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- Dalmar, Abdirisak Ahmed, et al.
(author)
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Rebuilding research capacity in fragile states : the case of a Somali-Swedish global health initiative
- 2017
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In: Global Health Action. - Abingdon : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 10:1
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Journal article (peer-reviewed)abstract
- This paper presents an initiative to revive the previous Somali-Swedish Research Cooperation, which started in 1981 and was cut short by the civil war in Somalia. A programme focusing on research capacity building in the health sector is currently underway through the work of an alliance of three partner groups: six new Somali universities, five Swedish universities, and Somali diaspora professionals. Somali ownership is key to the sustainability of the programme, as is close collaboration with Somali health ministries. The programme aims to develop a model for working collaboratively across regions and cultural barriers within fragile states, with the goal of creating hope and energy. It is based on the conviction that health research has a key role in rebuilding national health services and trusted institutions.
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3. |
- Emmelin, Maria, et al.
(author)
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Pol-ethical considerations in public health. : The views of Swedish health care politicians
- 1999
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In: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 9:2, s. 124-130
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Journal article (peer-reviewed)abstract
- Background: Public health policy is often concerned with the conflicting values emanating from the individually formulated ethics for curative care and more collectively oriented ethics. In this study we have focused on the pol-ethical considerations involved in Swedish health care politicians' assessment of public health measures. Methods: We described a hypothetical situation in a questionnaire, where a community has a 50% excess mortality for disease X, compared to the national average. Scientific disagreements were identified and discussed. The respondents gave their preference for a specific intervention strategy and considered, on a graded scale, 17 different value statements related to ethical principles and intervention strategies. Results: Only one out of 451 politicians preferred the alternative ‘no intervention’. The majority preferred an intervention including active involvement of primary health care. There was overall strong support for equity and beneficence. A factor analysis gave a model for the association between ethical values, political affiliation and choice of intervention strategies. The relative weights of autonomy and equity were strongly related to political affiliation. Conclusions: Among Swedish health care politicians there is consensus about the value of performing interventions in public health when the problem is large, even if there is some uncertainty about the consequences. Their overall strong support for equity and beneficence implies that these principles are crucial when formulating policies for interventions. Politicians need to state their ethical standpoint explicitly so that we as citizens can judge their decisions and actions based on our own political ideology and support for basic ethical principles.
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4. |
- Emmelin, Maria, et al.
(author)
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Self-rated ill-health strengthens the effect of biomedical risk factors in predicting stroke especially for men : An incident case referent study
- 2003
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In: Journal of Hypertension. - 0263-6352 .- 1473-5598. ; 21:5, s. 887-896
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Journal article (peer-reviewed)abstract
- OBJECTIVES: To examine how self-rated ill-health interacts with biomedical stroke risk factors in predicting stroke and to explore differences between men and women and educational groups. DESIGN: An incident case-referent study where the study subjects had participated in a prior health survey. SETTING: Nested within the Västerbotten Intervention Program (VIP) and the Northern Sweden MONICA cohorts. SUBJECTS: The 473 stroke cases had two referents per case, matched for age, sex and residence, from the same study cohorts. RESULTS: Self-rated ill-health independently increased the risk of stroke, specifically for men. The interaction effect between self-rated health and biomedical risk factor load was greater for men than for women. The attributable proportion due to interaction between having a risk factor load of 2+ and self-rated ill-health was 42% for men and 15% for women. Better-educated individuals with self-rated ill-health and two or more of the biomedical risk factors had a higher risk of stroke than the less educated. Calculations of the respective contribution to the stroke cases of self-rated health, hypertension and smoking showed that self-rated ill-health had a role in 20% of the cases and could alone explain more than one-third of the cases among those who rated their health as bad, more so for men than for women. CONCLUSIONS: The results underscore the importance of including both a gender and a social perspective in discussing the role of self-rated health as a predictor of disease outcome. Physicians must be more gender sensitive when discussing their patient's own evaluation of health in relation to biomedical risk factors.
