The 2010 Haitian earthquake underscored the fact that disaster response is increasingly complex, multi-sectoral and multi-faceted in character. Nonetheless, disaster relief operations both globally and nationally tend to operate within a highly fragmented context in which potentially overwhelming human and infrastructure needs must be served by limited material and financial aid delivered by disparate humanitarian actors specializing in varying functional domains.  Such a chaotic environment demands highly effective communication, collaboration and coordination among a variety of humanitarian actors if relief efforts are to be successful. Even though the coordination mechanisms of multi-organizational actors during disaster response have been studied in a variety of contexts, much less attention has been paid to how international non-governmental (INGOs) and private sector actors may be able to operate collaboratively in disaster settings. This dissertation provides a case analysis of the efforts of one set of cross-sectoral humanitarian actors that worked through a network in response to the 2010 Haitian earthquake. This mixed methods case study incorporates interview, personal observation, and survey data from INGO field staff, headquarters personnel, and corporate donor representatives, all of whom were members of the cross-sectoral Partnership for Quality Medical Donation (PQMD) that responded to the 2010 Haitian earthquake.  The inquiry explores what the coordination-related challenges to disaster response are for network members and then examines whether and in what ways a cross-sector network, PQMD in this instance, can effectively mitigate or overcome those obstacles.  This study contributes to the body of disaster coordination and cross-sector network scholarship in two ways. First, the analysis reviews prevailing trends within the cross-sector network and disaster coordination-related literature concerning the requisites and challenges of coordination in humanitarian relief emergencies.  Second, this study augments existing understanding of the extremely complex processes involved in coordinating INGO-business disaster response as part of efforts to mobilize multi-sectoral humanitarian action. This research suggests that efforts to develop cross-sector networks prior to disaster events can build communication, collaboration and coordination pathways that later enhance coordinated INGO-business disaster response to crises.  It argues that current theoretical horizons in both network and disaster coordination studies need to be broadened. Specifically, this inquiry highlights the importance of incorporating cross-sector networks (i.e., INGO and corporate actors) into all planning efforts aimed at enhancing collaboration and coordination practices in disaster relief. / Ph. D.

Bakgrund: Ätstörningsproblematik är ett hälsoproblem som sjuksköterskan upplever som komplext. Detta eftersom det innefattar ett psykosomatiskt sjukdomstillstånd med en komplicerad sjukdomsbild. De vanligaste ätstörningsdiagnoserna är anorexia nervosa och bulimia nervosa. Sjuksköterskan har en betydelsefull roll i att hjälpa den sjuke individen till att nå ett tillfrisknande. Individer med ätstörningsproblematik besitter ofta en låg sjukdomsinsikt och har en ambivalens för behandling. Det kan upplevas problematiskt ur sjuksköterskans perspektiv, detta för att problem uppstår när den sjuke individen inte är samarbetsvillig i omvårdnaden. Syfte: Att uppmärksamma sjuksköterskans förståelse för att tillämpa en god omvårdnad av individer med ätstörningsproblematik Metod: En integrativ litteraturöversikt med induktiv ansats föreligger denna studie. Tio artiklar varav nio artiklar med kvalitativ metod och en artikel med mixed- method analyserades med hjälp av Fribergs (2017) analysmodell. Resultat: Två huvudkategorier identifierades: Att skapa en god relation samt att ställas inför utmaningar i omvårdnaden med tillhörande underrubriker. Sjuksköterskan menade att den terapeutiska relationen var en viktig del att kunna tillämpa, detta för att tillgodose en god omvårdnad. Sjuksköterskan hade en förståelse för att det kunde vara utmanande att ständigt agera professionellt i vårdrelationen till den sjuke individen. Det framgick att sjuksköterskan upplevde omvårdnaden som komplex för individer med ätstörningsproblematik och önskade därför kunna besitta djupare kunskap kring sjukdomen och dess följder. Slutsats: Individer med ätstörningsproblematik innebär utmaningar för sjuksköterskan. Sjukdomen som vårdas upplevs komplicerad utifrån sjuksköterskans perspektiv. Personcentrerad omvårdnad har visat sig ha en betydande roll i omvårdnaden av ätstörningsproblematik. Genom att sjuksköterskan placerar den sjuke individen i centrum, kan sjuksköterskan tillsammans med teamet möjliggöra ett tillfriskande.

