HPRnews

| Health Promotion Research News | Issue 5 - September 2011 | |ISBN 978-87-91245-04-6 Printed | ISBN 978-87-91245-05-3 Electronic |

HPRnews| Sundhedsvidenskab |

| Nyt fra Sundhedsfremmeforskning | SDU Esbjerg

10-year anniversary Forskningsenheden for Sundhedsfremme

unit’s 10-year anniversary issue of hpr news 10-års jubilæumsudgave af hpr news

Editorial no1 by Arja R Aro, Editor-in-Chief

his issue of the HPR NEWS celebrates the 10 years of work and existence of the Public

Health study programmes and the Unit for Health Promotion Research, SDU, Esbjerg. The issue highlights some central features of the study programmes. From the research side the issue lifts up the most central research themes of the Unit and gives essential information and links to the present research projects. Further, the issue provides information about our collaboration in research, teaching and consulting. This time we give room and visibility to our technical and administrative staff members, who provide essential services to the researchers, teachers and students, and whose work is seldom credited.

I want to express my warmest thanks to all Unit staff members, university administration and colleagues, collaborators on the municipal, regional, national and international levels, as well as to external funders, but also to all our students, who have challenged us, given us motivation and helped us to make our 10 years successful.

enne udgave af HPR News fejrer 10 års arbejde og beståen af uddannelserne i

Folkesundhedsvidenskab og Forskningsenheden for Sundhedsfremme, SDU Esbjerg. I nyhedsbrevet er centrale højdepunkter fra uddannelserne samt centrale forskningstemaer i enheden blevet fremhævet. Der er oplysninger og links til nuværende forskningsprojekter. Yderligere oplyser nyhedsbrevet om vores samarbejde i forskning, undervisning og konsulentarbejde. I dette nummer er der givet plads og synlighed til vores teknisk- og administrativt personale, som yder en uundværligt assistance til forskerne, underviserne og de studerende. Min taknemmelighed går til mine medarbejdere i enheden, universitetsadministrationen og kollegaer, nationale og internationale samarbejdspartnere, eksterne bidragsydere samt til alle vores studerende, som har udfordret, motiveret og hjulpet os til at gøre vores 10 års jubilæum til en succes.

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health promotion in esbjerg - a gem in the west

Editorial no2 by Jesper Bo Nielsen, Head, Institute of Public Health, SDU

n the occasion of the 10-year anniversary of the Unit for Health Promotion Research and the study programme in public health.

In 2001 a dean with a vision and an enterprising professor with a mission began to establish a Unit for Health Promotion Research and a study programme in public health. At that time the term health promotion was unknown to most in the country, and people may ask why we use that term instead of just public health like they do at other universities. The reason is that there is a distinction between public health and health promotion – a difference that makes us special.

Health promotion represents a focused and process-oriented approach - a comprehensive social and political process not only embracing actions directed at strengthening the skills and capabilities of individuals, but also actions directed towards changing social, environmental and economic conditions, so as to alleviate their impact on public and individual health. Health promotion is the process of enabling people to increase control over the determinants of health and thereby improve their health. Public health is a broader concept aimed at improving health, prolonging life and improving the quality of life among whole populations based on health promotion, disease prevention and other forms of health intervention. Thus, health promotion is about making changes that work, on a structural level as well as on group or individual levels.

We have a very strong and dedicated group of researchers, administrative staff and students that have not only “survived” for ten years, but have managed to develop a strong research profile on health promotion and place themselves in the frontline of evidence-informed health promotion internationally. They have continuously been able to attract substantial funding from EU. They have developed the only international master programme in public health in Denmark that continuously attracts many Danish as well as foreign students. They have been pioneers in establishing close collaborations with local municipalities, not only based on shorter student projects, but also longer term collaborations with joint funding of research positions.

The staff has changed over the years, as would be expected in a vital and dynamic research and educational environment, but we have through the years always had a scientifically strong team eager to interact with the surrounding society and eager to educate the best Danish candidates in health promotion. To this day more than 200 bachelors and more than 100 candidates have graduated from our study programme. The vast majority of these candidates have been able to find work in research, public administration, private

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companies or patient organisations. As a university, we can be proud that our candidates and our junior staff are very attractive to organisations in Denmark and abroad.

On the occasion of this 10-year anniversary, I believe that the vision from ten years ago is still valid, and that we have the staff and the means to move on. The Institute of Public Health will be looking forward to continuing our close collaboration on research as well as education during the next decade.

sundhedsfremme i esbjerg- en juvel på vestkysten

I anledningen af 10-års jubilæum for Forskningsenheden for Sundhedsfremme og uddannelsen i Folkesundhedsvidenskab

Syddansk Universitet har i 10 år kunne bryste sig af at have en forskningsenhed og en uddannelse i Folkesundhedsvidenskab, som skiller sig ud fra øvrige universiteter ved at lægge vægt på sundhedsfremme. Sundhedsfremme er en procesorienteret tilgang, som omfavner ikke kun sociale og politiske tiltag rettet mod at styrke individers færdigheder og evner, men også tiltag rettet mod strukturelle ændringer i de sociale, miljømæssige og økonomiske forhold til gavn for individ og samfund.

Enheden har skabt en stærk profil udadtil inden for forskning i sundhedsfremme og internationalt udmærket os inden for evidensbaseret sundhedsfremmende beslutningstagning. Enheden har været i stand til at tiltrække betydelige forskningsmidler fra EU, udvikle en international kandidatuddannelse i Folkesundhedsvidenskab, som tiltrækker både danske og udenlandske studerende og derudover skabt et tæt samarbejde med nærliggende kommuner i form af sammenfinansierede forskerstillinger. Vi har uddannet over 200 bachelorer og over 100 kandidater i Folkesundhedsvidenskab, som er eftertragtet både af forskningsinstitutioner, offentlig administration, private virksomheder og patientorganisationer både indenlands og udenlands.

I anledningen af dette 10-års jubilæum, tror jeg på, at visionen fra 10 år siden stadig er gældende og at vi har arbejdskraften og midlerne til at fortsætte. Institut for Sundhedstjenesteforskning ser frem til at fortsætte vores forskningssamarbejde såvel som uddannelse det næste årti.

content 10-års jubilæumsudgivelse 10-year anniversary issue of HPR News

2 Editorial no 1: Unit’s 10 year anniversary issue of HPR News 10-års jubilæumsudgave af HPR News

3 Editorial no 2: Health promotion in Esbjerg – a gem in the west Sundhedsfremme i Esbjerg – en juvel på vestkysten

6 Tribute to TAP-technical and administrative staff Anerkendelse til TAP – teknisk og administrativt personale

12 10 years of public health teaching in Esbjerg

16 Current research areas of the Unit

23 International health promotion work

25 Enheden som en del af Institutet for Sundhedstjenesteforskning

28 Ph.D. News PhD Nyheder

32 Other news Andre nyheder

HPRnews issue 5, September 2011

Front page photo Esbjerg, August 2011 by Bettina Gundolf Abstracts by Mette Winge Fredsgaard, Maja Larsen, Stella RJ Kræmer and many more

Tryk: Print & Sign, Syddansk Universitet Odense

Editor-in-chief Arja R. Aro

araro@health.sdu.dk

Managing Editor Stella RJ Kræmer

skraemer@health.sdu.dk

HPR News is the ‘voice’ of the Unit of Health Promotion, NOT of the SDU as a whole. HPR News udtrykker meninger fra Enheden for Sundhedsfremme, IKKE SDU som

helhed.

tribute to tap-technical and administrative staff anerkendelse til tap – teknisk og administrativt personalby Arja R Aro, Editor-in-Chief

otivated and qualified staff is a pre-requisite for high level research work as

well as teaching. In this issue we pay tribute to those colleagues who in their positions build and maintain the very necessary basis for scientific and teaching tasks: secretaries and research and student assistants. In the academic world scientific staff often gets all the credits with their visibility, publications, lectures, and research grants. In this issue the secretary of the Unit for Health Promotion Research, Bettina Gundolf writes about her 10 years of experience; the two study secretaries Janne Krogh and Linda Fritze Madsen paint a profile of their work in the day-to-day running the BSc and MSc in Public Health study programme. Further, junior researcher Christina Mischorr Boch and student assistant Anders Fournaise tell their personal development story related to combination of studies and research work in the Unit.

otiverede og kvalificerede medarbejdere er en absolut forudsætning for et højt

niveau af forskningsarbejde samt undervisning. I denne udgave vil vi specielt lægge vægt på de kollegaer, som i deres arbejdsrolle varetager og vedligeholder de meget nødvendige videnskabelige- og undervisningsopgaver: sekretærerne og studentermedhjælperne. I den akademiske verden får de videnskabelige medarbejdere ofte hele æren ved deres synlighed, publikationer, foredrag samt forskningslegater. I denne jubilæumsudgave skriver enhedssekretær Bettina Gundolf, Forskningsenheden for Sundhedsfremme om hendes 10 års erfaring, de to studiesekretærer Janne Krogh og Linda Fritze Madsen giver et billede af deres daglige arbejdsdag med bachelor- og kandidatuddannelserne i Folkesundhedsvidenskab. Tillige vil vores junior forsker, Christina Mischorr-Boch og studentermedhjælper Anders Vestergaard Fournaise berette om deres personlige udvikling relateret til kombinationen af uddannelses- og forskningsarbejdet i Enheden.

