Despite a well-documented gender pattern of adolescent mental health, public health research investigating possible influencing factors from a gender-theoretical approach is scarce. This study aimed to explore what factors and circumstances are related to adolescent mental health and to apply a gender analysis to the findings in order to improve the understanding of the relationships between life circumstances and the gendered patterning of mental health among young people.   The study population was 16-19-year-old Swedish students and data was collected by means of focus groups (N=29) and self-administered questionnaires (N=1,663, 78.3% response rate) in school settings. Mental health problems were defined in a broad sense including the adolescents’ own understandings, perceived stress, psychological distress and deliberate self-harm.   The mental health problems of perceived stress, psychological distress and deliberate self-harm were twice as common among girls as boys. The findings suggest that adolescent mental health is associated with the life circumstances of social relationships, demands and responsibility taking and experiences of violence and harassment.  Supportive relationships with friends, family and teachers were found to be of importance to positive mental health, whereas poor social relationships, loneliness and lack of influence were associated with mental health problems.  Perceived demands and responsibility taking regarding school work, relationships, future plans, appearance and financial issues were strongly related to mental health problems, particularly among girls regardless of social class. The results indicate that physical violence, sexual assault, bullying and sexual harassment are severe risk factors for mental health problems in young people. Boys and girls experienced different types of violence, and the victim-perpetrator relationships of physical violence differed. These diverging experiences appeared to influence the associations with mental health problems in boys and girls.   A gender analysis provides the tools to gain knowledge about the ways that boys’ and girls’ lives are shaped by gender relations and constructions at different levels in society and how these life circumstances represent risk- or protective factors for mental health. For example, unequal power structures and the ways girls are expected to ‘do’ femininity likely influence their life circumstances in ways that place them at greater risk of mental health problems. Hegemonic constructions of masculinity and advantaged positions likely contribute to life circumstances that are positive for mental health but are also implying risk factors for poor mental health among boys, e.g., violence. It is also important to recognise how the intertwined cultural and structural aspects of gender and social class influence the lives and mental health of boys and girls. In conclusion, gendered and class-related mechanisms at the different levels in society influence the distribution of risk factors unevenly among boys and girls, which could be a possible explanation for the gender differences in reports of perceived stress, psychological distress and deliberate self-harm.   The likelihood of gender and socioeconomic differences in mental health problems should be taken into account in prevention and health promotion strategies at all levels in society. A greater awareness about gender relations and the gendered social circumstances under which young people live is required. The school environment is an important arena with respect to prevention and health promotion. There is also a need for a joint action against violence and harassment at all levels in society. Implications do not only concern young people; social policy and legislation should focus on reducing gender and class inequalities in general. / Sammanfattning Svensk titel: Livsvillkor och ungdomars psykiska hälsa: uppfattningar, associationer och en genusanalys.   