Socialmedicinsk tidskrift (smt)
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Utkik och utmaningar i socialt arbete - sociala landskap, solidaritet och reflektion
No full textRecenserad bok: Hva er Sosialt Arbeid (2. utgave)Författare: Irene LevinFörlag: Universitetsforlaget AS, Oslo, Norg
Ukraina 2022
Get PDFNär detta skrivs har Ryssland under president Putin startat ett oprovocerat anfallskrig mot Ukraina.När du läser detta vet du hur situationen har utvecklats. Ukraina är på väg att utplånas som nation och kanske sträcker sig förödelsen ännu längre.Rysslands agerande mot Ukraina är ett brutalt övergrepp mot de ansträngningar inom det sociala och medicinska området som görs för att ge alla människor på vår jord drägliga och säkra livsvillkor. Vi ger Ukraina allt vårt stöd i kampen mot kriget och för en självständig stat och vi hoppas att goda krafter i Ryssland också förmår ändra den politik som nu förs
Samisk hälsoforskning - framsteg och utmaningar
No full textForskningen rörande samisk hälsa har de senaste två decennierna ökat avsevärt och bit för bit börjat förbättra ett fragmentariskt kunskapsläge. Det kan också sägas om det internationella forskningsområdet urfolkshälsa (Indigenous Health), där samisk hälsoforskning ofta hämtar jämförelser och inspiration. Vi önskar med detta temanummer väcka intresse för den samiska befolkningens hälsa och sätta ljus på den pågående samiska hälsoforskningen. Temanumret innehåller sammanlagt fem peer-review granskade originalartiklar, två översiktsartiklar och tre recensioner. Välkomna till det första temanumret om samisk hälsoforskning
Hjärt- Kärlsjukdom bland samer – en avhandling som öppnar dörrar: Review of Susanna Ragnhild Andersdatter Siri's dissertation, “Cardiovascular risk factors and incidence of acute myocardial infarction and cerebral stroke in Sami and non-Sami populations — The SAMINOR Study”.
No full textSusanna Ragnhild Andersdatter Siri's dissertation on the prevalence of cardiovascular disease in the Sami population in Norway opens the door to exciting and important explanatory models about heredity and the environment. The results show small ethnic differences but are an important reference for continued surveillance in the area. The dissertation was presented at the Center for Sami Health Research, UiT Norway's Arctic University in Tromsö in September 2020 and was approved for a dissertation on 8 February 2021.Recension av Susanna Ragnhild Andersdatter Siris avhandling, ”Cardiovascular risk factors and incidence of acute myocardial infarction and cerebral stroke in Sami and non-Sami populations - The SAMINOR Study”.Författare: Sven Hassler, lektor i folkhälsovetenskap vid avdelningen för Samhällsmedicin och folkhälsa vid institutionen för medicin, Sahlgrenska akademin, Göteborgs universitet
Bengmarks begärliga biotika
No full textDen lundensiske kirurgprofessorn Stig Bengmark har efter sin pensionering ägnat sig åt forskning och hälsoupplysning om hälsoeffekterna av tarmens bakterieflora samt den sjukdomsalstrande rollen som kroniska eller systemiska inflammationer spelar. Bengmark har behandlat den roll som kostfibrerna, prebiotika, spelar. Han har kanske främst studerat de godartade tarmbakterierna, probiotika, och även de skadliga effekterna av bakteriegifter, endotoxiner. Han har belyst den mekanism som kroniska eller systemiska inflammationer spelar för utvecklingen av cancer, hjärtkärlsjukdomar och andra systemsjukdomar. Bengmarks forskning har därmed flyttat forskningshorisonterna framåt och pekat på nya samband mellan inflammation, tarmflora, kostfibrer och endotoxiner.
Professor Stig Bengmark, for many years professor of surgery at Lund University, Sweden, has after his retirement focused on research and health education on the role of intestinal microflora on health, and on the pathogenic role played by chronic and systemic inflammation. Bengmark has addressed the role played by fibers, prebiotics, on health. He has first and foremost studied the role played by the beneficial intestinal microbiota, probiotics, and the detrimental effects of endotoxins. He has also highlighted the mechanism of chronic and systemic inflammation in the development of cancer, cardiovascular and other systemic diseases. Bengmark´s research has thus moved the research horizons forward and highlighted previously unknown correlations between inflammation, intestinal microflora, fiber, and disease.