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Bettina – 10 years of experience as Unit Secretary by Bettina Gundolf

ooking back at my 10 years as the unit secretary in this very multi-cultural unit so many nice memories come to me. I started my job as the unit secretary on 1 June 2001 with 1 professor (Dutch), 1 associate

professor (Dane) and 1 PhD student (Dane). Now we are almost 20 staff members including junior and senior staff members. Before that I had worked only in the private sector as a language secretary (Danish, English, Spanish and German) translation, teaching, sales assistant, so this was a totally new challenge within the university world. I had worked in Germany at a bilingual NATO headquarters which gave me some advantages as to working with different nationalities using English as the business language as well as understanding the professional confidentiality.

Since the beginning in 2001 the Unit has grown a lot with so many inspiring colleagues and it has been very exciting to follow and to meet, greet and sometimes wish the best of luck and good bye to new and old staff members from all over the world – Denmark, Slovakia, Estonia, the Netherlands, Germany, UK, US, Finland, Poland, Ghana, India, Sudan, Cameroon and Romania.

Even though it has been a very international work environment with busy staff members travelling a lot to conferences and meetings all over the world, we have always managed to keep a ‘hyggelige’ and relaxed Danish atmosphere with outings to different parts of Denmark – even once to Finland in a colleague’s summer house. Birthday cakes and other delicious multi-ethnic dishes have been served during working hours, lunch breaks, Christmas dinners and at private events of the staff members including the families. The close student environment of this small campus in Esbjerg has also invited young and bright students to work as student assistants – leading to promising PhD students in the unit and other exciting job careers.

My role as the secretary of the unit is first of all to provide service to the researchers in their daily work, travel and hotel arrangements, office supplies, contact to the institute and faculty secretaries and other administrative staff in the other campuses of SDU, answer the phones and emails, arrange meetings, conferences, social events, keep records of personnel issues, contracts, invoicing, website maintenance, translations, assist in projects, contact with the rest of Esbjerg Campus, work environment representative and many other challenging tasks. It has also been very important to be able to deal with the different cultures when arriving to Denmark and to help in settling in a town like Esbjerg.

The professional atmosphere and high level of work ethic and the combination of the warm and friendly personal atmosphere makes the work environment very pleasant. All this has paid tribute to my daily work as the unit secretary and made it a never boring and at times very challenging place to be in. I am looking forward to at least another decade in this exciting unit with all my friendly, cheerful and wonderful colleagues.

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Billedet på den foregående side er en illustration af Bettinas 10 år omgivet af forskning, undervisning, glædelige begivenheder og sociale arrangementer.

Studiesekretariatet for Folkesundhedsvidenskab - Hvem er vi og hvad laver vi? by Janne Krogh and Linda Fritze Madsen

vis du jævnligt har din gang på Syddansk Universitet (SDU) i Esbjerg i forbindelse med uddannelsen i Folkesundhedsvidenskab (FSV), hvad enten du er studerende, underviser eller ekstern

samarbejdspartner, har du helt sikkert mødt studiesekretariatets medarbejdere eller SUND-pigerne, som en af vores søde pedeller kalder os. Hvis du ikke allerede kender os, vil vi gerne benytte lejligheden til at give dig en præsentation.

Vi hedder Janne Krogh og Linda Fritze Madsen, er studiesekretærer på bachelor- og kandidatuddannelsen i FSV og er ansvarlige for de fleste studieadministrative opgaver på de to uddannelser. Vi er en del af Uddannelse & Kvalitet under det Sundhedsvidenskabelige Fakultetssekretariat, som er placeret i Winsløwparken i Odense. Det faktum at vores leder og nærmeste kolleger er placeret i Odense, giver os en del udfordringer i dagligdagen, men samtidig med at det fordrer selvstændighed, giver det os også en høj grad af selvbestemmelse, som vi har valgt at betragte som et gode. Vi har dog en god kontakt til vores kolleger, bl.a. i kraft af at vi er en del af et team som mødes et par gange i løbet af semestret. Desuden er der også etableret netværk for bl.a. studienævnssekretærer, hvor vi kan sparre med vores kolleger og holde os ajourført med nye tiltag.

Vores kontor er placeret ved Forskningsenheden for Sundhedsfremme, hvor studieledelsen og en række forskere som underviser på uddannelsen hører til og som vi dagligt har en del samarbejde med.

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bettina, 10 års erfaring som sekretær for enheden for sundhedsfremme

Jeg har været enhedssekretær siden starten i 2001 og det har været et spændende årti, hvor afdelingen er vokset fra fire ansatte til næsten tyve kollegaer fra hele verden. Denne sammensætning af mange nationaliteter har gjort min hverdag meget anderledes og udfordrende, da det kræver noget mere indsats med andre kulturer og vaner. Jeg hjælper med at få hverdagen i enhedens administration til at fungere: Bestilling af flyrejser, hotel, sociale arrangementer, indkøb, personalesager, fakturering, hjemmesider, oversættelser, arbejdsmiljørepræsentant, kontakt til Esbjerg Campus og instituttet i Odense og mange flere ad hoc opgaver. Den professionelle atmosfære og den høje grad af arbejdsmoral kombineret med et varmt og venligt miljø kollegaerne imellem har givet mig et dejligt indhold i mit arbejdsliv og jeg glæder mig meget til at fortsætte i enheden som sekretær det næste årti.

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Vi beskæftiger os med alt lige fra studiestarten til dimissionen som den afsluttende begivenhed på uddannelsen. Derfor har vi opnået en bred viden om uddannelsens mange facetter og kan svare på de fleste spørgsmål i forbindelse med uddannelsen. Vi har hver vores ansvarsområde, som vi er eksperter på, men kan selvfølgelig supplere hinanden i forbindelse med ferier og kurser.

Efterhånden som vi har fået mere erfaring, har vi opnået en større forståelse for de studerendes behov. Derfor gør vi meget ud af at opdatere uddannelsens hjemmeside og lægge diverse informationer på vores interne e-læringssystem, så de studerende hele tiden kan følge med i, hvad der foregår.

Som noget helt nyt har vi fået lavet en Facebook-side (Folkesundhedsvidenskab ved Syddansk Universitet) med nyheder om uddannelsen og forskning indenfor sundhed, sundhedsfremme og forebyggelse. Siden er allerede blevet en succes. I løbet af få uger har 489 personer tilkendegivet, at de ’synes godt om’ vores side. Det er vores håb at siden kan være medvirkende til at udbrede kendskabet til folkesundhedsvidenskab og ikke mindst tiltrække nye studerende til især vores bacheloruddannelse.

Campus Esbjerg er et lille sted, hvilket giver mulighed for en tæt kontakt studerende og personale imellem. Det ligger os meget på sinde at vores studerende får en god oplevelse, når de henvender sig til os. Derfor forsøger vi altid at modtage alle med et smil på vores kontor og at give os tid til at svare på spørgsmål og vejlede. Forhåbentlig lykkes det.

Studierelevant arbejde, kompetencer og karrierevalg by Christina Mischorr-Boch and Anders Fournaise

olkesundhedsvidenskabelige kandidaters kvalifikationer efter endt uddannelse favner bredt og en entydig positionering eller titel i et fremtidigt arbejde er uklar. Dette stiller store krav til den studerende

om at være målrettet og bevidst om egne interesser tidligt i studiet. For at understøtte dette engagement er forskere og undervisere ved Forskningsenheden for Sundhedsfremme i deres kontakt med de studerende opmærksomme på at inddrage de studerende i deres forskning og projekter. Dette har været med til at etablere et unikt forhold imellem studerende og undervisere - et forhold som både nuværende og tidligere studerende beskriver som yderst væsentligt for deres uddannelse.

Christina Mischorr-Boch og Anders Fournaise drog tidligt fordel af mulighederne i Esbjerg, hvilket har hjulpet dem begge til en målrettet uddannelses- og karriereplan. De blev begge tidligt i deres studie ansat som studentermedhjælpere i forskningsenheden - et arbejde hvor de begge oplevede stort ansvar, og hvor

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the study secretariat

The study secretaries of the bachelor and master of science in public health programmes, Janne Krogh and Linda Fritze Madsen, are responsible for numerous administrative tasks in connection with the students’ study period.

The secretaries have gained a lot of experience over the years and are both making an effort of putting themselves in the students’ place and trying to assist students in every way they possibly can with a smile and a friendly, positive attitude.

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medinddragelse og engagement var en del af hverdagen. Arbejdsopgaver der spændte lige fra databearbejdning til koordinering af projektopgaver.

Christina startede kandidatuddannelsen med en baggrund som sygeplejerske. Hendes mål med uddannelsen var at kvalificere sig til at undervise professionsbachelorer. Hendes tilknytning til forskningsenheden har i mellemtiden betydet, at hendes målsætning har ændret sig, og Christinas mål er i dag at fortsætte sin ansættelse på projektet ”Public Health Genomics European Network II” i en ph.d.-stilling. Christina er i øjeblikket ved at udforme sin ph.d.-beskrivelse samtidig med, at hun hjælper med koordinering af kandidatuddannelsens brobygningskursus for professionsbachelorer og udenlandske studerende.

”Studiet samt arbejdet i enheden har udstyret mig med gode forudsætninger for og et ønske om at udfordre mig selv fagligt - et ph.d. studie er et naturligt næste skridt.”

Anders begyndte i 2006 på bacheloruddannelsen. Han fandt hurtigt sin hylde og begyndte at interessere sig for sundhedsøkonomi og ledelse indenfor sygehusvæsenet. Hans arbejde på FøSu projektet ”How to individualise vitamin K- antagonist treatment”, vækkede yderligere Anders´ interesse for forskning. Han håber nu at kunne fortsætte i et ph.d.-studie, hvor han kan kombinere sin interesse for forskning, sundhedsøkonomi og ledelse.

