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Recordando juntos – Diseño del estudio de una intervención participativa comunitaria para el cuidado de la demencia en dos comunidades Inuit de Groenlandia
No full textIntroduction: This article outlines the study design for the research and development project “Reminiscing together – care development for people with dementia in Greenland”. Longevity is increasing in the world, including Greenland, and the increase in the number of older people brings with it an increase in the number of people living with dementia. Only few materials and care methods are adjusted to or developed in the Greenlandic Inuit context and knowledge about the disease is scarce. In this study we will investigate images of ageing among care workers and how these images affect the day-to-day care work in two nursing homes in Qeqqata municipality.
Methods: We will co-design designated spaces for reminiscence activities for residents in nursing homes and co-create smaller reminiscence actions to be integrated into daily care work. Theoretically we draw on the concepts of Identity and identification from sociology, Reminiscence as practiced cultural history from ethnology and The older person as ‘the other’ inspired by postcolonial feminist theory. Methodologically we will apply ethnographic fieldwork methods including participant observation, in-depth interviews and sharing circles, design thinking and co-design workshops as well as implementation and monitoring tools from promising practices.
Dissemination: The results of this multidisciplinary community based participatory project will be disseminated widely in research and practice through articles, guidelines and instructional videos.Introducción: Este artículo presenta el diseño del estudio para el proyecto de investigación y desarrollo “Recordando juntos: desarrollo de cuidados para personas con demencia en Groenlandia”. La longevidad está aumentando en todo el mundo, incluida Groenlandia, y con el incremento del número de personas mayores también crece el número de personas que viven con demencia. Existen muy pocos materiales y métodos de atención adaptados o desarrollados en el contexto Inuit groenlandés, y el conocimiento sobre la enfermedad es limitado. En este estudio investigaremos las imágenes del envejecimiento que tienen los trabajadores del cuidado y cómo estas imágenes influyen en el trabajo cotidiano en dos residencias de ancianos en el municipio de Qeqqata.
Métodos: Codiseñaremos espacios específicos para actividades de reminiscencia dirigidas a los residentes de las residencias y co-crearemos pequeñas acciones de reminiscencia para integrarlas en el cuidado diario. Teóricamente, nos basamos en los conceptos de identidad e identificación desde la sociología, la reminiscencia como historia cultural practicada desde la etnología, y la figura de la persona mayor como “el otro”, inspirada en la teoría feminista poscolonial. Metodológicamente, aplicaremos métodos etnográficos de trabajo de campo, como la observación participante, entrevistas en profundidad y círculos de diálogo, además de pensamiento de diseño, talleres de codiseño y herramientas de implementación y monitoreo provenientes de prácticas prometedoras.
Difusión: Los resultados de este proyecto multidisciplinario, basado en la comunidad y de enfoque participativo, se difundirán ampliamente tanto en la investigación como en la práctica mediante artículos, guías y videos instructivos
Permitir que los jóvenes lideren la defensa de la salud mental: el caso de Filipinas
No full textThe paper presents a case of a civil society initiative that enables youth to lead advocacy campaigns to strengthen mental health governance in the Philippines. It begins by presenting how youth in the Philippines are affected by mental health issues and a quick review of government policies. It then shares the experience of and lessons from PRO-Health, a civil society health rights initiative, which is collaborating with the largest student organization in the country, the Student Council Alliance of the Philippines (SCAP), to organize youth to lead advocacies to improve mental health governance. Particularly, it shows why and how young people should lead mental health advocacy, focusing on the kind of evidence that can be generated, how the capacities of youth can be enhanced, and the importance of multi-level and multi-sectoral linkages in youth organizing for accountability. The paper ends by discussing the Youth on Mental Health Assemblies being convened that have formulated a youth-led and youth-centered mental health agenda.El artículo presenta el caso de una iniciativa de la sociedad civil que permite a los jóvenes liderar campañas de incidencia para fortalecer la gobernanza de la salud mental en Filipinas. Comienza mostrando cómo los jóvenes en Filipinas se ven afectados por problemas de salud mental y ofrece una revisión rápida de las políticas gubernamentales. Luego comparte la experiencia y las lecciones de PRO Health, una iniciativa de la sociedad civil enfocada en los derechos en salud, que colabora con la organización estudiantil más grande del país, la Student Council Alliance of the Philippines (SCAP), para organizar a la juventud y apoyarla en el liderazgo de acciones de incidencia para mejorar la gobernanza de la salud mental.