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This thesis is concerned with presenting analyses regarding key ethical issues regarding and arising from the development and potential use of gene drive modified mosquitoes for the purpose of malaria elimination. Each of the chapters constituting this thesis offers a rigorously researched analysis which attempts to answer questions thus far unanswered in the academic literature. Chapter one explores whether the development and use of this technology can be fairly considered unethical in principle; concluding it cannot be. Chapter two explores the appropriate relationship between this technology and the precautionary principle, a prominent regulatory and governance principle which has been invoked as ostensible support for an indefinite global moratorium on all gene drive technology. The chapter concludes that the precautionary principle, at least as articulated by UNESCO, does not provide justification for a global moratorium on gene drive technology. In fact, the precautionary principle is likely unfit as a regulatory norm for some kinds of gene drive products and purposes. Chapter three was co-authored with Delphine Thizy, Global Stakeholder Engagement Manager for Target Malaria, one of the leading consortiums working on research and development of gene drive biotechnology for malaria control. Together we articulate the ethical principles selected to guide Target Malaria’s stakeholder engagement, as well as provide the rationale for their selection and expound upon some early lessons from their implementation. Chapter four offers an analysis with the goal of locating the ethically appropriate locus of political organization from which to seek permission for a gene drive modified organism release into the shared environment. The chapter considers the appropriateness of each of the following levels of political organization: consent of individuals, local communities, nation states, and international governance institutions. The conclusion arrived at, with some caveats, is that such a decision is most appropriately issued by a nation state. / Thesis / Doctor of Philosophy (PhD) / This thesis is concerned with presenting analyses regarding key ethical issues regarding and arising from the development and potential use of gene drive modified mosquitoes for the purpose of malaria elimination. Chapter one explores whether the development and use of this technology can be fairly considered unethical in principle; concluding it cannot be. Chapter two explores the appropriate relationship between this technology and the precautionary principle, a prominent regulatory and governance principle which has been invoked as ostensible support for an indefinite global moratorium on all gene drive technology. Chapter three articulates, expounds, and provides rationale for the ethical principles selected to guide stakeholder engagement by Target Malaria, one of the leading consortiums working on research and development of gene drive biotechnology for malaria control. Chapter four attempts to locate the ethically appropriate locus of political organization from which to seek permission for a gene drive modified organism release.

Inledning: När patient- och medborgardeltagande i forskningsstudier diskuteras i Sverigegörs sällan en tydlig skillnad i retoriken mellan de två grupperna. Istället klumpas patienteroch medborgare ihop och betraktas som en grupp med lekmannaexpertis i förhållande tillhälso- och sjukvårdens professioner och beslutsfattare. Den akademiska litteraturen gördäremot en distinktion mellan grupperna och teoretiserar att de olika rollerna har skildaperspektiv, erfarenheter, förväntningar och intressen med sitt deltagande. Trots att det finnsmånga teorier som beskriver skillnaden mellan patienter och medborgare är frågan i stortempiriskt outforskad. Syfte: Syftet med studien var att undersöka eventuella skillnader irollen som patient respektive medborgare har med avseende på attityden till fördelningen avhälso- och sjukvårdens resurser. Metod: Ett enkätexperiment som inhämtade kvantitativadata användes för att studera syftet. Sammanlagt deltog 1032 deltagare i studien. Resultat: Studiens resultat visade att deltagare som blivit tilldelade rollen som patient respektivemedborgare hade skilda åsikter gentemot varandra. Åsikterna skilde sig från grupperna ifrågor om resursfördelning (r = 0,182, p <,001) och patientgruppers inflytande (r = -0,206, p<,001) i hälso- och sjukvården. Studien visade även att det fanns skillnader i attityder somhörde samman med utbildningsnivåer, könsidentitet samt ålder. Resultaten går i linje med deteoretiska ramverk som studien hade för avsikt att hypotespröva. Däremot var medborgaremer benägna att anta åsikter som i teorin relaterade till patienter. En möjlig förklaring är attmedborgare intuitivt antar ett patientperspektiv i frågor som berör hälso- och sjukvården,något som inte tidigare teoretiseras.

