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  • 251. Bevelander, Pieter
    et al.
    H. Bilde, Rasmus
    Dahlstedt, Inge
    Eskelund, Marc
    Møller Hansen, Line
    Macura, Miroslav
    Gehrke Pedersen, Kasper
    Østby, Lars
    Scandinavia's Population Groups Originating from Developing Countries: Change and Integration2013Book (Other academic)
    Abstract [en]

    Scandinavia’s foreign-origin population has steadily increased over the past six decades. Migration flows into the region have been linked to societal phenomena such as growing labour demands, family reunification and the acceptance of refugees fleeing wars and political conflicts. Whereas earlier migration streams were generally expected to integrate relatively easily, concerns about the current streams are high on the political agenda. This report is a cross-country research into selected key features of population change and the integration of population groups with roots in Iran, Iraq, Pakistan, Somalia, Turkey and Vietnam in Denmark, Sweden and Norway. The research has sought to achieve three objectives. The first is to determine how and when the groups came to the three Scandinavian countries and how they have since developed. The second is to analyze two aspects of the groups’ integration, namely their participation in education and their participation in the labour market. And the final objective is to provide a brief overview of the groups’ situation in each of the three countries with regards to economic development, immigration history and policy development.

  • 252. Beyersdorff, Sven
    et al.
    Lanthén, Esben
    Baltic 2030 Bumps on the Road: How the Baltic Sea States are performing on the SDGs2018Other (Other (popular science, discussion, etc.))
    Abstract [en]

    The report Baltic 2030: Bumps on the Road provides an overview of the 2030 Agenda implementation in the Baltic Sea Region, aimed at informing strategy and prioritisation discussions for national and regional collaboration. For each of the region’s eleven countries, performance on the Sustainable Development Goals (SDGs) is examined and five selected SDGs are discussed at the indicator level. Based on this analysis, the authors recommend seven avenues for action where greater collaboration in the region can support SDG achievement. The report was commissioned by the Council of the Baltic Sea States (CBSS) and iis jointly published by CBSS and the Nordic Council of Ministers (NCM). It was drafted by the advisory firm Nordic Sustainability and follows the previous Bumps on the Road to 2030 report published by the NCM in 2017.

  • 253. Bian, Ying
    et al.
    Sun, Qiang
    Zhao, Zhengyan
    Blas, Erik
    Nordic Council of Ministers, Nordic School of Public Health NHV. UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), The World Health Organization, 20 Avenue Appia, CH-1211 Geneva 27, Switzerland.
    Market reform: a challenge to public health--the case of schistosomiasis control in China.2004In: International Journal of Health Planning and Management, ISSN 0749-6753, E-ISSN 1099-1751, Vol. 19 Suppl 1, p. S79-94Article in journal (Refereed)
    Abstract [en]

    This study examines how the provision of schistosomiasis control has adapted to increased exposure to market forces which has occurred in China over the past decades with the main emphasis on contemporary performance of the services. Financial and service data were collected and analysed from ten schistosomiasis stations in the Hunan province. A document and literature review, key informant interviews, as well as two focus group discussions were conducted to establish their context. The study found that the schistosomiasis control stations had shifted their emphasis from prevention to clinical services and that 62% of the stations' total income now comes from charging for individual clinical services, while 90% of the total costs was related to providing these services. The study found that revenue generation had become the primary motive, and that over-treatment and prescription had become an accepted practice for all the stations. The study concludes that a combination of lax supervision and accountability, and a greater reliance on user-payment and market mechanisms has severely compromised the provision of the public goods elements of the schistosomiasis control programme.

  • 254.
    Biong, Stian
    Nordic Council of Ministers, Nordic School of Public Health NHV.
    Between death as escape and the dream of life: Psychosocial dimensions of health in young menliving with substance abuse and suicidal behaviour2008Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Substance abuse and suicidal behaviour are major challenges to public health. These phenomena are mainly studied by quantitative designs. This qualitative thesis aims at gaining a deeper understanding of substance abuse and suicidal behaviour, as experienced by young men in different types of treatment. By describing, exploring and interpreting lived experiences, in this thesis I try to give a more nuanced language of both substance abuse and suicidal behaviour, also in young migrating men. I also focus on the system of services related to the prevention and follow-up of life-threatening overdoses by describing and exploring how this phenomenon is experienced by individuals and professionals in Oslo. By researching the lived experiences of substance abuse and suicidal behaviour, combined with researching the phenomenon of life-threatening overdoses, a deeper insight is gained and this can be an important source to both prevention and health promotion for the group in question. The first three papers are based on descriptive, explorative and interpretative studies. How meaning is constructed is the core research question. In the fourth study I describe and explore life-threatening overdoses as a contemporary phenomenon in its context. The research questions are on a descriptive level. In the first three papers, the research object is the personal narratives from in-depth interviews, which are analysed using a phenomenological hermeneutic method. The case study is composed of data collected from different sources, and analysed by triangulation. The main finding in the first paper is that substance abuse and suicidal behaviour can be understood as goal-oriented, communicative and meaning-making activities about the individuals’ balance between death as an escape from pain and the hope of a life. In the second study, metaphorical expressions about a shifting sense of self is understood as balancing being an agent or a victim. In migrating young men these phenomena are interpreted as goal-oriented, communicative and meanig-making activities about existing in a maze that is perceived as closed. The findings of the case study show that different forms of life-threatening overdoses in Oslo are experienced in a state of existential and material stress. A wish of follow-up might not be expressed by the individual. Due to structural problems, such as lack of goals, professionals do not prevent such events in a planned way, nor do they cooperate between different levels. Professionals decide what is good quality in prevention and follow-up of life-threatening overdoses

  • 255.
    Biong, Stian
    et al.
    Nordic Council of Ministers, Nordic School of Public Health NHV.
    Karlsson, Bengt
    Svensson, Tommy
    Nordic Council of Ministers, Nordic School of Public Health NHV.
    Metaphors of a shifting sense of self in men recovering from substance abuse and suicidal behavior.2008In: Journal of Psychosocial Nursing and Mental Health Services, ISSN 0279-3695, E-ISSN 1938-2413, Vol. 46, no 4, p. 35-41Article in journal (Refereed)
    Abstract [en]

    The purpose of this descriptive study was to explore and interpret men's experience of sense of self within the context of recovery from substance abuse and suicidal behavior. A secondary analysis of data from a previous study of four young Norwegian men revealed how a shifting sense of self was constructed through the use of metaphors. The analysis identified three themes related to the participants' sense of self: The Meaning of Being Isolated, The Meaning of Being Close to the Point of No Return, and The Meaning of Still Being on the Edge. By acknowledging metaphorical expressions as a source of important knowledge, this study reflects on how mental health professionals can use metaphors in the recovery process. As part of the' treatment alliance and therapeutic communication, we suggest that metaphors may aid the assessment of suicidal ideation, promote a sense of a more active self, and signal acceptance and recognition of subjectivity.

  • 256.
    Biong, Stian
    et al.
    Nordic Council of Ministers, Nordic School of Public Health NHV.
    Ravndal, Edle
    National Institute of Alcohol and Drug Research, Oslo, Norway.
    Living in a maze: Health, well-being and coping in young non-western men in Scandinavia experiencing substance abuse and suicidal behaviour2008In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 4, no 1, p. 4-16Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to illuminate and interpret the lived experiences of emigration, substance abuse and suicidal behaviour in young non-western men in Scandinavia. The research questions were formulated as: (1) How is meaning constructed in the narratives? (2) What impact do these experiences have on health, well-being and coping? Data were collected using open-ended in-depth interviews. A phenomenological-hermeneutic approach, inspired by the philosophy of Ricoeur, was used to analyse the data. The naïve reading involved awareness of the participants’ perceived sense of insecurity in life. The structural analysis identified three themes: (1) the meaning of getting in a tight spot, (2) the meaning of being in a fog and (3) the meaning of the burning bed. A comprehensive understanding of the data was formulated as “living in a maze”. Ill health involved having a sense of liminality, which impaired one's possibilities to define and re-define goals. Substance abuse and suicidal behaviour were explicit expressions of not being well, when living in a maze that was perceived as closed. Both problem-focused and emotion-focused coping were used by the participants. These provided the motivation for substance abuse and suicidal behaviour.