En particular, muestra por qué y cómo los jóvenes deben liderar la defensa de la salud mental, con énfasis en el tipo de evidencia que puede generarse, en cómo pueden fortalecerse las capacidades juveniles y en la importancia de los vínculos multinivel y multisectoriales en la organización juvenil orientada a la rendición de cuentas. El artículo concluye con una discusión sobre las Asambleas de Juventud por la Salud Mental que se están convocando y que han formulado una agenda de salud mental dirigida y centrada en los jóvenes
In search of legal barriers to Roma’s right to education: Mitigating epistemic injustice through Buber’s distinction between I-Thou and I-It
Full text linkThe department of law at University of Gothenburg has for a number of years worked in tandem with local non-profit organizations (focusing on such things as social work, minority rights, asylum rights, and labor law.) Collaboration has, for example, been implemented within law school clinics where students receive valuable experience and non-profit organizations benefit from the legal support provided by law students. In addition, a group of researchers at the department has explored the possibilities of mutually beneficial collaborations with civil society non-profit organizations. This paper explores the possibilities of research within the triad of students, researchers, and non-profit organizations, based on the experience of working with a Roma women’s organization, Trajosko Drom, in Gothenburg, Sweden. The paper argues that Martin Buber’s distinction between “I-Thou” and “I-It” (Buber 1958) may be fruitful when assessing the reciprocal dimension of such a collaboration and may mitigate the risk of what Miranda Fricker describes as “epistemic injustice” (Fricker 2007). The concrete context of this paper concerns barriers to education for Roma minorities in Sweden. These barriers are visible in materials well established within legal scholarship. However, without the benefit of a minority perspective, there is a risk of not noticing them. The paper’s main argument is that a collaboration with a local NGO that creates possibilities for the genuine and ontologically constitutive I-Thou relationships reduces the risk of marginalizing and silencing of voices within legal scholarship. However, in order to create possibilities for I-Thou, there is a need, first, of a mutual beneficial I-It relationship. Research collaborations with local NGO’s set up in this manner reduce the risk of epistemic injustice
Problemas de salud sexual y reproductiva a los que se enfrentan los adolescentes escolarizados en comunidades de bajos recursos de Kwazulu-Natal, Sudáfrica: Perspectivas de profesores y enfermeras escolares
No full textIntroduction: To address the unmet sexual and reproductive health (SRH) needs of adolescents, the South African government introduced various policies and programs, including the recent Integrated School Health Policy (ISHP). This policy provides students with comprehensive health services, including screenings for pregnancy, STIs, and HIV, as well as education on menstruation, safe sex, and contraception. School health practitioners are responsible for implementation of the ISHP, yet little is known about their perspectives regarding the SRH issues faced by learners. This study aimed to explore the SRH challenges that secondary school learners’ face, the contributing factors for these challenges and possible solutions to deal with these challenges from the perspective of school health practitioners.
Methods: We used an exploratory and descriptive qualitative research design to provide an in-depth understanding of the SRH challenges that secondary school learners encounter. In-depth interviews were used to collect data from school health practitioners comprising eleven Life Orientation (LO) teachers and four school health nurses. All the interviews were analysed using thematic analysis.
Results: School health practitioners perceive high unplanned teen age pregnancy, sexual abuse and lack of adequate knowledge of the symptoms of STIs as key SRH issues requiring attention among learners. Inadequate human resources hinder school health nurses from meeting the demands of screening and providing quality SRH services to learners. Perspectives of LO teachers suggested that they were insufficiently equipped to deliver the LO content. They pointed out a need for adequate training and provision of adequate teaching resources. Parents were highlighted as important stakeholders to be actively involved in the implementation of the ISHP.