BACKGROUND: The World Bank report warns that the poor living in informal settlements and slum conditions are the most likely to be killed or harmed by extreme weather. They are morevulnerable to disasters often due to clogged drains, land subsidence, heat waves, and increased health risks. Disaster management (DM) in slums is part of a larger development problem in developing countries. However, analytical literature on the exact link and nature of problemsfaced by slum dwellers due to climate change and disasters is scarce. More research is needed to address the gap in literature between increasing urbanisation and the implications for the urban poor in disaster management plans (DMPs). METHODOLOGY: This research was granted approval by the Hamilton Health Sciences ResearchEthics Board on May 28, 2014. In June 2014, semi-structured interviews and focus groups were conducted, including 24 interviews and 9 focus groups with community members (CMs), 12 interviews with key informants from organisations in the civil society (CSOs), and 3 interviews with Government officials (GOs). The interviews and focus groups were transcribed verbatim (to the extent possible) and imported into NVivo 10 (QSR International) for qualitative content analysis. RESULTS: Five key points were made by participants in the focus groups and interviews: 1.) Some physical and non-physical infrastructure needs were not considered by GOs and CSOs for slum upgrading, such as the repair of shelter roofs and the creation of self-formed slum groups, 2.) Bottom-up participation and citizen engagement needed to be improved during the design and implementation of DMPs, 3.) Communication was pertinent during all phases of the DM cycle, including multisectorial involvement from all three stakeholder groups, 4.) Different barrierswere raised, including urbanization and planning, which affected the required participation and communication in DM, and 5.) Even substantial levels of water in the home at 3-4 inches high were described as waterlogging rather than flooding, suggesting that disasters were being normalised. DISCUSSION AND CONCLUSION: By describing different measures and approaches that are used for and by the urban poor, new DM strategies are suggested (such as scaling up and including new components in Slum Upgrading Programs). Several recommendations were made to improve DM planning, including the need to overcome several barriers and the potential of formulating contextual DMPs (such as an Earthquake Action Plan). A novel finding was the apparent normalisation of disasters. This raises important questions about how disasters are framed in Ahmedabad and the policy solutions that result from it. Climate change was seldom noted, even though it is expected to increase the frequency and intensity of future disasters. These findings can be considered for policy makers in megacities around the world and in the post-2015 Millennium Development Goals and Hyogo Framework of Action. / Thesis / Master of Science (MSc)

This thesis looked at the effects of offshore drilling on food security prospectively. The thesis aimed to understand the effects of offshore drilling and the importance of traditional foods to the Canadian Arctic Indigenous People. Furthermore this thesis aimed to contribute to food security research that is conceptualized within an indigenous context. / Background: Due to global climate change, the melting of arctic ice has increased geopolitical interest in the land due to newly accessible oil reservoirs on the continental shelf. With the imminent rise in offshore gas drilling, this presents an additional threat to Arctic food security. Indigenous populations living in the circumpolar north face many challenges in accessing adequate and nutritional food sources. One of the most significant factors impacting food security is the availability of traditional food. Objectives: To critically examine existing data and literature to discuss the impact of offshore gas drilling on traditional marine food sources. Additionally, the cultural, spiritual and physical health aspects of traditional food consumption will be determined. Methods: Arksey and O’Malley’s scoping review framework was adopted to examine the effects of offshore drilling activities on marine fauna. Furthermore, a literature review was used to determine the significance of traditional food to Canada Arctic Aboriginals. Conclusions: Offshore drilling activities may impact the four dimensions (access, availability, utilization and stability) of food security, therefore threatening food security in the Canadian Arctic. / Thesis / Master of Science (MSc)