”Forskningsenheden for Sundhedsfremme har været af stor betydning for min uddannelse. Den åbenlyse tillid, gensidige respekt og vilje til at vejlede har i høj grad været med til at inspirere mig og sætte mine mål.”

Begge studerende er eksempler på, hvordan målrettethed kan resultere i et studierelevant arbejde som kan have stor betydning for uddannelse såvel som kompetencetilegnelse. Forskningsenheden for Sundhedsfremme sætter en stor ære i at bistå, involvere og guide studerende og studentermedhjælpere i deres uddannelse - en proces som fremtidigt også vil være en del af enhedens udviklingsstrategi.

juniors stepping on to their careers

Candidates with a Master of Science in Public Health from the University of Southern Denmark possess a wide variety of qualifications enabling to address several different positions in their future working life. However specialisation is an important part of the study and students are early on encouraged to find and address their own area of interest. The Unit for Health Promotion plays a crucial role in students successfully achieving focus and awareness of their interest. This article describes the unique relationship between students and researchers which is a result of intentionally recognising the responsibility of guiding and supporting students. In the article two student assistants describe what working in the Unite of Health Promotion has done for both their studies and future career plans.

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10 years of public health teaching in esbjerg

Studying public health at SDU: Using international perspectives for solving local health problems by Christiane Stock, Jens-Jørgen Jensen, Pernille Tanggaard Andersen

ver the last 10 years, the public health programmes in Esbjerg have undergone different revisions and extensions in profiles. However, the main characteristics of the programmes remained the same over

the years with a strong international perspective combined with a focus on approaches to health promotion in local settings, an emphasis set on policy and socio-political determinants of health and the teaching largely based on student centred teaching methods. The SDU public health programmes aim at utilising international knowledge and global thinking for developing solutions for public health problems on all levels local, national and international.

“Public health is the science and art of preventing disease, prolong life and promote health through organised efforts of society”. This definition of public health has been widely adopted by the World Health Organisation, but had its origin in report on public health in England from 1988. When starting up public health programmes at SDU in 2001 our aim was to plan, implement and develop a teaching programme that produces graduates that have the skills in science and art to establish the practical co-operations needed to fulfil this task. Evelyne de Leeuw coming from Maastricht University, an institution with a public health programme with high recognition and known as a university entirely building on problem-based learning as teaching method, was the first head of studies and developer of the public health bachelor and master programmes. With employing her to develop the public health programmes and the attached Unit for Health Promotion Research it was made sure that the programme would be updated to the most recent trends in public health education. The main characteristics of the programme were clear-cut: The public health programmes will have a strong international perspective combined with a focus on approaches to health promotion in local settings, there will be an emphasis set on policy and socio-political determinants of health and the teaching will be based largely on PBL and other student centred teaching methods.

Although both the Bachelor of Science (BSc) programme as well as the Master of Science (MSc) programme have undergone major revisions since the first curricula were set up, the main characteristics remained. We are still unique in the way we are providing internationalisation of studies on different levels. There is a strong focus on international and global health issues in our programmes, the teaching staff reflects internationality, the research in the Unit for Health Promotion Research as the basis of our teaching is to a large extent on international level, the student composition is colourful and the possibilities to study abroad are very good. Besides this, the focus is on socio-political determinants of health and policy approaches remained and we still put a strong emphasis on student-centred teaching methods. One may ask critically whether the SDU programmes might be too international and too policy oriented to produce graduates that have the competencies and skills to solve public health problems that may occur on local

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level. Actually our experience is that the opposite is true. We have focused our teaching on theory and methods of community health. In addition, we have built up an increasingly well functioning network of internship placements, which enable our students to experience public health practice during studies. Students are able to do internships in private or public organisations/companies in Denmark or abroad. The intention of the internship opportunities is to promote students’ professional functioning and acquisition of relevant skill and knowledge to prepare them for professional practice.

Many of our graduates find jobs in health planning departments of municipalities and other local agencies and we receive positive feedback from them about the practical applicability of knowledge and skills from our public health programme. We are in close exchange with our graduates through our external advisory board (aftagerpanel), through surveys that are conducted among graduates (dimittendundersøgelsen), and through personal contacts. In the survey graduates were asked whether they have acquired competencies in different areas through our programmes. The vast majority (75%) stated that they received practically applicable knowledge in the field of public health while the other 25% stated that this was only to a smaller extent true and no one stated not having received practically useful competencies. Therefore we are confident that we are on the right track in making international knowledge and global thinking relevant to finding solutions for public health problems on all levels, local, national and international.

Besides bridging between international and local level we are also unique in bridging between professional bachelor and public health bachelor level as entry requirement for the MSc programme. We are the only university in Denmark that admits professional bachelors to a MSc in public health programme after having completed the bridging course in epidemiology and biostatistics. We have attempted to bridge between different entry qualifications, while also offering three different specialisation options. The low drop out, the high percentage completing the programme in the expected time as well as the high employability of the graduates from our programme suggests that diversity in individual careers within the health sector is not only a highly demanded option for students, but also meets a need of the Danish labour market.

history facts

2001 First bachelor cohort started with

2004 First master cohort started with two options for specialisation (“health promotion” and “health economics and management”)

2006 Revision of the bachelor programme and implementation of the quarter system

2008 New entry requirements for the bachelor programme and sharp decline in applicants

2009 Revision of the master programme and implementation of the quarter system

2010 New specialisation in “global health” opened

2011 10-year anniversary

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Folkesundhedsvidenskab på Esbjerg campus– Teaching across faculty boundaries by Jens-Jørgen Jensen

elt fra den første planlægningsfase blev det ny studium udviklet i samarbejde med de eksisterende undervisnings- og forskningsaktiviteter på Esbjerg campus. En helt særlig rolle spillede

Forskningsenheden for tromboseforskning, hvor professor Jørgen Jespersen havde arbejdet for udbygning af den sundhedsvidenskabelige forskning i Esbjerg lige siden afdelingens oprettelse og integration med det tidligere Sydjysk universitetscenter. Relevant for den ny Folkesundhedsvidenskab var også den arbejdsmiljøforskning som stadig foregår ved Center for Maritim Sundhed og Sikkerhed (CMSS) med Jørgen Riis Jepsen som nuværende forskningsleder.

Sundhedsvidenskab er ganske vist ’ejer’ af studiet, men det er blevet udbudt ”i samarbejde med samfundsvidenskab”, hvor daværende samfundsvidenskabelige dekan Tage Koed Madsen og senere hans afløser Bjarne Graabech Sørensen har bakket det ny studium kraftigt op. Den lokale og tværfakultære tilgang viste sig tydeligt i sammensætningen af den lille arbejdsgruppe, der skulle koordinere planlægningsarbejdet. Foruden sundhedsdekan Mogens Hørder og SDU’s daværende udviklingschef, Erik Knudsen, kom arbejdsgruppen til at bestå af Tromboseafdelingens leder Jørgen Jespersen og Jens-Jørgen Jensen, daværende samfundsvidenskabelig prodekan.

Fagligt samarbejde med andre fagområder er en nødvendighed for Folkesundhedsvidenskab, ikke mindst når fokus som i Esbjerg studiets tilfælde ligger på sundhedsfremme. Samarbejdet med samfundsvidenskab har ytret sig ved, at en række af de videnskabelige medarbejdere på Institut for miljøøkonomi (IME)har bidraget til uddannelsen. Uden IME medarbejdernes indsats ville det ikke have været muligt at udbyde en kvalificeret og forskningsbaseret undervisning i bl.a. så centrale fag som organisation, projektledelse, evaluering og samfundsvidenskabelige metoder. Tilsvarende har videnskabelige medarbejdere fra Afdelingen for tromboseforskning haft ansvaret for undervisning i fag ”krop og sundhed” og anden biomedicinske undervisning, som også må være en central del af studiet i Folkesundhedsvidenskab.

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at studere folkesundhed på sdu: brug af internationale perspektiver til at løse lokale sundhedsproblemer

Gennem de sidste 10 år har der løbende været en videreudvikling af uddannelsesprogrammet indenfor Folkesundhedsvidenskab på Syddansk Universitet i Esbjerg. Uddannelsen i Folkesundhedsvidenskab er dog karakteriseret ved en gennemgående profil, med fokus dels på det internationale perspektiv og en stærk tilknytning til det regionale og lokale sundhedsområde. Denne profil betyder bl.a. en særlig vægtning af policy og omgivelses determinanter, når det drejer sig om folkesundhed og sundhedsfremme. Et andet gennemgående karakteristika er, at undervisning forsøger at engagere de studerende via gruppearbejde, projektarbejde og præsentationer sideløbende med forelæsningerne.

Folkesundhedsvidenskab på Syddansk Universitet ser det som sit højeste mål at videreformidle international viden og global tænkning for at udvikle og formidle løsninger på folkesundhedsproblemer lokalt, nationalt og internationalt.

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Samarbejdet startede naturligvis på bachelorstudiet, hvor der i dag også sker en regulær samlæsning af visse fag, bl.a. offentlig forvaltning, med studierne i Miljøplanlægning samt den nye uddannelse i Sociologi og Kulturanalyse. Men med udbygningen af kandidatstudiet er samarbejdet også blevet udbygget her, ikke mindst fordi det samfundsvidenskabelige udbud af kandidatkurser i stigende grad er blevet engelsksproget.