  • 257.
    Biong, Stian
    et al.
    Nordic Council of Ministers, Nordic School of Public Health NHV.
    Ravndal, Edle
    National Institute of Alcohol and Drug Research, Oslo, Norway.
    Young men's experiences of living with substance abuse and suicidal behaviour: Between death as an escape from pain and the hope of a life2007In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 2, no 4, p. 246-259Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to illuminate the experiences of suicidal behaviour in young Norwegian men with long-term substance abuse and to interpret their narratives with regard to meaning. Data were collected using open-ended, in-depth interviews. A phenomenological hermeneutic approach, inspired by the philosophy of Ricoeur, was used to analyse the data. The naïve reading involved awareness of the perceived sense of pain and hope in the participants. In the structural analysis, three themes were identified: (1) the meaning of relating, (2) the meaning of reflecting and (3) the meaning of acting. A comprehensive understanding of data indicated that the meaning of living with suicidal behaviour could be understood as a movement between different positions of wanting death as an escape from pain and hope for a better life. Our conclusion is that suicidal behaviour in men with substance abuse is a communicative activity about the individual's lived experience of pain and hope. How the participants experienced and constructed masculinity influenced the suicidal behaviour. To reduce pain and create hope by being seen and confirmed in social relationships, and being helped to verbalize existential thoughts and openly discuss possible solutions, are of importance.

  • 258. Birch Christiansen, Lena
    et al.
    Zierau Kuds, Mette
    Winther Wehner, Lasse (Editor)
    Nordic Council of Ministers, Nordic Centre for Welfare and Social Issues.
    Smedegaard, Marianne (Editor)
    Mental health for families with a child with disabilities2012Book (Other (popular science, discussion, etc.))
  • 259. Birch Christiansen, Lena
    et al.
    Zierau Kudsk, Mette
    Пилотный проект «Психологическое здоровье2011Book (Other (popular science, discussion, etc.))
  • 260. Bird, Tim
    et al.
    Weaver, Sally
    Climate action in Peru: Nordic support for waste sector management yields results2018Other (Other (popular science, discussion, etc.))
    Abstract [en]

    The Nordic Partnership Initiative on Upscaled Mitigation Action (NPI) supported developing countries in designing and implementing mitigation action and attracting funding from international climate finance and carbon markets. In Peru, the initiative focused on building readiness for mitigating greenhouse gas emissions in the municipal solid waste sector. It generated comprehensive information on the sector’s status and trends in terms of waste and emissions, mitigation potential and costs, and barriers to action. Mitigation plans for landfills were prepared, a robust information system developed, and policy reforms introduced for recognising waste as a valuable raw material. The NPI results have been integrated into national and local development plans and serve as valuable building blocks in the design and implementation of Peru’s mitigation pledges under the Paris Agreement.

  • 261. Bird, Timothy
    Nordic Action on Climate Change2017Other (Other (popular science, discussion, etc.))
    Abstract [en]

    This booklet presents actions taken by the Nordic countries to speed the transition to a sustainable low-carbon society. It shows how sustainable development is possible, with strong climate policies contributing to economic growth and job creation as well as environmental improvements. The Nordic countries successfully demonstrate how ambitious climate change mitigation targets and policies can be combined with high levels of human development.

  • 262. Birk, Flemming
    Use of Intellectual Property Rights in Service Companies2006Book (Other (popular science, discussion, etc.))
    Abstract [en]

    A new survey conducted by the Nordic consultancy company ECON Analysis reveals that large Nordic enterprises in the service sector fail to recognize IPR as a natural part of their strategic management. That can be a problem in a globalized world, where also service enterprises must compete on innovation and new ideas.

  • 263.
    Birkemose, Jan
    Nordic Council of Ministers, NORDICOM.
    Nogle medier vil overlevead blockerne2016In: Nordicom Information, ISSN 0349-5949, Vol. 38, no 1, p. 56-59Article in journal (Other academic)
    Abstract [no]

    Det er en alvorlig trussel mod nordiske netmedier, at op mod hver fjerde bruger filtrererannoncerne væk og dermed underminerer mediernes økonomi. Allerede nu eksperimenterermange medier med forskellige initiativer for at få brugerne til at betale ellerse annoncerne. For at kompensere for de tabte annonceindtægter, vil mange medierintroducere native annoncering. Og takket være ad blockerne vokser en ny annoncefripublicisme frem, hvor brugerne, og deres ønsker og behov, kommer i centrum, somaldrig tidligere. De medier, der ikke formår at omstille sig til de nye forhold, får sværtved at overleve.

  • 264. Birkemose, Jan
    Nogle medier vil overlevead blockerne2016In: Nordicom Information, ISSN 0349-5949, Vol. 38, no 1, p. 56-59Article in journal (Other academic)
    Abstract [no]

    Det er en alvorlig trussel mod nordiske netmedier, at op mod hver fjerde bruger filtrererannoncerne væk og dermed underminerer mediernes økonomi. Allerede nu eksperimenterermange medier med forskellige initiativer for at få brugerne til at betale ellerse annoncerne. For at kompensere for de tabte annonceindtægter, vil mange medierintroducere native annoncering. Og takket være ad blockerne vokser en ny annoncefripublicisme frem, hvor brugerne, og deres ønsker og behov, kommer i centrum, somaldrig tidligere. De medier, der ikke formår at omstille sig til de nye forhold, får sværtved at overleve.

  • 265. Birkjær, Michael
    Skyggen af lykken2018Other (Other (popular science, discussion, etc.))
    Abstract [da]

    De nordiske befolkninger er lykkeligere end andre i verden, men der findes også mennesker i Danmark, Finland, Island, Norge og Sverige, som giver udtryk for mistrivsel eller sågar for at være ulykkelige, når de beskriver deres liv. Denne rapport undersøger, hvem der ikke er lykkelige i Norden, samt hvilke livsomstændigheder der ligger bag.

  • 266. Birkjær, Michael
    et al.
    Kaats, Micah
    Er sociale medier faktisk en trussel for unges trivsel?2019Other (Other (popular science, discussion, etc.))
    Abstract [da]

    Denne rapport undersøger sammenhængen i Norden mellem unges trivsel og deres forbrug af sociale medier. Er unges stigende brug af sociale medier og skærmtid et problem for deres personlige trivsel og deres deltagelse i de ikke-digitale fællesskaber i samfundet? Hovedkonklusionen er at vi ikke kan dømme forbruget af sociale medier som noget entydigt positivt eller negativt for unges trivsel, uden at vi forholder os til en række helt specifikke betingelser, som nuancerer billedet væsentligt. Vi må forholde os til hvem som bruger de sociale medier, hvilke sociale medier de bruger og hvor lang tid de bruger. Vi må også forholde os til hvordan sociale medier bruges. Når vi tager højde for de ovennævnte betingelser, finder vi en række betydelige effekter fra unges forbrug af sociale medier, som man kan læse mere om i rapporten.

  • 267. Bisgaard, Tanja
    et al.
    Høgenhaven, Casper
    Creating new concepts, products and services with user driven innovation2010Book (Other (popular science, discussion, etc.))
    Abstract [en]

    User driven innovation is emerging as one of the successful ways of creating breakthrough innovations for companies and organisations. Based on our research we have been able to identify four generic methods of working with user driven innovation: user test, user exploration, user innovation and user participation. Even though these methods might vary slightly from one company to the other, they have some basic features which are common. When working with users, companies might chose to include the users either directly or indirectly in the innovation process, depending on what type of knowledge the company wants to obtain from the user. Users’ ability to communicate and express their problems and needs varies greatly and will also influence the user driven innovation method chosen by a company.

