Background: Skin cancer is one of the most preventable forms of cancer yet for certain types of skin cancers, it can be fatal if it goes untreated. While ultraviolet radiation is the main cause of skin cancer, there are several other risk factors, including sunburn history, smoking, environmental pollutants, family history, personal history, and skin color. Practicing sun protection behaviors and receiving regular skin cancer screenings can prevent the cancer from ever developing. This study examines the demographic and socioeconomic status risk factors for skin cancer. Methods: The Health Information National Trends Survey data was used from 2005. Using this secondary dataset, chi-square analysis was performed to determine the prevalence of skin cancer within the demographic categories of age and race/ethnicity as well as socioeconomic status indicators educational attainment, annual household income, employment status, and marital status. Univariate and multivariate analyses were performed to determine the correlations of the variables with skin cancer. A p-value of 0.05 and a 95% confidence interval were maintained throughout the analyses to determine any statistical significance. Results: Of the 3,804 respondents who answered the question related to cancer diagnosis, 226 indicated they had a positive skin cancer diagnosis, which was 5.94% of the total sample. Skin cancer and increased age were consistently associated (χ2 (2) = 171.5, p<.001). The skin cancer peak prevalence was for all those respondents aged 65 and older. Higher educational attainment and higher annual household income were associated with greater likelihood of skin cancer. Conclusions: This study revealed that skin cancer is significantly associated with increased age, higher educational attainment, and higher annual household income. Implementing consistent screening practices and targeted behavioral interventions are important areas for health focus in the future.

Timely access to end-of-life care is a growing problem. One under-referred group is adults who die shortly after cancer diagnosis. This group’s challenges include a lack of definition for short diagnosis-to-death (SDTD), and inability of health care providers to identify risks for SDTD. Research indicates socioeconomic factors may influence access to end-of-life care, though how is unclear. This study used recursive partitioning methods to define SDTD for decedent adults with colorectal cancer and identify socioeconomic predictors of SDTD. SDTD was defined as less than 18.5 days. Socioeconomic predictors included long-term care residence and community-level characteristics such as education, immigration, marital status, Aboriginal status, and income. Results showed existing SDTD timeframes may be too long to adequately understand the population’s needs, and indictors of risk may be unique for this population. Additional research could establish consistency for defining SDTD and clarify the utility of socioeconomic predictors for mitigating barriers to care.

Gender and socioeconomic inequalities in health are ubiquitous in developed countries; however, the modifying effect of gender on the relationship between socioeconomic position (SEP) and health over time is less clear. The potentially different health effects of changes in SEP on changes in health for working-age women and men are examined over a 10-year period. Three main questions are addressed: (1) are there gender differences in health over time, (2) do changes in SEP lead to health inequalities and (3) do changes in SEP impact health differently for women and men? Generalized estimating equations (GEE) were used to analyze the Canadian National Population Health Survey for four measures of health, number of chronic conditions, self-rated health, functional health, and psychological distress, and three measures of SEP, income, education and employment status. Men and women in this nationally-representative sample of Canadians do not differentially embody changes in SEP, though both gender and SEP independently impact health.