Conclusions: The perspectives of school health practitioners are important in the delivery of the ISHP as they identify the implementation challenges they encounter daily as well as the SRH challenges affecting learners. Addressing these challenges can contribute to the effective implementation of the Integrated School Health Policy.Introducción: Para abordar las necesidades insatisfechas en salud sexual y reproductiva (SSR) de los adolescentes, el gobierno de Sudáfrica ha implementado diversas políticas y programas, incluyendo la reciente Política Integrada de Salud Escolar (PISE). Esta política ofrece a los estudiantes acceso a servicios sanitarios integrales, incluyendo pruebas de embarazo, detección de infecciones de transmisión sexual (ITS) y VIH, así como educación sobre menstruación, sexo seguro y anticoncepción. Aunque los profesionales de la salud escolar son fundamentales para la implementación de la PISE, existe un conocimiento limitado sobre sus perspectivas respecto a los problemas de SSR enfrentados por los estudiantes. Este estudio exploró los problemas de SSR en estudiantes de secundaria, los factores contribuyentes y las soluciones potenciales desde la perspectiva de profesores y enfermeras.
Métodos: Se empleó un enfoque cualitativo, exploratorio y descriptivo para profundizar en los problemas de SSR de los alumnos de secundaria. Mediante entrevistas en profundidad se recopilaron datos de once profesores de Orientación para la Vida (OV) y cuatro enfermeras escolares. Las entrevistas fueron analizadas utilizando análisis temático.
Resultados: Los entrevistados identificaron como principales problemas de SSR el alto número de embarazos no planificados, los abusos sexuales y la insuficiencia de conocimientos sobre los síntomas de las ITS. La falta de recursos humanos adecuados limita la capacidad de las enfermeras escolares para ofrecer servicios de SSR eficaces. Los profesores de OV señalaron una deficiencia en la capacitación y en recursos didácticos para impartir educación eficazmente. Además, se destacó la importancia de la participación activa de los padres en la implementación de la PISE.
Conclusiones: Las percepciones de los profesionales de la salud escolar son cruciales para la aplicación de la PISE, pues señalan tanto los desafíos cotidianos de su implementación como los problemas específicos de SSR que afectan a los estudiantes. Resolver estos desafíos podría mejorar significativamente la implementación de la Política Integrada de Salud Escolar
Entre la promesa y la práctica: experiencias de los profesionales de salud materna, neonatal e infantil sobre las adaptaciones de los servicios digitales en Uganda durante la pandemia del COVID-19
No full textIntroduction: The COVID-19 pandemic severely disrupted maternal, neonatal, and child health (MNCH) services in Uganda. In response, digital health tools were rapidly adopted as one of the strategies to restore service delivery. However, the experiences of MNCH professionals implementing these adaptations remain underexplored. This study aimed to explore how MNCH professionals in Uganda experienced the digital tools adaptations made to restore MNCH services during the pandemic.
Methods: This qualitative study involved seven in-depth interviews with MNCH professionals in Kampala, Uganda. Participants were purposively sampled based on their direct involvement in digital health adaptations during the pandemic. Data were analysed using qualitative content analysis to explore both manifest and latent meanings in participants’ experiences.
Results: One overarching theme emerged: Experiencing digitalisation as a paradox between promise and practice. This was supported by two sub-themes: realising multi-dimensional gains of digitalisation and recognising digitalisation as only ‘part of the puzzle’, and six categories. The results explored how digital tools improved work-life balance, collaboration, and service continuity, they also exposed infrastructural and socioeconomic barriers, particularly in rural and low-income settings.
Conclusions: Digital health innovations offer valuable support for MNCH service delivery during public health emergencies. However, their effectiveness is limited by structural inequities and digital exclusion. This underscores the need for context-sensitive strategies that balance technological innovation with persistent structural and clinical realities.Introducción: La pandemia del COVID-19 interrumpió de forma severa los servicios de salud materna, neonatal e infantil (SMNI) en Uganda. Como respuesta, las herramientas de salud digital se adoptaron rápidamente como una de las estrategias para restablecer la prestación de servicios. Sin embargo, las experiencias de los profesionales de SMNI que implementaron estas adaptaciones siguen poco exploradas. Este estudio tuvo como objetivo analizar cómo los profesionales de SMNI en Uganda vivieron las adaptaciones digitales implementadas para restablecer los servicios durante la pandemia.
Métodos: Este estudio cualitativo incluyó siete entrevistas en profundidad con profesionales de SMNI en Kampala, Uganda. Los participantes fueron seleccionados intencionalmente según su participación directa en las adaptaciones de salud digital durante la pandemia. Los datos se analizaron mediante análisis de contenido cualitativo para explorar tanto significados manifiestos como latentes en las experiencias de los participantes.