  • 268. Bjarnadóttir, Hólmfrídur
    et al.
    Bradley, Karin
    Ny kurs för Norden - planering och hållbar utveckling2003Book (Other academic)
    Abstract [sv]

    Syftet med denna rapport är att ge en översikt över hur fysisk och rumslig planering i de nordiska länderna kan bidra till en hållbar utveckling och även att visa hur planering kan stödja åtgärder i den nordiska hållbarhetsstrategin från år 2000. I rapporten återfinns exempel på planering för hållbar utveckling från nationell, regional och kommunal nivå i de fem nordiska länderna samt en sammanställning av återkommande angreppssätt. Avslutningsvis tecknas förslag på områden för fortsatt nordisk samverkan inom planering för en hållbar utveckling.

  • 269. Bjarnadóttir, Hólmfríður
    et al.
    Hilding-Rydevik, Tuija
    Final disposal of spent nuclear fuel in Sweden2001Other (Other (popular science, discussion, etc.))
    Abstract [en]

    Some unresolved issues and challenges in the design and implementation of the forthcoming planning and EIA processes.

  • 270. Bjerg, Jens
    Nordic scalers - A study of drivers of growth and barriers to scaling of Nordic companies2019Report (Other (popular science, discussion, etc.))
    Abstract [en]

    The Nordic region has the potential to become one of the leading scale-up hubs in the world. Drawing on internationally comparable data, this report shows that in all the Nordics the number of scale-ups per capita is well above the EU average.Indeed the scale-up density for the Nordic region is almost on par with the UK and Switzerland – two renowned scale-up nations. Finland, Sweden and Iceland rank especially high.But the analysis also documents a significant gap between the Nordics and two scale-up champions: the US and Israel.Thus, on average Nordic countries have 5 scale-ups per 100,000 inhabitants, while in the US this figure is close to 8, and in Israel it is 12.If the Nordic region is to narrow the gap between it and the US and Israel it is vital that founders of1. Executive Summary scale-ups, investors and policymakers in all of the Nordic countries have comprehensive knowledge and insights on the key challenges and barriers that Nordic scale-ups face at different stages of growth.Even more importantly, all of the key actors will need to understand how successful scale-ups manage to meet and overcome key barriers for growth.Based on more than 50 interviews with CEOs and founders of Nordic scale-ups, and representatives from the investor side, this report provides new and detailed insights into common traits and challenges among Nordic scale-ups.

  • 271. Bjerke, Paul
    et al.
    Kjos Fonn, Birgitte
    A Hidden Theoryin Financial Crisis Journalism?: The Case of Norway2015In: Nordicom Review, ISSN 1403-1108, E-ISSN 2001-5119, Vol. 16, no 2, p. 113-127Article in journal (Refereed)
    Abstract [en]

    The present article analyses press coverage of the dramatic finance crisis and the ensuingEuropean debt crisis in Europe, in three decisive periods. The authors conduct quantitativeand qualitative content analyses of two major mainstream Norwegian newspapers, Aftenpostenand Dagbladet, employing concepts and methods from framing theory, to analysecoverage in the framework of two contesting schools in economics.The study finds traces of discussions of finance brokers’ ethics and some discussions ofgovernmental regulations that made the 2008 crisis possible, but few indications of a basicdiscussion of the system as such. The authors conclude that the crisis was framed more asa superficial, short-term problem (as per a mainstream, neoliberal theory of economics)than as a deeper and long-term system problem (as a more critical ‘political economics’theory would have held).

  • 272.
    Bjerkeli Grøvda, Lillian
    Nordic Council of Ministers, Nordic School of Public Health NHV.
    Evaluering av bruken av egenjournal i helsestasjon: et empowermentprosjekt2005Independent thesis Advanced level (degree of Master (Two Years))Student thesis
    Abstract [en]

    Background:Research has shown that insufficient communication skills and lacking continuity has led to poor quality of the children's health services. In some cases this has caused incorrect diagnosis and treatment and insufficient information to the parents. The Norwegian Board of Health appointed a working group that created a parent-held child health record. The group proposed the record to betried out in a selected population and evaluated before introducing it for the whole country.

    Aim: Tostudy parents use of the PHCHR, and to evaluate participation in decisionmaking and communication with the professionals. We also wanted to determine the PHCHR’s influence on health care utilisation, knowledge about child health and self-care.

    Setting: Maternal child health centres in ten municipalities in the North-west of Norway between October 2001 and January2003.

    Method: A sample of 309 children born between Jan 8. 2000 (00.08.01) and Oct 1. 2001 (01.10.01) was recruited successively at routine health surveillance visits and randomised into an intervention ora control group. First-born children were excluded. We used self-completed questionnaires, which had standardised, specific and closed questions. Both groups answered part one before and after the intervention, and the intervention group also answered part two after the intervention. It was 289(94%) parents who answered the questionnaires before the intervention, and 260 (84%) after. Public health nurses introduced both the PHCHR and the questionnaires. The nurses were interviewed to validate the interpretation of the results.

    Results: 3/4 of the parents used the PHCHR when visiting the maternal child health centres, 3/4 reported that the record had been helpful to them and 3/4 had entered information in the PHCHR themselves. Half of the parents claimed that the PHCHR led to better view of the child's health and development, and that they got more involved in decisions. The PHCHR was less used visiting other health professionals. The use of PHCHR did not influence the utilisation of health care services, parents’ knowledge of child's health, or the parents' satisfaction of information and communication with professionals.

    Conclusions: The PHCHR was well acceptedand frequentlyused in this randomised controlled trial, but the survey does not support the positive results using PHCHR shown in earlier descriptive follow up studies. Still, the public health nurses taking part in the study believe that an earlier introduction of the parent-held child record – at the first home visit, and more training would alter the results. Further studies are needed before one is to decide what to do about PHCHR in health promotion in children

  • 273. Björk, Olle
    et al.
    Palm, Viveka
    Steinbach, Nancy
    Lone, Øyvind
    Kolshus, Kristine
    Pedersen, Ole Gravgård
    Krarup, Signe
    Kolttola, Leo
    Lindblom, Annika
    Making the environment count: - Nordic accounts and indicators for analysing and integrating environment and economy2016Book (Other academic)
    Abstract [en]

    In 2013, the Nordic Ministers for the Environment decided to strenghten the measurement of green estimates of welfare and socio-economic developments. The report Making the Environment Count is describing how statistics on the environment and the economy thorugh the System of Environmental-Economic Accounts can be used to enable cross-sectorial analysis. The report proposes indicators that can be compiled annually in a Nordic context through existing statistics linking economic statistics to environmental statistics.

  • 274. Björkhagen, Martin
    From Communal War to Peaceful Coexistence:: The Influence of Adat Culture in North Maluku, Indonesia2017In: Asia in Focus: A Nordic journal on Asia by early career researchers, ISSN 2446-0001, no 4, p. 6-17Article in journal (Refereed)
    Abstract [en]

    This article examines how adat culture influenced peace-building and reconciliation efforts in North Maluku Province (NMP), Indonesia. This province was plagued by communal conflict from 1999 to 2000 following the fall of President Suharto’s regime. Nonetheless, NMP stands out as a rare success story for its comparatively quick consolidation of peace and its bottom–up efforts to reconcile the community, which was divided along ethno-religious lines. In-depth interviews were conducted with local elite and expert actors, and the Reality Check Approach (RCA) was used to explore the emic perspective of villagers at the grassroots level. An important key to the successful peace-building was that both the elite actors in regency government and most people at the grassroots level were united in their efforts to use a reinvigorated adat culture to reconcile the communities. In addition, minority groups and migrants were largely included and standard top-down attempts at reconciliation were absent, as most international organisations also promoted the local initiatives. The level of reconciliation does not, however, extend further than peaceful coexistence, partly because issues of culpability remain taboo in NMP. To achieve thorough reconciliation, the former conflicting parties would need to assume responsibility for wrongdoing and follow it up with forgiveness.