Why are non-communicable diseases (NCDs) near the bottom of the list in terms of global health funding and political priority when together they account for the most death and suffering globally, particularly amongst the world’s poorest populations? The dissertation engages this puzzle by analyzing the work and impact of two model public health programs, one which succeeded in making legible the problem of NCDs as understood and experienced by citizens in the Global North in Finland and one which is challenging that understanding, based on the experiences of the poor in the Global South in Sierra Leone. The North Karelia Project, launched in eastern Finland in the early 1970s, generated science and practice that was taken up by the World Health Organization (WHO) (Puska 2002) and has become hegemonic, dominating global NCD public health discourse and rendering understandings of alternative causes and potential interventions invisible (Weisz and Vignola-Gagné 2015). The integrated NCD clinic at Koidu Government Hospital is the first clinical program to treat ongoing chronic illnesses—an issue that is frequently assumed to be too expensive for poor governments to address—in post-conflict and post-Ebola Sierra Leone, which hosts one of the weakest health systems in the world but which is part of a broader movement to challenge the dominant WHO NCD policy (PIH 2019; NCD Synergies 2015). Drawing on theories from medical sociology, science and technology studies, and global and transnational sociology, I use this comparison to explore how and why some understandings of NCDs prevail and why others fail. I also use it to gain leverage on three important related questions: (1) How are depictions of the burden of NCDs and their severity constructed in different material and social settings? (2) How do those depictions become stabilized (or not) in the global discourse about global health priorities? And, (3) What are the implications of such contrasting stabilization processes? I approach these questions by using a triangulated qualitative comparative case study research design (Bartlett and Vavrus 2016; Rihoux 2006), building on existing models of comparative research in the field of Science and Technology Studies (STS) (Knorr-Cetina 1999; Crane 2013). I conducted participant observation at organizational headquarters and clinical settings; semi-structured interviews with leaders, researchers, and clinical staff; and critical discourse analysis of the scientific literature, reports, and other historical and organizational materials generated by the actors. Each component compares the two cases (North Karelia Project, Finland and Koidu Government Hospital, Sierra Leone) along the lines of material setting, discourse, and science-making practices. Differences in epistemic practices reveal how power and politics are enacted and reproduced through public health science. I find that public health scientists in both cases must work to quell, or neutralize, persistent sociological ambivalence – irreconcilable tensions in values, interests, and politics – to solve local public health problems and produce science that can travel beyond the local. Ambivalences inherent in local public health science-making are quelled in patterned ways, shaped by an institutional field of struggle and strategies of accumulation of scarce symbolic and material capital. The North Karelia Project exemplified a public health social epistemology that I term “UHC-Insulated Population Optimization” which deployed three tactics for quelling persistent ambivalence such as offloading obligations, epistemic normality, and utilitarian construction. Conversely, the integrated NCD clinic at Koidu Government Hospital’s public health social epistemology, characterized as “Attending to Undone Care”, utilized other strategies for quelling ambivalence: making preferential option for the poor obligations, hybrid methods, and polar distinctions. The field of global health struggle, and the doxa on which it rests, is rooted in principles of distinction and hierarchy built from the legacies of extractive colonialism which remain powerful today in maintaining enormous health inequalities between the Global North and South. This dissertation and the comparison on which it rests opens new ground on the material conditions for epistemic justice and the material reparations necessary to ‘decolonize global’ health. / 2025-09-21T00:00:00Z

