Epidemiology and Global Health

Umeå, Sweden

Epidemiology and Global Health

Umeå, Sweden
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News Article | December 12, 2016
Site: www.eurekalert.org

Ethiopian maternal health researcher Hagos Godefay at Umeå University in Sweden has created a locally feasible method to estimate maternal mortality rates with a bottom-up measurement approach. Providing insights into the effectiveness of local interventions to reduce maternal mortality, the approach will be important for health sector planning and decision-making on local-, regional- and state levels. Hagos Godefay at the Department of Public Health and Clinical Medicine, Epidemiology and Global Health Unit has researched current efforts to reduce maternal mortality in the Tigray Region of northern Ethiopia. He has set out to quantify overall mortality levels, identify specific causes and evaluate local interventions. By using methods that can also be scaled at national level, Hagos Godefay's results provide a strong empirical basis for decision-making by the Tigray Regional Health Bureau. "We see encouraging results of improved reproductive health and reduced pregnancy-related deaths in the Tigray region. A key reason for this has been the creation of small local women's groups of volunteers who act as ambassadors for the benefits of utilizing the existing health services," says Hagos Godefay. In the Tigray region, the government have created the Health Development Army, an initiative that seeks to integrate and strengthen the linkages between the community, politicians and the health sector. The overall goals are improved sustainability of health programs and community empowerment. To achieve these goals, the initiative brings together community action, as represented by Women's Development Groups, and the commitment of the regional political leadership and the health sector itself, represented by the health workforce. A key aspect of the Health Development Army is the focus on community and social mobilization in Women's Development Groups. The initiative encourages women in neighboring households to volunteer and organize in so called "1-to-5 networks", which then form larger networks of 25-30 members. The groups set out to create demand for and increase utilization of existing maternal health services. This is in part accomplished by tackling behavioral barriers and potentially unhealthy traditional practices through community dialogue. The groups also encourage facility-based delivery by preparing cultural porridges and Ethiopian coffee for postnatal mothers at health facilities. "The goal is to reinforce positive behaviors and locally initiated good practices by celebrating women's achievements. Creating a conducive environment, where women living in the rural areas can meet and discuss together based on their own agenda, can make a big difference in reducing maternal mortality. This has been one of the more challenging goals, but achieving it demonstrates that women can work together to save the lives of other women," says Hagos Godefay. In research findings published earlier this year in the Journal of Global Health, Hagos Godefay and his colleagues showed that transport and communication innovations in Tigray and other rural areas of Ethiopia correlated with appreciably reduced maternal mortality. The study showed that a national program providing free-of-charge ambulances, which can be ordered on a 24/7 basis via mobile phones, coincided with a reduction of maternal mortality rates by about 50 percent. "Despite noticeable achievements in the Tigray region, major challenges remain in many settings in terms of both measuring and reducing maternal mortality effectively," concludes Hagos Godefay. Hagos Godefay is a Global Health Epidemologist who has been studying the epidemiology of maternal health in Tigray region of northern Ethiopia for several years. Hagos completed his Master's Degree in Public Health at Gondar University in Ethiopia, and his PhD Degree in Epidemology and Public Health at Umeå University in Sweden. His research interest focuses on the condition of maternal health in rural Ethiopia. He currently heads the Tigray Regional Health Bureau, where he is committed to using his findings to implement several immediate actions and to influence policy making to further reduce pregnancy-related deaths on a regional and national level. For more information, please contact: Hagos Godefay, Department of Public Health and Clinical Medicine, Umeå University Telephone: +251914707866 (in Ethiopia); +46764071796 (in Sweden) E-mail: hgodefay@yahoo.com