  • 275. Björklund, Hanna
    et al.
    Damsgaard, Ole
    Knudsen, Jon P.
    Nordiske prioriteringer og satsninger i Østersjøregionen2005Report (Other academic)
    Abstract [da]

    Denne rapporten er skrevet som et underlag til arbeidet med fjerde generasjons interregprogram som vil løpe av stabelen fra 2007 av. Nordisk ministerråd ved NERP har ønsket innspill til dette arbeidet for Østersjøregionen. Rapporten tar utgangspunkt i allerede etablerte samarbeidsmønstre i regionen og gir en kortfattet gjennomgang av hovedtendenser og utviklingstrekk i dette arbeidet. Generelt har det vært en tendens til å bevege seg fra et bistands- til et samarbeidsperspektiv i de årene østersjøsamarbeidet har eksistert. Det har også skjedd en tematisk utvikling ved at allment demokratiarbeid og generell erfaringsutveksling er tonet ned til fordel for et bredere samarbeid innenfor en rekke sektorer. De enkelte landenes interesser og temaønsker gjennomgås. Det er betydelige nyanser landene i mellom, men dette bør ikke fremstå som noe hinder for å kunne utvikle relativt entydige prioriteringer rundt et knippe oppgaver for videre arbeid.

  • 276.
    Björklund, Margereth
    Nordic Council of Ministers, Nordic School of Public Health NHV.
    LIVING WITH HEAD AND NECK CANCER: AHEALTH PROMOTION PERSPECTIVE: A Qualitative Study2010Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background and aim: In society there is a growing awareness that a vital factor for patientswith chronic diseases, such as head and neck cancer (HNC), is how well they are able tofunction in their everyday lives – a common, but often overlooked, public health issue. Theoverall aim of this thesis is to reach a deeper understanding of living with HNC and toidentify the experiences that patients felt promoted their health and well-being. It alsoexplores the patients’ experiences of contact and care from health professionals and whetherthese encounters could increase their feelings of health and well-being; salutogenic approach.

    Methods: This thesis engages a qualitative data design. On three occasions, 35 purposivelyselected patients were interviewed (31 from Sweden and one from Denmark, Finland, Island,and Norway). The first study was conducted in the Nordic counties (I), and the remainingstudies were conducted in Sweden (II, III, IV). Interviews were performed on a single basis(I, II, III) and then repeated (IV). The individual, semi-structured qualitative interviews usedopen-ended questions (n=53). Three different forms of analyses were used: critical incidenttechnique (I), thematic content analysis (II), latent content analysis (III), and interpretativedescriptive analysis (paper IV).

    Findings: Living with head and neck cancer was expressed as living in captivity, in the sensethat patients’ sometimes life-threatening symptoms were constant reminders of the disease.The patients experienced a threat against identity and existence. Patients struggled to findpower and control over everyday life, and if successful this appeared to offer them better health and well-being along with spiritual growth. The general understanding was that these patients had strong beliefs in the future despite living on a virtual rollercoaster. The patients went through a process of interplay of internal and external enabling that helped them acquire strength and feelings of better health and well-being. Consequently, they found power and control from inner strength and other health resources, e.g. social networks, nature, hobbies,activity, and health professionals. However, the findings also revealed the opposite; that somepatients were more vulnerable and felt powerless and faced everyday life with emotional andexistential loneliness. They were dependent on next of kin and health professionals. Having good interpersonal relationships and emotional support 24 hours a day from next of kin were crucial, as were health promoting contacts and care from health professionals. This healthpromoting contact and care built on working relationships with competent healthprofessionals that were available, engaged, respectful, validating, and, above all experiencedin the treatment phase. But many patients experienced not health promoting contact and care –and a sense of not being respected, or even believed. Added were the patients’ experiences ofinadequate coordination between phases of their lengthy illness trajectory. They felt lost andabandoned by health services, especially before and after treatment.

    Conclusions: Inner strength, good relationships with next of kin, nature, hobbies, andactivities could create strength and a sense of better health and well-being. Patientsexperienced a mutual working relationship during dialoguing and sensed co-operation andequality in encounters with competent health professionals. This could lead to enhancedpower and control i.e. empowerment in a patient’s everyday life. The findings highlightpsychosocial rehabilitation in a patient-centred organisation when health professionals supportpatients’ inner strength and health resources, and also offer long-term support to next of kin.Finally, this research suggests that if health professionals could gain a deeper understandingof the psychosocial, existential, social, and economic questions on patients’ minds, they couldbetter sense how patients feel and would be better equipped not only to offer greater support,but to raise their voices to improve health policy and health care for these patients.

  • 277.
    Björklund, Margereth
    et al.
    Nordic Council of Ministers, Nordic School of Public Health NHV.
    Fridlund, B
    Centre for Health Promotion Research, Halmstad University, Halmstad, Sweden .
    Cancer patients' experiences of nurses' behaviour and health promotion activities: a critical incident analysis.1999In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 8, no 4, p. 204-12Article in journal (Refereed)
    Abstract [en]

    Patients with head and neck cancer report several disease- and health-related problems before, during and a long time after completed treatment. Nurses have an important role in educating/supporting these patients about/through the disease and treatment so that they can attain well-being. This study describes the cancer patients' experiences of nurses' behaviour in terms of critical incidents after nurses had given them care to promote health. The study had a qualitative, descriptive design and the method used was the critical incident technique. Twenty-one informants from the Nordic countries diagnosed with head and neck cancer were strategically selected. It was explained to the informants what a critical incident implies before the interviews took place; this was defined as a major event of great importance, an incident, which the informants still remember, due to its great importance for the outcome of their health and well-being. The nurses' behaviour was examined, and critical incidents were involved in 208 cases-150 positive and 58 negative ones-the number of incidents varying between three and 20 per informant. The nurses' health promotion activities or lack of such activities based on the patients' disease, treatment and symptoms, consisted of informing and instructing the patients as well as enabling their participation. Personal consideration and the nurses' cognisance, knowledge, competence, solicitude, demeanour and statements of understanding were found to be important. Continuous health promotion nursing interventions were of considerable value for the majority of this group of cancer patients. Oncology nurses could reconfirm and update the care of head and neck cancer patients by including health promotion activities in individual care plans. By more frequent use of health promotion models, such as the empowerment model, the nurses could identify and focus on those individuals who needed to alter their life-style as well as tailor their approach towards these patient by setting goals for well-being and a healthy life-style.

  • 278.
    Björklund, Margereth
    et al.
    Nordic Council of Ministers, Nordic School of Public Health NHV.
    Sarvimäki, Anneli
    Nordic Council of Ministers, Nordic School of Public Health NHV.
    Berg, Agneta
    Kristianstad University College, Kristianstad, Sweden.
    Health promoting contacts as encountered by individuals with head and neck cance2009In: Journal of Nursing and Healthcare of Chronic Illness, ISSN 1752-9816, E-ISSN 1752-9824, Vol. 1, no 3, p. 261-268Article in journal (Refereed)
    Abstract [en]

    Aim.  To describe the characteristics of health promoting contacts with health professionals as encountered by individuals with head and neck cancer.

    Background.  Head and neck cancer has a profound and chronic impact on the individual’s everyday life, e.g. physical problems that hinder speaking, breathing, eating and drinking. Furthermore, fear and uncertainty can lead to long-term psychological and psychosocial problems. The National Institute of Public Health in Sweden advocates that all care contacts should improve the quality of the individual’s health.

    Design.  A qualitative descriptive and explorative design was used. Eight participants were interviewed in the year 2005 and a qualitative thematic content analysis of the data was performed.