Resultados: Surgió un tema general: experimentar la digitalización como una paradoja entre la promesa y la práctica. Este tema estuvo respaldado por dos subtemas: reconocer los beneficios multidimensionales de la digitalización y entender la digitalización como solo “una parte del rompecabezas”, además de seis categorías. Los resultados muestran que, si bien las herramientas digitales mejoraron el equilibrio entre vida laboral y personal, la colaboración y la continuidad de los servicios, también evidenciaron barreras socioeconómicas y de infraestructura, especialmente en entornos rurales y de bajos ingresos.
Conclusiones: Las innovaciones en salud digital ofrecen un apoyo valioso para la prestación de servicios de SMNI durante emergencias de salud pública. No obstante, su efectividad está limitada por inequidades estructurales y exclusión digital. Esto resalta la necesidad de estrategias sensibles al contexto que equilibren la innovación tecnológica con las realidades estructurales y clínicas persistentes
Knowledge Gaps about Mining Impacts on Sami Lands: A Call for Epistemic Justice in European Minerals Extraction
Full text linkIn the context of the EU’s Critical Raw Materials Act, which prioritizes mineral extraction and imposes time limits on project approvals, there have been a surge of policy proposals that aim to expedite licenses for green industry projects. Meanwhile, the academic literature largely overlooks risks for Indigenous Sami rights and reindeer herding. In this paper, we examine if a similar knowledge gap exists in a key part of the practitioner literature informing licensing decisions for new mines, namely environmental impact assessments (EIAs). To do so, we undertake a comparative synthesis of results from i) unpublished findings from a review of selected EIAs from mining companies in Sweden, and ii) a review of Sami knowledge about impacts at two mining sites in Sweden. Findings reveal a considerable mismatch between predicted impacts in corporate EIAs and those impacts experienced by herding communities. Using an epistemic justice lens, we argue that this knowledge gap is no coincidence—instead it reflects an epistemic injustice underlying European and hence Swedish minerals policy and its ambitions to fast-track licensing and exploit Sami lands in the name of the green transition
Interrogating International Environmental Law’s Approach to Nature: An Arctic Indigenous Model?
Full text linkInternational Environmental Law (IEL) reflects a rooted misconception of nature present across the international legal system, whereby nature is presented as instrumental to satisfying human needs oriented to unlimited economic growth. Such an anthropocentric view lacks an ecological awareness that conceives and values nature in its own right, and fails to recognize humans as part of it, leading to relentless exploitation of the natural world, at the core of the climate and ecological crises. In this article, I contend that rethinking IEL in a way to interrogate its inherent conceptual premises and embrace non-Western views on and relationalities with nature is essential. The Arctic being at the forefront of climate effects that severely and disproportionally impact its ecosystems and (human and non-human) communities; and “sustainable development” projects contextualised as part of the green transition pose additional risks to the region. I argue that Indigenous knowledge from Arctic peoples can contribute to expanding IEL’s conceptual horizons and correcting inherited (mis-)understanding of nature and reimagining the human–nature relationship. Integrating, for example, the overarching principle of respect of the Skolt Sami in ordinary human–nature relationships can assist in rethinking IEL and inform a truly sustainable design, interpretation and implementation of its provisions
Rural Risk and Disaster Management from a Relational Approach: Insights from Northern Sweden
Full text linkThis article emphasizes the significance of relational concepts in understanding Disaster Management (DM) in rural areas. Specifically, we turn to the concepts of relational place and peripheralization to illustrate how places derive meaning from their relationships with other places and argue for a deeper understanding of how these dynamics influence DM professionals’ experiences of their work and of peripheralization. Despite extensive research on DM, place is often treated as a neutral backdrop rather than as an active agent that shapes professionals’ work. To explore the role of place in DM, we draw on interviews with professionals from four municipalities in northern Sweden, characterized by expansive geographies, declining populations, and a decreasing tax base. By employing the concept of relational place, we show how DM professionals perceive laws and regulations as ill-adapted to their contexts and their work as diverging from broader societal norms. We also illustrate how feelings of peripheralization, understood as a process rather than a static condition, are linked to the political, financial, and social dimensions of DM. Through this article, we aim to broaden the discourse on DM by providing insights into the unique challenges faced in rural contexts, emphasizing how these intersect with professionals’ understandings of place
Impacto de la intervención comunitaria 'Auzozaintza' para abordar la soledad en personas mayores que viven en la comunidad: un estudio piloto pre-post
No full textIntroduction: Chronic loneliness is increasingly recognized as a significant detriment to health and well-being. Projections indicate a substantial escalation in cases of chronic loneliness in the forthcoming years, with a particularly pronounced impact on women. In response, a variety of interventions are currently being developed and executed to mitigate this issue. However, empirical evidence supporting the efficacy of group interventions in alleviating loneliness remains sparse. The aim of this study was to assess the impact of the pilot community intervention “Auzozaintza” on loneliness and health (anxiety, depression and self-rated health) of older adults in the town of Hernani, Spain.