Trots ett väldokumenterat genusmönster i ungdomars psykiska hälsa finns det en kunskapslucka i den folkhälsovetenskapliga forskningen avseende genusteoretiska analyser av sambanden mellan ungas livsvillkor och psykisk hälsa. Föreliggande studie syftade till att undersöka vilka faktorer och omständigheter som är relaterade till psykiska problem, samt att analysera fynden ur ett genusperspektiv för att fördjupa förståelsen av relationerna mellan ungas livsvillkor och genusmönster i psykiska hälsa.   Studiepopulationen var gymnasielever i åldern 16-19 år. Studien genomfördes i skolmiljö och data insamlades genom fokusgrupper (N=29) och en enkätstudie (N=1,663, 78.3% svarsfrekvens). En bred definition av psykisk ohälsa tillämpades vilken representerades av ungdomarnas egen förståelse, samt de psykiska problemen upplevd stress, psykiska besvär samt självskadebeteende.   Resultaten visade att stress, psykiska besvär och självskadebeteende var dubbelt så vanligt bland flickor som bland pojkar. Psykiska problem var relaterade till livsvillkoren sociala relationer, krav och ansvarstagande samt utsatthet för våld och trakasserier. Stödjande relationer med vänner, familj och lärare var av stor betydelse för psykisk hälsa medan dåliga relationer, ensamhet och brist på inflytande var relaterat till psykiska problem. Psykiska problem var starkt kopplade till erfarenheter av höga krav och ansvarstagande avseende skolarbete, relationer, framtidsplaner, utseende och ekonomi, i synnerhet bland flickor oavsett socioekonomisk bakgrund. Resultaten indikerar att olika former av våld och trakasserier är allvarliga riskfaktorer för psykiska problem och att flickors och pojkars skiljda erfarenheter av olika former av våld samt relationen till förövaren, kan vara relaterade till skillnader i psykiska problem.   Genusanalysen av resultaten föreslår att flickors livsvillkor påverkas av ojämlika maktstrukturer och konstruktioner av femininitet och att dessa livsvillkor bidrar till en ökad risk för psykisk ohälsa bland flickor. Livsvillkor kopplade till manlig överordning och hegemoniska konstruktioner av maskulinitet influerar sannolikt pojkars psykiska hälsa positivt. Dessa villkor kan dock också innebära risk faktorer för psykiska problem, t.ex. i fråga om våld. Studien uppmärksammar även hur kulturella och strukturella aspekter av både genus och social klass kan påverka livsvillkor och psykisk hälsa för pojkar och flickor. Studiens slutsats är att genusifierade och klassrelaterade mekanismer på olika nivåer i samhället bidrar till en skev fördelning av riskfaktorer för psykiska problem vilket kan vara en möjlig förklaring till skillnaderna mellan pojkar och flickor i fråga om upplevd stress, psykiska besvär och självskadebeteende.   Genus- och socioekonomiska skillnader i psykiska problem bör tas i beaktande i preventivt och hälsofrämjande arbete på alla nivåer i samhället. Detsamma gäller för en ökad medvetenhet om hur ungas livsvillkor är relaterade till psykisk hälsa och hur dessa villkor är genus- och klassrelaterade. Studien uppmärksammar skolan som en viktig arena för preventivt och hälsofrämjande arbete samt att gemensamma insatser krävs på olika arenor för att motverka våld och trakasserier. Implikationer av studien omfattar även generella samhällspolitiska insatser för minskad ojämlikhet. Nyckelord: Stress; psykiska besvär; självskadebeteende; gymnasieelever; maskulinitet; femininitet; sociala determinanter; sociala relationer; krav; ansvarstagande; våld och trakasserier; skola. / Forskarutbildningsämne: Hälsovetenskap.