    Findings.  Health promoting contacts were defined as contacts where health care professionals contribute positively to the well-being of individual patients. Characteristics include being available, engaged, respectful and validating. Three themes were identified: being believed in one’s illness story; having a working relationship with health professionals and receiving individualised, tailored care.

    Conclusions.  Health promoting contacts were experienced mainly during the treatment phase, when patients had daily contact with specific, qualified health professionals. Although the interview questions focused on health promoting contacts, nearly half of the contacts were experienced as not health promoting. Feelings of abandonment were particularly manifested before and after treatment. The starting point for achieving health promoting contact lies in understanding the patient’s lifeworld in relation to health, illness and suffering and focusing on the individual’s personal strengths and health resources.

    Relevance to clinical practice.  The findings highlighted the importance of ensuring that patient interests and concerns are core considerations in health care. The participants viewed continuing individualised, tailored care and access to ear, nose and throat healthcare professionals as highly important.

  • 279.
    Björklund, Margereth
    et al.
    Nordic Council of Ministers, Nordic School of Public Health NHV.
    Sarvimäki, Anneli
    Nordic Council of Ministers, Nordic School of Public Health NHV.
    Berg, Agneta
    Kristianstad University College, Kristianstad, Sweden.
    Health promotion and empowerment from the perspective of individuals living with head and neck cancer.2008In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 12, no 1, p. 26-34Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to shed light on health promotion from the perspective of individuals living with head and neck cancer. Eight informants were interviewed and latent content analysis was used. Individuals living with head and neck cancer experienced many problems that had a negative impact on their health. One overarching main theme was demonstrated; the ability to regain control and empower oneself. Three themes emerged: (1) Being enabled by dialogue with one's inner self, including three sub-themes: transformed and improved self-esteem, recognising and embracing existentiality, and increased self-determination. (2) Being enabled by means of contact with a social network, including two sub-themes: emotional support and practical support. (3) Being enabled by means of contact with and a passion for the environment, including two sub-themes: nature, hobbies and activities. Empowerment, the goal of health promotion, was understood as an ongoing process, and the ability to promote health varied and was dependent on internal and external enabling of acting and doing. The interpretation of this ongoing process demonstrates interplay assisted by a dialogue with one's inner self, contact with a social network and a passion for the environment. Altogether, these findings may inspire nurses and other health care professionals to support the individual's empowerment process and pose non-pathology-oriented questions such as "what improves your health?" or "what makes you feel good?"

  • 280.
    Björklund, Margereth
    et al.
    Nordic Council of Ministers, Nordic School of Public Health NHV.
    Sarvimäki, Anneli
    Nordic Council of Ministers, Nordic School of Public Health NHV.
    Berg, Agneta
    Kristianstad University College, Kristianstad, Sweden.
    Living with head and neck cancer:: a profile of captivity2010In: Journal of Nursing and Healthcare of Chronic Illness, ISSN 1752-9816, E-ISSN 1752-9824, Vol. 2, no 1, p. 22-31Article in journal (Refereed)
    Abstract [en]

    Aim.  To illuminate what it means to live with head and neck cancer.

    Background.  Patients could experience head and neck cancer as more emotionally traumatic than other cancers because of visible disfigurement and its life-threatening impact on vital functions. This long-term illness often leads to lifestyle changes such as to physical function, work and everyday tasks, interpersonal relationships and social functioning.

    Design.  This study used a qualitative and explorative longitudinal and prospective design with semi-structured interviews and open-ended questions. Twenty-one interviews were conducted with six participants with newly diagnosed or newly recurrent head and neck cancer. The analysis was descriptive and interpretive.

    Findings.  The participants were living ‘in captivity’ in the sense that their symptoms were constant reminders of the disease. Our findings also revealed existential loneliness and spiritual growth, as interpreted within six themes: altered sense of affiliation; hostage of health care; locked up in a broken body, but with a free spirit; confined in a rogue body, forced dependency on others, and caught up in a permanent illness trajectory.

    Conclusions.  Living with head and neck cancer involves emotional and existential vulnerability. The participants and their next of kin experienced insufficient support from health services and inadequate coordination between phases of their lengthy illness trajectory. These findings call for changes in oncological rehabilitation and management. Patient care must take a holistic view of everyone involved, centring on the individual and the promotion of health. A care coordinator could navigate between the individual patient needs and appropriate health services, hopefully with results that lessen the individual’s emotional and existential confinement.

  • 281. Björnsdóttir, Rannveig
    Feed for Atlantic cod2006Book (Other (popular science, discussion, etc.))
    Abstract [en]

    Today the cost of feed is 50-60% of the total production of farmed cod. A 10% reduction in feed cost will therefore give a minimum of 5% reduction in production cost. The biggest single variable cost in cod farming, the high cost of feed, is the main obstacle in making cod farming economically feasible.

  • 282. Björnsdóttir, Rannveig
    et al.
    Ögmundarson, Ólafur
    Árnason, Jón
    Ressem, Helge
    Jónsson, Arnar
    Gunnar Kolbeinshaven, Arne
    Steinarsson, Agnar
    Overrein, Ingrid
    Jóhannsson, Ragnar
    BASECOD - Stable and safe production of high quality cod larvae and juveniles2010Book (Other (popular science, discussion, etc.))
    Abstract [en]

    Stable supplies of high quality cod larvae and juveniles are urgently needed for the development of successful cod farming industries in countries around the North Atlantic. The project is a collaboration between key actors from the cod farming industry and the research sector in Iceland, Norway and the Faroe Islands, with involvement of additional key actors and stakeholders within the Nordic countries and Canada

  • 283. Bjønness, Kathrine
    et al.
    Jónsson, Kári
    Danielsson, Helena
    Gustafsson, Tomas
    Sander Poulsen, Tomas
    Forsberg, Tommi
    Keller, Nicole
    Stefani, Martina
    Skyrudsmoen, Lene
    F-gas methodologies and measurements in the Nordic Countries2019Other (Other (popular science, discussion, etc.))
    Abstract [en]

    This project report is a part of the NMR KOL project Nordic Policy Cluster for F-gases with the purpose of comparing the Nordic countries’ methodologies and regulations related to the use of F-gases.Fluorinated gases (F-gases, including HFCs, PFCs, SF6 and NF3) are a range of potent greenhouse gases that are used in a number of different applications and products for refrigeration, foams, aerosols, and technical installations.The report contains a survey and an overview of F-gas methodologies used for UNFCCC reporting, as well as an account of emissions and regulations in the Nordic countries.The objective with the analysis was to provide an overview of differences and similarities within the Nordic countries in relation to F-gases. The analysis shall enable harmonization of data collection, emission factors, choice of methods, and regulatory instruments.

  • 284. Bjørn Larsen, Peter
    et al.
    Ahlqvist, Toni
    Friðriksson, Karl
    Applying converging technologies for innovation in Nordic regions2010Book (Other (popular science, discussion, etc.))
    Abstract [en]

    The report investigates how policy makers can place technological convergence at the top of the agenda in (regional) innovation policies to enable more companies and research institutions to begin to address opportunities for innovation and growth generated through technological convergence. The study draws on a literature review and interviews with experts, companies, mediating organisations, and regional authorities. In addition, we have conducted a survey in the Nordic countries.

  • 285.
    Bjørnerud, Anne Merete
    Nordic Council of Ministers, Nordic School of Public Health NHV.
    Fysisk aktivitet på resept.: Tre års oppfølging av aktivitetsnivå og helserelatert livskvalitet.2014Independent thesis Advanced level (degree of Master (Two Years))Student thesis
    Abstract [en]

    Background:Frisklivssentralen, or physical activity on prescription, is an intervention used by Norwegian municipalities for preventive health services. This approach helps individuals change lifestyle habits and increase physical activity. Research documenting thelong-termeffects of participation in Frisklivssentralen is sparse.