The understanding that Attention Deficit/ Hyperactivity Disorder (ADHD) commonly persists into adulthood has not been widely accepted until recently. Accordingly, less is known about diagnostic and treatment prevalence or health and social outcomes of ADHD in adulthood. The objectives of this study were to: determine lifetime prevalence of ADHD diagnosis and treatment for Manitoba young adults, investigate whether a socioeconomic gradient exists within Manitoba young adults with a lifetime diagnosis of ADHD, and investigate the relationship between ADHD in Manitoba young adults and health service utilization. Using the Manitoba Population Health Research Data Repository, this cross-sectional analysis used 24 years of data (1984/85-2008/09) and included all Manitoba adults aged 18-29 during 2007/08-2008/09 with a lifetime diagnosis of ADHD. Crude prevalence was calculated for ADHD diagnosis and psychostimulant prescriptions, in addition to several demographic variables. The presence of a socioeconomic gradient in lifetime ADHD diagnosis was investigated using Poisson and negative binomial regression. Relationships between young adults with lifetime ADHD diagnosis and health service utilization for several health and social outcome variables were explored using a matched cohort design with two comparison groups and GEE regression models. In relation to previous Manitoba research on childhood ADHD, the socioeconomic gradient for ADHD diagnosis was found to dissipate into young adulthood. However, when region of residence was accounted for, a small inverse gradient in the urban population and a direct gradient in the rural population were evident. Individuals from the highest income quintile were significantly less likely to be diagnosed before age 18 than all other income quintiles. Depression, anxiety, personality disorders, conduct disorder, substance abuse, multiple types of injuries, receipt of income assistance, and reduced high school graduation were significantly correlated with lifetime ADHD diagnosis. Given the high lifetime prevalence of ADHD in Manitoba young adults, significant socioeconomic correlates for diagnosis, and multitude of adverse health and social outcomes in this population, further investigation into the trajectory of this relatively unexplored population is recommended. Furthermore, continued measurement of the provision and success of additional resources will ultimately be necessary for enhancing the health status of all Canadian adults living with ADHD.

Background and aims: The overall aim of this thesis was to increase knowledge regarding the occurrence of childhood onset T1D and T2D in Sweden and in relation to that describe and elucidate important aspects on two grave complications to diabetes; end-stage renal disease (ESRD) and mortality. The two first studies included in this thesis aimed to describe and analyze the cumulative incidence of childhood onset T1D in Sweden and to assess the occurrence of undetected T2D in Swedish children. The aim with the third study was to describe the cumulative incidence of ESRD, and to analyze how ESRD risk differs with age at-onset and sex. The aim of the fourth study was to show how parental socioeconomic status (SES) affects all cause mortality in Swedish patients with childhood onset T1D. Study populations: The foundation for the studies on T1D was data from the Swedish Childhood Diabetes Registry (SCDR). When studying ESRD we also included adult onset T1D cases from the Diabetes Incidence Study in Sweden (DISS). The study on T2D was a population-based screening study where BMI was measured in 5528 school-children and hemoglobin A1c was measured in children with overweight according to international age and sex specific BMI cut-offs. To study ESRD and mortality, we linked the SCDR to various nationwide registers containing individual information on SES, mortality and ESRD. Results: The incidence rates of childhood onset T1D has continued to increase in Sweden 1977–2007. Age- and sex-specific incidence rates varied from 21.6 (95% CI 19.4–23.9) during 1978–1980 to 43.9 (95% CI 40.7– 47.3) during 2005–2007. Cumulative incidence by birth-cohorts has shifted to a younger age at-onset over the first 22 years of incidence registration. From the year 2000 there was a significant reverse in this trend (p&lt;0.01). In contrast to the increase of T1D, we found no evidence of undetected T2D among Swedish school children. Despite a relatively high incidence in T1D in Sweden there is low cumulative incidence of ESRD, 3.3% at maximum 30 years of duration. We found difference between the sexes regarding long-term risk of developing ESRD that was dependent on the age at onset of T1D. When analyzing how socioeconomic status affects mortality in different age at death groups, we found that having parents that received income support increased mortality up to three times in those who died after 18 years of age. Conclusion: The incidence of childhood onset T1D continued to increase in Sweden 1978-2007. Between the years 1978-1999 there was a shift to a younger age at-onset, but from the year 2000 there is a change in this shift indicating a possible trend break. The prevalence of T2D among Swedish children up to 12 years of age is probably very low. There is still a low cumulative incidence of T1D associated ESRD in Sweden. The risk of developing ESRD depends on age at-onset of T1D, and there is a clear difference in risk between men and woman. Excess mortality among subjects with childhood onset T1D still exists, and low parental socioeconomic status additionally increased mortality in this group.

