Publikationer

Research | Forskning - peer review

On 13th October 2015, Iceland quietly submitted its instrument of accession to the Antarctic Treaty to the US Department of State (the depositary for the Antarctic Treaty). Iceland’s accession was not accompanied by any official declaration or public discussion in Iceland or elsewhere. This paper in… On 13th October 2015, Iceland quietly submitted its instrument of accession to the Antarctic Treaty to the US Department of State (the depositary for the Antarctic Treaty). Iceland’s accession was not accompanied by any official declaration or public discussion in Iceland or elsewhere. This paper investigates some of the factors that are likely to have spurred the decision to join the Antarctic treaty system, examines current Icelandic interests in the Antarctic and proposes constructive policies to enhance Icelandic involvement in Antarctic governance and cooperation following the accession. The authors conclude that logistical operations and adventure tourism involving Icelandic companies in the Antarctic are the most likely triggers for the accession and they propose that Iceland consider ratification of the Protocol on Environmental Protection to the Antarctic Treaty (Madrid Protocol). Læs mere

Research | Forskning - peer review

Det problematiseres at det politiske fokus herhjemme handler om middelklassens ve og vel. Man kunne skabe mere rummelige grønlandske socialpolitkker og fokusere på det brede samfund. Et kritiske modtryk til hvad der her kaldes neokonservatisme bør skabes.

Research | Forskning - peer review

Various kinds of user and patient involvement are spreading in healthcare in most Western countries. The purpose of this study is to critically assess the actual conditions for patients’ involvement in healthcare practice in Greenland and to point to possibilities for development. Patients’ perspect… Various kinds of user and patient involvement are spreading in healthcare in most Western countries. The purpose of this study is to critically assess the actual conditions for patients’ involvement in healthcare practice in Greenland and to point to possibilities for development. Patients’ perspectives on their own conduct of everyday life with illness and their possibilities for participation when hospitalized are examined in relation to the conditions in a hospital setting dominated by biomedical practice. On a theoretical level, it is argued that the concept of ‘participation’ is preferable to the concept ‘involvement’ in healthcare. The study shows that there are several interconnected areas for development: the structural frames of hospital practice, including professionals’ possibilities for handling patient participation, and the agency of the patients conducting their everyday lives when hospitalized. Consequences of the biomedical hegemony are discussed in relation to WHO´s broader approach to disease, illness and health and the still existing postcolonial traces of power and hierarchy. Finally it is argued that patient participation during hospitalization will promote the patients´ conduct of everyday life, the cultural knowledge of the professionals, and the democratization of the healthcare sector. Such changes might be connected to a more encompassing democratic societal development – in Greenland as well as globally. Læs mere

Research | Forskning - peer review

Providing an in-depth look at the lives of women and girls in approximately 150 countries, this multivolume reference set offers readers transnational and postcolonial analysis of the many issues that are critical to the survival and success of women and girls. For millennia, women around the world… Providing an in-depth look at the lives of women and girls in approximately 150 countries, this multivolume reference set offers readers transnational and postcolonial analysis of the many issues that are critical to the survival and success of women and girls. For millennia, women around the world have shouldered the responsibility of caring for their families. But in recent decades, women have emerged as a major part of the global work force, balancing careers and family life. How did this change happen? And how are societies in developing countries responding and adapting to women's newer roles in society? This four-volume encyclopedia examine the lives of women around the world, with coverage that includes the education of girls and teens; the key roles women play in their families, careers, religions, and cultures; how issues for women intersect with colonialism, transnationalism, feminism, and established norms of power and control. Organized geographically, each volume presents detailed entries about the lives of women in particular countries. Additionally, each volume offers sidebars that spotlight topics related to women and girls in specific regions or focus on individual women's lives and contributions. Primary source documents include sections of countries' constitutions that are relevant to women and girls, United Nations resolutions and national resolutions regarding women and girls, and religious statements and proclamations about women and girls. The organization of the set enables readers to take an in-depth look at individual countries as well as to make comparisons across countries. Læs mere

Research | Forskning - peer review

Sårbarhedsundersøgelsen har identificeret, hvilke grupper i landet der ifølge en befolksningsundersøgelse, fokusgrupper , litteraturstudier og eksperter var dårligst stillede. En af samfundets vigtigste roller er at arbejde med og for dem som er identificeret som sårbare. Resultaterne skal hjælpe fo… Sårbarhedsundersøgelsen har identificeret, hvilke grupper i landet der ifølge en befolksningsundersøgelse, fokusgrupper , litteraturstudier og eksperter var dårligst stillede. En af samfundets vigtigste roller er at arbejde med og for dem som er identificeret som sårbare. Resultaterne skal hjælpe foreningen (Røde Kors) og dens afdelinger rundt om i landet (Island) med at identificere de mest presserende behov, og dermed bedre prioritere foreningens aktiviteter. Læs mere

Research | Forskning - peer review

The growing incidence of chronic diseases and an ageing population, worldwide as well as in Greenland, call for an intensified focus on health promotion and rehabilitation. However, research shows that the existing disease-oriented healthcare system is not geared to manage the psychosocial problems… The growing incidence of chronic diseases and an ageing population, worldwide as well as in Greenland, call for an intensified focus on health promotion and rehabilitation. However, research shows that the existing disease-oriented healthcare system is not geared to manage the psychosocial problems of chronically ill or disabled citizens. The problem is related to the prevailing biomedical institutional structures where expert- and professional knowledge trumps the knowledge and perspectives of the users of the institutions. Speaking about health in the broad sense of WHO, there is a need for an intensified focus on wellbeing, not only physical health. The chapter presents the visions for an ongoing research project in Sermersooq Municipality. The research aims at developing knowledge about the citizens’ everyday lives with illness or disabilities, their cultural values and perspectives. Involving this kind of knowledge in professional practice requires the professionals’ reflection on means and ends in a welfare institution like home care. Welfare-professional contributions are meant to support citizen participation in social living. Therefore, professionals must learn about citizens’ social and cultural conditions for managing their lives. Furthermore, the project aims at revealing and describing the conditions for professional practice as a contribution to the professionals’ abilities to analyze their practice. The material is developed through participant observations in the municipality and the citizens’ homes, and qualitative interviews with citizens, care personnel, therapists, and leaders on different levels. The expected outcome is a set of tools for professional practice reflection following the principles described above. Læs mere

Research | Forskning - peer review

This paper presents a case study on distance teaching in a school in Greenland. Data from work on Grounded Theory is used to investigate ways of utilizing distance teaching in the school. The analysis draws on a prevalent perspective on distance teaching as providing access to education. The perspec… This paper presents a case study on distance teaching in a school in Greenland. Data from work on Grounded Theory is used to investigate ways of utilizing distance teaching in the school. The analysis draws on a prevalent perspective on distance teaching as providing access to education. The perspective combines with Michel Foucault’s concept of “governmentality”. I will show how progressive possibilities are not necessarily to be found in ICT-driven distance teaching. Pedagogical drivers operate behind the choices of ICT equipment and ICT solutions which, in this case, brings ICT under the command of a less progressive pedagogical agenda. As I will show, the commitment from the municipality and from the teachers was to use distance teaching and ICT for conventional schooling. The case lays the ground for a discussion on the progressivity of distance teaching and the use of advanced ICT solutions in schools. My aim with the paper is to add to the understanding of the scope of distance teaching in schools. Does ICT and distance teaching serve progressive ends per se? What do we learn about distance teaching from this setup in the school in Greenland? Læs mere

Research | Forskning

The article reports some results from a study about an Everyday rehabilitation-project in Kommuneqarfik Sermersooq. Everyday rehabilitation in home care has spread rapidly in Scandinavia through the last few years and is part of a worldwide focus on ‘active ageing’ because of a growing share of peop… The article reports some results from a study about an Everyday rehabilitation-project in Kommuneqarfik Sermersooq. Everyday rehabilitation in home care has spread rapidly in Scandinavia through the last few years and is part of a worldwide focus on ‘active ageing’ because of a growing share of people 65+ years. Many citizens benefit from rehabilitative services, but research shows that those in most need often are excluded from home care services because of a one-sided focus on ‘growth’. This can bring along conflicts between professionals and citizens and a lack of relevant support for citizens. The purpose of this study was to investigate citizens’ perspectives on a good life as old in Nuuk and how rehabilitation can support them in conducting a meaningful life from their own perspectives. The study was conducted as an ethnographic field study. The methods were participant observations, qualitative interviews and document analysis. The study shows that home care and rehabilitation services are concentrated on practical and instrumental help, disconnected from the citizens’ everyday life, their resources and values. This has a passivating and demotivating effect. Old people are proud of their achievements in life, they are actively managing their lives on a daily basis, and they have dreams for the future. But they do need professional assistance. Their everyday life-knowledge and perspectives have to be integrated in professional practice in order to improve the quality of home care services through cooperation between citizens and professionals. An action possibility is proposed, namely a certain approach to ‘life stories’ as an instrument to involve the citizens as participants in home care and rehabilitation. Læs mere

Research | Forskning - peer review

Artiklerne i denne bog belyser aspekter af kristendommens religiøse, kulturelle og samfundsmæssige betydning i Grønland.

Research | Forskning - peer review

The Routledge Handbook of the Polar Regions is an authoritative guide to the Arctic and the Antarctic through an exploration of key areas of research in the physical and natural sciences and the social sciences and humanities. It presents 38 new and original contributions from leading figures and vo… The Routledge Handbook of the Polar Regions is an authoritative guide to the Arctic and the Antarctic through an exploration of key areas of research in the physical and natural sciences and the social sciences and humanities. It presents 38 new and original contributions from leading figures and voices in polar research, policy and practice, as well as work from emerging scholars. This handbook aims to approach and understand the Polar Regions as places that are at the forefront of global conversations about some of the most pressing contemporary issues and research questions of our age. The volume provides a discussion of the similarities and differences between the two regions to help deepen understanding and knowledge. Major themes and issues are integrated in the comprehensive introduction chapter by the editors, who are top researchers in their respective fields. The contributions show how polar researchers engage with contemporary debates and use interdisciplinary and multidisciplinary approaches to address new developments as well as map out exciting trajectories for future work in the Arctic and the Antarctic. The handbook provides an easy access to key items of scholarly literature and material otherwise inaccessible or scattered throughout a variety of specialist journals and books. A unique one-stop research resource for researchers and policymakers with an interest in the Arctic and Antarctic, it is also a comprehensive reference work for graduate and advanced undergraduate students. Læs mere

Research | Forskning - peer review

The Routledge Handbook of the Polar Regions is an authoritative guide to the Arctic and the Antarctic through an exploration of key areas of research in the physical and natural sciences and the social sciences and humanities. It presents 38 new and original contributions from leading figures and vo… The Routledge Handbook of the Polar Regions is an authoritative guide to the Arctic and the Antarctic through an exploration of key areas of research in the physical and natural sciences and the social sciences and humanities. It presents 38 new and original contributions from leading figures and voices in polar research, policy and practice, as well as work from emerging scholars. This handbook aims to approach and understand the Polar Regions as places that are at the forefront of global conversations about some of the most pressing contemporary issues and research questions of our age. The volume provides a discussion of the similarities and differences between the two regions to help deepen understanding and knowledge. Major themes and issues are integrated in the comprehensive introduction chapter by the editors, who are top researchers in their respective fields. The contributions show how polar researchers engage with contemporary debates and use interdisciplinary and multidisciplinary approaches to address new developments as well as map out exciting trajectories for future work in the Arctic and the Antarctic. The handbook provides an easy access to key items of scholarly literature and material otherwise inaccessible or scattered throughout a variety of specialist journals and books. A unique one-stop research resource for researchers and policymakers with an interest in the Arctic and Antarctic, it is also a comprehensive reference work for graduate and advanced undergraduate students. Læs mere

Research | Forskning - peer review

The Routledge Handbook of the Polar Regions is an authoritative guide to the Arctic and the Antarctic through an exploration of key areas of research in the physical and natural sciences and the social sciences and humanities. It presents 38 new and original contributions from leading figures and vo… The Routledge Handbook of the Polar Regions is an authoritative guide to the Arctic and the Antarctic through an exploration of key areas of research in the physical and natural sciences and the social sciences and humanities. It presents 38 new and original contributions from leading figures and voices in polar research, policy and practice, as well as work from emerging scholars. This handbook aims to approach and understand the Polar Regions as places that are at the forefront of global conversations about some of the most pressing contemporary issues and research questions of our age. The volume provides a discussion of the similarities and differences between the two regions to help deepen understanding and knowledge. Major themes and issues are integrated in the comprehensive introduction chapter by the editors, who are top researchers in their respective fields. The contributions show how polar researchers engage with contemporary debates and use interdisciplinary and multidisciplinary approaches to address new developments as well as map out exciting trajectories for future work in the Arctic and the Antarctic. The handbook provides an easy access to key items of scholarly literature and material otherwise inaccessible or scattered throughout a variety of specialist journals and books. A unique one-stop research resource for researchers and policymakers with an interest in the Arctic and Antarctic, it is also a comprehensive reference work for graduate and advanced undergraduate students. Læs mere

Research | Forskning

Rapport fra forsøg med fjernundervisning i faget matematik i mellem skolen i Tasiilaq og en bygdeskole i østgrønland. Fjernundervisningen lykkedes ikke, primært fordi internetforbindelsen var for lille og ustabil.