Methods: A pre-post study design without a control group was conducted with participants from the three neighbourhoods in which the intervention was piloted. All 20 participants were women, with a mean age of 80.3 ± 5.1 years, 15 of them were widow and 15 lived alone. Self-reported loneliness (measured by the UCLA Loneliness scale), anxiety, depression and self-rated health were assessed over a period of six months from February to September 2023. Bayesian inference was applied to estimate the association between the intervention and the selected outcomes.
Results: UCLA along with its three dimensions decreased after the intervention, with all of them showing near statistical significance. The prevalence of anxiety and depression decreased over the period, with a greater uncertainty for the former (PR=0.50; 95% CrI: 0.15, 1.31) but being statistically significant in the latter (PR=0.38; 95% CrI: 0.13, 0.90). No effects were observed in self-rated health.
Conclusion: The positive results observed in this study may justify the expansion of the “Auzozaintza” intervention across the municipality of Hernani. Future research should examine the replicability of these favourable effects in neighbourhoods of different social contexts, utilizing a larger and a more heterogeneous sample, specially including men. Additionally, future longitudinal and comparative studies are needed to determine whether the benefits observed are sustained over time and attributable to the intervention along with qualitative studies that explore participants’ experiences.Introducción: La soledad crónica es cada vez más reconocida como un factor perjudicial para la salud y el bienestar. Las proyecciones indican un aumento considerable en los casos de soledad crónica en los próximos años, con un impacto particularmente pronunciado en las mujeres. En respuesta, se están desarrollando y ejecutando diversas intervenciones para mitigar este problema. Sin embargo, la evidencia empírica que respalde la eficacia de las intervenciones grupales en la reducción de la soledad sigue siendo escasa. El objetivo de este estudio fue evaluar el impacto de la intervención comunitaria piloto “Auzozaintza” sobre la soledad y la salud (ansiedad, depresión y salud autopercibida) de personas mayores en la localidad de Hernani, España.
Métodos: Se llevó a cabo un estudio pre-post sin grupo control con participantes de los tres barrios donde se pilotó la intervención. Las 20 participantes eran mujeres, con una edad media de 80,3 ± 5,1 años; 15 eran viudas y 15 vivían solas. Se evaluaron la soledad autopercibida (medida mediante la escala de soledad de UCLA), la ansiedad, la depresión y la salud autopercibida durante un período de seis meses, de febrero a septiembre de 2023. Se aplicó inferencia bayesiana para estimar la asociación entre la intervención y los resultados seleccionados.
Resultados: La escala de UCLA y sus tres dimensiones disminuyeron tras la intervención, todas con una tendencia cercana a la significación estadística. La prevalencia de ansiedad y depresión disminuyó durante el período, con mayor incertidumbre en el caso de la ansiedad (RP=0,50; CrI: 0,15-1,31), pero siendo estadísticamente significativa en el caso de la depresión (RP=0,38; CrI: 0,13-0,90). No se observaron efectos sobre la salud autopercibida.
Conclusión: Los resultados positivos observados en este estudio podrían justificar la expansión de la intervención “Auzozaintza” al conjunto del municipio de Hernani. Futuros estudios deberán examinar la replicabilidad de estos efectos favorables en barrios con distintos contextos sociales, utilizando una muestra más amplia y heterogénea, especialmente incluyendo hombres. Además, se requieren estudios longitudinales y comparativos para determinar si los beneficios se mantienen en el tiempo y son atribuibles a la intervención, junto con estudios cualitativos que exploren las experiencias de las personas participantes