This thesis analyzes the development of national justice processes in Uganda in the wake of war in order to address key theoretical dilemmas that have recently emerged in the field of transitional justice. I focus on closely connected debates over the exclusion of socioeconomic justice, the relationship between international, national and local actors, the role of transitional justice discourse, and ultimately, the future of the field itself. Based on fieldwork undertaken in Kampala, the Acholi district and the temporary international arena created in Kampala for the 2010 ICC Review Conference, this thesis traces the role of local, national and international actors in the war itself, the search for peace, and the current post-conflict period. I examine the ways in which actors at all levels narrate the northern conflict and accordingly negotiate and contest the nature, scope and course of post conflict justice. I argue that the struggle for a meaningful approach to transitional justice is global in dimension. The power to define and perform postwar justice is concentrated in the hands of the state. A high risk persists that Uganda's transitional justice policy will prove an empty performance of 'victor's justice.' International and domestic actors alike have shaped and justified the Ugandan Government's self-interested approach and facilitated the dominance of international criminal justice. Conversely, civil society actors at all levels in Uganda draw on transitional justice as a radical language of resistance to fight for meaningful change. As long as it fails to address socioeconomic issues and structural violence however, transitional justice discourse will ultimately fall short of giving political voice to local priorities, and activating long-term social transformation. I argue that the field of transitional justice must be re-envisioned to embrace socioeconomic justice, in order to impel the endless pursuit of a just society. This task will require the collective efforts of a global constellation of actors.

This thesis draws on student testimony, curriculum analysis, and statistical tests to explore 1) the degree to which gender, financial aid status, and race/ethnicity correlate with student perceptions of Intro to IR course content and 2) the degree to which students conceptualize IR as interrelated with social identities, as opposed to an abstracted state-centric discipline.

BACKGROUND This thesis studies the relationship between area-level socioeconomic status and the incidence and 30-day survival of out of hospital cardiac arrest. The effect of socioeconomic status on health has been studied for over 150 years.  Although cardiac arrest is a major public health problem there has been very little focus on socioeconomic status and out of hospital cardiac arrest. DATA AND METHODS The cardiac arrest data are obtained from the Swedish cardiac arrest registry. Data on age structure and percentage of immigrants is from SCBs total population registry and socioeconomic data come from SCBs LISA database. The incidence analysis is made in two steps. The first step calculates the age standardized incidence and the second step is an OLS analysis. For the survival analysis a logistic regression analysis is made to measure the probability of survival in different income areas. RESULTS For the socioeconomic status – incidence analysis the results from the OLS analysis suggest that the incidence is almost twice as high in the lowest income area. Intercept (Highest group) = 26.8 and &lt;140 000 (lowest group) = 24.5. In the survival analysis (using a binary logistic regression analysis) there was a significantly lower OR for the lowest income group for all patients (OR= 0.521, p= 0.049) and for the sub group (patients 18-75 years old) there was a significant negative relationship for the two lowest groups. &lt;140 000 (OR= 0.444, p= 0.032) and 140 000-159 000 (OR= 0.620, p= 0.046). CONCLUSION There is a significant relationship between living in a poor neighborhood and out of hospital cardiac arrest. Those living in poorer areas have both an increased incidence and lower chance of survival of out of hospital cardiac arrest.

Introduction: While the influence of parental behavior and economic status on children’s weight status is well-known, little is known about the impact of specific family-related aspects such as parental and grandparental social support. This study investigates the importance of parental and grandparental social support and economic capital for children’s weight status in a clinical sample of preschoolers with obesity. Methods: Baseline data from an obesity intervention study for preschoolers, 4-6 years of age (n = 39, 56 % girls) was used. Among parents, 73% were overweight/obese, 60% had a 3-year high school education and 50% were of non-Swedish origin. Linear regression analyses, simple and multiple, were performed separately for mothers and fathers on indicators of economic capital and social support with child BMI SDS as the dependent variable. Additionally, combined analyses were conducted in which parental income was stratified by emotional support. Results: Low levels of income for both parents and low emotional support from grandparents for fathers were significantly associated with a higher child BMI. Moreover, the association between parental income and the child’s BMI SDS was stronger among those parents who had low emotional support versus those who had high emotional support. Conclusion: The study indicate that both economic capital and social support of parents may influence the level of obesity in their children and that emotional support of grandparents is especially important when parental income is low.