Research | Forskning - peer review

I 2019 forventes Grønlands første fængsel eller lukkede anstalt, som er den officielle betegnelse, at blive taget i brug. Den grønlandske kriminallov bygger på principper om resocialisering af lovbrydere og at undgå indespærringens skadelige virkninger. Hidtil har afsoning fundet sted i såkaldte åbn… I 2019 forventes Grønlands første fængsel eller lukkede anstalt, som er den officielle betegnelse, at blive taget i brug. Den grønlandske kriminallov bygger på principper om resocialisering af lovbrydere og at undgå indespærringens skadelige virkninger. Hidtil har afsoning fundet sted i såkaldte åbne anstalter, hvor hensigten var, at domfældte skulle være beskæftiget i byen mens de afsonede. Med den nye anstalt bliver Grønland som ”landet uden fængsel”, officielt fortid. Desuden slutter en lang tradition med at sende grønlandske forvaringsdømte til afsoning i Danmark. Forvaring er kriminallovens strengeste foranstaltning. Forvaringsdommen kan fuldbyrdes i en grønlandsk anstalt eller ”en psykiatrisk ledet anstalt under Kriminalforsorgen i Danmark”, Herstedvester Fængsel. Næsten en fjerdedel af Grønlands indsatte afsoner en forvaringsdom, og ca. en femtedel af alle indsatte er sendt ud af landet til afsoning i Herstedvester. Denne artikel vil kaste lys på den grønlandske forvaringsdom og dens konsekvenser for de dømte. Desuden vil forventninger til Grønlands nye lukkede anstalt blive undersøgt. Læs mere

Research | Forskning - peer review

Residents across the Baffin Bay/Davis Strait (BBDS) region have experienced common challenges in relation to rapid development and changes in living conditions, and they continue to adapt to the legacy of colonization. However, there are still significant symptoms of social problems and mental vulne… Residents across the Baffin Bay/Davis Strait (BBDS) region have experienced common challenges in relation to rapid development and changes in living conditions, and they continue to adapt to the legacy of colonization. However, there are still significant symptoms of social problems and mental vulnerability. The strong relation to nature and the importance of artistic creativity and cohesion remain central to the life of Inuit. These factors are of great importance for mental health and well-being. Læs mere

Research | Forskning - peer review

Commodity prices, together with extraction prices and technology development – not climate change effects – are the main drivers of change in the Baffin Bay/ Davis Strait (BBDS) non-living resources sector. The commodity prices of mineral resources are expected to decline in the coming years.

Research | Forskning - peer review

The following sections summarize the main adaptation options from this report, consider and consolidate the sectoral responses outlined in previous chapters, and add relevant adaptation options from other sources, including Arctic Council reports.

Research | Forskning - peer review

This contribution is based on a seminar and workshop on public participation processes related to extractive industries in the Arctic, organized by the Arctic Oil and Gas Research Centre at Ilisimatusarfik (University of Greenland) on October 17th and 18th 2017. The seminar was led by experts on ext… This contribution is based on a seminar and workshop on public participation processes related to extractive industries in the Arctic, organized by the Arctic Oil and Gas Research Centre at Ilisimatusarfik (University of Greenland) on October 17th and 18th 2017. The seminar was led by experts on extractive industries, indigenous peoples, impact assessments, law, and public participation. They came from Greenland, Denmark, Iceland, Norway, Russia, Scotland, England and Brazil. The seminar was open to the public and was well attended by representatives from the ministries, municipal governments, academic and research institutes, NGOs and others. A select group of invited experts and a group of graduate students from Ilisimatusarfik took part in the workshop. Læs mere

Research | Forskning - peer review

Seminal literature has documented broadly the living conditions of Mexican workers before the Revolution of 1910. Various authors argue that a continuous deterioration of real wages in the preceding years of the Mexican revolution contributed to the social unrest that lead to the armed conflict. Yet… Seminal literature has documented broadly the living conditions of Mexican workers before the Revolution of 1910. Various authors argue that a continuous deterioration of real wages in the preceding years of the Mexican revolution contributed to the social unrest that lead to the armed conflict. Yet, most of the quantitative evidence has focused on aggregate estimates overlooking the regional wage dynamics. Through regional historical data, this article reevaluates quantitatively the patterns of Mexican regional real wages providing new estimates for the period 1877-c.1910. The analysis reveals that a divergent pattern between sectors and regions emerged during these years. However, the study also shows that in general, locally-adjusted regional real wages remained relatively stable throughout the period. Læs mere

Research | Forskning - peer review

The background of the study reported in this chapter was the growing number of chronically ill patients. The purpose was to explore patients’ perspectives on life with chronic illness and how it relates to healthcare practice. The research was conducted as an ethnographic field study. A conclusion o… The background of the study reported in this chapter was the growing number of chronically ill patients. The purpose was to explore patients’ perspectives on life with chronic illness and how it relates to healthcare practice. The research was conducted as an ethnographic field study. A conclusion of the study is that the disease-oriented healthcare system is not geared to deal with rehabilitation because of a narrow focus on disease and treatment, and the exclusion of patients’ knowledge. However, knowledge about patients’ everyday life and perspectives hold potentials for rehabilitative and health promotional professional interventions. Læs mere

Research | Forskning - peer review

On pretty much any measure of international comparison, Iceland is a little fish. Nevertheless, its geographical location next to the Big Pond that is the Arctic Ocean has put it in a position of influence in a region of growing international importance. In this paper, we explore Iceland’s influenc… On pretty much any measure of international comparison, Iceland is a little fish. Nevertheless, its geographical location next to the Big Pond that is the Arctic Ocean has put it in a position of influence in a region of growing international importance. In this paper, we explore Iceland’s influence in the Arctic region based on international relations considerations such as its political alliances; and based on international law: Iceland’s rights and responsibilities. The paper presents the Arctic Council and Iceland’s role within it before turning to issues that are governed outside of the Arctic Council system, in particular, Arctic fisheries and maritime boundaries. The paper explains Iceland’s approach to Arctic cooperation in light of its published policy documents and explores the tools available to Iceland to defend its interests. Læs mere

Communication | Formidling

Grønland og EU har et helt specielt partnerskab, gentog begge parter i sommer under en række møder, hvor bl.a. Partnerskabsaftalen vedrørende uddannelse blev behandlet. Forholdet startede dog knap så smidigt, og i første halvdel af 1980’erne var skilsmissen en realitet.

Communication | Formidling

Kalaallit Nunaat aamma EU immikkuullarissumik suleqatigiipput, aasaanerani ataatsimiinnerni assigiinngitsuni tamanna suleqatigiilluarneq uteqqinneqarpoq, ilaatigut ilinniartitaanermut tunngasut suleqatigiissutiginissaanut isumaqatigiissut suliarineqarpoq. Pissutsit eqaatsumik aallartipput, 1980-ikku… Kalaallit Nunaat aamma EU immikkuullarissumik suleqatigiipput, aasaanerani ataatsimiinnerni assigiinngitsuni tamanna suleqatigiilluarneq uteqqinneqarpoq, ilaatigut ilinniartitaanermut tunngasut suleqatigiissutiginissaanut isumaqatigiissut suliarineqarpoq. Pissutsit eqaatsumik aallartipput, 1980-ikkullu qiteqqunneranni katissimasut avissinnaanerat piviusunngortinneqarluni. Læs mere

Communication | Formidling

Anmeldelse af bogen: Det er jo mennesker - skæbner fra fængslet, Dorte Kvist i samarbejde med Carl og Ingeborg Lomholt

Teaching | Undervisning - peer review

Kapitlet introducerer til en analysemetode, som bygger på socialpsykologisk teori om strukturer og relationer i social praksis. Betingelses-, betydnings- og begrundelsesanalysen integrerer samfundsmæssige og institutionelle strukturer i brugernes daglige livsførelse og i professionel praksis. Formål… Kapitlet introducerer til en analysemetode, som bygger på socialpsykologisk teori om strukturer og relationer i social praksis. Betingelses-, betydnings- og begrundelsesanalysen integrerer samfundsmæssige og institutionelle strukturer i brugernes daglige livsførelse og i professionel praksis. Formålet med analysen er at vise sammenhængen mellem institutionel praksis og brugernes daglige livsførelse med fx sundhedsproblemer, hvordan de forskellige praksisser påvirker hinanden, og hvilke muligheder og problemer, de rummer. Ved hjælp af eksempler fra empirisk forskning i patientperspektiver på sundhedspraksis i Grønland vises det, hvordan analysemetoden kan bruges på empirisk materiale, hvilke former for viden og praksis den analyserer, og hvilken viden og hvilke handlemuligheder, den kan generere. Læs mere

Research | Forskning

Første del af rapporten beskriver det grønlandske medielandskab, og giver et billede af de nyhedsmedier der findes og de journalister, der arbejder der. Anden del af rapporten beskriver forbruget af nyhedsmedier hos befolkningen i Grønland, og giver et billede af hvilke nyhedsmedier der benyttes h… Første del af rapporten beskriver det grønlandske medielandskab, og giver et billede af de nyhedsmedier der findes og de journalister, der arbejder der. Anden del af rapporten beskriver forbruget af nyhedsmedier hos befolkningen i Grønland, og giver et billede af hvilke nyhedsmedier der benyttes hvor og af hvem. Tredje del af rapporten er en analyse af indholdet i grønlandske nyhedsmedier, der blandt andet viser hvilke kilder der typisk kommer til orde i medierne. Læs mere

Research | Forskning

Nalunaarusiap immikkoortuani siullermi Kalaallit Nunaanni tusagassiuuteqarnerup qanoq issusia oqaluttuarineqarpoq, tusagassiuutit nutaarsiassaqartitsisut tusagassiortullu taakkunani sulisut eqqartorneqarlutik. Immikkoortup aappaani innuttaasut tusagassiuutinik atuinerat allaaserineqarpoq, tusagass… Nalunaarusiap immikkoortuani siullermi Kalaallit Nunaanni tusagassiuuteqarnerup qanoq issusia oqaluttuarineqarpoq, tusagassiuutit nutaarsiassaqartitsisut tusagassiortullu taakkunani sulisut eqqartorneqarlutik. Immikkoortup aappaani innuttaasut tusagassiuutinik atuinerat allaaserineqarpoq, tusagassiuutit nutaarsiassaqartitsisut suut, sumi kikkunnillu atorneqarnerat oqaluttuarineqarluni. Immikkoortut pingajuat Kalaallit Nunaanni tusagassiuutit nutaarsiassaqartitsiviusut imarisaasa misissorneqarneranni paasisanik imaqarpoq, soorlu tusarfiit kikkut tusagassiuutini oqaaseqartitaagajunnerannik. Læs mere

Research | Forskning - peer review

Udredning af bistandsværgeordningen for forvaringsdømte og psykisk syge foranstaltningsdømte grønlændere i Danmark og Grønland

