| 1. |
- Anne, Ouma, 1963-
(author)
-
From Rural Gift to Urban Commodity : Traditional Medicinal Knowledge and Socio-spatial Transformation in the Eastern Lake Victoria Region
- 2013
-
Doctoral thesis (other academic/artistic)abstract
- As we celebrate all the dynamic and dramatic improvements in human health care in the 21st century, life in much of Africa begins with and is sustained with the support of traditional medicinal knowledge. Research on traditional medicinal knowledge (TMK) is extensive, but rather few studies have been written about Traditional Healers' (THs') own perceptions about TMK and practices in relation to changing societal dynamics.The aim of this thesis is to examine how THs perceive on going socio-spatial transformation, including contemporary processes of urbanization, migration, commercialization and commodification of TMK, as well as changing dynamics of learning and knowledge systems between generations and genders and how these affect their medicinal healing practices in time and space.The thesis consists of four main empirical chapters, which derive from different data sources including literature, documentation review and qualitative interview material. The findings in this thesis can be summarised as follows: First that TMK today exists side by side with modern health systems, in what are seen as complex patterns of medical pluralism that provide evidence of an evolving role the TH plays in primary health care, in the rural and urban space. Youthful migrating population dynamics that are linked to historical processes, have effectively carved an emerging cross-sectoral role of the TH in the formal space.Secondly the developing legislation on IPR and ABS in parallel with the representation of an earlier official formal governance around TMK in Tanzania; and the difference in the sectors where TMK is anchored in the two contexts, could have paved way to some earlier collaborative mechanisms, that today provide space to enable a more natural engagement between formal and informal organizations involved in the governance of TMK in Tanzania. Thirdly, the practical ways in which TMK learning processes, which are characterized by learning systems in place, being sent and visiting sacred places that are lived by an apprentice over a number of years, have increasingly come under pressure. Fourthly the thesis shows approaches by THs, encouraging the youth to access conventional medicinal education followed by, or in parallel with TMK learned through traditional pedagogies employed by the THs themselves. The youth’s keen interest in learning TMK is seen to increase when they view improved livelihood possibilities due to the commercialization of medicinal plants. The future of TMK learning processes may be limited unless incentives are put in place for the youth regarding their future livelihoods. Fifth, gendered and generational dimensions suggest that older and some younger female THs reemphasize the values of the gift and TMK in a climate of increased commodification and commercialization of TMK, where TMK increasingly meets neoliberal processes, engaging an alternative paradigm than the gift economy, where a predominance of male TH’s in the urban space and places, increasingly define the diversification of the TMK livelihoods. The gift provided by a higher power and which is embedded in a particular cosmological view, to be used as a social service to help the community, is increasingly evolving as an emerging tested force in a changing ideological climate, with an increasing awareness of commodification, commercialization, IPR and ABS issues surrounding TMK. It implies awareness in relation to the increased benefits of commoditized and commercialized medicinal plant knowledge (which THs hold) for other individuals and institutions.The TH profession and TMK is seen as entering a contested IPR/ABS arena at a time when increasingly socio-spatial transformations are modifying its role from that of a gift to an owned commodity. However while the practice of TMK has changed over time and space, presenting new challenges as well as opportunities, it is also seen as a threat that anyone today can sell and market TMK products.
|
|
| 2. |
- Bonita, Ruth, et al.
(author)
-
Linnaeus : Alive and well
- 2011
-
In: Global Health Action. - : Co-Action Publishing. - 1654-9716 .- 1654-9880. ; 4, s. 5760-2
-
Journal article (peer-reviewed)
|
|
| 3. |
- Edvinsson, Sören, et al.