Uddannelsen i Folkesundhedsvidenskab blev planlagt i nært samarbejde med, hvad der foregik på Esbjerg campus i øvrigt. Den faglige bredde, som studiet forudsætter, kunne ikke og kan ikke fastholdes på et universitet uden de vigtige bidrag fra den øvrige campus. Forhåbentligt vil de positive vekselvirkninger blive udviklet yderligere i fremtiden. Potentialet i et samarbejde med fag som erhvervsøkonomi, organisation, sociologi, interkulturel kommunikation/turisme, arbejdsmiljøforskning og tromboseforskning er stort og bydes herfra velkomment.

public health and the sdu-esbjerg campus

From the very beginning the public health programme at the SDU campus in Esbjerg has been planned and developed in close collaboration with other research units and departments at the Esbjerg campus. Thus, the Unit for Thrombosis Research and the Centre of Maritime Health and Safety, parts of the former University Centre of Southern Jutland, have supported the new activities from their start. A major role has been played by the management and staff at the social science faculty, and lecturers from the Department of Environmental and Business Economics are now responsible for a wide range of courses in the programme like organisation, public administration, project management, evaluation and research methods. Without this commitment from the other research units at the SDU- Esbjerg it would not have been possible to provide research based teaching covering as broad a spectrum of subjects as required for a modern programme in the fields of public health and health promotion. A continuation of this cooperation will be decisive for the future development of the public health programme at SDU-Esbjerg, too.

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current research areas of the unit

Evidence-informed health promotion research by Arja R Aro, Gabriel Gulis, Maja Larsen, Christina Mischorr-Boch, Stella Kræmer and Mette Fredsgaard

ne of the over-arching themes in the research and other work of the Unit for Health Promotion Research is evidence-informed health promotion. We prefer to use the term evidence-informed

instead of evidence-based. The justification for this is to highlight the fact that we aim to base the interventions, including policy development, on best available evidence; however, in the everyday practice and policy making as well as in politics, decisions are made so that also other priorities and values as research evidence are respected and taken into account. These other priorities can be e.g. economic resources of a municipality or needs and interests of sectors beyond the health sector.

What university researchers can do in evidence-informed health promotion is to provide the scientific knowledge in finding out what needs to be done to improve health of the citizens and communities. Municipality level health profiles can be used as a basis for this. However, health profiles as such are seldom enough. Decision makers need to know how to apply the knowledge these profiles provide in their settings e.g. in choosing and planning cost-effective interventions and feasible and sustainable policies, implementing and evaluating interventions. Into this academics can bring methodological know-how and guidance. The basic principle is that the researchers cannot and should not impose their know-how and perspectives. Evidence-informed collaboration happens on equal terms between academics, practitioners and policy makers.

Projects & products The Unit for Health Promotion Research has been a pioneer in Denmark in its systematic approach in the evidence-informed health promotion. The unit was involved in 2003-2005 in the Getting Evidence into Health Promotion (GEP) EC-funded project; it also produced the contents for the two National Board of Health booklets on the issues http://www.sst.dk/Publ/Publ2007/CFF/Evidens_forebyggelse/Evid_Health_Prom_jan2008.pdf

To apply the partnership approach in the evidence transfer theme, the Unit pioneered co-financed three year long PhD collaboration on the local level with Varde (see PhD project Maja Larsen www.sdu.dk/Om_SDU/Institutter_centre/Ist_sundhedstjenesteforsk/Forskning/Forskningsenheder/Sundhedsfremme/Ph,-d-,d,-d-,-projekter/Maja%20Larsen.aspx) and a post doc position with Esbjerg municipality, both 2009-2011. Those interested can read in Ugeskrift for Læger a report on this experience (Larsen et al, Gode erfaringer med brobygning mellem forskning og praksis i folkesundhed Ugeskr Læger 2011;173(25):1792-1794).

To develop further the evidence-informed health promotion work the Unit initiated and launched EIRA network (Evidence Into Research and Action, www.sdu.dk/eira) in 2009.This work was kindly supported by

O

http://www.sst.dk/Publ/Publ2007/CFF/Evidens_forebyggelse/Evid_Health_Prom_jan2008.pdfhttp://www.sdu.dk/Om_SDU/Institutter_centre/Ist_sundhedstjenesteforsk/Forskning/Forskningsenheder/Sundhedsfremme/Ph,-d-,d,-d-,-projekter/Maja%20Larsen.aspxhttp://www.sdu.dk/Om_SDU/Institutter_centre/Ist_sundhedstjenesteforsk/Forskning/Forskningsenheder/Sundhedsfremme/Ph,-d-,d,-d-,-projekter/Maja%20Larsen.aspxhttp://www.sdu.dk/eira

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SDU Rector. The work carried fruit rather soon when we received a network grant from the Danish Research Council for Innovation and Technology to build collaboration with a research group led by Bonnie Spring of Northwestern University in Chicago. Bonnie Spring leads a successful web-based programme on evidence-based behaviour change (www.ebbp.org ).

New EC funded REPOPA project But we also got a ‘bigger fish’ when the unit was successful in obtaining a major EC FP7 grant of three million euro August this year. This REPOPA project (Research Into Policy to enhance Physical Activity), which starts officially 1 October 2011, is a five year research project with nine institutes in six EU countries and Canada (Ottawa University). SDU and The Unit for Health Promotion Research (Arja R Aro) is the REPOPA coordinator, and other Danish institutes involved are IOB (Institute of Idræt and Biomekanik) from SDU and Region Hovedstaden/ Research Centre for Prevention and Health, Glostrup Hospital). Other European countries and institutes involved are Finland (National Institute of Welfare and Health), the Netherlands (Tilburg University), Italy (National Research Council), Romania (Babes-Bolyai University) and UK (Herefordshire Primary Care Trust).

The aim of the REPOPA project is to integrate scientific research knowledge (=evidence), expert know-how and real world policy making processes in the area of physical activity to increase synergy and sustainability in promoting health and preventing disease among Europeans. The project will build on evidence and experiences, study innovative win-win ways to collaborate between academia and policy makers, and establish structures and best practices. The sub-projects (work packages) aim to 1) assess needs, role and use of research evidence in policy making; 2) study ways research evidence is combined and negotiated with ‘other kind of evidence’ in cross-sector policy making process; 3) develop and carry out two interventions to explore innovative ways to translate research evidence into policy making process; 4) translate the results into guidance and tools; 5) to disseminate the results and lessons learned; 6) evaluate the research process and results but also the impact of the whole REPOPA enterprise.

Contact information: REPOPA Coordinator Arja R Aro (araro@health.sdu.dk) and Project Secretary Mette Winge Fredsgaard (mfredsgaard@health.sdu.dk); www.repopa.eu

HIA and HiAP –Health impact assessment and Health in All Policies The Unit has been active both in research including EC-funded projects and in training Danish decision maker in the area of health impact assessment and also in the health in all policies approach, which was launched during the Finnish EU presidency. The Health in All Policies approach (HiAP) and health impact assessment (HIA) as one of key instruments of HiAP widen the field for evidence transfer from health sector to other sectors of society. By default they target other than health sectors and their policies adding one more level to evidence transfer from research to practice and policy. On other hand they provide an opportunity to work inter-sectorally and cross- disciplinary. Research evidence produced by properly designed epidemiological studies is transferred within impact assessment to different audience, often not familiar with health issues; this poses public health research and HiAP + HIA practitioners to new tasks with important role of communication. The Ph.D. project “Science based guidance for identification of relevant governmental policies to be screened for possible health impacts” by Stella RJ Kræmer is on how to utilise

http://www.ebbp.org/mailto:araro@health.sdu.dkmailto:mfredsgaard@health.sdu.dkhttp://www.repopa.eu/

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HIA on a national level in Denmark to enable HiAP. See more at: http://www.sdu.dk/Om_SDU/Institutter_centre/Ist_sundhedstjenesteforsk/Forskning/Forskningsenheder/Sundhedsfremme/Ph,-d-,d,-d-,-projekter/Stella+Rebecca+Jonsdatter+Kræmer.

The Unit has provided HIA training to six Danish municipalities and consulted with others; in addition a Sundhedsstyrelsen brochure on HIA was written by Unit staff contributing to increased interest for and use of HIA on municipal level. Please see project website for more information at www.sdu.dk/rapid.

Contact information: RAPID Project Coordinator Gabriel Gulis (ggulis@health.sdu.dk) and RAPID Project Manager Stella RJ Kræmer at skraemer@health.sdu.dk.

Public Health Genomics European Network II PHGEN aims to develop policies for the quality assurance, provision and use of genome-based knowledge and technologies in Public Health Genomics. The project is a follow-up of PHGEN (2006-2008), which like PHGEN II, was funded by DG SANCO. The main task of PHGEN II is to adapt existing guidance to the needs of public health genomics and to gather new evidence where gaps are detected. The interdisciplinary task builds on the existing evidence and guidance coming out of other EU-funded projects, international, national and regional guidance. The Unit is included in the USE work package. The specific aim of the work package is to develop best practice guidance for the use of genome-based information and technologies. The term “use” is defined as a domain where participants address the demand of patients and customers, all aspects related to ELSI (ethical, legal, and social issues) research, the health literacy of lay persons and the involvement of stakeholders. The emphasis lies on the responsible application of genome-based information and technologies in order to ensure equity and solidarity in genomics. More information: http://www.phgen.eu/typo3/index.php

Contact information: Christina Mischorr-Boch (cmischorr@health.sdu.dk) and Arja R Aro (araro@health.sdu.dk)

evidens - informeret sundhedsfremme

Et af de overordnede temaer i Forskningsenheden for Sundhedsfremmes arbejde er evidens- informeret sundhedsfremme. Vi tilstræber at basere interventioner, herunder udvikling af politikker, på den bedst tilgængelige viden, men anerkender samtidig, at der i den daglige praksis og politikudformning også er andre prioriteter og værdier, som må tages i betragtning. Vi arbejder tæt sammen med praksis for i højere grad at få forskning implementeret i praksis og omvendt tage højde for praksisforhold i planlægning og udførelse af forskning. Vi har flere forskellige nationale og internationale projekter gennemført eller i gang indenfor dette forskningstema.