Hälsoskillnader förekommer mellan individer som bor i städer och på landsbygden och en orsak till dessa är fysisk aktivitet. Individers förutsättningar för fysisk aktivitet och hälsa påverkas av den närmiljö där de bor. Syftet var att göra jämförelser mellan stad och landsbygd gällande vuxna invånares upplevelser av samhällsplaneringen för fysisk aktivitet i sin hemkommun och i sitt närområde. En kvantitativ empirisk tvärsnittsstudie gjordes med 321 vuxna invånare som bodde i ett landskap med både stad och landsbygd i Finland. En webbenkät som studerade respondentens bakgrund och upplevelser gjordes, piloterades och delades på Facebook under två veckor våren 2023. Jämförande analyser gjordes med chi-två test mellan stad och landsbygd och upplevelserna samt mellan olika bakgrundsfaktorer och upplevelserna. Multivariata logistiska regressioner gjordes för att utesluta påverkan av andra möjliga samband. Respondenterna var överlag nöjda med samhällsplaneringen gällande både motionsmöjligheterna och rörelsemöjligheterna i sina hemkommuner och närområden. Skillnader förekom mellan respondenterna som bodde på landsbygden och dem som bodde i en stad men utanför centrum (OR: 2,1 95% KI: 1,13-4,06) samt dem som bodde centralt i en landsbygdskommun (OR: 2,4 95% KI: 1,21-4,65) i att uppleva att de kunde utöva den motion som önskas. Skillnaderförekom mellan dem som bodde på landsbygden och dem som bodde centralt i en landsbygdskommun (OR: 3,4 95% KI: 1,39- 8,30) gällande trygghet att motionera i sitt närområde. Invånarna verkar överlag nöjda med samhällsplaneringen gällande både motionsmöjligheterna och rörelsemöjligheterna i hemkommunen och närområdet. / <p>Betyg i Ladok 231010.</p>

Ongoing global health inequities have been amplified since the 2020 COVID-19 pandemic and subsequent social movements. Such inequities have resulted in increased literature critiquing the historical roots and current practices in global health. From this literature, questions have emerged about the future of global health and Canada’s role in this future. However, there is little research consolidating existing critiques and, based on these critiques, exploring adolescent sexual and reproductive health (ASRH) research and the role of Canadian funding for ASRH. The aim of this dissertation is to consolidate contemporary critiques of global health to develop a conceptual framework for one potential imagined future for global health. It then explores the conceptual framework for an imagined future through an example of global health research, policy, and practice, as it relates to ASRH in Eastern sub-Saharan Africa, to consider the opportunities and challenges of achieving this new potential vision. In this dissertation, I present four unique contributions. The first article presents the conceptual framework for an imagined future that will be used to explore ASRH research, policy, and practice. The second article presents findings from a scoping review on adolescent engagement in ASRH research. The third article presents a review of Canada’s Feminist International Assistance Policy (FIAP) and examines the development of the policy in relation to an imagined future. The fourth article presents a qualitative description of stakeholder perspectives who are implementing ASRH projects with Canadian funding and discusses these perspectives in relation to an imagined future. Conclusions suggest that language to support changes towards an imagined future in global health exists although there is continued opportunity to operationalize the changes. Further research is encouraged to engage local actors and consider practical ways to shift towards equity and justice in Canadian funding for ASRH. / Dissertation / Doctor of Philosophy (PhD) / There is growing controversy in the field of global health and it is not yet clear how the field will respond and evolve. As the number of critiques grow, responding with new ideas for the future of global health becomes more urgent and yet more difficult. This thesis aimed to address this challenge by examining what an imagined future for global health research, policy, and practice might be, and how it might be achieved. This research focuses on the future of global health and Canada’s role in it, particularly regarding adolescent sexual and reproductive health (ASRH) in Eastern sub-Saharan Africa. By reviewing documents and conducting qualitative interviews, this study explores adolescent involvement in ASRH research, Canada’s Feminist International Assistance Policy (FIAP) and stakeholder experiences implementing ASRH projects with Canadian funding. Findings emphasize the need for concrete actions to implement the changes proposed by scholars. Further research is encouraged to engage local actors and consider practical ways forward for shifts towards equity and justice in Canadian funding.