(author)
-
Do unequal societies cause death among the elderly? : a study of the health effects of inequality in Swedish municipalities, 2006
- 2013
-
In: Global Health Action. - : Taylor & Francis. - 1654-9716 .- 1654-9880. ; 6:1
-
Journal article (peer-reviewed)abstract
- Background: A lively public and academic debate has highlighted the potential health risk of living in regions and nations characterized by inequality. However, previous research provides an ambiguous picture, with positive association mainly having been found on higher geographical levels. One explanation for this could be that the effect of living in more heterogeneous social settings differs between levels of aggregation. Methods: We examine the association between income inequality (using the Gini coefficient) and all-cause mortality in Swedish municipalities in the age group 65-74. A multi-level analysis is applied and we control for e.g. individual income and average income level in the unicipality. The analyses are based on individual register data on all residents born between 1932 and 1941, and outcomes are measured for the year 2006.Results: Lower individual income as well as lower average income level in the municipality of residence increased mortality significantly. We found an association between income inequality and mortality with excessive deaths in unequal municipalities even after controlling for mean income level and personal income. The results from the analysis of individual data differed substantially from analyses using aggregate data.Conclusions: Income inequality has a significant association with mortality in the age groups 65 to 75 at municipality level. The association is small compared to many other variables, but it is not negligible. Even in a comparatively equal society like Sweden, we need to consider possible effects of income inequality on mortality at the local level.
|
|
| 4. |
- Edvinsson, Sören, 1953-, et al.
(author)
-
Do unequal societies cause death and disease? : A study of the health effects on elderly of inequality in Swedish municipalities, 2006
- 2011
-
Reports (other academic/artistic)abstract
- A lively public and academic debate has highlighted the potential health risk of living in regions and nations characterized by inequality (Wilkinson and Pickett 2007; 2009). It is argued that inequality may add to increasing health differentials over the life course. However, previous research provides so far an ambiguous picture. One explanation could be that the effect of living in more heterogeneous social settings may differ between levels of aggregation. A hypothesis is that homogeneity is positive on the national or regional level, while on a lower level of aggregation living in homogeneous settings could be detrimental for health, at least in poor neighborhoods. In this paper we present the preliminary results of our examination on how residence in unequal versus homogeneous areas is associated with health outcome of elderly people in Sweden. These first results are based on municipality level data on individuals born between 1932 and 1941 and the outcome is measured for the year 2006. Furthermore, we analyze the effect on health of income inequality (measured by Gini-coefficient) as compared to the effect of individual income and the average income level in the area. We analysed the associations both with individual-level and multi-level analysis. Our main finding is that inequality has an independent effect on mortality in the way that unequal municipalities have excessive deaths even after controlling for mean income level and personal income. This result was found not only in the individual-level analysis but also in the multilevel analysis.
|
|
| 5. |
- Edvinsson, Sören, 1953-, et al.
(author)
-
Neighbourhood inequality as a health risk : Empirical evidence from Swedish registers
- 2013
-
Conference paper (other academic/artistic)abstract
- In this paper, we explore the impact on mortality of income inequality in residential neighbourhoods and municipalities among elderly 65-84 years in the year 2004, using Swedish longitudinal micro-data covering the entire Swedish population for the period 1970 – 2006. Preliminary cross-sectional multi-level analyses are now complemented by longitudinal analyses of long-term residential histories with exposure to equal/unequal municipalities and neighbourhoods and the long-term impact on mortality. We investigate the association between mortality and income inequality at place of residence at different time lags and the effect of a summary measure of previous exposures to environments characterised by different inequality levels. We also compare groups that have different experiences of residential characteristics, i.e. those that have resided in unequal or equal places and those that have changed from equal to unequal residences or vice versa. Preliminary results from a cross-sectional analysis on 2006, show that income inequality in the municipality of residence had an independent effect on mortality in the age group 65-74 years
|
|
| 6. |
- Eriksson, Madeleine, 1978-
(author)
-
(Re)producing a periphery : popular representations of the Swedish North
- 2010
-
Doctoral thesis (other academic/artistic)abstract