Osteoarthritis (OA) is the leading cause of disability in North American and has major economic consequences for society. People with knee OA experience the worst quality of life, among musculoskeletal conditions, with function and mobility being influenced by symptoms such as pain and stiffness. However, the impact of OA symptoms varies due to intrinsic and extrinsic factors, leading many researchers to employ biopsychosocial and other population health frameworks to study the disease. These population health approaches have not been adopted when studying knee OA outcomes in bioarchaeology, where a limited biological lens prevails due to the sole reliance on skeletal remains. The purpose of this research was to explore methods for identifying the impairment potential of knee OA in archaeological populations using a clinical sample and population health approaches. Clinical studies have the advantage of assessing not only the biological implications of knee OA but also the functional outcomes. By creating a knee OA grading system applicable for both MRI and dry bone femora samples (Clinical Archaeological Osteoarthritis Score) a link between clinical and archaeological populations was proposed. Using this link to infer functional deficits onto archaeological populations using population health frameworks, a theoretical analysis was performed with two populations; the 17th century Huron and the 19th century Inuit from the Igloolik region of Nunavut. The results demonstrated the increased impairment potential of knee OA in the Inuit population versus the Huron population, produced by contrasting factors captured by the determinants of health, including social and physical environments.

There are unequivocal health disparities, both physical and mental, between the Indigenous and non-Indigenous peoples of Canada. Utilizing narrative inquiry, a qualitative methodology, 15 néhiyawak (Plains Cree people) between 18 and 71 years of age from Thunderchild First Nation were interviewed to explore what improved their mental health and well-being and what they needed to attain optimal mental health and well-being. The néhiyawak interviewed for this study responded with descriptions of strength and resilience. By posing questions that focused on the positive, the strengths, and resilience of the néhiyawak in this study came to the forefront. Narrative thematic analysis of the interviews conducted with the néhiyawak from Thunderchild First Nation consistently revealed four overarching themes that highlighted what positively impacted their mental health and well-being and their perceived needs to attain optimal mental health and well-being: relationships; spiritual beliefs and cultural practices; tānisīsi wāpahtaman pimātisiwin (worldview); and ēkwa ōhi kikwaya piko ka-ispayiki kīspin ka-nohtē-miyo-mahcihoyān (these are the things that need to happen if I want to be healthy). The néhiyawak in this study described holistic health determinants that could best be associated with the medicine wheel and the determinants of health as making a positive difference to their mental health and as necessary for them to obtain optimal mental health and well-being. These results suggest that mental health programming and intervention should be harmonious with Indigenous culture; utilize a holistic approach that takes physical, emotional, mental, and spiritual well-being into consideration; and address the existing mental health disparities using the determinants of health as a framework, with an increased focus on the current socio-economic status of Indigenous peoples in Canada.

There are unequivocal health disparities, both physical and mental, between the Indigenous and non-Indigenous peoples of Canada. Utilizing narrative inquiry, a qualitative methodology, 15 néhiyawak (Plains Cree people) between 18 and 71 years of age from Thunderchild First Nation were interviewed to explore what improved their mental health and well-being and what they needed to attain optimal mental health and well-being. The néhiyawak interviewed for this study responded with descriptions of strength and resilience. By posing questions that focused on the positive, the strengths, and resilience of the néhiyawak in this study came to the forefront. Narrative thematic analysis of the interviews conducted with the néhiyawak from Thunderchild First Nation consistently revealed four overarching themes that highlighted what positively impacted their mental health and well-being and their perceived needs to attain optimal mental health and well-being: relationships; spiritual beliefs and cultural practices; tānisīsi wāpahtaman pimātisiwin (worldview); and ēkwa ōhi kikwaya piko ka-ispayiki kīspin ka-nohtē-miyo-mahcihoyān (these are the things that need to happen if I want to be healthy). The néhiyawak in this study described holistic health determinants that could best be associated with the medicine wheel and the determinants of health as making a positive difference to their mental health and as necessary for them to obtain optimal mental health and well-being. These results suggest that mental health programming and intervention should be harmonious with Indigenous culture; utilize a holistic approach that takes physical, emotional, mental, and spiritual well-being into consideration; and address the existing mental health disparities using the determinants of health as a framework, with an increased focus on the current socio-economic status of Indigenous peoples in Canada.

This thesis analyses the agricultural import demand of Turkey for the period 1993-2009. The main objective of the thesis is to assess the reason for the rapid increase in imports. Turkey has a trade surplus since 1993, yet, imports have surged since 2001. In this study import demand has been analyzed descriptively i.e., the developments in foreign trade have been described by the help of available, official trade statistics. Increasing population, economic growth (income) and overvalued exchange rate are among important factors that give rise to this rapid import increase. Foreign relations, such as the World Trade Organization&rsquo / s Agreement on Agriculture (1995) and Free Trade Agreement with European Union (1997), play also an important role. Future developments of EU-Turkey relations and a new WTO Agreement (Doha) may become instrumental to convert Turkey to a net importer of agricultural products. Turkey may keep its net-exporter position also in the future by increasing her agricultural output and productivity rather than relying on protectionism.

No description available.