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5. |
- Emmelin, Maria, et al.
(author)
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To be seen, confirmed and involved - a ten year follow-up of perceived health and cardiovascular risk factors in a Swedish community intervention programme
- 2007
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In: BMC Public Health. - : BioMed Central. - 1471-2458. ; 7, s. 190-
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Journal article (peer-reviewed)abstract
- BACKGROUND: Public health interventions are directed towards social systems and it is difficult to foresee all consequences. While targeted outcomes may be positively influenced, interventions may at worst be counterproductive. To include self-reported health in an evaluation is one way of addressing possible side-effects. This study is based on a 10 year follow-up of a cardiovascular community intervention programme in northern Sweden. METHODS: Both quantitative and qualitative approaches were used to address the interaction between changes in self-rated health and risk factor load. Qualitative interviews contributed to an analysis of how the outcome was influenced by health related norms and attitudes. RESULTS: Most people maintained a low risk factor load and a positive perception of health. However, more people improved than deteriorated their situation regarding both perceived health and risk factor load. "Ideal types" of attitude sets towards the programme, generated from the interviews, helped to interpret an observed polarisation for men and the lower educated. CONCLUSION: Our observation of a socially and gender differentiated intervention effect suggests a need to test new intervention strategies. Future community interventions may benefit from targeting more directly those who in combination with high risk factor load perceive their health as bad and to make all participants feel seen, confirmed and involved.
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6. |
- Eriksson, Malin, 1969-, et al.
(author)
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Social capital, gender and educational level : impact on self-rated health
- 2010
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In: The Open Public Health Journal. - : Bentham Science Publishers. - 1874-9445. ; 3, s. 1-12
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Journal article (peer-reviewed)abstract
- Objectives: Social capital has been recognized as one important social determinant for health, but we still have limited knowledge about how it can be used to explain inequality in health. This study investigated the links between individual social capital and self-rated health by gender and educational level, and analyzed if access to social capital might explain the observed disparities in self-rated health between men and women and different educational groups. Study design: A cross-sectional survey in Northern Sweden. Methods: A social capital questionnaire was constructed and mailed to 15 000 randomly selected individuals. Different forms of structural and cognitive social capital were measured. Self-rated health was used as the outcome measure. Crude and adjusted OR and 95% CI were calculated for good selfrated health and access to each form of social capital. Multivariate regression was used to analyze how sociodemographic factors and access to social capital might influence differences in self-rated health by gender and educational level. Results: Access to almost each form of social capital significantly increased the odds for good self-rated health for all groups. A higher education significantly increased the odds for access to each form of social capital, and being a man significantly increased the odds for having access to some forms of social capital. The health advantage for higher educated and men partly decreased when controlling for access to social capital. Conclusions: Access to social capital can partly explain the observed health inequality between men and women and different educational groups. Strengthening social capital might be one way of tackling health inequality. It is important to consider the structural conditions that create unequal opportunities for different groups to access social capital.
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7. |
- Nordyke, Katrina, et al.