    Objective:This study aimed to evaluate whether Frisklivssentralen achieves its goal of permanently changing individuals’ activity level and health-related quality of life, as measured three years after participation.

    Method: Three years after the Frisklivssentralen intervention (04.2010–03.2011) concluded, 33 former participants answered a questionnaire exploring their current level of physical activity, adherence to physical activity, factors affecting such adherence, health-related quality of life, and experiences from participation at Frisklivssentralen. We compared their answers to data collected at baseline and the 3-month follow up. We used descriptive statistics to assess the range and is tribution of participants and their answers. Non-parametric tests explored changes over time and compared subgroups.

    Results: Our results revealed that the positive change in activity level achieved from baseline to 3-month follow upp ersisted three years later(P=0.001). From baseline to three years, 39.4% of participants increased their activitylevel. Interestingly, participants in the current study who reported no increase in activity were more activeat baseline. After three years, the median activity level for the total sample was> 4 hours per week. Regardless of changes in activitylevels from baseline to three years, participants reported positive changes in health-related quality of life (P≤0.001).

    Conclusion: Frisklivssentralen increases physical activity levels and health-related quality of life. Participants who initially were less active (i.e., 1–2 hours/week) increased their activity level to > 4 hours per week and maintained it for 3 years. Respondents improved their health-related quality of liferegardless of changes in activitylevel

  • 286.
    Bladini, Moa
    NIKK.
    Hat och hot på nätet: en kartläggning av den rättsliga regleringen i Norden från ett jämställdhetsperspektiv2017Report (Other academic)
    Abstract [sv]

    Hur näthat ska stoppas är en aktuell fråga i alla nordiska länder. Men att komma åt förövarna är inte helt enkelt. Ett av problemen är att lagstiftningen på området inte är uppdaterad. Därför har Nordisk information för kunskap om kön (NIKK), på uppdrag av Nordiska ministerrådet, kartlagt den rättsliga regleringen av hat och hot på nätet.

    Rapporten visar att såväl kvinnor som män är utsatta för kränkningar på nätet – i ungefär lika stor utsträckning. Män och kvinnor drabbas dock på olika sätt. När män – särskilt i offentligheten – utsätts för näthat är det oftare fråga om kränkningar med anspelning på yrkesskicklighet och kompetens eller hot om våld. Kvinnor utsätts istället för kränkningar med betydligt större inslag av sexism, sexuella hot och trakasserier som snarare kopplar an till person än profession.

    I hela Norden råder det en osäkerhet kring hur bestämmelserna som omfattar hatbrott ska tillämpas och var gränsen mot yttrandefriheten går, vilket leder till att bestämmelserna inte används i den utsträckning som i teorin är möjligt. Det innebär att det praktiska skyddet är litet för samtliga grupper, och i dagsläget obefintligt för dem som utsätts på grund av kön. Det bör sättas i relation till den forskning som visar att näthat mot kvinnor i stor utsträckning kan kopplas till kön.

  • 287.
    Blas, Erik
    Nordic Council of Ministers, Nordic School of Public Health NHV. UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), The World Health Organization, 20 Avenue Appia, CH-1211 Geneva 27, Switzerland.
    1990 - 2000: A Decade of Health Sector Reformin Developing Countries: Why, and What Did We Learn?2005Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Objective: The overall aim of the work is to contribute to a better understanding of the dynamics between health sector reform policies and practices as well as the factors that determine and shape the thinking about global public health; and to try out a framework for understanding the inter-linkages and interactions between the determinants for and the elements of health sector reforms and their implementation.

    Methods: The object of study was a contemporary phenomenon, consisting of a diverse array of interventions in many different directions and fields within a complex political, social and economic environment. It is difficult to attribute the effects of the reforms to any single intervention or to establish exact boundaries between the phenomenon and the context. Therefore, a multi-stage case study research strategy, based on the work of R.K.Yin, was chosen. The study involved two major sub-units of analysis, i.e., the macro and the micro level. Each of these involved several sub-units of analysis. The analysis of the micro level further comprised a cross-case analysis of 10 individual case studies conducted in six developing countries.

    Results: Clear linkages were found between the greater societal processes and the shape and results of reforms during the decade. The reforms had not been completed in any of the countries studied, but appeared to be stuck with undesired effects, lacking energy to move forward. Contributing to this was the diminishing role of the state, which bordered abdication from public health in most of the countries, leaving the drive to the market and individual demands and interests. The net effect could well be a reversal of some of the public health achievements of the past - however, it was also found that reverting to dedicated disease control programmes would not be the answer, as these were found unsustainable and undermining the health systems.

    Conclusion: There is a divide between libertarian and utilitarian values on the one side and communitarian and egalitarian values on the other. Thus, it is not just about public health practitioners not being good enough to implement, it is more so about what we want to achieve and what it acceptable respectively not acceptable and reaching compromises. This place the societal processes at centre-stage for public health. However, it is also about implementation, it is about how public health policy-makers and reformers can effectively dialogue and facilitate achieving consensus and translate the societal 'wants' and 'want nots' into managerial bites. Implementation becomes a process of constant adjustment and readjustment oscillating between political and technocratic levels

  • 288.
    Blas, Erik
    Nordic Council of Ministers, Nordic School of Public Health NHV. UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), The World Health Organization, 20 Avenue Appia, CH-1211 Geneva 27, Switzerland.
    The proof of the reform is in the implementation.2004In: International Journal of Health Planning and Management, ISSN 0749-6753, E-ISSN 1099-1751, Vol. 19 Suppl 1, p. S3-23Article in journal (Refereed)
    Abstract [en]

    In 2000, TDR funded a series of studies to examine the opportunities and threats of health sector reform to the control of tropical diseases. This article is a cross-case analysis of ten of those studies, exploring the similarities in patterns across the countries covered: Colombia, China, Nigeria, the Philippines, Sudan, Tanzania and Uganda. The implementation experiences across countries were strikingly similar despite very different socio-economic and epidemiological situations. The reform implementation was neither complete nor clean and had in all the countries found some sort of least-energy equilibrium where the processes had stopped at a sub-optimal stage needing considerable renewed 'change-energy' to achieve its objectives. The role of the state had, in several cases, been reduced to a situation where it neither pursued the interest of the public nor protected the individual against harm caused by the behaviours of others. Whether one should follow a dedicated disease control programme or a systems approach is not a relevant question. Effective disease control cannot be implemented without strong and functioning health systems and health system performance cannot be improved without considering which purpose the system is to serve.

  • 289.
    Blas, Erik
    et al.
    Nordic Council of Ministers, Nordic School of Public Health NHV. UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), The World Health Organization, 20 Avenue Appia, CH-1211 Geneva 27, Switzerland.
    Limbambala, M
    The challenge of hospitals in health sector reform: the case of Zambia.2001In: Health Policy and Planning, ISSN 0268-1080, E-ISSN 1460-2237, Vol. 16 Suppl 2, p. 29-43Article in journal (Refereed)
    Abstract [en]

    Zambia underwent a period of health sector reform from 1993 to 1998. The reform attracted substantial support from the World Bank and bilateral donors. While significant achievements were made with respect to decentralization, increased accountability and donor collaboration, the reform stalled in 1998 without having achieved its objectives, largely because of the handling of hospital reform and the civil servants in the health sector. This study was an attempt to analyze this experience with the hospital issue. Service and infrastructure information was collected from all 88 hospitals in the country. Further, information was collected about the social, economic, and political context of the reform. The results show that an historical legacy from the colonial and post-colonial eras has left the country with an expensive and skewed hospital structure that is rapidly deteriorating and very difficult to reform. The referral system is not functioning: higher-level hospitals provide a higher level of care to their immediate catchment populations than is available to the population in general. The reality is thus far from the vision of equity of access to cost-effective quality care. Zambian doctors have either left the country or are concentrated at the highest referral levels in two provinces, leaving the lower levels and most of the country in the hands of expatriate doctors. There are no resources in the government or the private systems to maintain the current hospital infrastructure and things will likely deteriorate unless radical decisions are taken and implemented. The study further shows that the question of hospital reform is a political high-risk zone. If the problems are to be dealt with, the Zambian planners must, together with the politicians, work to create a broad national consensus for understanding the situation, its urgency, and the limited options for forward action.