Et af vores større projekter, som enheden er koordinator for er det 5-årige EC FP7 finansieret REPOPA projekt (Research Into POlicy to enhance Physical Activity), som officielt starter d. 1. oktober 2011. Både danske og udenlandske partnere er involveret. Af danske partnere indgår SDU Institut for Idræt og Biomekanik, Region Hovedstadens Forskningscenter for Forebyggelse og Sundhed. Formålet med projektet er at integrere den forskningsbaserede viden (=evidens), ekspert know-how i de praktiske politiske processer inden for området fysisk aktivitet til at øge synergien og bæredygtigheden i at udøve sundhedsfremme og forebygge sygdomme i Europa.

Øvrige projekter inkluderer blandt andet folkesundheds genomik (PHGEN).

http://www.sdu.dk/Om_SDU/Institutter_centre/Ist_sundhedstjenesteforsk/Forskning/Forskningsenheder/Sundhedsfremme/Ph,-d-,d,-d-,-projekter/Stella+Rebecca+Jonsdatter+Kræmerhttp://www.sdu.dk/Om_SDU/Institutter_centre/Ist_sundhedstjenesteforsk/Forskning/Forskningsenheder/Sundhedsfremme/Ph,-d-,d,-d-,-projekter/Stella+Rebecca+Jonsdatter+Kræmerhttp://www.sdu.dk/rapidmailto:ggulis@health.sdu.dkmailto:skraemer@health.sdu.dkhttp://www.phgen.eu/typo3/index.phpmailto:cmischorr@health.sdu.dkmailto:%20(araro@health.sdu.dkmailto:%20(araro@health.sdu.dk

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Forskning i social ulighed i sundhed by Pernille Tanggaard Andersen, Christiane Stock, Delia Bancila and Gabriele Berg-Beckhoff

egrebet social ulighed i sundhed beskriver det faktum, at sundhedsrisici og sygdomme er socialt skævt fordelt i samfundet. Det medfører, at jo dårligere borgerne er stillet socialt set, jo højere sygelighed og

dødelighed har de statistisk set. Den sociale ulighed i sundhed kommer til udtryk på to måder:

1) Som en gradvis ulighed i den brede befolkning også kaldet den sociale gradient i sundhed. Det betyder, at udsatheden for sundhedsrisici og sygdom i befolkningen stiger gradvis i takt med, at den sociale position falder. Der er forskellige faktorer som har betydning for den sociale gradient i sundhed eksempelvis uddannelseslængde, indkomst, beskæftigelsesforhold og boligforhold.

2) Som ulighed i forhold til de særligt udsatte grupper som fx socialt udsatte borgere. Her gælder at udsathed for sundhedsrisici og sygdom er markant højere end for nogle andre befolkningsgrupper.

Forskningsenheden for sundhedsfremme beskæftiger sig med problematikken om social ulighed i sundhed indenfor to projekter:

FELIS –projektet FELIS (Flerstrengede evidensbaserede lokale indsatser for sundhedsfremme 2008-2014) er et forskningsprojekt der udspringer af et tæt samarbejde med flere kommuner i Region Syddanmark omkring gennemførelse af målrettede og evidensbaserede sundhedsfremme indsatser i udsatte nærmiljøer i kommunerne, eksempelvis bestemte boligområder eller bydele. Den overordnede målsætning for projektet er at bidrage med at udvikle, dokumentere og evaluere sundhedsfremme indsatser i udsatte nærmiljøer. Metoder er kombinationsdesign med udarbejdelse af lokale kvantitative sundhedsprofiler, dybdegående kvalitative interviews og metoder til involvering af beboere.

Bevillingshavere er Trygfonden og Det Kommunale Momsfond. Samarbejdende kommuner har bl.a. været Fredericia, Esbjerg og Langeland kommuner. Samarbejder med Sundhedsstyrelsen og NIRAS omkring Satspulje til: Forebyggelsesindsatser i Nærmiljøet og med forskere på Roskilde Universitet. FELIS -projektet har bl.a. udarbejdet en forskningsrapport for Sundhedsstyrelsen om anvendelse af lokale sundhedsprofiler i udsatte områder (2011), som er en grundrapport for de 12 deltagende udsatte nærmiljøer. http://www.sdu.dk/Om_SDU/Institutter_centre/Ist_sundhedstjenesteforsk/Forskning/Forskningsenheder/Sundhedsfremme/Forskningsprojekter/FELIS+projektet/Publikationer+og+links.

Et eksempel på denne forskning er relationen mellem ledighed og sociale ydelser og hospitalsindlæggelser i Esbjerg hvor der analyseres på data fra mere end 100.000 mennesker.

Kontakt information: Projektlederne Pernille T. Andersen (ptandersen@health.sdu.dk) og Carsten Kronborg Bak (cakr@sam.sdu.dk.), se mere på www.sdu.dk/FELIS.

Does social deprivation exist in Denmark (2008-2011)? Deprivation i et område er signifikant forbundet med en befolknings helbred. En bestemt regions, nabolags eller kommunes ”sociale status” og ressourceniveau har en effekt på indbyggernes helbred, som overstiger og rækker ud over den enkeltes helbredsadfærd. Den hypotese er blevet fremsat, at socialt dårligt stillede områder har en dårlig social og materiel infrastruktur, som fx en ringe kvalitet og mængde af fritidsfaciliteter, transport, boligbyggeri såvel som ringere primære og sekundære sundhedstilbud. Desuden

B

http://www.sdu.dk/Om_SDU/Institutter_centre/Ist_sundhedstjenesteforsk/Forskning/Forskningsenheder/Sundhedsfremme/Forskningsprojekter/FELIS+projektet/Publikationer+og+linkshttp://www.sdu.dk/Om_SDU/Institutter_centre/Ist_sundhedstjenesteforsk/Forskning/Forskningsenheder/Sundhedsfremme/Forskningsprojekter/FELIS+projektet/Publikationer+og+linksmailto:ptandersen@health.sdu.dkmailto:cakr@sam.sdu.dkhttp://www.sdu.dk/FELIS

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kan koncentreret deprivation underminere samfundsengagementet og øge kriminaliteten. Disse træk kan påvirke helbredet direkte eller indirekte ved at påvirke livsstil og adfærd. Dette forskningsoplæg har således to formål: 1) At forsøge at finde ud af, om relativ deprivation findes, og hvad effekten af den er i Danmark, og at udvikle egnede mål for deprivation, som specielt retter sig mod en dansk sammenhæng. Dette vil ske ved hjælp af landsdækkende registerdata for alle dødsårsager og for sygdomsspecifikke dødsårsager og med de indikatorer for deprivation, som er tilgængelige på sogneniveau. 2) At gennemføre en multi-level undersøgelse af hvordan faktorer på nabolagsniveau berører den individuelle helbredsadfærd hos danske skolebørn i 7. klasse.

Geographic Information Systems (GIS) bruges som metode, som tillader analyse af geografiske variable og giver gode muligheder for at linke til aggregerede socioøkonomiske data med hidtil uset spatial præcision. Analysen af spatial variation i sygdom og repræsentationen heraf på et kort er et vigtig emne inden for epidemiologien. Et af hovedformålene med kortlægning af sygdomme er at teste hypotesen om at sygdomstilfælde optræder tilfældigt inden for den undersøgte region. Heterogenitet i sygdomsrisiko er en vigtig overvejelse (dvs. at der eksisterer forskellige niveauer af risiko i den undersøgte region, som skyldes geografisk variation af ukendte/ikke observerede faktorer). Til dette formål er hierarkiske eller multi-level modeller bedst, idet de tillader strukturel variabilitet mellem arealer. Bevillingshavere er Forskningsradet and Helsefonden og samarbejdende kommende har bl.a. været Kraeftens Bekaempelse, Statens Institut for Folkesunded og Charité Berlin.

Kontakt information: Projektlederne Christiane Stock (cstock@health.sdu.dk ) og Kim Bloomfield (Center for Rusmiddelforskning, Aarhus Universitet). http://www.sdu.dk/Om_SDU/Institutter_centre/Ist_sundhedstjenesteforsk/Forskning/Forskningsenheder/Sundhedsfremme/Forskningsprojekter/Does+relative+deprivation+exist+in+Denmark

social inequality in health

The purpose of the FELIS-project is to investigate and evaluate which types of local, social and health related interventions that may eventually help reduce social inequality in health. The target group of the FELIS-project includes residents in deprived communities. Two main findings from FELIS: 1) In a deprived neighbourhood no association between ethnicity and self-rated health was observed, while number of life resources (e.g. living with others, education beyond primary school) was found to be significant predictor of self-rated health. 2) In a deprived neighbourhood perceived stress was found to be unequally distributed among people in disadvantaged conditions. Stress levels were higher in groups characterised by unemployment, economic deprivation, history of sick leave, being single and being lonely.

An example of ongoing research in the area is a sub-study on the association of unemployment and social aid with hospitalisation in Esbjerg. This is a register-based study on over 100 000 people and studies first inpatient hospital admission.