Research | Forskning - peer review

I rapporten undersøges forekomsten af trivsel og udbrændthed blandt ansatte i Grønlands sociale sektor ved hjælp af et online spørgeskema. Undersøgelsen er den første af sin slags i mere end 10 år. Ud af 348 adspurgte svarede omkring 200 ansatte inden for socialområdet på spørgsmål om trivsel i ar… I rapporten undersøges forekomsten af trivsel og udbrændthed blandt ansatte i Grønlands sociale sektor ved hjælp af et online spørgeskema. Undersøgelsen er den første af sin slags i mere end 10 år. Ud af 348 adspurgte svarede omkring 200 ansatte inden for socialområdet på spørgsmål om trivsel i arbejdslivet med afsæt i en række baggrundsspørgsmål om køn, løn, arbejdssted, kommune osv. Undersøgelsen er udformet som et åbent spørgeskema med en indlagt test om det psykiske arbejdsmiljø, som er baseret på en Maslach Burnout Inventory. Langt størstedelen af de adspurgte inden for det sociale område oplever at de trives i deres arbejde. Det forekommer dog for ca. 1 ud af 4 at de føler sig udkørte når arbejdsdagen er ovre. Undersøgelsen peger endvidere på en lav anciennitet på området og det kan vække bekymring. Lav anciennitet kan resultere i en lav organisationshukommelse og kan kobles til med udfordringer inden for socialområdet omkring kontinuitet i sagsbehandlingen og et for lavt niveau af opfølgninger på socialklienters handleplaner. Anciennitetsniveauet kan være et tegn at man på disse offentlige arbejdspladser må fastholde et fokus på at sikre et godt psykiske arbejdsmiljø til gavn for de ansatte. Fremadrettet er det vigtigt løbende at få undersøgt arbejdsmiljøet inden for det sociale område, da man særligt i børne- og familieforvaltningerne møder ansatte, som til tider arbejder under i et meget omfattende arbejdspres. Læs mere

Research | Forskning - peer review

Despite the fact that not a single barrel of Greenlandic oil was ever extracted, refined and consumed in or exported from Greenland, hydrocarbon has nevertheless played a significant role in contemporary economical, environmental, and political. discourses. Not least as a key political issue in Gree… Despite the fact that not a single barrel of Greenlandic oil was ever extracted, refined and consumed in or exported from Greenland, hydrocarbon has nevertheless played a significant role in contemporary economical, environmental, and political. discourses. Not least as a key political issue in Greenland as well as between Greenland and Denmark is the discourse about Greenland’s development from a colony to Self-Governance (2009) via status as a Danish county (1953) and Home Rule (1979). One of the article’s foci is how the discourse about and the gradual acknowledgement of the Greenlanders’ rights to the Greenland subsurface has been an important part of Greenlandic nation building. Furthermore, visions for an independent Greenland have been fuelled by the hopes for ‘a shortcut’ via discoveries of oil and gas that eventually could compensate for the Danish block grant and pave the way for an independent Greenland. In 2012 Greenland Self-Governance took over the full authority of mineral resources including oil and gas. 2012 was also the year following explorative drillings of eight wells that were all dry. The following years were characterised by a rapidly declining interest from the oil industry in developing hydrocarbon activities in Greenland waters and demonstrated Greenland’s dependency on the international market for oil. Greenland being part of a globalised world also became apparent when Greenland was confronted with, for instance, environmental concerns caused by Greenland’s wish to be an oil-producing country. Conflicting interests internationally were also reflected in the results based on a national survey on attitudes to, perceptions of as well as hopes and concerns related to oil development. Some results are presented in the article. Læs mere

Research | Forskning - peer review

The Far Islands and other Cold Places: Women Travelers in the Arctic, 1850–1935

This article uses historical travel writing by Anglo-European Women to investigate the construction of gendered geographies in the Far North. Applying an interdisciplinary approach that combines history, literary analysis and gender studies, the paper examines the gendered aspects of travel, and the… This article uses historical travel writing by Anglo-European Women to investigate the construction of gendered geographies in the Far North. Applying an interdisciplinary approach that combines history, literary analysis and gender studies, the paper examines the gendered aspects of travel, and the intersectionality of gender, class and race. Using examples from two published travel accounts and personal archives, the paper will demonstrate the historical processes of gender differences and representations, as well as capture the intersectionality of literature and the construction of place in real, imaginary and symbolic terms. Læs mere

Research | Forskning - peer review

Although Greenland has pursued hydrocarbon development over the last four decades, no viable reserves have been found to date. Therefore, local Greenland communities have little experience or knowledge of how such development might affect their way of life or how to influence project development and… Although Greenland has pursued hydrocarbon development over the last four decades, no viable reserves have been found to date. Therefore, local Greenland communities have little experience or knowledge of how such development might affect their way of life or how to influence project development and outcomes should a significant reserve be found. On the North Slope of Alaska, in contrast, hydrocarbon extraction was commercialized in the 1970s, and the industry is now highly developed. North Slope residents have experienced dramatic influences on their everyday lives and well-being as a result of large-scale hydrocarbon projects. Some consequences have been welcomed, such as economic development and higher employment rates; however, other impacts are harmful, such as reduced ability of local peoples to maintain subsistence hunting practices. The villages on Alaska’s North Slope share many features in common with settlements in Greenland, such as small size, isolation, and limited political influence. In this study, we explore how Greenlanders might learn from the Alaska experience by examining the comments of North Slope residents. We propose that increased local-to-local recommendation- sharing across the Arctic would better guide sustainable development practices and benefits into potential future projects in Greenland. We conclude that an Arctic “Community Guide” and the process to create one could improve planning and implementation of hydrocarbon projects across the Arctic and promote locally appropriate sustainable development in the affected communities. Læs mere

Research | Forskning - peer review

This paper uses the 2014–2015 plunge in oil prices as a linchpin for understanding how petroleum development represents a challenge to Arctic societies. Analysis of media discourses, grey literature and fieldwork material from 2013 to 2017 compared with previous work in the region shows that the 75%… This paper uses the 2014–2015 plunge in oil prices as a linchpin for understanding how petroleum development represents a challenge to Arctic societies. Analysis of media discourses, grey literature and fieldwork material from 2013 to 2017 compared with previous work in the region shows that the 75% price decrease in oil price brings into stark relief the perceived level of ontological security that future petroleum economies in Northern Norway, Alaska and Greenland provides. The findings reveal that while the communities in each location find themselves along different timelines of the petroleum economy, there are transferable insights that can benefit other communities influenced by (the potential for) petroleum development in both the Arctic and beyond, in particular concerning the way in which specific ideas about oil and oils future features as contributing to or diminishes ontological security perceptions on the ground. The goal of this paper is to deepen the comparative analysis of research on tensions in Arctic communities as petroleum is perceived as either strengthening or threatening future ontological security in the region. The discussion considers the consequences of path de- pendent petroleum economies, and how perceptions on alternative futures can fruitfully be introduced into petroleum-dominated narratives about viable Arctic futures. Læs mere

Research | Forskning - peer review

Zoonotic infections transmitted from marine mammals to humans in the Baltic and European Arctic are of unknown significance, despite given considerable potential for transmission due to local hunt. Here we present results of an initial screening for Brucella spp. in Arctic and Baltic seal species. B… Zoonotic infections transmitted from marine mammals to humans in the Baltic and European Arctic are of unknown significance, despite given considerable potential for transmission due to local hunt. Here we present results of an initial screening for Brucella spp. in Arctic and Baltic seal species. Baltic ringed seals (Pusa hispida, n = 12) sampled in October 2015 and Greenland Sea harp seals (Pagophilus groenlandicus, n = 6) and hooded seals (Cystophora cristata, n = 3) sampled in March 2015 were serologically analysed for antibodies against Brucella spp. The serological analyses were performed using the Rose Bengal Test (RBT) followed by a confirmatory testing of RBT-positive samples by a competitive-enzyme linked immunosorbent assay (C-ELISA). Two of the Baltic ringed seals (a juvenile male and a juvenile female) were seropositive thus indicating previous exposure to a Brucella spp. The findings indicate that ringed seals in the Baltic ecosystem may be exposed to and possibly infected by Brucella spp. No seropositive individuals were detected among the Greenland harp and hooded seals. Although our initial screening shows a zoonotic hazard to Baltic locals, a more in-depth epidemiological investigation is needed in order to determine the human risk associated with this. Læs mere

Research | Forskning

Various kinds of user and patient involvement are spreading in healthcare in most Western countries. The purpose of this study is to critically assess the actual conditions for patients’involvement in healthcare practice in Greenland and to point to possibilities… Various kinds of user and patient involvement are spreading in healthcare in most Western countries. The purpose of this study is to critically assess the actual conditions for patients’involvement in healthcare practice in Greenland and to point to possibilities for development. Patients’ perspectives on their own conduct of everyday life with illness and their possibilities for participation when hospitalized are examined in relation to the conditions in a hospital setting dominated by biomedical practice. On a theoretical level, it is argued that the concept of ‘participation’ is preferable to the concept ‘involvement’ in healthcare. The study shows that there are several interconnected areas for development: the structural frames of hospital practice,including professionals’ possibilities for handling patient participation, and the agency of the patients conducting their everyday lives when hospitalized. Consequences of the biomedical hegemony are discussed in relation to WHO ́s broader approach to disease, illness and health and the still existing postcolonial traces of power and hierarchy. Finally it is argued that patient participation during hospitalization will promote the patients ́ conduct of everyday life, the cultural knowledge of the professionals, and the democratization of the healthcare sector. Such changes might be connected to a more encompassing democratic societal development – in Greenland as well as globally. Læs mere

Research | Forskning - peer review

For the last two and a half decades, a network of human health experts under the Arctic Monitoring and Assessment Program (AMAP) has produced several human health assessment reports. These reports have provided a base of scientific knowledge regarding environmental contaminants and their impact on h… For the last two and a half decades, a network of human health experts under the Arctic Monitoring and Assessment Program (AMAP) has produced several human health assessment reports. These reports have provided a base of scientific knowledge regarding environmental contaminants and their impact on human health in the Arctic. These reports provide scientific information and policy-relevant recommendations to Arctic governments. They also support international agreements such as the Stockholm Convention on Persistent Organic Pollutants (POPs) and the Minamata Convention on Mercury. Key topics discussed in this paper regarding future human health research in the circumpolar Arctic are continued contaminant biomonitoring, health effects research and risk communication. The objective of this paper is to describe knowledge gaps and future priorities for these fields. Læs mere

Research | Forskning - peer review

The children immunisation programme in Greenland correlates to the one in Denmark with the addition of the Bacille Calmette–Guerin (BCG)-vaccine and the immunisation against Hepatitis B (HBV). The immunisation rate among children in Greenland has been and is currently unknown and this study aims to… The children immunisation programme in Greenland correlates to the one in Denmark with the addition of the Bacille Calmette–Guerin (BCG)-vaccine and the immunisation against Hepatitis B (HBV). The immunisation rate among children in Greenland has been and is currently unknown and this study aims to estimate the immunisation rates among children in Nuuk from 1 July 2015 until 30 June 2016. We did an observational cross-sectional study based on a statistical extraction identifying all children in Nuuk eligible for an immunization in the children immunisation programme from 1 July 2015 until 30 June 2016 and a review of their medical records. We found acceptable coverage rates among children younger than 12 months, but coverage rates lower than recommended by the World Health Organization (WHO) among older children. Among children between 15 months and 4 years the coverage dropped as low as 33.9 %. Increased awareness of child immunisation rates is suggested including continuously monitoring and adjusting of the organisation of the immunisation programme. Læs mere