(author)
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Health-related quality-of-life in children with coeliac disease, measured prior to receiving their diagnosis through screening
- 2011
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In: Journal of Medical Screening. - : SAGE Publications. - 1475-5793 .- 0969-1413. ; 18:4, s. 187-192
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Journal article (peer-reviewed)abstract
- Objective To compare the health-related quality-of-life (HRQoL) of children with screening-detected coeliac disease (CD), before they learned of their diagnosis, with that of children without CD and in those previously diagnosed with CD. Methods In a cross-sectional CD screening study ('ETICS': Exploring the Iceberg of Coeliacs in Sweden), of 10,041 Swedish 12-year-olds invited, 7567 (75%) consented to participate, and 7208 (72%) children without previously diagnosed CD had serological markers analysed. Before the screening results were known, 7218 children (72%) and 6524 of their parents (65%) answered questionnaires. Questionnaires included the Swedish child-friendly pilot version of the EQ-5D instrument and proxy version of the EQ-5D instrument, which are generic tools used to describe HRQoL. Results We found no significant difference in HRQoL between the groups of children with screening-detected CD, without CD, and those previously diagnosed with CD. Conclusion The HRQoL reported by 12-year-olds with screening-detected CD, before they learned of their diagnosis, was not worse than that of the children without CD or those previously diagnosed with CD. Thus, mass screening for CD should not be justified on the basis that children with unrecognized CD have a poor HRQoL. However, because these children rated their HRQoL before diagnosis and treatment, they may not have recognized or perceived symptoms as severe enough to seek medical attention which demonstrates how difficult clinical/active case finding can be. Mass screening may still, therefore, be considered if the aim is early detection and prevention of future complications.
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9. |
- Ankre, Rosemarie, 1975-
(author)
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Friluftslivkonflikter i svenska kustlandskap ur ett planerings- och användarperspektiv : Studier av Luleå och Blekinge skärgårdar
- 2019
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Doctoral thesis (other academic/artistic)abstract
- Hav och kust har alltid varit viktiga för oss människor. I svenska kustlandskap har boende, infrastruktur och fiskenäring existerat sedan lång tid tillbaka samtidigt som områdena också varit viktiga för nöje och rekreation. Men mellan olika intressen, samt mellan och inom olika användargrupper samt förvaltning, kan det uppstå målkonflikter. Utgångspunkten för den här avhandlingen är att beskriva och analysera eventuella målkonflikter kopplat till friluftsliv utifrån både ett planerings- och ett användarperspektiv genom två fallstudier i Luleå och Blekinge skärgårdar. Friluftslivet är en del av samhället och dess relevans för fysisk och mental återhämtning ger planering och förvaltning av friluftsliv ett ökat politiskt stöd, samtidigt som tidigare forskning visat att friluftsliv är stark i retoriken - men svag i planeringspraktiken. Därför behövs kunskap som kan utveckla planering och förvaltning av friluftsliv i svenska kustlandskap.Resultaten från den här avhandlingen visar att användarnas perspektiv på målkonflikter i Luleå och Blekinge skärgårdar ännu inte till stora delar har inkluderats i den kommunala planeringen. En slutsats är alltså att det finns skillnader i hur konflikter i samband med friluftsliv beskrivs och identifieras i den fysiska planeringen jämfört med användarnas upplevelser. Det har betydelse för förståelsen av friluftlivskonflikter och hanteringen av dessa. Förutom analys och diskussion av konflikter kopplat till friluftsliv, ingår en fördjupande studie av buller och tystnad som konflikt. Upplevelserna av lugn och ro samt tystnad är centrala för användarna i Luleå och Blekinge skärgårdar. Ett problem som avslöjas är att metoder med decibelnivåer inte avgör skillnader i buller som upplevelse i sig. Upplevelsen av buller och tystnad är nämligen subjektiv. Även zonering undersöks som ett planerings- och förvaltningsverktyg för att hantera friluftslivkonflikter i svenska kustlandskap. Som denna avhandling visar, finns det flertalet exempel på olika sorters zonering i Luleå och Blekinge skärgårdar. När man i planering och förvaltning utgår från ett perspektiv där naturvård och bevarande är utgångspunkterna, så måste ytterligare värderingar och verktyg inbegripas som att inkludera användare med deras olika behov, upplevelser och aktiviteter som äger rum i skärgårdarnas landskap. Att landskapet i sig är av betydelse syns också i resultaten. I fallstudiernas översiktsplaner markeras det värdefulla, attraktiva och unika med skärgårdslandskapet, medan användarna betonar det äkta, naturliga och opåverkade landskapet som grund för deras friluftsupplevelser.Den här avhandlingen tillför kunskap om spänningen mellan olika attityder och synsätt i den fysiska planeringens processer, förvaltning samt friluftslivets användare i svenska kustlandskap. Avhandlingen är också ett tillägg till tidigare kunskap om zonering som ett sätt att hantera konflikter i svenska kustlandskap, där särskilt användarperspektivet är en viktig del. Avhandlingen bidrar även till en grundläggande översikt av fysisk planering i relation till friluftsliv.