News Article | October 26, 2016
Site: www.eurekalert.org

Umeå University is among the 25 leading research and public health organizations from Latin America, North America, Africa, Asia, and Europe gathered in Recife, Brazil, for the launch of ZikaPLAN (Zika Preparedness Latin American Network). The global initiative, created in response to a Horizon 2020 funding call by the European Commission's Directorate-General Research and Innovation, will address the Zika virus outbreak and the many research and public health challenges it poses. "We are greatly honoured to host and coordinate this important global network of researchers around the world, but particularly in Latin America. This is part of a crucial collective and ongoing response to Zika, and other emerging infectious diseases in the long term," says Annelies Wilder-Smith, Umeå University guest Professor and Principal Investigator of ZikaPLAN. The Umeå University Epidemiology and Global Health Unit is tasked with hosting and coordinating ZikaPLAN. At Umeå University, both global health and virology researchers are partaking. The consortium will be scientifically coordinated by Professor Annelies Wilder Smith, who is an international expert in infectious and vaccine preventable diseases. Associate Professor John Kinsman will work with social science for communication strategies with affected communities. Associate Professor Joacim Rocklöv will focus on modelling of vector control. Professor of virology Niklas Arnberg will focus on neuropathogenesis. All the non-scientific coordination will be managed by Dr. Raman Preet. Other research organizations in the ZikaPLAN consortium will look at Zika's connection with congenital syndromes and neurological complications, and the pathogenesis of severe cases, through a series of clinical studies. They will explore non-vector and vector transmission and risk factors for geographic spread, measure the burden of disease and investigate how the virus has evolved, comparing current and historic strains. ZikaPLAN will look at novel personal preventive measures, innovation in diagnostics and modelling on vector control and vaccine strategies to inform policy decisions. The social sciences will also play a role in ZikaPLAN, which aims to determine the best communication strategies to keep the affected communities informed. ZikaPLAN will work closely with two other European Union-funded consortia, ZIKAction and ZikAlliance, to establish a Latin American and Caribbean network. This network will address the broader issue of building local capacity in Latin America to prepare for and rapidly launch a large-scale research response to emerging infectious disease threats. ZikaPLAN will contribute to developing an inter-epidemic research plan, policy recommendations, training, research networks and dissemination strategies that are designed to permanently strengthen local capacities, beyond the four years of the project. The three consortia will set up common bodies for the global management of scientific programs, communication, and ethical, regulatory and legal issues. ZikaPLAN is coordinated by an Executive Board comprised of Prof. Annelies Wilder-Smith as director, representing the University of Umeå, Prof. Eduardo Massad, as deputy director, representing the Fundacao de Apoio a Universidade de Sao Paulo and 15 Work Package leaders from partner organizations. Independent ethical, scientific and industrial advisory boards provide guidance. ZikaPLAN receives funding from the European Union's Horizon 2020 research and innovation program (under grant agreement number 734584). The consortium builds on expertise and existing relationships in a variety of research areas related to Zika and emerging infectious diseases. The 25 member organizations come from five continents, with 13 from Europe, eight from Latin America, two from the United States, one from Africa and one from Asia. For more information about Zika research funding by EU under Horizon 2020, please visit: http://ec. A ZikaPLAN consortium website will soon be available on The Global Health Network web portal.


PubMed | Karolinska Institutet, Clinical Epidemiology Unit, Skelleftea Research Unit, Umeå University and 2 more.
Type: | Journal: International journal of epidemiology | Year: 2016

Cigarette smoking is associated with a lower risk of Parkinsons disease. It is unclear what constituent of tobacco smoke may lower the risk. Use of Swedish moist smokeless tobacco (snus) can serve as a model to disentangle what constituent of tobacco smoke may lower the risk. The aim of this study was to determine whether snus use was associated with a lower risk of Parkinsons disease.Individual participant data were collected from seven prospective cohort studies, including 348 601 men. We used survival analysis with multivariable Cox regression to estimate study-specific relative risk of Parkinsons disease due to snus use, and random-effects models to pool estimates in a meta-analysis. The primary analyses were restricted to never-smokers to eliminate the potential confounding effect of tobacco smoking.During a mean follow-up time of 16.1 years, 1199 incident Parkinsons disease cases were identified. Among men who never smoked, ever-snus users had about 60% lower Parkinsons disease risk compared with never-snus users [pooled hazard ratio (HR) 0.41, 95% confidence interval (CI) 0.28-0.61]. The inverse association between snus use and Parkinsons disease risk was more pronounced in current (pooled HR 0.38, 95% CI 0.23-0.63), moderate-heavy amount (pooled HR 0.41, 95% CI 0.19-0.90) and long-term snus users (pooled HR 0.44, 95% CI 0.24-0.83).Non-smoking men who used snus had a substantially lower risk of Parkinsons disease. Results also indicated an inverse dose-response relationship between snus use and Parkinsons disease risk. Our findings suggest that nicotine or other components of tobacco leaves may influence the development of Parkinsons disease.


