställa fakta om cykeltrafiken i regionen. Brister behöver identifieras för att Vägverket ska kunna välja lämpliga insatser och sätta upp rimliga mål för cykeltrafikområdet inom regionen. Den här enkätstudien ingår som en del i VTI:s arbete med att bygga upp nödvändig kunskapsbas. Enkäten syftade till att få en uppfattning om det cykeltrafikrelaterade arbetet i kommunerna i Stockholms län, som underlag för Vägverkets framtagande av ett regionalt cykelprogram. I enkäten har kommunerna även givits tillfälle att lämna synpunkter på vilken roll de vill att Vägverket ska ta i det fortsatta arbetet med att få en ökad och säker cykeltrafik i länet.
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| 5. |
- Bergström, Anna
(författare)
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Renal cell cancer : the role of physical activity and body size
- 2001
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis was to explore how physical activity, obesity, weight change, and birth weight influence the risk of renal cell cancer. The relation between occupational physical activity and risk of renal cell cancer was studied in a cohort of Swedish men and women identified in the nationwide censuses in 1960 and 1970, and followed for the occurrence of cancer by linkages to the Swedish Cancer Registry 1971-1989 (Paper I). We identified 2,704 male and 587 female cases with the same level of occupational physical activity in 1960 and 1970 (n=674,025 men and 253,336 women). In multivariate models, men with long-term sedentary jobs had a 25% increased risk compared to men with physically demanding occupations. In contrast, we found no clear evidence of an association between occupational physical activity and renal cell cancer risk among women. The association between occupational and leisure time physical activity and renal cell cancer risk was further studied in a prospective cohort of 17,241 Swedish twins (Paper II). Exposure information was obtained through a mailed questionnaire. During follow-up from 1967 through 1997 we identified 102 renal cell cancer cases. We found no evidence of a significant association between either occupational or leisure time physical activity and risk of renal cell cancer in this cohort. To evaluate the existing evidence that obesity increases the risk of renal cell cancer among both men and women, we conducted a quantitative summary analysis of published studies (Paper III). Fourteen studies on each sex assessed obesity as body mass index (BMI, kg/m 2), or equivalent, and were included in our analysis. In contrast to previous qualitative reviews, our quantitative summary showed that increased BMI is equally strongly associated with renal cell cancer risk among both men and women. The risk increased by 7% per one unit of increase in BMI (1 kg/m2 , corresponding to about 3 kg body weight increase for a subject of average height). The relation between body size and renal cell cancer was evaluated in more detail in a population-based case-control study with 877 patients with newly diagnosed renal cell cancer and 1,508 control subjects, frequency-matched by age (Paper IV). Exposure information was obtained through a mailed questionnaire. General and abdominal obesity (measured as BMI and waist-to-hip ratio, respectively) were independently associated with increased risk of renal cell cancer among both men and women. Furthermore, tall height was associated with an increased risk among both sexes. Weight gain and repeated weight changes in adult life were associated with an increased risk, especially among those with a high BMI already at age 20. The relation between birth weight, a marker of fetal nutrition and growth, and renal cell cancer was evaluated in the case-control study described above (Paper V). A total of 648 cases and 900 control subjects reported their birth weight and were included in the analyses. An increased risk of renal cell cancer was suggested among men with a high (>3500 g ) birth weight, compared to men with a birth weight between 3000 and 3499 g. We found no clear association among men with a low (<3000 g) birth weight, or among women. Our study shows that conditions in utero, reflected by birth weight, might affect the risk of renal cell cancer in adulthood.