Research | Forskning - peer review

Ca homoeostasis is important to human health and tightly controlled by powerful hormonal mechanisms that display ethnic variation. Ethnic variations could occur also in Arctic populations where the traditional Inuit diet is low in Ca and sun exposure is limited. We aimed to assess factors important… Ca homoeostasis is important to human health and tightly controlled by powerful hormonal mechanisms that display ethnic variation. Ethnic variations could occur also in Arctic populations where the traditional Inuit diet is low in Ca and sun exposure is limited. We aimed to assess factors important to parathyroid hormone (PTH) and Ca in serum in Arctic populations. We included Inuit and Caucasians aged 50–69 years living in the capital city in West or in rural East Greenland. Lifestyle factors were assessed by questionnaires. The intake of Inuit diet was assessed from a FFQ. 25-Hydroxyvitamin D (25OHD2 and 25OHD3) levels were measured in serum as was albumin, Ca and PTH. The participation rate was 95 %, with 101 Caucasians and 434 Inuit. Median serum 25OHD (99·7 % was 25OHD3) in Caucasians/Inuit was 42/64 nmol/l (25, 75 percentiles 25, 54/51, 81) (P<0·001). Total Ca in serum was 2·33/2·29 mmol/l (25, 75 percentiles 2·26, 2·38/2·21, 2·36) (P=0·01) and PTH was 2·7/2·2 pmol/l (25, 75 percentiles 2·2, 4·1/1·7, 2·7) (P<0·001). The 69/97 Caucasians/Inuit with serum 25OHD <50 nmol/l differed in PTH (P=0·001) that rose with lower 25OHD levels in Caucasians, whereas this was not the case in Inuit. Ethnic origin influenced PTH (β=0·27, P<0·001) and Ca (β=0·22, P<0·001) in multivariate linear regression models after adjustment for age, sex, BMI, smoking, alcohol and diet. In conclusion, ethnic origin influenced PTH, PTH response to low vitamin D levels and Ca levels in populations in Greenland. Recommendations are to evaluate mechanisms underlying the ethnic influence on Ca homoeostasis and to assess the impact of transition in dietary habits on Ca homoeostasis and skeletal health in Arctic populations. Læs mere

Research | Forskning - peer review

We previously showed that a common genetic variant leads to a remarkably increased risk of type 2 diabetes (T2D) in the small and historically isolated Greenlandic population. Motivated by this, we aimed at discovering novel genetic determinants for glycated hemoglobin (HbA1C) and at estimating the… We previously showed that a common genetic variant leads to a remarkably increased risk of type 2 diabetes (T2D) in the small and historically isolated Greenlandic population. Motivated by this, we aimed at discovering novel genetic determinants for glycated hemoglobin (HbA1C) and at estimating the effect of known HbA1C-associated loci in the Greenlandic population. We analyzed genotype data from 4049 Greenlanders generated using the Illumina Cardio-Metabochip. We performed the discovery association analysis by an additive linear mixed model. To estimate the effect of known HbA1C-associated loci, we modeled the effect in the European and Inuit ancestry proportions of the Greenlandic genome (EAPGG and IAPGG, respectively). After correcting for multiple testing, we found no novel significant associations. When we investigated loci known to associate with HbA1C levels, we found that the lead variant in the GCK locus associated significantly with HbA1C levels in the IAPGG (PIAPGG=4.8×10−6,βIAPGG=0.13SD). Furthermore, for 10 of 15 known HbA1C loci, the effects in IAPGG were similar to the previously reported effects. Interestingly, the ANK1 locus showed a statistically significant ancestral population differential effect, with opposing directions of effect in the two ancestral populations. In conclusion, we found only 1 of the 15 known HbA1C loci to be significantly associated with HbA1C levels in the IAPGG and that two-thirds of the loci showed similar effects in Inuit as previously found in European and East Asian populations. Our results shed light on the genetic effects across ethnicities. Læs mere

Research | Forskning - peer review

A prospective national cohort study assessed the development of health‐related quality of life (HRQoL) and symptoms in adult patients undergoing treatment and care for advanced cancer in Greenland. HRQol was examined by EORTC QLQ‐C30 version 3.0 questionnaire monthly for 4 months. Changes over time… A prospective national cohort study assessed the development of health‐related quality of life (HRQoL) and symptoms in adult patients undergoing treatment and care for advanced cancer in Greenland. HRQol was examined by EORTC QLQ‐C30 version 3.0 questionnaire monthly for 4 months. Changes over time and between‐group comparisons were examined. Of 58 patients included in the study, 47% completed the questionnaire four times. Functioning was generally high, and improved social functioning was observed after 1 and 2 months. The highest symptom score was for fatigue followed by pain and nausea/vomiting. A high score for financial problems remained unchanged during the entire period. Patients with higher income had reduced pain intensity (p = .03) and diarrhoea (p = .05) than patients with income below the poverty line. After 1 month, reduction in pain intensity was observed for Nuuk citizens compared with non‐Nuuk citizens (p = .05). After 2 months, non‐Nuuk citizens reported improved social functioning compared with Nuuk citizens (p = .05). After 3 months, Global Health in Nuuk citizens was improved compared with non‐Nuuk citizens (p = .05). An important clinical finding was that patients’ needs for support are related to social status, and geographical factors should be taken into account when planning palliative care. Læs mere

Research | Forskning - peer review

The purpose of the article is to compare different indicators of social position as measures of social inequality in health in a population sample from an indigenous arctic people, the Inuit in Greenland. Data was collected during 2005–2015 and consisted of information from 3967 adult Inuit from tow… The purpose of the article is to compare different indicators of social position as measures of social inequality in health in a population sample from an indigenous arctic people, the Inuit in Greenland. Data was collected during 2005–2015 and consisted of information from 3967 adult Inuit from towns and villages in all parts of Greenland. Social inequalities for smoking and central obesity were analysed in relation to seven indicators of social disparity in four dimensions, i.e. education and employment, economic status, sociocultural position, and place of residence. For each indicator we calculated age-adjusted prevalence by social group, rate ratio and the concentration index. The indicators were correlated with Pearson’s r ranging from 0.24 to 0.82. Concentration indices ranged from 0.01 to 0.17. We could not conclude that one indicator was superior to others. Most of the indicators were traditional socioeconomic indicators used extensively in research in western countries and these seemed to be useful among the Inuit too, in particular household assets and job. Two sociocultural indicators developed for use among the Inuit and which included parameters specific to the indigenous peoples in the transition from a traditional to a modern life style proved to be equally useful but not superior to the traditional socioeconomic indicators. The choice of indicator must depend on what it is realistic to collect in the actual research setting and the use of more than one indicator is recommended. It is suggested to further develop culture specific indicators of social position for indigenous peoples. Læs mere

Research | Forskning - peer review

Greenland is a country in transition from a colonial past with subsistence hunting and fishing to an urban Nordic welfare state. Epidemiological transition from infectious to chronic diseases has been evident since the 1950s. Ninety percent of the population is Inuit. We studied three public health… Greenland is a country in transition from a colonial past with subsistence hunting and fishing to an urban Nordic welfare state. Epidemiological transition from infectious to chronic diseases has been evident since the 1950s. Ninety percent of the population is Inuit. We studied three public health issues based on published literature, namely adverse childhood experiences, addictive behavior, and suicide; diet and obesity; and smoking. Alcohol consumption was high in the 1970s and 1980s with accompanying family and social disruption. This is still a cause of poor mental health and suicides in the generations most affected. The diet is changing from a traditional diet of fish and marine mammals to imported food including food items rich in sugar and fat from domestic animals, and the level of physical activity is decreasing with an ensuing epidemic rise in obesity. The prevalence of smoking is high at around 60% among both men and women and is only slowly decreasing. Smoking shows large social variation, and tobacco-related diseases are widespread. The diseases and conditions outlined above all contribute towards a low life expectancy at birth—69 years for men and 74 years for women in 2011–2015—compared with 78 and 84 years for men and women, respectively, on average in the European countries. The translation of government public health programs into local activities needs strengthening, and it must be realized that the improvement of public health is a long-term process. Læs mere

Research | Forskning - peer review

Aims: The aim was to investigate the prevalence of diabetic sensorimotor polyneuropathy (DSPN) and cardiovascular autonomic neuropathy (CAN) in a Danish population of young adults with type 1 diabetes (T1D) using both established and novel measuring modalities. Furthermore, to investigate the associ… Aims: The aim was to investigate the prevalence of diabetic sensorimotor polyneuropathy (DSPN) and cardiovascular autonomic neuropathy (CAN) in a Danish population of young adults with type 1 diabetes (T1D) using both established and novel measuring modalities. Furthermore, to investigate the association between continuous subcutaneous insulin infusion (CSII) treatment and these complications. Materials and Methods: CAN was assessed by cardiovascular autonomic reflex tests. DSPN was assessed not only by perception of light touch and pain, vibration perception threshold (VPT), Brief Pain Inventory (BPI), and Michigan Neuropathy Screening Instrument questionnaires but also by novel modalities: electrochemical skin conductance (ESC), sural nerve conduction velocity (SNCV), and sural nerve amplitude potential (SNAP). Results: The study comprised 156 young adults with a mean age of 22 years (standard deviation 1.6). The prevalence of CAN and early CAN was 9% and 28.1%, respectively. Subclinical DSPN was 55.1% and confirmed DSPN was 2.6%. Prevalence of abnormal SNAP was 23.8%, SNCV was 37.1%, ESC on the hands and feet was 4% and 8%, respectively, VPT was 1.3%, and BPI questionnaire was 1.9%. No association was found between CSII treatment and the measures of DSPN and CAN. Conclusion: DSPN and CAN are prevalent in young adults with T1D with no association found with CSII treatment. The use of novel measuring modalities identified a higher number of subjects with DSPN compared with established measures. Screening for diabetic neuropathy in young adults may be beneficial to detect and prevent nerve damages at early stages. Læs mere

Research | Forskning - peer review

The Arctic Council, a collaborative forum among governments and Arctic communities, has highlighted the problem of suicide and potential solutions. The mental health initiative during the United States chairmanship, Reducing the Incidence of Suicide in Indigenous Groups: Strengths United Through Net… The Arctic Council, a collaborative forum among governments and Arctic communities, has highlighted the problem of suicide and potential solutions. The mental health initiative during the United States chairmanship, Reducing the Incidence of Suicide in Indigenous Groups: Strengths United Through Networks (RISING SUN), used a Delphi methodology complemented by face-to-face stakeholder discussions to identify outcomes to evaluate suicide prevention interventions. RISING SUN underscored that multilevel suicide prevention initiatives require mobilizing resources and enacting policies that promote the capacity for wellness, for example, by reducing adverse childhood experiences, increasing social equity, and mitigating the effects of colonization and poverty. Læs mere

Research | Forskning - peer review

Background: Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions. With our comprehensive approach to health accounting within the Global Burden o… Background: Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions. With our comprehensive approach to health accounting within the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we generated improved estimates of alcohol use and alcohol-attributable deaths and disability-adjusted life-years (DALYs) for 195 locations from 1990 to 2016, for both sexes and for 5-year age groups between the ages of 15 years and 95 years and older. Methods: Using 694 data sources of individual and population-level alcohol consumption, along with 592 prospective and retrospective studies on the risk of alcohol use, we produced estimates of the prevalence of current drinking, abstention, the distribution of alcohol consumption among current drinkers in standard drinks daily (defined as 10 g of pure ethyl alcohol), and alcohol-attributable deaths and DALYs. We made several methodological improvements compared with previous estimates: first, we adjusted alcohol sales estimates to take into account tourist and unrecorded consumption; second, we did a new meta-analysis of relative risks for 23 health outcomes associated with alcohol use; and third, we developed a new method to quantify the level of alcohol consumption that minimises the overall risk to individual health. Findings: Globally, alcohol use was the seventh leading risk factor for both deaths and DALYs in 2016, accounting for 2·2% (95% uncertainty interval [UI] 1·5–3·0) of age-standardised female deaths and 6·8% (5·8–8·0) of age-standardised male deaths. Among the population aged 15–49 years, alcohol use was the leading risk factor globally in 2016, with 3·8% (95% UI 3·2–4·3) of female deaths and 12·2% (10·8–13·6) of male deaths attributable to alcohol use. For the population aged 15–49 years, female attributable DALYs were 2·3% (95% UI 2·0–2·6) and male attributable DALYs were 8·9% (7·8–9·9). The three leading causes of attributable deaths in this age group were tuberculosis (1·4% [95% UI 1·0–1·7] of total deaths), road injuries (1·2% [0·7–1·9]), and self-harm (1·1% [0·6–1·5]). For populations aged 50 years and older, cancers accounted for a large proportion of total alcohol-attributable deaths in 2016, constituting 27·1% (95% UI 21·2–33·3) of total alcohol-attributable female deaths and 18·9% (15·3–22·6) of male deaths. The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0·0–0·8) standard drinks per week. Interpretation: Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption. Læs mere

