Regenerative medicine (RM) has the potential to develop new treatments for chronic disease and injury that are desperately needed in developing countries. Several emerging economies are actively participating in RM, producing new knowledge and initiating clinical trials. This thesis presents case studies of RM in China and Brazil and a comparative analysis of RM across Brazil, China and India. I aim to better understand the state of RM, how it has developed and what is needed for RM innovation to succeed within these countries. Case studies were conducted using face-to-face in-depth semi-structured interviews with RM experts from different areas including research institutes, hospitals, firms, educational institutes, government, policy agencies, and bioethics groups. Interviews were analysed using thematic analysis and triangulated with the analysis of research articles, government reports, laws and other primary and grey literature. China is now the 5th most prolific publisher on stem cells in the world. Chinese RM benefits from permissive regulations and the expertise of Chinese returnees that have trained abroad, but the field’s reputation is challenged by a weak regulatory system and the clinical availability of untested stem cell therapies. Brazil has created a small but strong RM program, but needs to address challenges to the field including inconsistent funding, slow importation of materials, and weak linkages between stake-holders. Comparative analysis of the three countries identifies several common elements that support RM, including linkages between stake-holders, government support, infrastructure, human resources, and good governance. RM capacity is clustered in large urban centres, which could exacerbate socio-economic and health disparities unless measures are taken to ensure equitable distribution of benefits. RM does not adhere to classical views of southern innovation, suggesting that new models are needed to describe innovation in emerging technologies, where countries are keeping up instead of catching up.

The following paper explores three case studies of large-scale forced and coercive surgical sterilizations on indigenous women in Canada, the United States and Peru. The author utilizes settler colonialism as explanation for the complicity of these states in reproductive rights abuses and identifies some risk factors for reproductive rights abuses in future social welfare and global health aid projects.

Tuberculosis is one of the deadliest communicable diseases in the world, and consequently remains one of the biggest global healthcare challenges. Tuberculosis is treatable and curable. However, within many low resource settings, underdeveloped medical infrastructure limits the effectiveness and accuracy of existing diagnostics. These limitations severely impede the timely diagnosis of the disease, and thus contribute to the disease spreading, developing drug resistance, and killing more individuals. There is an urgent need for an inexpensive, portable, rapid, easy-to-use point of care diagnostic that can function outside of the laboratory at the community level. Currently, there is a wide range of available tuberculosis diagnostics ranging from sputum smear microscopy to nucleic acid amplification tests. Yet, none have met every standard of the ideal point of care diagnostic. Since the World Health Organization’s endorsement of Xpert MTB/RIF in 2010, there has been a resurgence of interest in point of care diagnostic development. This investigation reviewed diagnostic development projects funded by the National Institutes of Health in 2008 and 2014 in order to examine the technologies being developed, how researchers in industrial and academic sectors are addressing this problem, and what challenges still need to be overcome. More projects in 2014 were expected to rely on sample types other than sputum and be funded than those in 2008. The results of this investigation confirm this hypothesis, and that the development of a point of care device is a multi-faceted challenge with numerous underlying issues that need to be addressed before such a device can be successfully implemented.

The central argument that I advance in this dissertation is that the influence of the Rockefeller Foundation (RF) and the Bill and Melinda Gates Foundation (BMGF) in the governance of global health and agricultural development has been derived from their ability to advance knowledge structures crafted to accommodate the preferences of the dominant states operating within the contexts where they have sought to catalyze change. Consequently, this dissertation provides a new way of conceptualizing knowledge power broadly conceived as well as private governance as it relates to the provision of public goods. In the first half of the twentieth-century, RF funds drove scientific research that produced tangible solutions, such as vaccines and high-yielding seed varieties, to longstanding problems undermining the health and wealth of developing countries emerging from the clutches of colonialism. At the country-level, the Foundation provided advanced training to a generation of agricultural scientists and health practitioners, and RF expertise was also pivotal to the creation of specialized International Organizations (IOs) for health (e.g. the League of Nations Health Organization) and agriculture (e.g. the Consultative Group on International Agricultural Research) as well as many informal international networks of experts working to solve common problems. Finally in the neo-liberal era, RF effectively demonstrated how the public-private partnership paradigm could provide public goods in the face of externally imposed austerity constraining public sector capacity and the failure of the free-market to meet the needs of populations with limited purchasing power. Since its inception, the BMGF has demonstrated a similar commitment to underwriting innovation through science oriented towards reducing global health disparities and increasing agricultural productivity in poor countries, and has greatly expanded the application of the Public-Private Partnership (PPP) approach in both health and agriculture. Unlike its intellectual forebear, BMGF has been far more focused on end-points and silver bullets than investing directly in the training of human resources. Moreover whereas RF has for most of its history decentralized its staff, those of BMGF have been concentrated mainly at its headquarters in Seattle. With no operational programs of its own, BMGF has instead relied heavily on external consultants to inform its programs and remains dependent on intermediary organizations to implement its grants. Despite these and other differences, both RF and BMGF have exhibited a common capacity to catalyse institutional innovation that has benefited historically marginalized populations in the absence of structural changes to the dominant global power structure. A preference for compromise over contestation, coupled with a capacity for enabling innovation in science and governance, has resulted in broad acceptance for RF and BMGF knowledge structures within both state and international policy arenas. This acceptance has translated into both Foundations having direct influence over (i) how major challenges related to disease and agriculture facing the global south are understood (i.e. the determinants and viable solutions); (ii) what types of knowledge matters for solving said problems (i.e. who leads); and (iii) how collective action focused on addressing these problems is structured (i.e. the institutional frameworks).