Formål: Denne studien ville undersøke tannhelseeffekt ved et intervensjonsprogram for forebygging av karies på klinikknivå.   Metode: Et ex post-facto quasi-eksperimentell design ble anvendt til kvantitativ analyse av data fra journal programmet i Tannhelsetjenesten i Vest-Agder fylke, Norge. Effekten av et beskrevet intervensjonsprogram for forebygging av karies ble analysert ved sammenlikning mellom tre klinikker, og delvis med fylkesgjennomsittet for Vest-Agder. De sosioøkonomiske forhold i klinikkenes tilhørende bydeler ble beskrevet med indekser ut fra gitte kriterier. Kalibreringsøvelser med røntgenbetrakting på behandlernivå ble utført post hoc for å få en formening om mulige målefeil og presisjon i det statistiske materialet.   Resultat: Planmessig, nytenkende og godt folkehelsearbeid i undersøkelsesperioden 2004– 2008 med tidlig intervensjon på småbarn og praktisk opplæring i effektiv tannpuss, gav betydelig tannhelsegevinst for 5- åringene. Resultatene var mindre entydige for 12- og 18-åringene. Klinikken med det forebyggende intervensjonsprogrammet var beliggende i et område med bra sosioøkonomisk indeks, hvilket kan forkludre resultatene. Forskjell i diagosenivå mellom klinikerne, viser hvordan helseresultater kan bli påvirket av behandlervariasjon. Ulik diagnose- og behandlernivå blant klinikerne slik det kommer fram i studien, ser ut for å være en vedvarende utfordring for tannhelsetjenesten.    Konklusjon: Studien understreker betydningen av intensiv og målrettet forebyggende intervensjon fra tidlig alder, og at forebyggende arbeid og tannhelseresultat må ses i et langtidsperspektiv. Ulike sosioøkonomiske forhold i et undersøkt område, reduserte mulighetene for å konkludere om helseresultater i denne quasi-eksperimentelle studien. / Purpose: This study aimed to evaluate oral health results at the clinical level of an intervention program for the prevention of dental caries.   Method: An ex post facto quasi-experimental design was used for quantitative analysis of data using digital records in the Public Dental Health Service of County Vest-Agder, Norway. The effect of a described intervention program for prevention of caries was analyzed by comparing oral health data from the intervention clinic with two other clinics and also with the county average. The socioeconomic conditions in the neighbourhoods served by the clinics were described with indexes containing known criteria. The test of the treatment criteria of salaried dentists was based on post hoc x-rays to estimate the size of measurement error and precise statistical material.   Result: Systematic, innovative, and good public health practices conducted during the 2004–2008 study period provided early intervention treatment for toddlers and trained effective tooth-brushing skills, beneficially affected oral health results among 5-year-old children. However, the results were less clear among 12- and 18- years-old children. The clinic with the best oral health results was located in the best socioeconomic area in the study, possibly confounding the results. An unsatisfactory agreement of the diagnostic level between the clinicians showed that practice variations might influence health effects. Differing diagnostic and treatment levels among clinicians shown in the study, poses an ongoing challenge for dental service.   Conclusion: This study emphasizes the importance of initiating and maintaining intensive and targeted preventive dental activities in early childhood, and shows that preventive dental treatment and oral health results require a long-time perspective. Varying socioeconomic conditions in the trial area reduced the possibility of concluding health results in this quasi-experimental study. / <p>ISBN 978-91-86739-20-1</p>