Samverkan i kristid - för och med äldre med intellektuell funktionsnedsättning - Främjande och hindrande faktorer
No full textÄldre personer med intellektuella funktionsnedsättningar (IF) representerar en växande grupp med multisjuklighet och komplexa vårdbehov. Samverkan mellan huvudmän har lyfts som en strategi för att bättre möta personer med komplexa behov. Syftet med studien var att utforska uppfattningar hos strategisk personal på kommunal- och regional nivå om hindrande och främjande faktorer för samverkan mellan socialtjänst och hälso- och sjukvård, avseende komplexa behov hos äldre personer med IF. Åtta personer intervjuades utifrån ett fenomenografiskt perspektiv. Resultatet dominerades av hinder för samverkan; den pågående samhällskrisen, olika lagstiftningar och uppdrag, avsaknad av styrning, hög personalomsättning och svårigheter i kommunikationen mellan organisationer. Resultatet visar att samverkan tvingas bli nedprioriterad när en samhällskris utsätter välfärdssystemet för stora påfrestning. Implementering av samverkan för denna sårbara grupp äldre är en angelägen fråga för både praktiken och forskningen
Covid-19 som en strukturell beslutsutmaning i vård- och omsorgssektorn
No full textArtikeln problematiserar beslutsfattande i vård- och omsorgssektorn till följd av Covid-19 pandemin. Detta görs deduktivt genom att applicera en empiriskt framtagen beslutsmodell på nya data som utgörs av medieartiklar. Beslutsmodellen kan delas in i två dimensioner; en medarbetarinriktad och en organisationsinriktad. Varje dimension anger beslutsriktningen och sträcker sig från anti till pro. Det innebär att beslut kan fattas pro/anti medarbetare/organisation. Vi har funnit belägg för tre av modellens fyra dimensioner, vilka är utgångspunkter för analys av vilka konsekvenser beslut kan få på medarbetare, på arbetslivet och det civila samhället i stort
Om påverkan och skada En diskussion av ett av kriterierna i lagen om etikprövning av forskning som avser människor (Lag 2003: 460)
No full textEtikprövningslagen (Lag 2003:460) är huvudsakligen lätt att tolka, men ett kriterium innefattar en oklarhet som kan skapa tolkningsproblem och leda till att forskningsprojekt granskas i onödan. Syftet med denna artikel är att diskutera detta kriterium för att se hur det kan, eller borde kunna, tolkas. Kriteriet gäller forskning som ”utförs enligt en metod som syftar till att påverka forskningspersonen fysiskt eller psykiskt” eller ”som innebär en uppenbar risk att skada forskningspersonen” och innehåller således två krav. Frågan är om inte det första kravet är alltför inklusivt, eftersom det även gäller metoder där det inte finns någon risk för skada.Artikeln presenterar några viktiga distinktioner och tolkningsalternativ, och exempel ges på forskning som verkar omfattas av lagen trots att den knappast borde kräva etikprövning. Författarna avslutar med några tentativa förslag till lösning på problemet.
The Swedish Act concerning the Ethical Review of Research Involving Humans (Lag 2003:460) is relatively easy to understand. However, one criterion is unclear, creating an interpretative problem, which might lead to unnecessary reviewing of research projects. The aim of this paper is to discuss this criterion to see how it could, or should, be interpreted. The criterion concerns research that “is conducted according to a method that aims to influence a research participant physically or mentally” or “that might entail an obvious risk of harm for the participant,” and, thus, includes two conditions. The question is whether the first condition is not too inclusive, since it also covers the use of methods where there is no risk of harm.The article presents some crucial distinctions and alternative interpretations, and gives examples showing that the law seems to cover research that is not in need of ethical reviewing. The authors conclude with some tentative suggestions for solving this problem
Challenges with the interpretation of Sami ethnicity and the height differences in epidemiologic research comparing Sami and non-Sami population
No full textEthnicity is a common variable in epidemiology, which clusters individuals with some shared characteristics. Often it is not specified what is meant by a given ethnicity or what characteristics ethnicity entails in the different contexts. In public health research, ethnicity can be viewed as a non-modifiable risk factor of disease because modifying the ethnic composition in a population is not meaningful, nor ethical, public health policy. Importantly, ethnicity is typically associated with modifiable risk factors that are possible to intervene on for improvement of public health, and hence viewed as a risk marker not a risk factor. In the SAMINOR 1 Survey (2003–2004) from Northern and Mid Norway, Sami people were on average 6 cm lower than non-Sami people that lived in the same rural area. Low height has been associated with a higher risk of coronary heart disease, stroke, and diabetes, lower risk of some cancer types, and lower socioeconomic status. This article aims to discuss the use and interpretation of ethnicity and height in epidemiologic research when comparing Sami to non-Sami populations. Body height is a highly heritable trait in individuals, whereas at population level, the average height may be a marker of long-term exposure to health and living conditions, and hence, a non-modifiable variable for interventions at the time. We argue that height may be both an important risk factor for chronic lifestyle disease and an explanatory variable in studies of chronic lifestyle diseases in Sami vs non-Sami populations. For better interpretability of study results, we encourage