News Article | February 21, 2017
Site: www.eurekalert.org

A study carried out in Andalusia, Southern Spain, following the 2007/2008 economic recession detected increasing inequalities in male mortality rates. Men with lower educational levels saw an increase in mortality compared to men with university level education. In addition, 5,000 additional suicide attempts were registered among middle aged men and women between 2008 and 2012. High unemployment and financial strain played a key role in these findings, according to a doctoral dissertation at Umeå University. "Quite surprisingly, we found that people with intermediate educational levels were suffering more mental health problems during the crisis than any other group, and this occurred regardless of whether they were employed or unemployed," says Juan Antonio Córdoba Doña, doctoral student at the Department of Public Health and Clinical Medicine, Epidemiology and Global Health Unit and author of the dissertation. "We also found that social support was strongly associated with better mental health before and during the economic crisis in Andalusia." The findings illustrate the complexity of influences that the economic crisis have had on health inequalities in a region with a very high unemployment rate. According to Juan Antonio Córdoba Doña, the negative effects were further reinforced by austerity policies -- tax increases, cuts in budgets and healthcare personnel-- imposed on Spain and many European countries in response to the crisis. Despite these impacts on mental health and, to a lesser extent, on physical health, the research did not detect increased inequalities in healthcare utilisation in Andalusia during the first years of the recession. "The universal coverage health system seems to buffer the deleterious effect of the crisis and austerity policies in this context," says Juan Antonio Córdoba Doña. For more information, please contact: Juan Antonio Córdoba Doña, Department of Public Health and Clinical Medicine, Epidemiology and Global Health Unit, Umeå University Phone: +34 690 37 6683 Email: jantonio.cordoba@juntadeandalucia.es


Styrke J.,Urologkliniken | Johansson M.,Urologkliniken | Granasen G.,Epidemiology and Global Health | Israelsson L.,Umeå University
Scandinavian Journal of Urology | Year: 2015

Objective. There are no data on the frequency of parastomal hernia (PSH) after ileal conduit with a prophylactic mesh. The primary objective of this study was to determine the prevalence of PSH. Secondary objectives were to elaborate whether age, gender, body mass index (BMI), previous laparotomy or diabetes influenced the outcome; and to find any mesh-related complications. Materials and methods. In a single centre during 2003-2012, a large-pore, lightweight mesh was placed in a sublay position in 114 consecutive patients with ileal conduits. Preoperative and postoperative patient data were retrospectively collected and cross-sectional follow-up was conducted. During the predefined clinical examination a PSH was defined as any protrusion in the vicinity of the ostomy with the patient straining in both an erect and a supine position. Results.Fifty-eight patients (24 women and 34 men, mean age 69 years) had follow-up examinations after a mean of 35 months (median 32 months). Bladder cancer was the most common cause for surgery. Eight patients (14%) had a PSH. Age, gender, BMI, previous laparotomy and diabetes did not affect the outcome. No mesh-related complications occurred among the 114 patients with a prophylactic mesh. Conclusions. The prevalence of PSH after ileal conduit with a prophylactic mesh corresponded to that of colostomies with a prophylactic mesh. A prophylactic mesh did not seem to be associated with complications. The degree to which a prophylactic mesh may reduce the rate of PSH after an ileal conduit should be established in randomized trials. © Informa Healthcare.


PubMed | Epidemiology and Global Health
Type: | Journal: Journal of multidisciplinary healthcare | Year: 2011

The objective of this study is to analyze the commitment to a more health-promoting health service and to illuminate important barriers for having a health-promoting role in daily practice, among Swedish health care professionals.Out of a total of 3751 health professionals who are working daytime in clinical practice in the province of Vsterbotten, 1810 were invited to participate in a survey. The health professionals represented eight different occupational groups: counselors, dieticians, midwives, nurses, occupational therapists, physical therapists, psychologists, and physicians. A questionnaire that operationalized perceptions found in a previous qualitative study was mailed to residential addresses of the participants.The majority believed that health services play a major role in long-term health development in the population and saw a need for health orientation as a strategy to provide more effective health care. Willingness to work more in health promotion and disease prevention was reported significantly more often by women than men, and by primary health care personnel compared to hospital personnel. Among the professional groups, psychologists, occupational therapists, and physiotherapists most frequently reported willingness. The most common barriers to health promotion roles in daily practice were reported to be heavy workload, lack of guidelines, and unclear objectives.This study found strong support for reorientation of health services in the incorporation of a greater health promotion. A number of professions that are not usually associated with health promotion practices are knowledgeable and wish to focus more on health promotion and disease prevention. Management has a major role in creating opportunities for these professionals to participate in health promotion practices. Men and physicians reported less positive attitudes to a more health-promoting health service and often possess high positions of power. Therefore, they may play an important role in the process of change toward more health promotion in health services.

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