The social deprivation research project combines data on mortality and morbidity from the Danish Cancer Society and data on the health behaviour of adolescents from the National Institute of Public Health with registry data from Statistics Denmark and other sources to study whether area-level deprivation explains differences in mortality, cancer morbidity and health behaviours in the Danish population. Individual level health data of large datasets are combined with area-level data on social and physical factors of neighbourhoods. Geographic information system techniques are used to define and describe neighbourhoods. We apply multi-level statistics to analyse the data of individuals nested in neighbourhoods.

mailto:cstock@health.sdu.dkhttp://www.sdu.dk/Om_SDU/Institutter_centre/Ist_sundhedstjenesteforsk/Forskning/Forskningsenheder/Sundhedsfremme/Forskningsprojekter/Does+relative+deprivation+exist+in+Denmarkhttp://www.sdu.dk/Om_SDU/Institutter_centre/Ist_sundhedstjenesteforsk/Forskning/Forskningsenheder/Sundhedsfremme/Forskningsprojekter/Does+relative+deprivation+exist+in+Denmark

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Risk research by Anja Leppin, Gabriele Berg-Beckhoff and Gabriel Gulis

“Forecasting is difficult, particularly when it concerns the future” his somewhat quaint complaint, attributed to Niels Bohr and Mark Twain alike, is certainly shared by many among the public health scientists and professionals as well as policy makers involved in

assessing, managing and communicating health risks. Health risk issues arise in a wide variety of fields: From a community council committee, which has to assess the potential health impact of a new chemical plant, to the National Board of Health, which has to plan countermeasures against an emerging new pandemic flu virus and develop communication strategies to inform a worried public, to medical professionals and health educators who need to tell patients about the health risks of being overweight or having a genetic disposition for breast cancer or Alzheimer’s, to public health officials and politicians facing questions by the local community about possible health risks created by the erection of new mobile phone stations or power wind mills.

But why do these tasks so often turn into challenges? A major problem is that there tends to be considerable disagreement about what is “risky”. Based on different cultural worldviews different groups of the public hold different views about what is a “risk”. Also, lay people and experts tend to diverge in their perceptions of risk. For lay people it is often new and relatively unknown technologies which are associated with a particularly high threat potential, whereas experts, thinking in terms of mortality rates, consider life style factors, such as unhealthy eating, not exercising or car speeding as more relevant risks – behaviours which most lay people experience as normal parts of their daily lives and which do not trigger any specific alarm signals. Not uncommonly though, even experts do not agree about the extent of risk posed by some health hazards. Resulting contradictory messages transported by the media then further contribute to confuse the public while policy makers and administrators face the challenge of integrating expert and public opinions when assessing and managing the health impact of their policies.

Despite some progress in recent years there still is a lack of tools and methods allowing for a quick assessment of health risks related to policies and strategies as well as a lack of effective methods and tools to communicate with different groups of the public about health risks. Research in the area of health risk assessment and lay risk perception and risk communication is therefore high on the agenda of the Unit for Health Promotion Research. Examples are the development and pilot testing of risk assessment methods which facilitate the evaluation of health impacts of policies for administrators and policy makers or research on risk perception and communication in areas such as pandemic influenza, but also chronic disease and technological risks, such as mobile phone magnetic fields.

New teaching module on risk communication The Unit aims at providing special qualifications within the area of risk assessment and management to our Masters of Science of Public Health. Currently we already offer modules on health risk impact assessment and on risk communication. Future plans include the development of a whole master-level specialisation track on risk management and communication.

Risk assessment from policy to impact dimension – RAPID project The “Risk Assessment from Policy to Impact Dimension – RAPID” project (www.sdu.dk/rapid) set an ambitious aim; to develop and test a methodology for policy risk assessment. The idea of the project grew

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http://www.sdu.dk/rapid

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up from the previous HIA-NMAC project conducted also within Community Action Plan for public health of EC during 2005-2007. While running case study HIA’s on different policy issues the project group realised that our methodological toolbox to conduct risk assessment of policies across range of determinants of health is rather week. The project team, a group of 12 partners from 11 countries supported by WHO EURO Rome office as collaborating partner aims to

• Develop a policy risk assessment capacity database • In two sets of case studies develop a methodology for so-called “full chain risk assessment”

(policy-determinants of health influenced by policy- risk factors influenced by determinants – health effect) employing two approaches o from policy to health effect – top-down approach o from health effect to policy – bottom-up approach

• after summarising the developed methodologies implementation should be done by two activities o case study application of developed methodology on a EU policy (to be selected in

discussion with European Commission, DG SANCO and EAHC) o conduct of national workshops

To ensure maximum of generalisability of results across different policy areas and different contexts project partners are free to choose their preferred subject for assessment, however, they have to comply with a pre-developed template (first task to be done parallel with database development). As of risk assessment, the project groups aims to discuss all elements of risk management, e.g. risk perception, risk assessment, risk communication and risk management itself.

Contact information: Risk perception and communication research: Anja Leppin (aleppin@health.sdu.dk); RAPID project: Coordinator Gabriel Gulis (ggulis@health.sdu.dk) and Project Manager Stella RJ Kræmer (skraemer@health.sdu.dk).

risiko forskning

Hvorfor er der ofte sådanne massive og konfliktfyldte udfordringer i at vurdere og formidle om de moderne livs risici? En afgørende årsag til dette problem er, at forskellige mennesker har forskellige forestillinger om, hvad en ‘risiko’ er. Befolkning tilskriver for eksempel ofte ukontrollerbare teknologier som atomenergi eller genetisk modificerede fødevare en højere risiko. Eksperter på den anden side, er uddannet i at tænke i dødelighedsstatistikker, og derfor associerer ofte risiko som værende individuel livsstil, såsom rygning, spisevaner og fedme. At udvikle redskaber og metoder til at vurdere sundhedskonsekvenserne og risici associeret med bestemte politikker samt at udvikle og teste effektive strategier til at formidle risici er derfor et højtprioriteret forskningsområde hos Enheden for Sundhedsfremme.

mailto:aleppin@health.sdu.dkmailto:ggulis@health.sdu.dkmailto:skraemer@health.sdu.dk

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international health promotion work

What do the following countries have in common? by Gabriel Gulis

Australia, Korea, Kazakhstan, Romania, Bulgaria, Slovak Republic, Slovenia, Hungary, Poland, Lithuania, Germany, Italy, Spain, Sweden, Finland, the Netherlands, France, Belgium, Austria, Norway, Malta, Turkey, UK, Canada, USA

he answer is simple: institutions from enlisted countries became research partners of the Unit for health promotion research of SDU in Esbjerg during last 10 years. Capacity building for public health,

behavioural health, impact and risk assessment, public health genomics and research-policy-practice are the main subjects of extensive research collaboration developed in form of international collaborative projects and networks.

Such a network provides an excellent background for global health training which in turn brings new partners, new opportunities for research. Countries like Sudan and Cameroon were among the first providing PhD themes and students. Within Master of Science programme students coming from other African countries (Nigeria, Uganda, Rwanda, Kenya, Ghana, and Ethiopia) and Asian countries (Iran, Afghanistan, India, and Nepal) further enhance the truly global environment at the Unit.

At the beginning of the programme in Esbjerg there was an aim to develop an international programme and make the “local” Esbjerg campus a real global campus. The first step, having a global network is completed, yet the challenge is still ahead and welcomed.

Having students from many countries, running international research projects and managing networks is not all of the activities on field of international public health and health promotion. The Unit is an institutional member of the International Union for Health Promotion and Education; staff members are on editorial boards of international peer reviewed journals such as International Health Promotion, Translational Behavioural Medicine, Public Health Genomics and other public health journals; they serve as external experts for World Health Organisation and are reviewers for different scientific journals as well as for two directorates of the European Commission (Research DG and Public health and consumer protection DG) and several international research councils and funding agents.

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globalt samarbejde

Gennem de sidste 10 år har forskningsenheden for sundhedsfremme på SDU i Esbjerg etableret forskningssamarbejde med institutioner fra over 25 forskellige lande. Et sådant forskningsnetværk giver en glimrende baggrund for undervisning i global sundhed, som så til gengæld bringer nye forskningspartnere og nye muligheder for forskning. Enheden har fx haft ph.d. projekter i Sudan og Cameroun, og på kandidatuddannelse er der studerende fra andre afrikanske lande (Nigeria, Uganda, Rwanda, Kenya, Ghana og Etiopien) og asiatiske lande (Iran, Afghanistan, Indien og Nepal). Disse forskningsprojekter og studerende styrker det global miljø i enheden.

Enheden er medlem af Den Internationale Union for Sundhedsfremme og Uddannelse. Ansatte i enheden er medlem af redaktioner og fungerer som reviewere på internationale tidsskrifter omhandlende sundhedsfremme, adfærdsmedicin, folkesundheds genomik. Ansatte i enheden fungerer også som eksterne eksperter for verdenssundhedsorganisationen WHO såvel som for to direktorater i Europa Kommissionen, internationale forskningsråd samt kommissioner.

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enheden som en del af Institutet for Sundhedstjenesteforskning

Institut for Sundhedstjenesteforskning (IST) nstitut for Sundhedstjenesteforskning (www.sdu.dk/IST) består af 11 forskningsenheder dækkende en meget bred vifte af videnskabelige områder og med en helt enestående bred faglighed repræsenteret.

Vores styrke er analyser af sygelighed og sundhed i forhold til såvel patient, befolkning, som samfund. Det gør vi under anvendelse af registerforskning, aldringsforskning, studier af lægemidler og andre fremmedstoffers effekter, undersøgelser på grænsefladen mellem borger, patient, og behandlingssystem, samt analyser af resurseallokering, kvalitetssikring og interventionsstrategier.