Research | Forskning - peer review

Background and aims: Low levels of vitamin D are suspected to be a risk factor for cardiovascular disease and atherosclerosis. The aim of this study was to assess the prevalence of subclinical atherosclerosis among Inuit in Greenland, and to evaluate the association with vitamin D status. We hypothe… Background and aims: Low levels of vitamin D are suspected to be a risk factor for cardiovascular disease and atherosclerosis. The aim of this study was to assess the prevalence of subclinical atherosclerosis among Inuit in Greenland, and to evaluate the association with vitamin D status. We hypothesized that low vitamin D status could be associated with higher carotid intima-media thickness (IMT) as a marker of atherosclerosis. Methods: 756 adults from the Inuit Health in Transition (IHIT) study carried out in Greenland in the period 2005–2010 were included. A blood sample donated in 1987 was available for a sub-sample of 102 individuals. Serum 25(OH)D3 from the IHIT study and the 1987 survey was used as a measure of vitamin D status. IMT measurements were conducted by ultrasound scanning. The prevalence of atherosclerosis was estimated, and the association between serum 25(OH)D3 and IMT measurements was examined by linear regression. Results: The overall prevalence of subclinical atherosclerosis was 20.1% (n = 152). The linear regression analyses indicated a weak positive association between serum 25(OH)D3 level and IMT measurements from the IHIT study, though not statistically significant after adjustment for potential confounders (β = 0.35% per 10 nmoL/L 25(OH)D3, p = 0.06). Linear regression analyses of the association between serum 25(OH)D3 level in the 1987 survey and IMT measurements also indicated a positive, though not statistically significant, association after adjustment (β = 0.07% per 10 nmoL/L 25(OH)D3, p = 0.86). Conclusions: Our findings did not support the hypothesis of an association between low vitamin D levels and risk of atherosclerosis. Læs mere

Communication | Formidling - peer review

We have identified a variant in ADCY3 (encoding adenylate cyclase 3) associated with markedly increased risk of obesity and type 2 diabetes in the Greenlandic population. The variant disrupts a splice acceptor site, and carriers have decreased ADCY3 RNA expression. Additionally, we observe an enrich… We have identified a variant in ADCY3 (encoding adenylate cyclase 3) associated with markedly increased risk of obesity and type 2 diabetes in the Greenlandic population. The variant disrupts a splice acceptor site, and carriers have decreased ADCY3 RNA expression. Additionally, we observe an enrichment of rare ADCY3 loss-of-function variants among individuals with type 2 diabetes in trans-ancestry cohorts. These findings provide new information on disease etiology relevant for future treatment strategies. Læs mere

Research | Forskning - peer review

Aims/hypothesis: In a recent study using a standard additive genetic model, we identified a TBC1D4 loss-of-function variant with a large recessive impact on risk of type 2 diabetes in Greenlanders. The aim of the current study was to identify additional genetic variation underlying type 2 diabetes u… Aims/hypothesis: In a recent study using a standard additive genetic model, we identified a TBC1D4 loss-of-function variant with a large recessive impact on risk of type 2 diabetes in Greenlanders. The aim of the current study was to identify additional genetic variation underlying type 2 diabetes using a recessive genetic model, thereby increasing the power to detect variants with recessive effects. Methods: We investigated three cohorts of Greenlanders (B99, n = 1401; IHIT, n = 3115; and BBH, n = 547), which were genotyped using Illumina MetaboChip. Of the 4674 genotyped individuals passing quality control, 4648 had phenotype data available, and type 2 diabetes association analyses were performed for 317 individuals with type 2 diabetes and 2631 participants with normal glucose tolerance. Statistical association analyses were performed using a linear mixed model. Results: Using a recessive genetic model, we identified two novel loci associated with type 2 diabetes in Greenlanders, namely rs870992 in ITGA1 on chromosome 5 (OR 2.79, p = 1.8 × 10−8), and rs16993330 upstream of LARGE1 on chromosome 22 (OR 3.52, p = 1.3 × 10−7). The LARGE1 variant did not reach the conventional threshold for genome-wide significance (p < 5 × 10−8) but did withstand a study-wide Bonferroni-corrected significance threshold. Both variants were common in Greenlanders, with minor allele frequencies of 23% and 16%, respectively, and were estimated to have large recessive effects on risk of type 2 diabetes in Greenlanders, compared with additively inherited variants previously observed in European populations. Conclusions/interpretation: We demonstrate the value of using a recessive genetic model in a historically small and isolated population to identify genetic risk variants. Our findings give new insights into the genetic architecture of type 2 diabetes, and further support the existence of high-effect genetic risk factors of potential clinical relevance, particularly in isolated populations. Læs mere

Research | Forskning - peer review

For decades the spread of sexually transmitted infections (STIs) has been a health concern in Greenland, especially within the age group of 15–34 year olds. However, no overview exists of the potential differences in regional incidence and management of STIs. This study investigates the age, gender… For decades the spread of sexually transmitted infections (STIs) has been a health concern in Greenland, especially within the age group of 15–34 year olds. However, no overview exists of the potential differences in regional incidence and management of STIs. This study investigates the age, gender and region specific diagnostic activity and incidence of gonorrhoea in Greenland in 2015. The study design was an observational cross sectional register study with inclusion of patients tested for gonorrhoea in 2015. Patients above 15 years of age were included. Data was obtained from the laboratory system used at The Central Laboratory at Queen Ingrid’s Hospital in Nuuk. We found, in 2015, a total of 17,911 tests for gonorrhoea were performed on both men and women. Women accounted for 68% of the tests, while men accounted for 32%. The positivity rate was 7,878 pr. 100,000 of which 56% were women and 44% were men. The regional distribution showed a disparity of the testing rate and the rate of positive gonorrhoea tests.. Thus, we have documented a high diagnostic activity and high incidence of gonorrhoea in Greenland in 2015 among both women and men. We also found significant regional differences in both diagnostic activity and gonorrhoea incidence. Læs mere

Communication | Formidling - peer review

While healthcare in many Nordic countries is increasingly centralized, some nurses are working very much on their own. This applies to nurses in Greenland, who provide care for patients in some of the world’s most rural and remote areas. Still, they share the same ambition of evidence-based care as… While healthcare in many Nordic countries is increasingly centralized, some nurses are working very much on their own. This applies to nurses in Greenland, who provide care for patients in some of the world’s most rural and remote areas. Still, they share the same ambition of evidence-based care as their colleagues around the world. Læs mere

Research | Forskning - peer review

Aim: Previous studies have found high rates of stunted linear growth in Greenlandic children. We measured growth patterns in Greenland and compared them with international growth charts. Methods: The study cohort comprised 279 healthy children aged 6–10 years in 2012. They participated in two pregn… Aim: Previous studies have found high rates of stunted linear growth in Greenlandic children. We measured growth patterns in Greenland and compared them with international growth charts. Methods: The study cohort comprised 279 healthy children aged 6–10 years in 2012. They participated in two pregnancy and birth cohorts in Greenland and longitudinal growth data as birth was extracted from their medical records. Growth reference ranges were estimated with the lambda‐mu‐sigma (LMS) method and compared with growth charts from Denmark and the World Health Organization (WHO). Results: The children's mean length, weight and head circumference were significantly larger than the WHO growth charts (p < 0.001). We found that 21–28% of the children aged zero to one years exceeded the WHO growth chart for length by more than two standard deviations. For weight and head circumference, 9–16% of the children aged 0–10 years and 9–11% of the children from zero to two years exceeded the WHO charts by more than two standard deviations. The Danish references were exceeded to a lesser degree. Conclusion: This study showed that the growth of Greenlandic children up to 10 years was no longer stunted. Major determining factors suggested are genetic admixture, maternal overweight, changes in nutrition and improved health. Læs mere

Research | Forskning - peer review

Background: Studies have found mercury to be associated with cardiovascular disease (CVD), however, primarily in populations with low exposure. The highest levels, and variations in the levels, of whole blood mercury (WBM) worldwide have been found in Greenland. We prospectively assessed the associa… Background: Studies have found mercury to be associated with cardiovascular disease (CVD), however, primarily in populations with low exposure. The highest levels, and variations in the levels, of whole blood mercury (WBM) worldwide have been found in Greenland. We prospectively assessed the association between WBM and the risk of developing CVD in the Greenlandic population. Methods: We assessed the effects of WBM levels on incident CVD among 3083 Greenlandic Inuit, participating in a population-based cohort study conducted from 2005 to 2010. WBM was measured at baseline. Participants were followed in the National Patient Registries for Denmark and Greenland and in the causes of death register for CVD events from inclusion in the study until CVD event, emigration, death or end of follow-up (30/9–2013). Using Cox regression analyses, we calculated the incidence rates and the hazard ratio of CVD events according to WBM levels. Potential interactions with sex were also investigated. Results: The highest levels of WBM were found in men, who had a significantly higher median level (19 μg/L (IQR:1–44)), compared with women (15 μg/L (IQR: 1–32), (p < 0.001)). The crude hazard ratio (HR) for incident CVD was 1.00 (95% CI 1.00–1.00) for 5 µg/l increase in WBM. After adjusting for several potential confounders, there was still no association between WBM and incident CVD (HR 0.99; 95%CI:0.99–1.00). We found no interactions with sex. Conclusions: In a population with high levels of WBM, we found no association between WBM and the risk of developing CVD in Greenland. Læs mere

Research | Forskning - peer review

Previously, head and neck cancer (HNC) patients in Greenland have had significant diagnostic delay and poor survival rates. From 2005-2009 several initiatives have been made to ensure faster diagnosis and better survival. The aim of this study was to compare the prognosis before and after these init… Previously, head and neck cancer (HNC) patients in Greenland have had significant diagnostic delay and poor survival rates. From 2005-2009 several initiatives have been made to ensure faster diagnosis and better survival. The aim of this study was to compare the prognosis before and after these initiatives were introduced. All Greenlandic patients diagnosed with HNC between 2005 and 2012 were included. Data were retrieved from medical records and national databases and compared with the period 1994-2003. A total of 98 patients were identified. Diagnostic delay was significantly lower compared to the period 1994–2004 (p=0.048). The 3-year overall survival was 56% for all HNC and 47% for nasopharyngeal carcinomas. We found that patients with HNC between 1994 and 2003 had a higher risk of death from all reasons compared with the period 2005–2012 (HR 2.17; CI 1.46–3.23) after adjustments for stage and diagnostic delay. Patients with head HNC in Greenland from 2005-2012 were diagnosed earlier and had a better overall survival compared to the period 1994–2003. The change in survival is more likely to be due to improvement in treatment rather than the initiated interventions. Although survival has improved in Greenland, demographic problems and lack of specialists remain a challenge. Læs mere

Research | Forskning - peer review

Diabetes mellitus is a large and growing worldwide health issue. Prior to this publication, a direct comparison of the prevalence of persons treated with anti-diabetic medicine in Greenland and Denmark has not been found. Therefore, the aim of this study is to estimate and compare the age- and gende… Diabetes mellitus is a large and growing worldwide health issue. Prior to this publication, a direct comparison of the prevalence of persons treated with anti-diabetic medicine in Greenland and Denmark has not been found. Therefore, the aim of this study is to estimate and compare the age- and gender-specific prevalence of patients treated with anti-diabetic medicine comparing Greenland and Denmark. The study was performed as a cross-sectional register study using data from population and medical registers in Greenland and Denmark. A total of 784 Greenlandic and 215,580 Danish patients treated with anti-diabetic medicine were included. The prevalence of patients aged 20–79 years treated with anti-diabetic medicine in Greenland was 2.6% (95% CI 2.4–2.8), much lower (p < 0.001) compared to Denmark with 5.2% (95% CI 5.2–5.2). The difference was less pronounced after excluding those treated with insulin and women below 45 years treated with metformin. In conclusion, this study showed a lower prevalence of patients treated with anti-diabetic medicine in Greenland than Denmark. The main reason may be a much higher prevalence of undiagnosed diabetes in Greenland, particularly among the middle-aged. Differences in awareness of diabetes and access to continued primary healthcare may be contributing factors. Læs mere

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Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical i… Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20–29 years to 70–79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probit-transformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results: In 2005–16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the high-income Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups. Læs mere