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- Ankre, Rosemarie, 1975-, et al.
(author)
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Silence – an article of short supply in outdoor recreation? Handling noise conflicts in Swedish planning
- 2008
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In: Management for protection and sustainable development. The Fourth International Conference on Monitoring and Management of Visitors Flows in Recreational and Protected Areas.. - Montecatini Terme, Tuscany, Italy. ; , s. 399-403
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Conference paper (peer-reviewed)abstract
- Outdoor recreation areas are exposed to several causes of conflict. Many interests, along with different types of recreation activities, are competing in the same area. In these areas, conflicts are handled by spatial planning and by the separation in space of different functions. One source of conflict is noise. The lack of noise-free areas in the Swedish coastal areas has become an amenity problem. Does this make noise an important problem to consider in planning? An assumption is that the sound environment is relevant for the visitors’ experience; spending time in nature is associated with peace and quiet, where one should not be disturbed. In this study, it will be investigated how silence and noise actually are considered in the Swedish municipal planning. “Silence” is one of the amenity categories reported in the Swedish tourism data base. Is there a discrepancy between the existing municipal planning and the visitors’ opinions, attitudes and experiences? Furthermore, there will be an analysis of how silence and noise could be handled in spatial planning. One possible method is zoning. By excluding certain outdoor recreation activities from some areas, zoning may handle, or at least reduce, the problem of conflicts. The biosphere reserve concept (where zoning is an important part) will for that reason be discussed as a potential tool. A case study of the Blekinge archipelago, Sweden is the foundation of the study, which data consist of planning documents and questionnaire surveys considering outdoor recreation and nature tourism.
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- Ankre, Rosemarie, et al.
(author)
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Zoning and opportunity Spectrum Planning in a Discontinuous Environment : Planning for Tourism and Outdoor Recreation in the Luleå Archipelago, Sweden
- 2006
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Reports (other academic/artistic)abstract
- Zoning is generally used as a planning instrument to handle land use conflicts. In recreation planning in Sweden, zoning systems such as the recreation opportunity spectrum model has been applied in mountain areas. An underlying assumption of the ROS-system is a gradient from the urban to wilderness allowing the planner to provide a spectrum of recreation opportunities. In contrast, the Swedish coastal areas consist of a discontinuous environment which challenges a zoning. Archipelagos are essentially discontinuous with respect to many of the important spatial variables. Zoning in the archipelagos in Sweden has so far followed a zoning logic from physical geography; the assumption being that the gradient from inner, wooded zones to outer treeless would also be a gradient from the more urban or human influenced cultural landscape to a more pristine, �marine wilderness� in the outer. In 2003, a questionnaire survey to visitors was conducted in the Luleå archipelago, Sweden. Based on the results, the study examines the spatialization of the visitor characteristics, the activity patterns etc in relation to the ongoing planning of the area. This paper explores the planning challenges in adapting zoning to cope with recreation and tourism development as well as with the other land and resources uses that municipal comprehensive planning is charged with. Thereby possible conflicts are identified, and the potential of zoning is explored.
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- Bladh, Gabriel, 1959-, et al.
(author)
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Friluftsliv och naturvård - En komplicerad relation
- 2013
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In: Friluftsliv i förändring. Resultat från ett forskningsprogram, Slutrapport. Naturvårdsverket Rapport 6547. - Stockholm : Naturvårdsverket. - 9789162065478 ; , s. 229-250
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Book chapter (other academic/artistic)
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16. |
- Blomstedt, Yulia, et al.