  • 290.
    Blas, Erik
    et al.
    Nordic Council of Ministers, Nordic School of Public Health NHV. UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), The World Health Organization, 20 Avenue Appia, CH-1211 Geneva 27, Switzerland.
    Limbambala, M
    User-payment, decentralization and health service utilization in Zambia.2001In: Health Policy and Planning, ISSN 0268-1080, E-ISSN 1460-2237, Vol. 16 Suppl 2, p. 19-28Article in journal (Refereed)
    Abstract [en]

    The study was undertaken to assess the impact of health sector reform from 1993 to 1997 in Zambia in respect of health care service utilization and the shift of caseload from hospitals to health centres. Four key indicators were chosen: general attendance, measles vaccinations, general admissions, and deliveries. Complete sets of district data were analyzed, covering 4.5 million people out of the total population in 1997 of 9.7 million. The results show, on the one hand, a dramatic decrease of about one-third in general attendance for both hospitals and health centres over a 2-year period, followed by a period with a continued but slower decrease. On the other hand, the results also show increases at health centres in measles vaccinations (up 40%), in admissions (up 25%) and in deliveries (up 60%). The study further documents a shift of caseload from hospitals to health centres for some key services. The health centre share increased from 72.2% to 79.8% for measles vaccinations, from 23.9% to 31.0% for general admissions, and from 22.9% to 32.4% for deliveries. However, the intended overall shift in outpatient caseload from hospitals to health centres did not materialize. The main lessons are: utilization patterns can be influenced by policies such as user-payment and decentralization; user payment in poor populations leads to dramatic declines in utilization of services; and decentralization with local control of resources could be an alternative to the traditional vertical disease programme approach for priority interventions.

  • 291.
    Blidberg, Eva
    et al.
    The Keep Sweden Tidy Foundation.
    Bekken, Anne Lise
    Oslofjord Outdoor Recreation Council.
    Bäckström, Aija
    Keep the Archipelago Tidy.
    Haaksi, Hanna
    Keep the Archipelago Tidy.
    Hansen, Liv-Marit
    Oslofjord Outdoor Recreation Council.
    Skogen, Mali Hole
    Keep Norway Beautiful.
    Frandsen, Bjarke Lembrecht
    Keep Denmark Tidy.
    Thernström, Tomas
    The Keep Sweden Tidy Foundation.
    Ångström, Jessica
    The Keep Sweden Tidy Foundation.
    Marine Littering and Sources in Nordic Waters2015Book (Other academic)
    Abstract [en]

    Marine litter is a global environmental problem that endangers wildlife and has great socio-economic and aesthetic impacts. To identify sources of marine litter is an important key in order to propose cost-effective measures. Pick analyses of beach litter have therefore been conducted in order to categorise litter items from a product perspective. The results confirm that plastic are the most common litter material found on beaches in the Nordic countries. Short life items and packaging are dominating, which is strongly linked to individual consumers. It is further concluded that the plastics and packaging industry has an important role to play to decrease the amount of marine litter.

  • 292. Blidberg, Eva
    et al.
    Leander, Elin
    Plug the marine litter tap: A pilot study on potential marine litter sources in urban areas2017Book (Other academic)
    Abstract [en]

    Marine litter is a growing environmental problem where especially plastic material is accumulated in the seas where it will fragment to smaller pieces. The purpose of the presented pilot study is to raise awareness amongst officials at municipalities and authorities about the need to reduce the presence of litter in the marine environment and to give ideas/suggestions on how this can be done. The project has therefore developed a “Plug the Marine Litter Tap”-approach, which together with local knowledge and experience, can be used to identify sources of marine debris by using existing statistics. Södertälje is used as a pilot area where we give examples on indicators for marine litter in the urban environment and proposed measures for each indicator. We hope that this will encourage municipalities to reflect on how preventive measures against marine litter can be incorporated in local waste management plans and become part of their regular routine.

  • 293.
    Blix, Ellen
    Nordic Council of Ministers, Nordic School of Public Health NHV.
    INNKOMST-CTG. En vurdering av testens prediktive verdier, reliabilitet og effekt: Betydning for jordmødre i deres daglige arbeid2006Doctoral thesis, comprehensive summary (Other academic)
  • 294.
    Blix, Ellen
    et al.
    Nordic Council of Ministers, Nordic School of Public Health NHV. Nordic School of Public Health NHV.
    Ohlund, Lennart S
    Norwegian midwives' perception of the labour admission test.2007In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 23, no 1, p. 48-58Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To explore what information and knowledge the labour admission test is perceived to provide and what meaning the test carries in the daily work of practising midwives.

    DESIGN: In-depth interviews transcribed verbatim and analysed using the grounded theory technique.

    SETTING: Four different labour wards in Norway.

    PARTICIPANTS: A theoretical sample of 12 practising midwives.

    FINDINGS: The core category "experiencing contradictions" was identified during the analyses, indicating that the midwives found conflicting interests within themselves, or between themselves and others when using the labour admission test. They experienced contradictions between professional identity and the increasing use of technology, between feeling safe and feeling unsafe and between having power and being powerless.

    KEY CONCLUSIONS: The labour admission traces could be difficult to interpret, especially for newly qualified midwives. Some midwives thought that a labour admission trace could protect them in case of litigation. The hierarchy of power in the labour ward influences the use and interpretation of the labour admission test. Some midwives felt their professional identity threatened and that midwives in general are losing their traditional skills because of the increasing use of obstetric technology.

    IMPLICATIONS FOR PRACTICE: The findings of the present study should be taken into consideration when changing practice to not routinely perform the labour admission test. There is also a need for further research on what effect the increasing use of obstetric technology has on traditional midwifery skills.

  • 295. Blix, Ellen
    et al.
    Oian, Pål
    Interobserver agreements in assessing 549 labor admission tests after a standardized training program.2005In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 84, no 11, p. 1087-92Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The labor admission test is a short cardiotocography (CTG) performed upon admission to the maternity ward. The aim of the present study is to examine interobserver agreements when the labor admission tests were assessed by midwives and obstetricians who had received training in interpreting CTG.

    METHODS: Five hundred forty-nine high- and low-risk women who delivered at Hammer-fest Hospital were included. The tests were assessed by three midwives and three obstetricians who had completed a standardized training program. The traces were assessed as normal, intermediary, or abnormal. Weighted kappa (kappaw), proportion of agreement (Pa), and predictive values were calculated.

    RESULTS: Between the pairs of observers, kappaw varied between 0.57 and 0.75; Pa for a normal test between 0.78 and 0.88, and Pa for an intermediary/abnormal test between 0.56 and 0.69. At a cutoff intermediary test, mean sensitivity was 0.43 (range=0.39 -- 0.48), specificity 0.75 (range=0.69 - 0.81, positive predictive value 0.13 (range=0.12 -- 0.15), negative predictive value 0.94 (range=0.94 -- 0.94), likelihood ratio (LR) for a positive test result 1.73 (range=1.53--1.99), and LR for a negative test result 0.76 (range=0.75--0.77).

    CONCLUSIONS: Midwives and obstetricians who had completed the training program achieved good levels of agreements in assessing labor admission tests. The agreements in normal tests were better than those in intermediary/abnormal tests. Obstetric staff should be aware that there are disagreements in assessing labor admission tests; especially in tests assessed as intermediary/abnormal.