researchers to express what components or characteristics are assumed to comprise Sami ethnicity and height and clarify which variables may provide interventions. Furthermore, we urge researchers to be aware of the potential for bias when studying health measures influenced by height, such as the popular body mass index.Ethnicity clusters individuals with shared characteristics and is a common variable in epidemiology. Often it is not specified what is meant by a given ethnicity or what characteristics ethnicity entails in the different contexts. In public health research, ethnicity can be viewed as a non-modifiable risk factor of disease because modifying the ethnic composition in a population is not meaningful, nor ethical, public health policy. Importantly, ethnicity is typically associated with modifiable risk factors that are possible to intervene on for improvement of public health, and hence viewed as a risk marker, not a risk factor. In the SAMINOR 1 Survey (2003–2004) from Northern and Mid Norway, Sami people were on average 6 cm lower than non-Sami people that lived in the same rural area. Low height has been associated with a higher risk of coronary heart disease, stroke, and diabetes, lower risk of some cancer types, and lower socioeconomic status. This article aims to discuss the use and interpretation of ethnicity and height in epidemiologic research when comparing Sami to non-Sami populations. Body height is a highly heritable trait in individuals, whereas, at a population level, the average height may be a marker of long-term exposure to health and living conditions, and hence, a non-modifiable variable for interventions at present. We argue that height may be both an important risk factor for chronic lifestyle disease and an explanatory variable in studies of chronic lifestyle diseases in Sami vs non-Sami populations. For better interpretability of study results, we encourage researchers to express what components or characteristics are assumed to comprise Sami ethnicity and height and clarify which variables may provide interventions. Furthermore, we urge researchers to be aware of the potential for bias when studying health measures influenced by height, such as the popular body mass index
Sex-specific height-correction of weight in a population with ethnic groups that differ in stature - the SAMINOR 1 Survey: a cross-sectional study
No full textBackground: Body mass index (BMI, weight/height2) is a common proxy for body fatness, but it is negatively correlated with height, particularly in women. In Norway, the ethnic Sami people, and especially women, have had higher BMI than their non-Sami peers. However, Sami and non-Sami differ substantially in stature. This article aimed to examine if previous findings of higher obesity measures in Sami compared to non-Sami persist when applying an adequately height-corrected weight index.
Methods: We estimated a sex-specific height-corrected weight index—the Benn index—that is, weight/heightp where p is estimated from log(weight)-log(height) regression. We used data on 15 717 men and women aged 30 and 36–79 years who participated in the SAMINOR 1 Survey (2003–2004). Correlations between height and weight and the indices BMI and Benn index were calculated using Pearson’s correlation coefficient.
Results: Sami were on average 5.8 cm shorter than non-Sami. BMI and height had a modest, negative correlation that was stronger in women than in men. Analyses were stratified by sex due to a statistically significant interaction (sex * log(height), p<0.001). There was no interaction with ethnicity (ethnicity * log(height), p=0.07 in women and p=0.24 in men). The p (95% confidence interval) in Benn index (weight/heightp) was estimated to 1.29 (1.21, 1.38) in women and 1.90 (1.83, 1.98) in men. Higher BMI in Sami compared to non-Sami was most evident in women, but Benn index did not differ by ethnicity in either sex.
Conclusion: Previous findings of higher obesity prevalence in Sami than in non-Sami may be biased. Future studies should take into account the marked height differences between these groups when comparing obesity indices.Background: Body mass index (BMI, weight/height2) is a common proxy for body fatness, but it is negatively correlated with height. In Norway, the ethnic Sami people have had higher BMI and lower height than their non-Sami peers. This article aimed to examine if previous findings of higher obesity measures in Sami compared to non-Sami persist when applying an adequately height-corrected weight index. Methods: We estimated a sex-specific height-corrected weight index—the Benn index—that is, weight/heightp where p is estimated from log(weight)-log(height) regression. We used data on 15 717 men and women aged 30 and 36–79 years who participated in the SAMINOR 1 Survey (2003–2004). Correlations between height and weight and the indices BMI and Benn index were calculated using Pearson’s correlation coefficient. Results: BMI and height had a modest, negative correlation. Analyses were stratified by sex due to a statistically significant interaction (sex * log(height), p<0.001). There was no interaction with ethnicity (ethnicity * log(height), p=0.07 in women and p=0.24 in men). The p (95% confidence interval) in Benn index (weight/heightp) was estimated to 1.29 (1.21, 1.38) in women and 1.90 (1.83, 1.98) in men. Higher BMI in Sami compared to non-Sami was most evident in women, but Benn index did not differ by ethnicity in either sex. Conclusion: Previous findings of higher obesity measures in Sami than in non-Sami may be biased. Future studies should take into account the marked height differences between these groups when comparing obesity indices