Almen Praksis orskningsenheden er samarbejde mellem SDU og Forskningsenheden for Almen Praksis i Odense, som er finansieret af Forskningsfonden for almen praksis. Forskningen fokuserer primært på kroniske

sygdomme, Astma og KOL, risikokommunikation, kræftrehabilitering, tidlige symptomer i befolkningen og forskning i kvalitetsudvikling i almen praksis. Det nationale kvalitetsudviklingsprojekt Audit Projekt Odense er en del af Forskningsenhedens aktiviteter. Enhedens medarbejdere underviser på en række sundhedsfaglige uddannelser ved SDU og er ansvarlige for forskningstræningen i forbindelse med speciallægeuddannelsen i almen medicin. Region Syddanmark har placeret praksiskonsulentordning og kvalitetsudviklingskonsulenter i tilknytning til Forskningsenheden. I huset findes desuden Dansk Almen Medicinsk Database under DAK-E og en værkstedspraksis (lægehus).

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Biostatistik orskningsenheden for Biostatistik er aktivt involveret i en række forskningsaktiviteter ved det Sundhedsvidenskabelige Fakultet og ved Odense Universitetshospital. Vi underviser ligeledes i en række

kurser på de sundhedsvidenskabelige uddannelser og tilbyder statistikvejledning for forskere indenfor det medicinsk videnskablige område på SDU.

Tromboseforskning nhedens vision er gennem forskning, uddannelse (bachelor- og kandidatuddannelse ved folkesundhedsvidenskab og lægevidenskab) og formidling at opnå de bedst mulige

sundhedsfremmende foranstaltninger og viden herom til forebyggelse og behandling af blodprop- og åreforkalkningssygdomme, dvs. hjertekarsygdomme.

Epidemiologi enneskets udvikling og aldring er det overordnede tema for forskningen ved Epidemiologi. Hvorfor ældes vi forskelligt, og hvad karakteriserer dem, som lever længe med godt helbred? Det

undersøger vi bl.a. ved hjælp af Det Danske Tvillingregister, og studier af fødselsårgangene 1895, 1905, 1910 og 1915 med tilhørende biobanker.

Helbred, Menneske og Samfund (HMS) HMS er forskningen baseret på interviews og deltager-observation og har fokus på bl.a. patienter, pårørende og personale i relation til kræft, KOL og depression med henblik på så forskellige aspekter som

rehabilitering, telemedicin, medicinbrug. Enheden rummer fem fastansatte forskere og godt 20 i eksternt finansierede stillinger.

Center for Maritim Sikkerhed og Sundhed ennem forskning har centret siden 1992 bidraget til at forbedre den arbejdsmæssige sundhed og sikkerhed indenfor det maritime erhvervsområde, herunder reduceringen af ulykker og forbedret

lægehjælp for personer der arbejder på søen. Udfordringerne omfatter sundhedsfaktorer relateret til livsstil, kultur, blandede besætningsmedlemmer samt psykosociale forhold om bord. Miljømedicin

en miljømedicinske forskningsgruppe stiller spørgsmål om omgivelsernes påvirkning af vores sundhed. I hvilken grad bør man kontrollere de skadelige eksponeringer? I hvilken grad kan man selv mindske

sin udsættelse for farlige stoffer? Hvordan undgår vi negative påvirkninger på langt sigt som følge af udsættelser tidligt i udviklingen. Enheden forestår laboratoriemålinger til forskningen samt undervisning.

Klinisk Farmakologi linisk farmakologi er et lægeligt speciale, som på et videnskabeligt grundlag kombinerer medicinsk, farmakologisk, epidemiologisk og sundhedsøkonomisk ekspertise med henblik på at fremme en

rationel, sikker og økonomisk anvendelse af lægemidler. Klinisk Farmakologi yder rådgivning og vejledning om alle forhold vedrørende anvendelse af lægemidler indenfor alle områder af sundhedsvæsenet. Klinisk Farmakologi i Odense er organiseret som et samarbejde mellem Forskningsenheden for Klinisk Farmakologi, IST, SDU og Klinisk Farmakologi ved Afdeling for Klinisk Biokemi & Farmakologi, OUH

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Sundhedsøkonomi orskningsenheden er specialiseret i sundhedsøkonomiske analyse. Forskningen er bl.a. fokuseret på virkningen af økonomiske styringsformer, afdækning af præferencer, produktionsoptimering og

metoder til at værdisætte sundhed eller øget levetid. Desuden forskes i organisatoriske forhold, ledelse og implementeringsprocesser i sundhedsvæsenet. Blandt forskningsområderne er adfærdsmæssig økonomi i relation til helbred, kvalitet i sundhedsvæsenet, kvantitative metoder i sundhedsøkonomi, sundhedstjenesteforskning, økonomisk organisation og incitamenter. Forskningen er på internationalt niveau og retter sig mod udvikling af teori og metode samt afprøvning i konkrete projekter typisk i samarbejde med personer i sundhedsvæsenet.

Center for Anvendt Sundhedstjenesteforskning og Teknologivurdering (CAST) AST gennemfører forskningsbaserede projekter, udredninger og analyser inden for sundhedsøkonomi, MTV og sundhedstjenesteforskning generelt i samarbejde med offentlige og private partnere.

Forskningsprofil er emne- og metodemæssigt karakteriseret ved sundhedsøkonomiske evalueringer, herunder registerbaserede analyser, sundhedsøkonomisk modellering samt analyser inden for lægemiddelområdet ; organisatoriske og kvalitative analyser; en stærk profil både nationalt og internationalt inden for medicinsk teknologivurdering (MTV) . CASTs drift er baseret på finansiering fra eksterne samarbejdspartnere.

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phd news Peter’s great day

eter Kuwoh defended his thesis 4th of July 2011 on Environmental exposure and public health impacts of poor clinical waste treatment and disposal in Cameroon.

This PhD thesis summarised the processes of collection, segregation, transportation, treatment and disposal of clinical waste in Cameroon. Emphasis was on environmental exposure and public health impacts which might result from poor treatment and disposal processes. Additionally, hospital workers’ awareness of health and environmental impacts of poor clinical waste management was investigated. Through the collaboration with some local stakeholders, evidenced-based recommendations were adopted for a prospective clinical waste management policy for Cameroon.

The study found significant flaws relating to collection, segregation, transportation, treatment and disposal of clinical waste in Cameroon. For example, collection containers were not appropriately distinct in any way, and they were sometimes broken and overloaded. Segregation was weak and ineffective and transportation was done by waste pickers with complete disregard for safety. The waste is openly dumped at the rear of hospitals and in some cases; it is incinerated in sub-standard systems with design, operational and maintenance deficiencies. These deficiencies restrict the systems from attaining the 99.99% or higher destruction and removal efficiency that is characteristic of modern day incinerators.

Most of the hospital workers had a basic understanding of effective clinical waste management, including its health and environmental impacts. Risk ratios for respiratory, intestinal and skin infections among children living within the vicinity of a clinical waste treatment and disposal location was 3.54 (95% CI, 2.19-5.73), 3.20 (95% CI, 1.34-7.60) and 1.35 (95% CI, 0.75-2.44) respectively. These results should be interpreted carefully as a study with larger sample size and enhanced study design will be needed to more definitively investigate these preliminary results.

Bottom ash from three clinical waste incinerators contained high amounts of selected heavy metals; especially lead (Pb), which was 230 mg/kg in one of the incinerators. Ash samples from an open fire pit and an engineered incinerator were found to be heavily polluted with organic compounds; especially polycyclic aromatic hydrocarbons (PAHs), whose total toxic equivalent quantity exceeded guideline levels for soil. This means that, the practice of adding bottom ash from these sub-standard incineration systems to farmlands

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should be discouraged as it can lead to incremental build-up of the compounds in the soil and in the food chain. Such a build-up can account for unacceptable exposures and contamination of humans and wildlife.

Evidenced-based recommendations centred on the necessity to harness and strengthen a strong political and economic will towards the development and implementation of a robust policy on efficient clinical waste management in Cameroon.

Supervisors were Gabriel Gulis (principal supervisor) and Morten Sodemann; Committee chair was Philippe Grandjean, IST/ Environmental Medicine; and Committee members were Fabrizio Bianchi, National Research Council of Italy and Peter Furu, WHO.

See more at: http://www.sdu.dk/Om_SDU/Institutter_centre/Ist_sundhedstjenesteforsk/Forskning/Forskningsenheder/Sundhedsfremme/Ph,-d-,d,-d-,-projekter/Peter+I,-d-,+K,-d-,+Mochungong

Field report: PhD project on cervical cancer in Khartoum, Sudan by Ahmed Ibrahim

y PhD project is coming to its end very soon. The last three years I have gathered data and worked on report writing on the topic: Cervical cancer, feasibility and acceptability of visual inspection

screening methods in primary health care setting in Khartoum State, Sudan.

Why this topic and why Khartoum: Cervical cancer is the third most common cancer in women globally. In Sudan cervical cancer was ranked as second cancer among women with burden of age-standardised incidence 15 per 100,000 and age-standardised mortality 25 per 100,000. I am Sudanese, have worked there as public health physician in Ministry of Health and have learned what is really needed is develop of National Cancer prevention programme which will include a national cancer registry and screening programme for cervical cancer and other prevalent cancer in the country.

At the moment I’m working in Saudi Arabia in position of public health physician in infection control department, while I’m finalising my PhD work. After I have finished my PhD my plan is return to Sudan and to disseminate the knowledge and experience that obtained from Denmark and contributes to development of national cancer control and prevention programme, cancer registry and cancer research projects.