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Objective: Type 2 diabetes (T2D) may develop slowly with few symptoms and may remain undetected for many years, leading to severe complications that potentially could have been prevented with timely diagnosis and treatment. Undiagnosed diabetes has been reported high in Greenland. However, awareness… Objective: Type 2 diabetes (T2D) may develop slowly with few symptoms and may remain undetected for many years, leading to severe complications that potentially could have been prevented with timely diagnosis and treatment. Undiagnosed diabetes has been reported high in Greenland. However, awareness and knowledges about diabetes in the general population remains unexplored. Methods: This study was performed as an observational cross sectional study based on telephone interview among a random sample of Greenlanders. The interview was performed in Greenlandic or Danish according to participant’ preference and included information about age, gender, place of birth, place of residence, medical history of diabetes, awareness of the diabetes, risk factors, symptoms, complications, and local possibilities to get tested for diabetes. Results: In total, telephone contact was established with 196 adults. Of those, 161 participants completed the interview while 35 were unwilling to participate in the interview corresponding to a response rate of 82% (161/196). The majority of responders, 85.7%, were aware of diabetes and local testing possibilities. However, only around 65% were aware of risk factors of diabetes. Also, the knowledge about common symptoms of diabetes was quite low, around 50%, and in particular low, around 40%, among males and inhabitants in settlements. Conclusions: The vast majority of the population was aware of diabetes. However, the present study revealed shortage of knowledge of common risk factors, symptoms, and complications to diabetes. This is challenging the effort to prevent diabetes and new alternative information strategies are needed. Furthermore, the shortage of knowledges of risk factors may not be isolated to diabetes and further studies on health literacy in Greenland are recommended. Læs mere

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Gestational diabetes mellitus (GDM) is a serious condition associated to both maternal and offspring complications. Yet, no globally accepted consensus exists on how to test and diagnose GDM. In Greenland, the clinical criteria for testing and diagnosing GDM are adapted from Danish guidelines. The a… Gestational diabetes mellitus (GDM) is a serious condition associated to both maternal and offspring complications. Yet, no globally accepted consensus exists on how to test and diagnose GDM. In Greenland, the clinical criteria for testing and diagnosing GDM are adapted from Danish guidelines. The aim of this study was to estimate the prevalence of GDM among Greenlanders using both the current clinical GDM criteria and the recent WHO 2013 criteria and, further, to study the association between GDM, pre-pregnant overweight or obesity and macrosomia. A cross-sectional study of all 450 Greenlandic women who gave birth to a singleton in Nuuk within 1 year was performed. Based on an oral glucose tolerance test measuring capillary whole blood glucose, 119 women were categorised as having clinical GDM, WHO 2013 GDM or not GDM. Macrosomia defined as birth weight above 4,000 g was used as outcome variable. The prevalence of clinical GDM and WHO 2013 GDM was 0.4% (95% CI; 0–1.1) and 6.9% (95% CI; 4.5–9.2). WHO 2013 GDM, fasting blood glucose, pre-pregnant maternal overweight and obesity were associated with macrosomia. WHO 2013 GDM criteria were superior to clinical criteria in predicting macrosomia indicating that it may be time to consider the diagnostic strategy used in Greenland. Pre-pregnant overweight may also need more intensified lifestyle-intervention. Læs mere

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Aim: The objective of this study was to estimate and compare between Greenlanders and non-Greenlanders living in Nuuk the proportion of patients with type 2 diabetes with microvascular complications. Methods: This study was performed as a cross-sectional register study based on information in the E… Aim: The objective of this study was to estimate and compare between Greenlanders and non-Greenlanders living in Nuuk the proportion of patients with type 2 diabetes with microvascular complications. Methods: This study was performed as a cross-sectional register study based on information in the Electronic Medical Record (EMR). All patients diagnosed with type 2 diabetes and with permanent addresses in Nuuk were included. Patients born in Greenland were considered to be Greenlanders, while patients born outside Greenland were considered as non-Greenlanders. Proportions of patients with retinopathy, microalbuminuria, nephropathy and neuropathy were estimated based on information from the EMR. Results: A total of 393 patients (295 Greenlanders and 98 non-Greenlanders) were included. In total 83.0% of all patients have been screened for retinopathy, while 66.4% were screened for microalbuminuria and 64.6% for neuropathy within a two year period. The most frequent microvascular complication was neuropathy, which was observed among half (49.6%) of all patients followed by microalbuminuria (28.4%), retinopathy (10.7%) and nephropathy (7.3%). Retinopathy was observed among 21.4% of the non-Greenlanders compared to only 7.0% of the Greenlanders (p = .001). Microalbuminuria was also observed more frequently (p = .047) among non-Greenlanders (37.5%) than among Greenlanders (24.9%). Conclusion: Greenlanders seem to be less prone to especially retinopathy than are non-Greenlanders. Læs mere

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Cardiovascular disease (CVD) is one of the leading causes of death worldwide. In Greenland, valid estimates of prevalence and incidence of CVD do not exist and can only be calculated if diagnoses of CVD in the Greenlandic Hospital Discharge Register (GHDR) are correct. Diagnoses of CVD in GHDR have… Cardiovascular disease (CVD) is one of the leading causes of death worldwide. In Greenland, valid estimates of prevalence and incidence of CVD do not exist and can only be calculated if diagnoses of CVD in the Greenlandic Hospital Discharge Register (GHDR) are correct. Diagnoses of CVD in GHDR have not previously been validated specifically. The objective of the study was to validate diagnoses of CVD in GHDR. The study was conducted as a validation study with primary investigator comparing information in GHDR with information in medical records. Diagnoses in GHDR were considered correct and thus valid if they matched the diagnoses or the medical information in the medical records. A total of 432 online accessible medical records with a cardiovascular diagnosis according to GHDR from Queen Ingrid’s Hospital from 2001 to 2013 (n=291) and from local health care centres from 2007 to 2013 (n=141) were reviewed. Ninety-nine and ninety-two percent of discharge diagnosis in GHDR from Queen Ingrid’s Hospital and local health care centres were correct in comparison with diagnoses in the medical record indicating valid registration practice. The correctness of cardiovascular diagnoses in GHDR was considered high in terms of acceptable agreement between medical records and diagnoses in GHDR. Cardiovascular diagnoses are valid for epidemiological use. Læs mere

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Background: During past decades the formerly active lifestyle in Greenland has become sedentary, and the intake of traditional food has gradually been replaced with imported food. These lifestyle and dietary habits may affect pregnant women. Aim: To describe age and regional differences in reproduct… Background: During past decades the formerly active lifestyle in Greenland has become sedentary, and the intake of traditional food has gradually been replaced with imported food. These lifestyle and dietary habits may affect pregnant women. Aim: To describe age and regional differences in reproductive factors, lifestyle and diet among Greenlandic pregnant women in their first trimester. Methods: A cross-sectional study during 2013–2015 including 373 pregnant women was conducted in five Greenlandic regions (West, Disko Bay, South, North and East). Interview-based questionnaires on reproductive factors, lifestyle and dietary habits were compared in relation to two age groups (median age ≤28 years and >28 years). Results: In total, 72.4% were Inuit, 46.6% had BMI >25.0 kg/m2, 29.0% were smoking during pregnancy and 54.6% had used hashish. BMI, educational level, personal income, previous pregnancies and planned breastfeeding period were significantly higher in the age group >28 years of age compared to the age group ≤28 years of age. In region Disko Bay, 90.9% were Inuit, in region South more had a university degree (37.9%) and region East had the highest number of previous pregnancies, the highest number of smokers during pregnancy and the most frequent intake of sauce with hot meals and fast-food. Conclusions: Overall a high BMI and a high smoking frequency were found. Age differences were found for BMI and planned breastfeeding period, while regional differences were found for smoking and intake of sauce with hot meals and fast-food. Future recommendations aimed at pregnant women in Greenland should focus on these health issues. Læs mere

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Background: The eight Arctic States exhibit substantial health disparities between their remote northernmost regions and the rest of the country. This study reports on the trends and patterns in the supply and distribution of physicians, dentists and nurses in these 8 countries and 25 regions and ad… Background: The eight Arctic States exhibit substantial health disparities between their remote northernmost regions and the rest of the country. This study reports on the trends and patterns in the supply and distribution of physicians, dentists and nurses in these 8 countries and 25 regions and addresses issues of comparability, data gaps and policy implications. Methods: We accessed publicly available databases and performed three types of comparisons: (1) among the 8 Arctic States; (2) within each Arctic State, between the northern regions and the rest of the country; (3) among the 25 northern regions. The unit of comparison was density of health workers per 100,000 inhabitants, and the means of three 5-year periods from 2000 to 2014 were computed. Results: The Nordic countries consistently exceed North America in the density of all three categories of health professionals, whereas Russia reports the highest density of physicians but among the lowest in terms of dentists and nurses. The largest disparities between “north” and “south” are observed in the Northwest Territories and Nunavut of Canada for physicians, and in Greenland for all three categories. The disparity is much less pronounced in the northern regions of Nordic countries, while Arctic Russia tends to be oversupplied in all categories. Conclusions: Despite efforts and standardisation of definitions by international organisations such as OECD, it is difficult to obtain an accurate and comparable estimate of the health workforce even in the basic categories of physicians, dentists and nurses . The use of head counts is particularly problematic in jurisdictions that rely on short-term visiting staff. Comparing statistics also needs to take into account the health care system, especially where primary health care is nurse-based. List of Abbreviations ADA: American Dental Association; AHRF: Area Health Resource File; AMA: American Medical Association; AO: Autonomous Okrug; AVI: Aluehallintovirasto; CHA: Community Health Aide; CHR: Community Health Representative; CHW: Community Health Worker; CIHI: Canadian Institute for Health Information; DO: Doctor of Osteopathic Medicine; FTE: Full Time Equivalent; HPDB: Health Personnel Database; MD: Doctor of Medicine; NOMESCO: Nordic Medico-Statistical Committee; NOSOSCO: Nordic Social Statistical Committee; NOWBASE: Nordic Welfare Database; NWT: Northwest Territories; OECD: Organization for Economic Co-operation and Development; RN: Registered Nurse; SMDB: Scott’s Medical Database; WHO: World Health Organization. Læs mere

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Background: During the last decades, social and life-style changes in Greenland have led to an increase in the incidence of several non-communicable diseases. Our aim is to present the cancer incidence and mortality in Greenland and compare the results with the other Nordic countries. Methods: The… Background: During the last decades, social and life-style changes in Greenland have led to an increase in the incidence of several non-communicable diseases. Our aim is to present the cancer incidence and mortality in Greenland and compare the results with the other Nordic countries. Methods: The data stems from The Danish Cancer Registry and The Danish Register of Causes of Death. Comparable data on cancer incidence and mortality in Denmark, Finland, Iceland, Norway, Sweden, and Greenland are available through collaboration between Nordic Cancer Registries (NORDCAN). We included all individuals residing in Greenland and diagnosed with or died of a cancer from 1983 to 2014. Findings: The total number of cancer cases in Greenland for the study period was 4716 and there were 3231 cancer deaths. Respiratory and gastrointestinal cancers had the highest incidence as well as mortality in Greenland for the entire time period and for both sexes. Compared to the other Nordic countries, Greenland had significantly higher incidence and mortality rates for several cancers. Cancer of the lip, oral cavity, and pharynx, respiratory cancer, and cancer of unknown sites had the highest incidence rate ratios (2.3–3.9) and mortality rate ratios (2.7–9.9) for both sexes. The time trend from 1983 to 2014 showed a significant increase in cancer incidence in Greenland with nearly the same incidence level as the other Nordic countries. While the cancer mortality decreased in the other Nordic countries during the time period studied, there was no change in the cancer-specific mortality in Greenland. Interpretations: The trends in cancer incidence and mortality in Greenland compared to the other Nordic countries have not been reported earlier. These data underline a need to focus on cancer-specific mortality in Greenland and prevention of high-incidence cancers related to well-established risk factors. Læs mere