- The discourse on Norrland (literally ‘North land’ in English) as essentially ‘different’ has been(re)produced in literature, politics and science for as long as the idea of ‘Norrland’ has existed. Thus,when investigating the discourse that constructs the identity of Norrland in opposition to a Swedishnational identity, it is important to connect these representations to their contemporary (andchanging) political-economic contexts. The aim of this thesis is to analyze contemporaryrepresentations in news, film, advertising and interviews to show how representations constructstereotypes informed by neoliberal ideals and internationally familiar stereotypes of a traditionalintransigent population positioned in Norrland and a modern and progressive population in theurban South. The findings in this thesis can be summarized as follows. First, Norrland has beenconsistently reproduced, resisted and reworked through various discursive networks and practicesover centuries, as simultaneously authentic and obsolete. Drawing on these discourses makes therepresentations of Norrland in the news become part of a wider discursive network that representsNorrland as an ‘internal other’ within Sweden. Secondly, discourses on Swedish modernity and onneoliberal growth and competition reproduce Norrland and its people as inferior to the rest ofSweden. These representations are reworked and resisted and result in ‘real’ material effects in, forinstance, the news media, place marketing and film. Thirdly, in order to resist these representationsand become part of the ‘modern’, progressive world, places and people need to adjust to neoliberalideals of competitiveness and growth. And, finally, people’s identities are affected by theseneoliberal ideals as they have to relate and react to the representations of different places andpeople and the discourse on the urban as progress. This results in different strategies in theconstruction of narrative identities. I conclude by arguing that these representations serve not onlyas contrasts but also as strategies in the quest to scapegoat certain groups for problems that initiallyoriginated in unequal opportunities and structures of power related to, for instance, ethnicity, class,gender and disabilities – something that is exacerbated by neoliberalist policies and ideologies. Themore pressure is put on individuals and places to produce constant growth, the more certain peopleand places are viewed as ‘unproductive’ and problematic. The problems of depopulation anddiminishing job opportunities in the inland areas of Norrland are thus blamed on the population through the representations of Norrland as an internal ‘other.’
|
|
| 7. |
|
|
| 8. |
- Gustafsson, Cecilia, 1977-
(author)
-
"For a better life..." : a study on migration and health in Nicaragua
- 2014
-
Doctoral thesis (other academic/artistic)abstract
- This thesis explores and analyses the manifold relations between migration and health, what I call the migration-health nexus, in the contemporary Nicaraguan context. The study is based on fieldwork in León and Cuatro Santos and a mixed-methods approach combining qualitative in-depth interviews and quantitative survey data. In the thesis health is “traced” within the migration process; i.e. in places of origin, during travel, at the destination and after return, including the situation and consequences for both migrants and family members to migrants (“left-behinds”). The study shows that migration-health relations in Nicaragua are connected to broader economic, social and political factors and to the country’s historical experiences of colonization, neo-colonization and structural adjustments. Contemporary Nicaraguan migrations are primarily related to the strategies of making a living and the struggle for a better life (i.e. a practice of mobile livelihoods). In the study setting health concerns were both indirectly embedded in people’s mobile livelihoods, as well as directly influencing decisions to move or to stay, and migration involved both advantages and disadvantages for health. Through migration, women could see an end to physical violence and sexual abuse. Internal migrants could improve their access to health care and medicine. Vulnerabilities related to the unpredictable nature conditions could be avoided through moving. And, through the money made from migrant work people’s everyday lives and health could be improved, in terms of better nutrition, housing, and access to education, health care and medicine. However, remittances do not necessarily lead to development, as they are used to compensate for the lacking public sector in Nicaragua. Under these circumstances, I argue that the Nicaraguan population is not guaranteed their social rights of citizenship. I also argue that the negative aspects surrounding migration must be taken into account when discussing the development potentials of migration and remittances. Both internal and international migrants in this study experienced stress while moving to a new place. International migrants had difficulties accessing health care in the destination, particularly those lacking documentation. The separation within families due to migration often caused emotional pain. Family members left behind did not rate their physical health as good as often as non-migrant families. The vulnerability, stress experiences and sufferings of migrants and left-behinds varied, however. I therefore conclude that social differences (in terms of e.g. gender, class, skin colour, and legal immigration status) are key for the enactment of the migration-health nexus, and that an interplay of individual, social and structural factors influence the outcome.
|
|
| 9. |
- Hatschek, T, et al.