At present there is a reliance on behavioral interventions that have been limited in their effectiveness to reduce the public health burden of chronic disease, partly because the effects of social context on the initiation and maintenance of health behaviors is not incorporated into public health policy and practice. Yet current research indicates that there are macro-level structural and contextual influences on population health that cannot be reduced to individual or compositional effects. This study investigated the associations between social structural factors, community social context, individual characteristics, and self-reported correlates of disease. Distal influences included social structural inequalities such as income inequality and absolute deprivation or poverty. Pertinent mechanisms through which these influences might have operated on disease included social contextual factors, such as social capital. Both political economy and the ecosocial perspective were selected to inform this study and to provide the theoretical framework from which hypotheses were derived.The design was a multilevel, retrospective, nonexperimental study using secondary data. The study linked three data sources (2001 Behavioral Risk Factor Surveillance System, Social Capital Community Benchmark Study, and U.S. Census) by Federal Information Processing Standards codes in order for individuals to be placed in their community or state contexts. Results provided mixed evidence of the direct role of structural and contextual inequalities on self-rated health. Any direct effects of social structural inequalities on the health outcomes disappeared once individual factors were included in the models. Findings demonstrated that one dimension of social capital, organizational activism, retained its significant direct effect on general health status, once individual characteristics were considered. Conclusions suggested indirect associations whereby the negative influence of social structural inequalities on health was mediated by the erosion of social trust, which in turn was associated with engaging in risk behavior, thus increasing the odds of reporting hypertension, fair/poor general health, and mental distress. Although results were inconsistent, this study contributed to advancing Healthy People 2010 goals of increasing quality of life and reducing health disparities by advancing understanding of the multilevel nature of perceived health and the chronic diseases they predict.

Entre 100 et 140 millions de femmes, de petites filles et d’adolescentes sont excisées (Andro et Lesclingrand, 2007). Les risques sanitaires de l’excision sont élevés et concernent la santé reproductive, physique et psychologique des femmes. Les nouvelles migrations et l’augmentation des pays qui légifèrent l’excision ont contribué à l’internationalisation de l’excision et à la modification de son processus. On constate actuellement une tendance de l’excision à devenir une pratique clandestine et une perte de sa signification rituelle. En même temps, les mouvements de lutte internationaux, régionaux autant que nationaux prennent de l’ampleur et connaissent une période de mutation afin de contrer la nouvelle figure de l’excision. Le Burkina Faso ne fait pas exception. Le gouvernement burkinabé s’est clairement positionné en faveur du mouvement de lutte contre l’excision et met en place de nombreux dispositifs juridiques, politiques et économiques afin d’en soutenir les initiatives. En 2003, 77 % des femmes burkinabè âgées de 15 à 49 ans se déclaraient excisées. Parallèlement, on assiste à une diminution de la pratique chez leurs filles entre 1998 et 2003 et à une augmentation du nombre de Burkinabè se déclarant contre la pratique. Pourtant en 2003, environ 40 % des femmes ont excisé ou souhaitent exciser leurs filles et environ 24 % des hommes et 26 % des femmes sont encore favorables à la perpétuation de l’excision. Ce mémoire s’intéresse d’abord aux changements de pratique, de connaissance et d’attitudes par rapport à l’excision entre 1998 et 2003. Il s’intéresse ensuite aux déterminants socioculturels, démographiques et économiques favorisant la persistance de cette pratique au sein de la société burkinabé et aux obstacles rencontrés par les intervenants pour combattre l’excision sur le terrain. Pour ce faire la recherche associe méthodes quantitatives et qualitatives. Elle combine analyses statistiques des données des enquêtes démographiques de santé de 2003 et de 1998 et analyse des données d’entretiens collectées auprès d’acteurs sur le terrain entre le premier et le 10 octobre 2005. / Between 100 and 140 million women, young and teenage girls have undergone feminine genital cutting (Andro and Lesclingrand, 2007). The medical risks of excision are high and relate to the reproductive, physical and psychological health of women. New migrations and the increase of countries legislating female genital cutting contributed to the internationalization of the practice and to the changes in its process. The loss of the ritual significance of excision and the increase as a concealed practice have clearly been noticed. In the meantime, the international movements fighting it, regional as well as national, amplify and put changes together in order to counter the new figure of female genital cutting. Burkina Faso does not make exception. The Government has clearly positioned itself in favour of movements fighting excision; and has set up many legal, political and economic devices in order to support their initiatives. In 2003, 77% of Burkina Faso women aged between 15 to 49 years old were declared excised. In parallel, a reduction in the practice for their daughter between 1998 and 2003 is noted as well as an increase in the number of Burkina Faso people declaring themselves against the practice. However in 2003, approximately 40% of women have performed or would like their daughter to undergo the cut; and approximately 24% of men and 26% of women are still encouraging the perpetuation of excision. This thesis’ first concern is the changes in the practice, and the knowledge and attitudes regarding excision between 1998 and 2003. Secondly, the attention is drawn on the socio-cultural, demographic and economic determinants indulging the doggedness of this practice within Burkina Faso people and on the concrete obstacles workers encounter on the ground. Therefore this research associates quantitative and qualitative methods. It combines statistic analysis of the Demographic and Health Surveys of 2003 and 1998 data; and analyzes data collected from talks made between October 1 st and 10th, 2005 with fields’ workers.

