digitalisering@umu.se

Såväl internationella som nationella styrdokument fastställer att unga personers hälsa bör främjas. Där benämns unga hbtq-personer som en prioriterad samhällsgrupp då hälsan hos denna minoritetsgrupp är sämre än genomsnittet, särskilt den psykiska hälsan. Risken för utanförskap är vanligare eftersom hbtq-personer är en stigmatiserad och marginaliserad samhällsgrupp med en ökad risk för diskriminering, hot, våld och kränkande behandling. Kulturen, samhällets normer och värderingar påverkar förutsättningarna för unga hbtq-personers hälsa. Därför syftet var att undersöka socialt utanförskap bland unga hbtq-personer i Västmanland samt att studera om socialt utanförskap kunde sättas i samband med psykisk ohälsa. För att genomföra detta har studien en deduktiv kvantitativ ansats där tvärsnittsdesign och sekundärdata från Liv & hälsa ung 2014 har använts. Studien konstaterar att det var vanligare bland unga hbtq-personer och personer som är osäkra på sin sexuella läggning eller könsidentitet, att leva i socialt utanförskap än bland heterosexuella, där bisexuella och osäkra var de som förekom oftare. Liknande resultat återfanns gällande den psykiska ohälsan där unga hbtq-personer och osäkra personer oftare hade psykisk ohälsa. Det fanns samband mellan att vara ung hbtq-person eller osäker och att leva i socialt utanförskap samt ha psykisk ohälsa. Samtidigt är unga hbtq-personer och osäkra personer mer drabbade av att leva med båda, där tycks också heterosexualitet vara en skyddsfaktor. Nyckelord; Hbtq, Psykisk ohälsa, Socialt utanförskap, Ungdomar, Västmanland. / Both international and national policy documents determine that young people's health should be prioritized. There, young lgbtq-people are referred to as a priority group, since the health of this minority group is worse than the average, especially their mental health. The risk of exclusion is greater because lgbtq-people are a stigmatized and marginalized group with an increased risk of discrimination, threats, violence and abusive treatment. Culture, society's norms and values affect the preconditions for young lgbtq-people achieving good health. Therefore, the purpose was to investigate social exclusion among young lgbtq-people in Västmanland, as well as studying if social exclusion could be associated with having mental health issues. To accomplish this, the study adopted a deductive quantitative approach where cross-sectional design and secondary data from Survey of Adolescent Life in Västmanland 2014 have been used. The study finds it more common for lqbtq-adolescents and people who are unsure about their sexuality or gender identity to live in social exclusion than among heterosexuals. It also showed that it is more frequently experienced by bisexuals and unsure people. Similar findings were found regarding mental health in which young lgbtq-people and people who are unsure about the sexual orientation, sexuality, gender identity or gender expression, more often had mental health issues. There was a correlation between being a young lgbtq-person or unsure and living in social exclusion and having mental health issues. Concurrantly lgbtq-adolescents and unsure had a greater risk of being affected by both of those, where heterosexuality can be seen as a protective factor. Key words; Adolescents, Lgbtq, Mental health issues, Social Exclusion, Västmanland.

<p>2017-05-31</p>

<p>2017-05-31</p>

No description available.

Tuberculosis (TB) has presented a challenge to the public health community in Thailand, especially as regards patient adherence to TB treatment. Direct observed treatment (DOT) is recommended for promoting patient adherence to TB treatment. There is good evidence that DOT can significantly increase the patient adherence to TB treatment. However, the implementation of DOT has complex relationships to socioeconomic factors and Thai context issues.  The overall aim was (1) to obtain a deeper understanding of what happens when the DOT is practised in a local Thai community, and (2) to generate knowledge for improving the implementation of DOT, and thereby improve patient adherence to TB treatment. The empirical data were collected in Trang province, in the southern region of Thailand, between 2013 and 2015. The sample of study I consisted of five District TB Coordinators and five TB clinic staff from the public health sectors in rural and urban areas. Phenomenographic analysis was used. Study II: Five focus group discussions were conducted with 25 village health volunteers and six family members; manifest and latent content analysis was used for the analysis. Study III: Twenty TB patients were interviewed, using grounded theory methodology. Study IV: A mixed-method systematic review was accessed through databases. Data from the selected studies were extracted and synthesized using thematic analysis.  The fear of stigma of TB patients was considered a significant barrier to the practice of DOT and adherence to TB treatment (studies I, II and III). Lack of TB knowledge and skills among DOT observers were revealed as barriers to the practice of DOT (studies I and II). At the same time, social facilitation and TB patients’ positive thinking and self-awareness were considered enablers of patient adherence to TB treatment (studies I and III). Another result is to provide an empowerment approach for DOT observers, who, in turn, will increase the empowerment of TB patients to achieve adherence to TB treatment  (study IV). This thesis contributes a deeper understanding of the perspective of healthcare providers, DOT observers and TB patients when DOT is practised in a local Thai community. A challenge from these results is to provide an empowerment approach towards DOT observers. The results of this thesis will be useful for policy-makers who will consider strategies for improving the implementation of DOT and enabling patient adherence to TB treatment in the Thai context.

No description available.

No description available.

Background: Injuries are one of the most common causes of death in the world. Varying types of injuries dominate in different parts of the world, which also have separate influences mortality. In Scandinavia blunt injuries dominates and the majority of those who die do so pre hospital. Over time different injury pattern may vary and by analyzing this we can assess when, where and how preventive work can be reinforced. The aim of this thesis was to study injury epidemiology in Sweden and assess the contribution of different injury patters on mortality. Method: We used the Swedish cause of death and the national patient registries which have a complete national coverage. ICISS was calculated (based on ICD-10) in the in hospital population. We have chosen to do this investigation with a broad perspective using the term injury, which includes trauma but also other diagnoses like suffocation and drowning. Results: During the study period (1999-2012) the number of deaths because of injury was 1213, 25 388, and 18 332 among children, working age and elderly, respectively. Mortality declined in the children and in the working age but inclined in the elderly. Mortality increased with each age group except between the ages of 15–25 and 26–35 years. One thousand two hundred sixty four (97%) of those who died because of penetrating trauma (sharp objects and firearms) were killed by intentional trauma (assault and intentional self-harm). One thousand and seventeen (83%) of the children died prehospital. In the working age 22 211 (80%) of 25 388 died pre hospital. Nine thousand six hundred and eighteen (53%) of 18 332 of the elderly died prehospital. During 2001- 2011 the risk adjusted in hospital mortality decreased in traffic and assault but not in fall related injuries. Discussion: Largely, the anticipated injury mortality picture was found, with blunt injuries (traffic accidents) dominating in the working age and falls in elderly. Further a significant portion of the deaths occurred pre hospital. The intentional injuries are dominated by intentional selfharm. The decrease in child injury mortality is notable as Sweden already has one of the lowest incidences in child injury mortality in the world. The decrease in injury mortality in the working age also implies that preventive work has had an effect. The incline in injury mortality in elderly on the other hand needs to be further studied. Areas of particular importance for future preventive work is the incline in injury mortality in elderly and intentional injuries among children.

<p>Godkänd datum 171026.</p>