The purpose of the study is to investigate midwife's work towards pregnant women.  The method of the study had a qualitative approach and the data collection was done using semistructured interviews. Three phoneinterviewes and an interview face to face.    The method used had a qualitative approach and semi structured telephone interviews as well an interview with a personal meeting was the results implementation. The participants in the survey were four midwives recruited by telephone. The interviews were recorded, transcribed and analyzed with a manifest thematic content analysis, with a phenomenological element.   The Result gave four different themes: The health call - a good foundation for maternity health care, trust and trust, diet and exercise, insufficient knowledge and midwives experience of support. The result showed that midwives work on the same guidelines, that is the BAS program. They felt short of time and wished that the visits with the women could be a bit more flexible.   The conclusion is that more time for each visit would be necessary and that cooperation with other actors would make the work more efficient and fair.

Background: HIV drug resistance is presumed to be inevitable due to the error-prone nature of the virus. However, poor adherence to the antiretroviral drugs is proven to be an impending factor for HIV drug resistance development. Of these two explanations, which is the most common reason for HIV drug resistance?Method: A total of 40 published studies about HIV drug resistance, were retrospectively collected in Pubmed (May 2017), from 36 different countries for this paper. From each study was participants, percentage of HIV drug resistance and HIV-1 subtype extracted for analysis. All studies were than classified by either high-income, middle-income or low-income, based on a country income status, defined by the World Bank. HIV drug resistance was tested against: continents, HIV-1 subtypes, number of study participants, income levels, GDP per capita and EWI’s. All statistical analysis was performed in R: The R project for statistical computing.Result: This paper show, that HIV drug resistance primarily is caused by poor adherence which is closely associated with drug stock out. Highest HIV drug resistance levels was found in middle-income countries. However, number of participants enrolled per study was important for the outcome and this indicates that HIV drug resistance would be higher in low-income countries if larger studied had been carried out in these settings. This means that there is a large unrecorded prevalence of HIV drug resistance in low-income countries.

Introduktion: I Sverige tar 1500 människor sitt liv varje år, en tiondel av dem tillhör gruppen unga. Regeringen menar att unga bör prioriteras i arbetet mot självmord och Folkhälsomyndigheten arbetar för att motverka självmord. Syftet med litteraturöversikten var att beskriva möjligheten att med skolbaserade interventioner förebygga självmord bland ungdomar 14-19 år.  Metod: Metoden som använts är systematisk litteraturöversikt. Artiklar har sökts i Pubmed och har systematiskt analyserats och bearbetats för att ge en relevant bas till studien. Femton vetenskapliga artiklar har använts som grund till resultatet. Resultat: Artiklarna genererade tre teman: screening, gatekeeper-program och utbildning för elever. Screening används för att identifiera elever i riskzonen för självmord och remittera dem vidare för vård..Gatekeeper-program innebär att lärare, skolpersonal och/eller elever utbildas i att identifiera elever som mår psykiskt dåligt. Utbildning syftar  till att öka elevers hälsolitteracitet.. Diskussion: Regeringen har slagit fast i en proposition att unga bör vara av prioritet i folkhälsoarbetet mot självmord men det finns inom Folkhälsomyndighetens åtgärdsområden ingen direkt fokus på unga människor. Litteraturöversikten visar att utbildning för elever kan reducera självmordstalen bland unga människor,och liknande litteraturöversikter visar att en kombination av olika program kan vara effektivt. Därför föreslås att utbildningsprogram används för att förebygga självmord bland unga. / Introduction: In Sweden, 1500 people take their lives every year, one tenth of them belonging to the group of young people. The government believes that young people should be prioritized in suicide prevention efforts and the Public Health Agency is working to counter suicide. The purpose of the literature review was to describe the possibility of preventing suicide among young people aged 14-19 years with school-based interventions.  Method: The method used is systematic literature review. Articles have been searched in Pubmed and have been systematically analyzed and processed to provide a relevant base for the study. Fifteen scientific articles have been used as the basis for the result.  Results: The articles generated three themes: screening, gatekeeper programs and education for students. Screening is used to identify students at risk of suicide and to refer them further for care. The gatekeeper program means that teachers, school staff and / or students are trained to identify students who are mentally ill. Education aims to increase students' health capacity.  Discussion: The government has stated in a proposition that young people should be a priority in public health work against suicide, but there is no direct focus on young people in the area of ​​public health authorities. The literature review shows that education for students can reduce suicide among young people, and similar literature reviews show that a combination of different programs can be effective. Therefore, it is proposed that education programs be used to prevent suicide among young people