(author)
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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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In: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 4, s. 5435-
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Journal article (peer-reviewed)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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17. |
- Brännström, Inger, 1945-, et al.
(author)
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Co-operation, participation and conflicts faced in public health : lessons learned from a long-term prevention programme in Sweden
- 1994
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In: Health Education Research. - : Oxford University Press. - 0268-1153 .- 1465-3648. ; 9:3, s. 317-329
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Journal article (peer-reviewed)abstract
- A comprehensive community-based programme for prevention of cardiovascular diseases (CVD) and diabetes was established in 1985 in a small municipality in northern Sweden. A cross-sectional survey to the general public was performed and semi-structured open-ended interviews were taken of actors at different levels. Notes from official records were also included in the study. The aim was to describe and discuss some factors that promote or constrain community participation in health programmes. The results generally confirmed that the right of definition concerning the health programme mainly remained with the health professionals. Community participation was mainly defined by the actors based on the medical and health planning approach and, thereby, as a means to transform health policy plans into reality by transmitting health knowledge and increasing consciousness among the citizens of the need for changing lifestyles. However, participation as a means of identifying problems and demonstrating power relationships and as elements in promoting local democracy was hardly represented among the actors at all. Overall, the CVD health programme was characterized by consensus between the actors. Despite this, debates and arguments about interpretations, social interests, personal conflicts and ideological constraints were observed. However, a majority of the public wanted the CVD preventive programme to continue.
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18. |
- Cashmore, Matthew, et al.
(author)
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Evaluating the effectiveness of impact assessment instruments : Theorising the nature and implications of their political constitution
- 2010
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In: Environmental impact assessment review. - : Elsevier. - 0195-9255 .- 1873-6432. ; 30:6, s. 371-379
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Journal article (peer-reviewed)abstract
- The central role of impact assessment instruments globally in policy integration initiatives has been cemented in recent years. Associated with this trend, but also reflecting political emphasis on greater accountability in certain policy sectors and a renewed focus on economic competitiveness in Western countries, demand has increased for evidence that these instruments are effective (however defined). Resurgent interest in evaluation has not, however, been accompanied by the conceptual developments required to redress longstanding theoretical problems associated with such activities. In order to sharpen effectiveness evaluation theory for impact assessment instruments this article critically examines the neglected issue of their political constitution. Analytical examples are used to concretely explore the nature and significance of the politicisation of impact assessment. It is argued that raising awareness about the political character of impact assessment instruments, in itself, is a vital step in advancing effectiveness evaluation theory. Broader theoretical lessons on the framing of evaluation research are also drawn from the political analysis. We conclude that, at least within the contemporary research context, learning derived from analysing the meaning and implications of plural interpretations of effectiveness represents the most constructive strategy for advancing impact assessment and policy integration theory.
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22. |
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Effective Environmental Assessment Tools – critical reflections on concepts and practice
- 2006
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Reports (other academic/artistic)abstract
- This report is an anthology from the research programme MiSt - Tools for environmental assessment in strategic decision making. MiSt is an interdisciplinary research programme on tools for environmental assessment in strategic decision making running from 2003 to 2008. The focus of the MiSt-programme is the empirical study of effectiveness of tools of environmental assessment as aid to strategic decision making. Two perspectives running through the programme are public participation and legal regulation of tools. There are three major steps in the programme: • a critical examination of the function of tools • a theory based understanding of their effectiveness • and ultimately a development of prescriptions for effective tool use including effective combinations of tools. MiSt is funded by the Swedish Environmental Protection Agency. Participating researchers come from a dozen leading Swedish research institutions in the field. The programme was initiated by the Blekinge Institute of Technology.
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25. |
- Emmelin, Lars
(author)
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EIA follow up
- 2007
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In: Standards and Thresholds for Impact Assessment. - : Springer Verlag..
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Book chapter (other academic/artistic)
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