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| 6. |
- Bergström, Anna
(författare)
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Tema Vintermodell : olycksrisker under för-, hög- och senvinter
- 2003
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Syftet med denna studie är att undersöka om förekomsten av ett is-/snöväglagutgör en högre olycksrisk i början och slutet av en vinter, i jämförelse medsjälva "högvintern". Orsaken till detta skulle kunna vara, att förarna underhögvintern är mer förberedda på och vana att hantera ett is-/snöväglag än vadde är i början och slutet av vintern. För att undersöka detta harolyckskvoter beräknats, för tre olika långa för- och senvinterperioder. Dessaolyckskvoter har sedan jämförts med olyckskvoten för motsvarandehögvinterperiod. Längden på högvinterperioderna varierade för olika delar avlandet. Olyckskvoterna uttrycks i antal olyckor dividerat med trafikarbetet,där olycksmaterialet omfattar samtliga polisrapporterade olyckor på detstatliga vägnätet exklusive viltolyckor. Olyckskvotsberäkningarna hardifferentierats på de fem väglag, som förekommer vid polisensolycksrapportering: torr barmark, fuktig eller våt barmark, packad snö ellertjock is, tunn is eller rimfrost, lös snö eller snömodd, där de tresistnämnda utgör is-/snöväglagen. Beräkningarna har även delats upp i sexdriftstandardklasser A1-A4 samt klass B1-B2 och med landet indelat i fyraolika klimatzoner: Södra, Mellersta, Nedre norra och Övre norra Sverige. Föratt beräkna trafikarbetet per väglag har väglagsfördelningar, baserat påutförda observationer under vintersäsongerna 1993/94 t.o.m. 1996/97 samtårsdygnstrafikarbetet använts som underlag. Analyserna visar attolyckskvoterna för is-/snöväglag under före- och senvinterperioderna i nästansamtliga fall är högre än för motsvarande högvinterperiod. Olyckskvoterna vardessutom i de flesta fall högre under senvinterperioderna än underförvinterperioderna. Det visade sig också att ju kortare för- ochsenvinterperiod, desto högre var olyckskvoten i många fall. Dessa samband vartydligast för vägar i driftstandardklass B1 och B2.
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| 7. |
- Bergström, Anna, 1971-
(författare)
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Winter maintenance and cycleways
- 2002
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Increasing cycling as a means of personal travel couldgenerate environmental benefits if associated with acorresponding decrease in car-based transport. In seeking topromote cycling in wintertime, it is desirable to understandhow important the road surface condition is compared to otherfactors in people's decision to cycle or not. In this thesis,the possibility of increasing the number of cyclists byimproving the winter maintenance servicelevel on cycleways isexamined. The attitudes towards cycling during winter ingeneral, and in relation to winter maintenance of cycleways inparticular, is studied through questionnaire surveys. Bicyclemeasurements are related to weather data from Road WeatherInformation System, in order to know the influence on cycleflow during winter from different weather factors. Fieldstudies are performed testing unconventional winter maintenancemethods, in order to see if a higher service level could beachieved on cycleways and if that would lead to an increase inwinter cycling frequency. The field studies are evaluatedthrough road condition observations, measurements of friction,bicycle counts, a questionnaire survey and interviews. A visualmethod to assess winter road conditions on cycleways isdeveloped, in order to compare the service levels achievedusing different winter maintenance methods.There is a clear difference in mode choice between seasons.With improved winter maintenance service level it could bepossible to increase the number of bicycle trips to work duringwinter with, at the most, 18 %, and decrease the number of cartrips with 6 %. However, it could not be concluded with bicyclemeasurements, that an enhanced service level in fact, generateda higher winter cycling frequency.To increase cycling during winter, snow clearance is themost important maintenance measure. Skid control is not assignificant for the choice of mode but is important to attendto for safety reasons. Winter road condition propertiesimportant both with regard to safety and accessibility ofcyclists, are icy tracks formed when wet snow freezes, snowdepths greater than about 3 cm of loose snow or slush,unevenness in a snow covered surface, loose grit on a baresurface.Weather factors with negative influence on winter cyclingfrequency, are temperatures below +5 ° C,precipitationand strong winds. Only the occurrence of precipitation, not theamount of rain or snow, is significant for the cycle flow. Lowtemperatures are more important in reducing the cycle flow thanprecipitation. Temperatures around 0 ° C seem to be extracritical for cyclists, probably due to the larger influence ofprecipitation and slippery road conditions at thesetemperatures.An unconventional method using a power broom for snowclearance and brine or pre-wetted salt for de-icing, provides ahigher service level than winter maintenance methodstraditionally used, but it is about 2 to 3 times moreexpensive. The method has great potential in regions, such assouthern Sweden, with low snow accumulations but with major iceformation problems. To assess the maintenance service level,the visual assessment method developed and tested in thisproject is adequate for the purpose, however, furtherimprovements are desirable. As a complement to the visualassessment, a Portable Friction Tester can be used to measurethe surface friction on cycleways during wintertime.Keywords:Cycleways, winter maintenance, maintenanceservice level, mode choice, winter cycling frequency, wintermaintenance equipment, winter road condition assessment,bicycle measurements, friction measurement.
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