L’utilisation continue de corticostéroïdes inhalés est reconnue pour réduire le nombre d’hospitalisations, la morbidité ainsi que les décès liés à l’asthme. Cependant, l’observance à cette médication chez les enfants asthmatiques demeure sous-optimale. Objectif : L’objectif général de ce mémoire de maîtrise est d’identifier les déterminants de l’observance aux corticostéroïdes inhalés durant les 28 jours suivant une visite médicale d’urgence en raison d’une une exacerbation d’asthme. Méthodologie : Il s’agit d’une analyse de données secondaires provenant d’un essai randomisé conduit auprès de patients se présentant dans un département d’urgence pour une exacerbation d’asthme. L’utilisation de corticostéroïdes inhalés au cours des 28 jours suivant la visite à l’urgence a été mesurée à l’aide de compteurs de doses électroniques. Résultats : Deux cent onze enfants ont été inclus dans les analyses et 76,8% étaient âgés de moins de 7 ans. L’observance moyenne au cours des 28 jours suivant la visite à l’urgence était de 62% (±29%). Les déterminants associés à une meilleure observance étaient une durée de traitement prescrite plus courte, une scolarité maternelle universitaire, une plus grande consommation de médication de soulagement rapide, une crise d’asthme plus sévère, un plus jeune âge de l’enfant et être Caucasien. Conclusion : Cette étude se distingue par le fait qu’elle inclut une large proportion d’enfants d’âge préscolaire, une population d’asthmatiques sous-représentée dans la littérature médicale malgré sa morbidité élevée. Une prescription de corticostéroïdes inhalés de courte durée s’est avérée être le meilleur prédicteur d’une bonne observance et témoigne d’une pratique en milieu hospitalier qui va à l’encontre des lignes directrices en matière de gestion de l’asthme. / Inhaled corticosteroids are recognized to prevent asthma related hospitalizations, morbidity and mortality. However, inhaled corticosteroids adherence among children with asthma remains suboptimal. Objective: This master’s thesis aimed to identify predictors of inhaled corticosteroids adherence during the 28 days following an emergency department visit. Methods: This study is a secondary analysis of data collected during a randomized control trial conducted among children presenting at an emergency department for an acute asthma exacerbation. Inhaled corticosteroids use was electronically monitored during the 28 days following the hospital discharge. Results: Two hundred and eleven children were included in the analyses and 76.8% were aged less than 7 years old. Mean adherence over the 28 days observation period was 62% (±29%). Predictors of a better adherence were: shorter prescribed duration of treatment, maternal university degree, more frequent use of rescue medication, more severe index exacerbation, younger age and Caucasian ethnicity. Conclusion: This study distinguishes itself by including a large proportion of preschool aged children, an especially vulnerable population of patients with asthma that is understudied despite its high morbidity. A short duration of treatment prescribed was the strongest predictor of inhaled corticosteroids adherence. This result highlights a medical practice that is contrary to guidelines on asthma management.

No description available.