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Zoonotic infections transmitted from terrestrial and marine mammals to humans in European Arctic are of unknown significance, despite considerable potential for transmission due to local hunt and a rapidly changing environment. As an example, infection with Brucella bacteria may have significant imp… Zoonotic infections transmitted from terrestrial and marine mammals to humans in European Arctic are of unknown significance, despite considerable potential for transmission due to local hunt and a rapidly changing environment. As an example, infection with Brucella bacteria may have significant impact on human health due to consumption of raw meat or otherwise contact with tissues and fluids of infected game species such as muskoxen and polar bears. Here, we present serological results for Baffin Bay polar bears (Ursus maritimus) (n = 96) and North East Greenland muskoxen (Ovibos moschatus) (n = 32) for antibodies against Brucella spp. The analysis was a two-step trial initially using the Rose Bengal Test (RBT), followed by confirmative competitive enzyme-linked immunosorbent assays of RBT-positive samples. No muskoxen had antibodies against Brucella spp., while antibodies were detected in six polar bears (6.25%) rendering a seroprevalence in line with previous findings in other Arctic regions. Seropositivity was not related to sex, age or biometrics i.e. size and body condition. Whether Brucella spp. antibodies found in polar bears were due to either prey spill over or true recurrent Brucella spp. infections is unknown. Our results therefore highlight the importance of further research into the zoonotic aspects of Brucella spp. infections, and the impact on wildlife and human health in the Arctic region. Læs mere

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N-acetyltransferase 2 (NAT2) is the main enzyme metabolizing isoniazid and genotype-based treatment has been studied for years without becoming common practice. To investigate whether genotype-based isoniazid treatment is feasible in Greenland, we sequenced the coding sequence of NAT2 and determined… N-acetyltransferase 2 (NAT2) is the main enzyme metabolizing isoniazid and genotype-based treatment has been studied for years without becoming common practice. To investigate whether genotype-based isoniazid treatment is feasible in Greenland, we sequenced the coding sequence of NAT2 and determined the NAT2 enzyme-activity by caffeine test. No additional genetic variants were identified in the coding sequence of NAT2, so that genotype status in 260 study participants could be assessed by a well-established 7-SNP panel. Studying the enzyme activity by the ratio of the two caffeine metabolites AFMU and 1X in 260 participants showed a high rate of slow phenotypes with intermediate or rapid genotype. These misclassifications were mainly observed in urine samples with pH<3, a deviation from the standard protocol due to the field work character of the study, where immediate pH adjustment to pH=3.5 was not possible. We excluded these samples. For the remaining 143 individuals with pH>3, we observed a moderate level of discrepancies (19 of the 116 individuals with intermediate or rapid genotype status having a slow phenotype). Further investigation showed that drinking coffee and not tea or cola was the most important factor for high levels of both metabolites. The concordance between phenotype and genotype status with regard to slow metabolism supported the recommendation of lower isoniazid doses in individuals with slow genotype status in order to avoid liver injury, a frequent side effect. The phenotypical variation observed for individuals with intermediate or rapid genotype status warrants further research before increased dosing of isoniazid can be recommended. Læs mere

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We summarised available hepatitis C virus (HCV) surveillance data for 2012–14 from Arctic/sub-Arctic countries/regions. We sent a HCV data collection template by email to public health authorities in all jurisdictions. Population statistics obtained from census sources for each country were used to… We summarised available hepatitis C virus (HCV) surveillance data for 2012–14 from Arctic/sub-Arctic countries/regions. We sent a HCV data collection template by email to public health authorities in all jurisdictions. Population statistics obtained from census sources for each country were used to estimate rates of reported acute and chronic/undifferentiated HCV cases. Seven countries with Arctic regions (Canada, Denmark, Finland, Greenland, Norway, Sweden and the United States, represented by the state of Alaska), including three Canadian territories and one province, as well as 11 Russian subnational Arctic regions, completed the data collection template. Data on acute HCV infection during 2014 was available from three Arctic countries and all Russian Arctic regions (rate range 0/100,000 population in Greenland, as well as Nenets and Chukotka Automous Okrugs (Russian subnational Arctic regions) to 3.7/100,000 in the Russian Republic of Komi). The rate of people with chronic/undifferentiated HCV infection in 2014 ranged from 0/100,000 in Greenland to 171.2/100,000 in Alaska. In most countries/regions, the majority of HCV-infected people were male and aged 19–64 years. Differences in surveillance methods preclude direct comparisons of HCV surveillance data between Arctic countries/regions. Our data can inform future efforts to develop standardised approaches to HCV surveillance in the Arctic countries/regions by identifying similarities/differences between the surveillance data collected. Læs mere

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SETTING: The northern circumpolar jurisdictions Canada (Northwest Territories, Nunavik, Nunavut, Yukon), Finland, Greenland, Norway, Russian Federation (Arkhangelsk), Sweden and the United States (Alaska). OBJECTIVE: To describe and compare demographic, clinical and laboratory characteristics, incl… SETTING: The northern circumpolar jurisdictions Canada (Northwest Territories, Nunavik, Nunavut, Yukon), Finland, Greenland, Norway, Russian Federation (Arkhangelsk), Sweden and the United States (Alaska). OBJECTIVE: To describe and compare demographic, clinical and laboratory characteristics, including drug resistance and treatment completion, of tuberculosis (TB) cases in the northern circumpolar populations. DESIGN: Descriptive analysis of all active TB cases reported from 2006 to 2012 for incidence rate (IR), age and sex distribution, sputum smear and diagnostic site characteristics, drug resistance and treatment completion rates. RESULTS: The annual IR of TB disease ranged from a low of 4.3 per 100 000 population in Northern Sweden to a high of 199.5/100 000 in Nunavik, QC, Canada. For all jurisdictions, IR was higher for males than for females. Yukon had the highest proportion of new cases compared with retreatment cases (96.6%). Alaska reported the highest percentage of laboratory-confirmed cases (87.4%). Smear-positive pulmonary cases ranged from 25.8% to 65.2%. Multidrug-resistant cases ranged from 0% (Northern Canada) to 46.3% (Arkhangelsk). Treatment outcome data, available up to 2011, demonstrated >80% treatment completion for four of the 10 jurisdictions. CONCLUSION: TB remains a serious public health issue in the circumpolar regions. Surveillance data contribute toward a better understanding and improved control of TB in the north. Læs mere

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This article focuses on the methodology of the project Ageing in the Arctic (AgeArc) – Wellbeing, Quality of Life and Health Promotion among Older People in Greenland, and how the use of a collaborative approach aims at integrating ageing research, practices and policies to the benefit of the Greenl… This article focuses on the methodology of the project Ageing in the Arctic (AgeArc) – Wellbeing, Quality of Life and Health Promotion among Older People in Greenland, and how the use of a collaborative approach aims at integrating ageing research, practices and policies to the benefit of the Greenlandic society. Thus, the aim of the article is to discuss how collaboration between research and practice can be an important factor in sustainable development of welfare solutions for older people in Greenland. In the project we study ageing policy, homecare, institutions, professional practices and municipal administration of these as well as older people’s health, well-being, everyday life and historical perceptions of the roles of older people in Greenland. Moreover, researchers and municipalities collaborate on developing policies, initiatives within municipalities and civil society as well as creating network across the municipalities and between municipal administrations and civil society. In addition to this, we develop educational material for healthcare workers and professionals and work to create more public awareness about ageing in Greenland. We present three examples of our collaborative methods and discuss how the approach influences development and implementation of specific co-creation projects involving researchers, professionals and citizens on equal terms. Læs mere

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Under indtryk af en stigende andel af ældre i befolkningen er rehabilitering på vej til at blive en del af kommunernes tilbud. Ikke kun som en opgave for ergo- og fysioterapeuter, men som en tværfaglig opgave, også for det omsorgsfaglige personale. Denne artikel diskuterer forskellige tilgange til r… Under indtryk af en stigende andel af ældre i befolkningen er rehabilitering på vej til at blive en del af kommunernes tilbud. Ikke kun som en opgave for ergo- og fysioterapeuter, men som en tværfaglig opgave, også for det omsorgsfaglige personale. Denne artikel diskuterer forskellige tilgange til rehabilitering og deres konsekvenser for brugerne. Artiklen er en bearbejdning af et oplæg holdt på ICCH-konferencen i august i år og bygger på materiale fra et projekt om rehabilitering i hjemmeplejen i Nuuk, som blev gennemført i 2017. Læs mere

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The evolutionary history of the wolf-like canids of the genus Canis has been heavily debated, especially regarding the number of distinct species and their re- lationships at the population and species level [1–6]. We assembled a dataset of 48 resequenced ge- nomes spanning all members of the genus… The evolutionary history of the wolf-like canids of the genus Canis has been heavily debated, especially regarding the number of distinct species and their re- lationships at the population and species level [1–6]. We assembled a dataset of 48 resequenced ge- nomes spanning all members of the genus Canis except the black-backed and side-striped jackals, encompassing the global diversity of seven extant canid lineages. This includes eight new genomes, including the first resequenced Ethiopian wolf (Canis simensis), one dhole (Cuon alpinus), two East African hunting dogs (Lycaon pictus), two Eurasian golden jackals (Canis aureus), and two Middle Eastern gray wolves (Canis lupus). The relationships between the Ethiopian wolf, African golden wolf, and golden jackal were resolved. We highlight the role of interspecific hybridization in the evolution of this charismatic group. Specifically, we find gene flow between the ancestors of the dhole and African hunting dog and admixture between the gray wolf, coyote (Canis latrans), golden jackal, and African golden wolf. Additionally, we report gene flow from gray and Ethiopian wolves to the African golden wolf, suggest- ing that the African golden wolf originated through hybridization between these species. Finally, we hypothesize that coyotes and gray wolves carry genetic material derived from a ‘‘ghost’’ basal canid lineage. Læs mere

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A solid primary school is an important part of the foundation for creating a strong and sustainable society. Almost every country has undertaken school system reforms during the past two decades, but very few have succeeded in improving their systems from poor to fair to good to great to excellent (… A solid primary school is an important part of the foundation for creating a strong and sustainable society. Almost every country has undertaken school system reforms during the past two decades, but very few have succeeded in improving their systems from poor to fair to good to great to excellent (Mourshed et al., 2010). History, culture, and context matter for understanding applicability, if any, of one educational innovation over another. This can be said to have been the case in Greenland. One of the fundamental objectives after the introduction of Home Rule in 1979 was to adapt the Danish structures and systems to the Greenlandic conditions and culture. This article aims to analyze the Greenlandic education governance system and how the central level design, organizes and steers education systems across complex multilevel governance arrangements. In governing educational systems, how the central and the decentralized levels interact and communicate and how this affects trust, cooperation and negotiation of conflicts, and ultimately the outcomes of reform, will be discussed. Læs mere

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North America is currently home to a number of grey wolf (Canis lupus) and wolf-like canid populations, including the coyote (Canis latrans) and the taxonomically controversial red, Eastern timber and Great Lakes wolves. We explored their population structure and regional gene flow using a dataset o… North America is currently home to a number of grey wolf (Canis lupus) and wolf-like canid populations, including the coyote (Canis latrans) and the taxonomically controversial red, Eastern timber and Great Lakes wolves. We explored their population structure and regional gene flow using a dataset of 40 full genome sequences that represent the extant diversity of North American wolves and wolf-like canid populations. This included 15 new genomes (13 North American grey wolves, 1 red wolf and 1 Eastern timber/Great Lakes wolf), ranging from 0.4 to 15x coverage. In addition to providing full genome support for the previously proposed coyote-wolf admixture origin for the taxonomically controversial red, Eastern timber and Great Lakes wolves, the discriminatory power offered by our dataset suggests all North American grey wolves, including the Mexican form, are monophyletic, and thus share a common ancestor to the exclusion of all other wolves. Furthermore, we identify three distinct populations in the high arctic, one being a previously unidentified “Polar wolf” population endemic to Ellesmere Island and Greenland. Genetic diversity analyses reveal particularly high inbreeding and low heterozygosity in these Polar wolves, consistent with long-term isolation from the other North American wolves. Læs mere

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Dogs were present in the Americas before the arrival of European colonists, but the origin and fate of these precontact dogs are largely unknown. We sequenced 71 mitochondrial and 7 nuclear genomes from ancient North American and Siberian dogs from time frames spanning ~9000 years. Our analysis indi… Dogs were present in the Americas before the arrival of European colonists, but the origin and fate of these precontact dogs are largely unknown. We sequenced 71 mitochondrial and 7 nuclear genomes from ancient North American and Siberian dogs from time frames spanning ~9000 years. Our analysis indicates that American dogs were not derived from North American wolves. Instead, American dogs form a monophyletic lineage that likely originated in Siberia and dispersed into the Americas alongside people. After the arrival of Europeans, native American dogs almost completely disappeared, leaving a minimal genetic legacy in modern dog populations. The closest detectable extant lineage to precontact American dogs is the canine transmissible venereal tumor, a contagious cancer clone derived from an individual dog that lived up to 8000 years ago. Læs mere