(author)
-
Individually tailored treatment with epirubicin and paclitaxel with or without capecitabine as first-line chemotherapy in metastatic breast cancer: a randomized multicenter trial
- 2012
-
In: Breast Cancer Research and Treatment. - New York, USA : Springer Verlag (Germany). - 0167-6806 .- 1573-7217. ; 131:3, s. 939-947
-
Journal article (peer-reviewed)abstract
- Anthracyclines and taxanes are active cytotoxic drugs in the treatment of early metastatic breast cancer. It is yet unclear whether addition of capecitabine to the combination of these drugs improves the treatment outcome. Patients with advanced breast cancer were randomized to first-line chemotherapy with a combination of epirubicin (Farmorubicin(A (R))) and paclitaxel (Taxol(A (R))) alone (ET) or in combination with capecitabine (Xeloda(A (R)), TEX). Starting doses for ET were epirubicin 75 mg/m(2) plus paclitaxel 175 mg/m(2), and for TEX epirubicin 75 mg/m(2), paclitaxel 155 mg/m(2), and capecitabine 825 mg/m(2) BID for 14 days. Subsequently, doses were tailored related to side effects. Primary endpoint was progression-free survival (PFS); secondary endpoints were overall survival (OS), time to treatment failure (TTF), objective response (OR), safety and quality of life (QoL). 287 patients were randomized, 143 to ET and 144 to TEX. Median PFS was 10.8 months for patients treated with ET, and 12.4 months for those treated with TEX (HR 0.84, 95% CI 0.65-1.07, P = 0.16); median OS was 26.0 months for women in the ET versus 29.7 months in the TEX arm (HR 0.84, 95% CI 0.63-1.11, P = 0.22). OR was achieved in 44.8% (ET) and 54.2% (TEX), respectively (chi(2) 3.66, P = 0.16). TTF was significantly longer for patients treated with TEX, 6.0 months, versus 5.2 months following ET (HR 0.73, 95% CI 0.58-0.93, P = 0.009). Severe hematological side effects related to epirubicin and paclitaxel were evenly distributed between the treatment arms, mucositis, diarrhea, and Hand-Foot syndrome were significantly more frequent in the TEX arm. Toxicity-adjusted treatment with ET and TEX showed similar efficacy in terms of PFS, OS, and OR. In this trial with limited power, the addition of capecitabine to epirubicin and paclitaxel as first-line treatment did not translate into clinically relevant improvement of the outcome.
|
|
| 10. |
- Hedin, Karin, et al.
(author)
-
Neoliberalization of housing in Sweden : gentrification, filtering, and social polarization
- 2012
-
In: Annals of the Association of American Geographers. - : Informa UK Limited. - 0004-5608 .- 1467-8306. ; 102:2, s. 443-463
-
Journal article (peer-reviewed)abstract
- During the last twenty-five years, housing policy in Sweden has radically changed. Once forming a pillar of the comprehensive welfare system, abbreviated the “Swedish model,” neoliberal housing politics have established market-governed housing provision with a minimum of state engagement. This shift has had consequences on the social geography of housing conditions. The research reported here analyzes social geographic change in Sweden's three largest cities—Stockholm, Gothenburg, and Malmö—between 1986 and 2001, relating observed patterns of gentrification and filtering to cycles of accumulation and to neoliberalization of housing policies. First, we outline the neoliberalization of Swedish housing policies. We then present an empirical analysis of gentrification and filtering in the three cities, spanning two boom periods (1986–1991, 1996–2001) and a bust period (1991–1996). The data reveal social geographic polarization manifested in the growth of supergentrification and low-income filtering. The analysis also introduces the concept of ordinary gentrification, supporting the move in gentrification research toward a broad generic conception of the process. Political reforms after 2001 are summarized and we argue that these underlie the continued increase in inequality and that the social geographic polarization mapped between 1986 and 2001 has probably intensified during this decade.
|
|