  • 296.
    Blix, Ellen
    et al.
    Nordic Council of Ministers, Nordic School of Public Health NHV. Nordic School of Public Health NHV.
    Reiner, Liv M
    Klovning, Atle
    Oian, Pal
    Prognostic value of the labour admission test and its effectiveness compared with auscultation only: a systematic review.2005In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 112, no 12, p. 1595-604Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To assess the effectiveness of the labour admission test in preventing adverse outcomes, compared with auscultation only, and to assess the test's prognostic value in predicting adverse outcomes.

    DESIGN: Systematic review.

    SETTING: Labour wards in hospitals.

    POPULATION: Pregnant women in labour. Three randomised controlled trials including 11,259 women and 11 observational studies including 5831 women.

    METHODS: Literature searches in Medline, EMBASE, CINAHL, SweMed, The Cochrane Central Register of Controlled Trials, reference lists from identified studies and contact with experts.

    MAIN OUTCOME MEASURES: Obstetric interventions (augmentation of labour, continuous electronic fetal monitoring, epidural analgesia, fetal blood sampling and operative deliveries) and neonatal outcomes (perinatal mortality, Apgar score, seizures, resuscitation and admission to neonatal unit).

    RESULTS: Meta-analyses of the controlled trials found that women randomised to the labour admission test were more likely to have minor obstetric interventions like epidural analgesia [relative risk (RR) 1.2, 95% confidence interval (95% CI) 1.1-1.4], continuous electronic fetal monitoring (RR 1.3, 95% CI 1.2-1.5) and fetal blood sampling (RR 1.3, 95% CI 1.1-1.5) compared with women randomised to auscultation on admission. There were no significant differences in any of the other outcomes. From the observational studies, prognostic value for various outcomes was found to be generally poor. Likelihood ratio (LR) for a positive test was above 10 in 2 of 28 single outcomes and between 5 and 10 in six outcomes.

    CONCLUSIONS: There is no evidence supporting that the labour admission test is beneficial in low risk women.

  • 297.
    Blix, Ellen
    et al.
    Nordic Council of Ministers, Nordic School of Public Health NHV.
    Sviggum, Oddvar
    Koss, Karen Sofie
    Øian, Pål
    Inter-observer variation in assessment of 845 labour admission tests: comparison between midwives and obstetricians in the clinical setting and two experts.2003In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 110, no 1, p. 1-5Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To assess the inter-observer agreement in assessment of the labour admission test between midwives and obstetricians in the clinical setting and two experts in the non-clinical setting, the inter-observer agreement between two experts in the non-clinical setting and to what degree fetal distress in labour could be predicted by the two experts.

    DESIGN: Observational study.

    SETTING: The maternity unit of Hammerfest Hospital, Norway.

    POPULATION: Eight hundred and forty-five high and low risk women.

    METHOD: The labour admission test was first assessed by the midwife or obstetrician in the clinical setting, and was later assessed by two experts. The traces were assessed as normal, equivocal or ominous. Weighted kappa (kappaw), proportion of agreement (Pa) and predictive values were calculated.

    MAIN OUTCOME MEASURES: Weighted kappa, proportion of agreement, sensitivity, positive predictive value and likelihood ratios.

    RESULTS: Inter-observer agreement between Expert 1 and Expert 2: kappaw 0.38 (CI 0.31-0.46), Pa for reactive labour admission test 0.86 (CI 0.83-0.88) and Pa for equivocal/ominous test 0.33 (CI 0.26-0.40). Agreement between Expert 1 and midwives/obstetricians: kappaw 0.25 (CI 0.15-0.36), Pa for reactive labour admission test 0.89 (CI 0.87-0.91) and Pa for equivocal/ominous labour admission test 0.18 (CI 0.11-0.25). Agreement between Expert 2 and midwives/obstetricians: kappaw 0.28 (CI 0.20-0.37), Pa for reactive labour admission test 0.85 (CI 0.82-0.88) and Pa for equivocal/ominous test 0.20 (CI 0.14-0.26). Totally 5.9% of the newborns had fetal distress. At cutoff equivocal test, sensitivity was 0.22 and 0.31 in the two observers. Positive predictive values were 0.13 and 0.11. Likelihood ratio for a positive test was 2.30 and 1.92 and likelihood ratio for a negative test 0.86 and 0.83.

    CONCLUSION: A labour admission test is still routine practice in most obstetric units in the Western world when there is little evidence on its benefits. The results from this study may provide some reconsideration for such practice, and for more research.

  • 298.
    Blix, Ellen
    et al.
    Nordic Council of Ministers, Nordic School of Public Health NHV. Nordic School of Public Health NHV.
    Øian, Pål
    Labor admission test: an assessment of the test's value as screening for fetal distress in labor.2001In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 80, no 8, p. 738-43Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: To determine if the labor admission test (LAT) can predict fetal distress in a population of laboring women, and in subgroups of low- or high-risk women, who delivered within six hours or between six and 24 hours after LAT.

    METHODS: The data charts of all women who delivered at Hammerfest Hospital in 1996, 1997 and 1998 were retrospectively read. If the woman was admitted to the hospital because of onset of labor, was in the first stage of labor and delivered within 24 hours after admission, she was included. In the study period, 1639 gave birth and 932 were included in the study. A descriptive analysis of the population and assessment of LAT's sensitivity, positive predictive value, specificity and negative predictive value at different cut-off values was done.

    RESULTS: In the study population 5.8% had fetal distress, and 5.3% had an operative delivery because of fetal distress. LAT's sensitivity in the whole population was 0.15 and positive predictive value was 0.16. Specificity was 0.95 and positive predictive value was 0.95. In the subgroups of low- and high-risk women, who delivered within six hours or between six and 24 hours after LAT, sensitivity varied between 0 and 0.36, and positive predictive value varied between 0 and 0.27. Specificity varied between 0.92 and 0.96, and negative predictive value varied between 0.89 and 0.97.

    CONCLUSIONS: According to these results, LAT cannot be recommended as a screening test for fetal distress in labor in low-risk women. Sensitivity is too low, and there are too many false-positive tests. It is unclear if LAT has benefits among high-risk women.

  • 299.
    Bloch, Bente
    Nordic Council of Ministers, Nordic School of Public Health NHV.
    ”Hygiejne på tværs”: tværsektorielt samarbejde omkring patient/borger med behov for infektionshygiejnisk bistand – hvordan løses opgaven?2012Independent thesis Advanced level (degree of Master (Two Years))Student thesis
    Abstract [en]

    Background: Today, patient care in hospitals is highly specialised and undertaken at high speed. Many patients receive complex treatment and care, which often continues in the primary-care sector after the patient is discharged. Structural reform of the health care sector requires infection control measures in intersectoral health agreements.

    Aim: This study aimed to investigate and analyse intersectoral collaboration and gain better understanding of collaboration across health sectors in relation to the treatment and care of patients requiring treatment and care for infection control.

    Method: This is a qualitative, multiple-case study, wherein semi-structured interviews form the basis of the empirical knowledge. The theory underpinning the study is the perspective on intersectoral collaboration, examples of models of collaboration, and the strengths and weaknesses of collaboration.

    Results: The findings showed that the motivational factors for intersectoral collaboration include focus on organisational structure and organisation, collaboration through networks, awareness of the importance of clear communication, and focus on the relationship between professional competencies and infection hygiene. Structured collaboration with the establishment of an actual infection control organisation resulted in access to expert knowledge, security among personnel, and motivation to work with infection control as an area of focus.

    Conclusion: Patient transference of nosocomial infections from one health sector to another likely can be prevented by increasing workers’ knowledge of infection control in all sectors, and by formalised collaboration across health sectors to establish an intersectoral, infection control organization.

  • 300. Bloch, Carter
    Measuring Public Innovation in the Nordic Countries (MEPIN)2011Book (Other (popular science, discussion, etc.))
    Abstract [en]

    Understanding the rate and degree of innovation in the public sector, as well as its incentives, processes and impact. Developing a measurement framework for collecting internationally comparable data on innovation in the public sector.

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