What is visual inspection and why not Pap smear test for screening: Visual inspection with use of acetic acid has emerged as promising screening method alternative to cytology-based methods. This test is easy, cost-effective and fitting to deprived countries. VIA is based on the premise that the majority of pre-invasive and invasive cervical lesions are visible on examination by naked–eye after application of acetic acid. In my PhD project I study risk factors and feasibility of visual inspection as an alternative to cytology and compare it to Pap smear in primary health care setting in Sudan. The study is a prospective study of asymptomatic women from December 2009 to April 2010. In a pilot study 100 women were screened and

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the main finding is that VIA test was positive in 16% of screened women. Main risk factors for women with positive VIA test were cervical tear, episiotomy and female genital mutilation. In the final study 934 women were screened. VIA detected more positive women than Pap smear (7.6 % versus 5.1%; p=0.004). Colposcopy and biopsy of all positive women confirmed that 88/119 (73.9%) were positive for intraepithelial cervical neoplasia (CIN). VIA had higher sensitivity than Pap smear (60.2% versus 47.2%; p=0.05) respectively. One of the PhD papers, the pilot study Cervical cancer risk factors and feasibility of VIA screening method in Khartoum State in Sudan, has been published; second paper: Predictors of advanced diagnosis of cervical cancer in Sudan is under revision and the third papers is prepared which is titled: Cervical cancer screening in primary health care setting in Sudan: a comparative study of visual inspection with acetic acid and fourth paper is under preparation and tiled: Health Professional’s Knowledge and Practice of Cervical Cancer Screening in Sudan. The principal supervisor is Professor Arja R Aro and co-supervisors are Professor Eero Pukkala from Finnish Cancer Registry, Finland and Associated Professor Vibeke Rasch from Copenhagen University, Denmark.

See more at:

http://www.sdu.dk/Om_SDU/Institutter_centre/Ist_sundhedstjenesteforsk/Forskning/Forskningsenheder/Sundhedsfremme/Ph,-d-,d,-d-,-projekter/Ahmed+Ibrahim

Our managing editor Stella reporting from Down-Under by Stella RJ Kræmer

octoral students in the Institute of Public Health of the University of Southern Denmark are encouraged, though not obligated during their doctoral training to spend time in another research

institution. It is in this regard that I travelled to Griffith University in Brisbane, Australia. Since my arrival, I have been attached to the School of Public Health as a Short-term Visiting Scholar and my tenure will expire in January 2012.

First of all I cannot help at telling that even though I travelled from a Danish summer the 2nd of July, this Queensland winter is absolutely fantastic. Secondly, I am very excited about this opportunity, and enjoy that I am allowed to work here for a while. My current office is shared with 5 wonderful people from all over the world and there is a lot of help available for those who need it. Griffith University is divided into 5

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campuses the same way the University of Southern Denmark is, and in this respect it is very much like home. The largest distance between campuses is 2 hours by public transportation so very manageable.

While I am here I am attending courses in e.g. Academic Skills and Grant Writing. I am also privileged to tutor and teach the Master level class of Social and Behavioural Determinants of Health. This has a special interest for me as am doing the same in Denmark, and this allows me to get a new perspective on how to do that.

I am in the data collection part of my PhD titled “Science based guidance for identification of relevant governmental policies to be screened for possible health impacts”. Said more plainly; my work is focused on a method to enable politicians to make healthier decisions, and I am gathering knowledge on the views of politicians as well as practitioners on this matter. Health Impact Assessment (HIA) as a tool and as a concept has been used for more than 10 years in some countries, but in Denmark it is mainly within the last few years that Municipalities have started to implement HIA. The concept of HIA is based on the following values: Democracy, Equity, Sustainable development, and Ethical use of evidence. Due to the nature of being based on values that will change from one target group to another target group, there are no current standardised tools or procedures. This is where my research comes in, I am aiming to develop and test a way to make tools that can be used in many different situations and still be specific enough to adhere to local values.

I further plan to do interviews with HIA practitioners and Decision Makers, to get an insight from them on how they perceive my research problem and how they envision a solution. This will give me a perspective that I most likely would not have gotten through literature search alone, and a perspective that will be good to have before I approach my Danish target group.

See more at:

http://www.sdu.dk/Om_SDU/Institutter_centre/Ist_sundhedstjenesteforsk/Forskning/Forskningsenheder/Sundhedsfremme/Ph,-d-,d,-d-,-projekter/Stella+Rebecca+Jonsdatter+Kræmer

http://www.sdu.dk/Om_SDU/Institutter_centre/Ist_sundhedstjenesteforsk/Forskning/Forskningsenheder/Sundhedsfremme/Ph,-d-,d,-d-,-projekter/Stella+Rebecca+Jonsdatter+Kræmerhttp://www.sdu.dk/Om_SDU/Institutter_centre/Ist_sundhedstjenesteforsk/Forskning/Forskningsenheder/Sundhedsfremme/Ph,-d-,d,-d-,-projekter/Stella+Rebecca+Jonsdatter+Kræmer

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other news Opening of the new Center for Sikkerhed og Risiko /Danish Centre for Risk And Safety Management (RISK)

ISK er et nyt center der bliver åbnet d.23. september 2011 på Esbjerg campus. RISK er et samarbejde mellem begge byens universiteter, Aalborg Universitet (AAU) Esbjerg og Syddansk Universitet (SDU)

Esbjerg. Professor Lars Damkilde (AAU) er centerleder for RISK. Centeret kan starte takket være en donation på 5 million kroner af Claus Sørensens Fond. Planen er at man kan begynde at tage studerende ind før opstart af en ny RISK udannelse i 2013. Samarbejdet mellem de to universiteter er meget velkomment og kan styrke den nuværende risikouddannelse og forskning i Enheden for Sundhedsfremme, SDU, og også arbejdet i Center for Maritim Sundhed og Sikkerhed, SDU.

Unit research seminars autumn 2011 ll seminars scheduled between 11.45 and 13.00, meeting room 2. Unit for Health Promotion Research, Esbjerg, University of Southern Denmark

Niels Bohrs Vej 9, 6700 Esbjerg

Contact: cmischorr@health.sdu.dk

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A 28th of September 2011 “Policy risk assessment methodology developed within RAPID project”

Gabriel Gulis, Associate Professor, Unit for Health Promotion Research

26th of October 2011 EPH conference preparation research seminar: Oral and poster presentations

23rd of November 2011 “REPOPA: Research into Policy to enhance Physical Activity – EC funded 5year research project”

Arja R Aro, Professor of Public Health, Unit for Health Promotion Research

7th of December 2011 “Being on anticoagulant treatment: Does it imply lower quality of life?””

Anja Leppin, Professor, Unit for Health Promotion Research

mailto:cmischorr@health.sdu.dk

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næste udgave next publication The next HPR News will be circulated in ultimo December 2011. Please forward contributions to Stella at skraemer@health.sdu.dk before the 15th of November 2011.

Det næste HPR News vil blive sendt ud ultimo december 2011. Fremsend venligst indlæg til Stella på skraemer@health.sdu.dk før d. 15. november 2011

mailto:skraemer@health.sdu.dkmailto:skraemer@health.sdu.dk

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| Health Promotion Research News | Issue 5 - September 2011 | |ISBN 978-87-91245-04-6 Printed | ISBN 978-87-91245-05-3 Electronic |

Photo top of this page: Unit staff members

From left: Mette Winge Fredsgaard, Solveig Bøggild Dohrmann, Maja Larsen, Pernille Tanggaard Andersen, Marianne Vámosi, Gabriel Gulis, Janne Krogh, Delia Bancila, Arja R Aro, Christina Mischorr-

Boch, Christiane Stock, Linda Fritze Madsen, Bettina Gundolf.

Other staff members:

Gabrielle Berg-Beckhoff, Ahmed Ibrahim, Jens-Jørgen Jensen, Stella RJ Kræmer, Anja Leppin, Nagla Sahal, Mohammed Suleiman.

| Nyt fra Sundhedsfremmeforskning | SDU Esbjerg |

Editorial no1Editorial no2Bettina – 10 years of experience as Unit SecretaryStudiesekretariatet for Folkesundhedsvidenskab- Hvem er vi og hvad laver vi?Studierelevant arbejde, kompetencer og karrierevalgStudying public health at SDU: Using international perspectives for solving local health problemsFolkesundhedsvidenskab på Esbjerg campus– Teaching across faculty boundariesEvidence-informed health promotion researchProjects & productsNew EC funded REPOPA projectHIA and HiAP –Health impact assessment and Health in All PoliciesPublic Health Genomics European Network II

Forskning i social ulighed i sundhedFELIS –projektetDoes social deprivation exist in Denmark (2008-2011)?

Risk researchNew teaching module on risk communicationRisk assessment from policy to impact dimension – RAPID project

What do the following countries have in common?Institut for Sundhedstjenesteforskning (IST)Almen PraksisBiostatistikTromboseforskningEpidemiologiHelbred, Menneske og Samfund (HMS)Center for Maritim Sikkerhed og SundhedMiljømedicinKlinisk FarmakologiSundhedsøkonomiCenter for Anvendt Sundhedstjenesteforskning og Teknologivurdering (CAST)Peter’s great dayField report: PhD project on cervical cancer in Khartoum, SudanOur managing editor Stella reporting from Down-UnderOpening of the new Center for Sikkerhed og Risiko /Danish Centre for Risk And Safety Management (RISK)Unit research seminars autumn 2011