Inledning: Äldre utgör den största gruppen som drabbas av depression och är också den snabbast ökande gruppen i världen som lider av depression. Det råder en brist på forskning inom området och det finns indikationer på att äldre inte svarar på samma sätt som yngre vid behandling. Syftet med litteraturstudien är att undersöka metoder för behandling av depression i den äldre befolkningen. Metod: En systematisk litteraturstudie med tematisk innehållsanalys av kvantitativa data. Resultat: Femton artiklar inkluderades för analys. Analysen utmynnade i fyra teman: Fysisk aktivitet, Terapi, Social interaktion, Medicinsk behandling. Slutsats: Det finns indikationer på behandlingsmetoder med god effekt, men heterogeniteten inom studiepopulationen är stor och försvårar eventuella kliniska implikationer. Det behövs fler studier inom området med fokus på undergrupper. / Background: The older population makes up the largest group of people struck by mental depression. Meanwhile it is also the most rapidly increasing population group suffering from depression. There is a lack of research in this field and there are indications that older people do not respond to treatment in the same way as the younger population. The aim of this literature review is to examine methods of treatment for depression in the elderly population.Method: A systematic literature review with thematic content analysis of quantitative data.Results: Fifteen articles were included. The analysis resulted in four themes: Physical activity, Therapy, Social interaction, Medical treatment. Conclusion: There are indications of treatments with good effect, but it is difficult to identify possible clinical implications due to heterogeneity within the study population. More studies in the field focusing on subgroups are needed.

Under dem senaste åren har allt fler ungdomar av olika skäl slutat med lagidrott. I samtidigt med detta har den fysiska hälsan minskat bland våra ungdomar. Problematiken har uppstått för att ledarskapet och föreningarna fokuserar på fel delar som resultat och prestation, istället för att utveckla våra ungdomar. Syftet med denna studie är att undersöka ledarnas uppfattningar om vilken betydelse ledarskapet inom föreningslivet har för att vidmakthålla ungdomars deltagande i lagidrott högre upp i åldrarna. Ämnet har avgränsats till bollsporter i Västerås. En kvalitativ ansats har valt att tillämpas som metod, för att samla in materialet från fem intervjuer. Urvalet bestod av ett ändamålsenligt urval av ledare som hade kännedom om ämnet och deltagarna var av både män och kvinnor med varierande åldrar. Vid datainsamlingen gjordes semistrukturerande intervjuer och analysen gjordes utefter en manifest innehållsanalys. Resultatet visade tre olika faktorer som ledare beaktar för att främja deltagandet bland unga. Hälsofrämjande ledarskap där det sociala och det pedagogiska förhållningssättet samverkar för att skapa struktur och tydlighet. Delaktighet som bidrar till att alla ska kunna vara aktiva och få sin röst hörd, samt bli inkluderade i planeringar och möten. Den sista faktorn är gemenskap och socialt stöd, som verkar för att öka sammanhållningen och meningsfullheten.

abstract: Food deserts are the collection of deprived food environments and limit local residents from accessing healthy and affordable food. This dissertation research in San Lorenzo, Paraguay tests if the assumptions about food deserts in the Global North are also relevant to the Global South. In the Global South, the recent growth of supermarkets is transforming local food environments and may worsen residential food access, such as through emerging more food deserts globally. This dissertation research blends the tools, theories, and frameworks from clinical nutrition, public health, and anthropology to identify the form and impact of food deserts in the market city of San Lorenzo, Paraguay. The downtown food retail district and the neighborhood food environment in San Lorenzo were mapped to assess what stores and markets are used by residents. The food stores include a variety of formal (supermarkets) and informal (local corner stores and market vendors) market sources. Food stores were characterized using an adapted version of the Nutrition Environment Measures Survey for Stores (NEMS-S) to measure store food availability, affordability, and quality. A major goal in this dissertation was to identify how and why residents select a type of food store source over another using various ethnographic interviewing techniques. Residential store selection was linked to the NEMS-S measures to establish a connection between the objective quality of the local food environment, residential behaviors in the local food environment, and nutritional health status. Using a sample of 68 households in one neighborhood, modeling suggested the quality of local food environment does effect weight (measure as body mass index), especially for those who have lived longer in poorer food environments. More generally, I find that San Lorenzo is a city-wide food desert, suggesting that research needs to establish more nuanced categories of poor food environments to address how food environments emerge health concerns in the Global South. / Dissertation/Thesis / Ph.D. Social Science and Health 2012