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This study investigated the effects of single nucleotide polymorphisms (SNPs) in xenobiotic and steroid hormone‐metabolizing genes in relation to breast cancer risk and explored possible effect modifications on persistent organic pollutants (POPs) and breast cancer associations. The study also asses… This study investigated the effects of single nucleotide polymorphisms (SNPs) in xenobiotic and steroid hormone‐metabolizing genes in relation to breast cancer risk and explored possible effect modifications on persistent organic pollutants (POPs) and breast cancer associations. The study also assessed effects of Greenlandic BRCA1 founder mutations. Greenlandic Inuit women (77 cases and 84 controls) were included. We determined two founder mutations in BRCA1: Cys39Gly (rs80357164) and 4684delCC, and five SNPs in xenobiotic and oestrogen‐metabolizing genes: CYP17A1 ‐34T>C (rs743572), CYP19A1 *19C>T (rs10046), CYP1A1 Ile462Val (rs1048943), CYP1B Leu432Val (rs1056836) and COMT Val158Met (rs4680). We used chi‐square test for comparison of categorical variables between groups. Odds ratio (OR) estimates with 95% confidence interval (95%CI) were obtained using logistic regression models. The variant allele of BRCA1 Cys39Gly increased breast cancer risk (Gly/Cys versus Cys/Cys, OR: 12.2, 95%CI: 1.53; 98.1), and carriers of the variant allele of CYP17A1 ‐34T>C had reduced risk (CT+CC versus TT, OR: 0.44, 95%CI: 0.21; 0.93). CYP17A1 ‐34T>C was an effect modifier on the association between perfluoroalkyl acids (PFAAs) and breast cancer risk (∑PFAA, ratio of OR: 0.18, 95%CI: 0.03; 0.97). Non‐significant modifying tendencies were seen for the other SNPs on the effect of polychlorinated biphenyls, organochlorine pesticides and PFAAs. In summary, the BRCA1 Cys39Gly and CYP17A1 ‐34T>C genetic variations were associated with breast cancer risk. Our results indicate that the evaluated genetic variants modify the effects of POP exposure on breast cancer risk; however, further studies are needed to document the data from the relatively small sample size. Læs mere

Research | Forskning - peer review

The Arctic populations have high blood concentrations of persistent organic pollutants (POPs). Exposure to POPs was related to adverse health effects e.g. immune, neurological and reproductive systems. This study investigates associations between serum POP levels and haematological markers in Greenl… The Arctic populations have high blood concentrations of persistent organic pollutants (POPs). Exposure to POPs was related to adverse health effects e.g. immune, neurological and reproductive systems. This study investigates associations between serum POP levels and haematological markers in Greenlandic pregnant women. This cross-sectional study included 189 women enrolled in 2010–2011 at the Greenlandic West coast by the inclusion criteria ≥18 years of age and had lived for 50% or more of their life in Greenland. The associations between the sum of the POP variables polychlorinated biphenyls (sumPCBs), organochlorine pesticides (sumOCPs), perfluoroalkylated substances (sumPFASs) and 24 haematological markers were analysed using linear regression adjusted for age, pre-pregnancy BMI, parity, gestation week, plasma-cotinine and alcohol intake. It showed a significantly inverse association between several haematological markers (eosinophil, lymphocyte, neutrophil and white blood cells) and sumPCBs, sumOCPs and sumPFASs. In addition, the monocyte, mean corpuscular haemoglobin concentration, plateletcrit and platelet count markers were significantly inversely associated with sumPFASs, but the haematocrit and mean erythrocyte corpuscular volume were positively associated with sumPFASs. In conclusion, exposure to POPs influenced several haematological markers, especially cell count parameters, suggesting immunosuppressive potential of POPs in Greenlandic pregnant women. The data need further investigations. Læs mere

Research | Forskning

Little research has been conducted to examine Greenlandic media and journalism. This thesis initially outlines the Greenlandic media landscape as a small media system which - despite some mutual differences - shares many similarities with the Danish media system. It is, however, also characterized b… Little research has been conducted to examine Greenlandic media and journalism. This thesis initially outlines the Greenlandic media landscape as a small media system which - despite some mutual differences - shares many similarities with the Danish media system. It is, however, also characterized by certain highly important vulnerabilities. The thesis therefore goes on to suggest the concept of “small society journalism”. The primary empirical data is collected through observation studies and qualitative interviews with practicing and former journalists, editors, interns and journalism teachers. By entering into a dialogue with journalists in Greenland, the study of the data sheds light on a range of issues that are related to journalism practice in Greenlandic news media. Theoretically, the thesis draws on Bourdieu’s field theory and the application of field theory by other journalism and media researchers in the study of journalistic practice. The application of field theory, however, requires a specific national context, and in the case of Greenland, a post-colonial prism is key in order to grasp the reality that unfolds in the editorial room as an analytical field. As a consequence, the thesis also draws on concepts from postcolonial studies. The analysis gives an ethnographic description of the routines and the structural framework surrounding the editorial work, and of how the production of news takes place. Subsequently, an analysis of the critical significance of the sources and of the challenges that are related to finding qualified and accessible sources, which is a crucial instrument in journalistic practice, follows. This is followed by a discussion of the - in a Greenlandic setting - inevitable question of language which partly determines much of the daily journalistic work procedure, for example by the central editorial role given to the translator. The thesis shows that journalism and media is a much debated and disputed field in Greenland and that Greenlandic journalists struggle with geographic, economic and structural vulnerabilities that exist in small media systems. Furthermore, a number of dilemmas relating to language and culture exist which are of vital importance to how the journalists work. Kalaallit Nunaanni tusagassiuutit tusagassiornerlu pillugit ilisimatusarneq annikitsuinnaammat ilisimatuutut allaaserisami matumani aallarniutigineqassaaq Kalaallit Nunaanni tusagassiornerup misissuiffigineqarnera, tusagassiorfeeqqatut systemi qanoq ittuunersoq misissuiffigalugu taannalu assigiinngissuteqartaraluarluni sananeqaatimigut inatsisiliorneqarnermigullu danskit tusagassiuuteqarnermi systemiannut assinguvoq, kisiannili Kalaallit Nunaanni tusagassiorfeeqqatut systemip ilisarnaatigai immikkut ittumik eqqoruminassuseqartuuneq. Taamaattumik ilisimatuutut allaaserisami siunnersuutigineqarpoq oqariartaaseq inuiaqatigiinni inukitsuni tusagassiorneq Hallinip Mancinillu tusagassiuuteqarnermi systemimut teoriannut ilisimaneqarluartumut ilassutigineqassasoq. Ilisimatuutut allaaserisami misilittakkat pingaarnerit katersorneqarsimasut alaatsinaattuunermit aalajangersimasumillu amerlassusilikkanik siornatigut maannalu tusagassiortunik, aaqqissuisunik, ilinniartunik ilinniartitsisunillu apersuinertigut ingerlanneqarput. Misilittakkanik misissueqqissaarnerup takutippaa ajornartorsiutinik arlaqartunik peqartoq Kalaallit Nunaanni nutaarsiassaqartitsinermut ingerlanneqartumut tunngasunik. Ilisimatuutut allaaserisami tunngavigineqarpoq Bourdieup misissuinermut teoria kiisalu tusagassiornermik tusagassiuutinillu ilisimatuut allat Bourdieup teoria atorlugu tusagassiornermik atuuttumik misissueriaasii. Teorip misissuinermi atorneqartup piumasaraa nunami pissutsit atuuttut isiginiarneqassasut Kalaallillu Nunaat pineqartillugu nunasiaataasimanerup kingunerisa sunniutai oqaluttuarisaanerlu pissusiviusunut atuuttunut pingaaruteqarput, aaqqissuisoqarfinni misissuiffiusuni atuuttut taamaattumillu ilisimatuutut allaaserisami oqariartaatsit nunasiaataasimanerup kingunerinut tunngasut misissuinermut ilaapput. Misissueqqissaarneq aaqqissuisoqarfinni sulinermi inuiattut kinaassuseq aallaavigalugu suleriaatsinik tamatumalu sinaakkutaanik takutitsivoq kiisalu takutilluguttaaq ulluinnarni nutaarsiassalerisarneq qanoq ingerlasarnersoq. Tamatumuma kingorna misissuiffigineqarput tusarfiit qanoq pingaaruteqartiginersut, tusagassioriaaseq qanoq ittoq ingerlanneqartarnersoq kiisalu tusarfinnik atorsinnaassusilinnik nassaassaasunillu nassaarsiortarnermi suut unamminartuusarnersut, tassalu tusagassiuinermi sakkut pingaaruteqarluinnartut pineqarlutik. Tulliullugu oqallisigineqarpoq – kalaallinut atatillugu – apeqqutit sammiuiminaatsut oqaatsinut tunngasut tassalu ulluinnarni tusagassiortutut sulinermi tunngaviusumik anguniarneqartartut aammalu imminni isumalerujussuit. Tusagassiornermut ingerlatamut tunngaannaratik aammali avatangiisigisat tusagassiorfinni oqaatsinik atuinermi naatsorsuutigisaannut tunngasut taamalu aamma kalaallinik kinaassusiliisut. Ilisimatuutut allaaserisap takutippaa tusagassiorneq tusagassiorfiillu Kalaallit Nunaanni annertuumik oqallisaasut kiisalu kalaallit tusagassiortut akiorniagassaat nunamut, aningaasaqarnermut aaqqissuussaanermullu tunngasutigut eqqoruminassuseqaannaratik aammali arlalitsigut oqaatsitigut kulturikkullu akunnattoorutinik nalaanneqartarnermut tunngasartut, tusagassiortutut qanoq suleriaaseqarnermut pingaaruteqartorujussuarnik. Læs mere

Communication | Formidling

Litteraturgennemgangen vil i oversigtsform bidrage med korte beskrivelser af en række af undersøgelserne og i nogle tilfælde tilføje kortere eller længere uddrag/sammendrag af undersøgelsernes resultater/konklusioner: 1. Befolkningsundersøgelserne (sundhedsprofilundersøgelser og undersøgelser med r… Litteraturgennemgangen vil i oversigtsform bidrage med korte beskrivelser af en række af undersøgelserne og i nogle tilfælde tilføje kortere eller længere uddrag/sammendrag af undersøgelsernes resultater/konklusioner: 1. Befolkningsundersøgelserne (sundhedsprofilundersøgelser og undersøgelser med relation til de landsdækkende sundhedsprogrammer) 2. Levevilkårsundersøgelser 3. Betænkninger og undersøgelser gennemført på foranledning af offentlige myndigheder 4. Undersøgelser af særlige grupper – herunder antologier Læs mere

Research | Forskning - peer review

Determinants of an integrated public health approach: the implementation process of Greenland’s second public health program

Background: Greenland struggles with a high prevalence of smoking, alcohol and drug abuse. In response to the increasing need for preventive initiatives, the first public health program Inuuneritta was introduced in 2007. Internationally, frameworks focus primarily on the implementation of a single,… Background: Greenland struggles with a high prevalence of smoking, alcohol and drug abuse. In response to the increasing need for preventive initiatives, the first public health program Inuuneritta was introduced in 2007. Internationally, frameworks focus primarily on the implementation of a single, well-described intervention or program. However, with the increasing need and emergence of more holistic, integrated approaches, a need for research investigating the process of policy implementation from launch to action arises. This paper aims to augment the empirical evidence on the implementation of integrated health promotion programs within a governmental setting using the case of Inuuneritta II. In this study, the constraining and enabling determinants of the implementation processes within and across levels and sectors were examined. Methods: Qualitative methods with a transdisciplinary approach were applied. Data collection consisted of six phases with different qualitative methods applied to gain a comprehensive overview and understanding of Inuuneritta II’s implementation process. These methods included: observations and focus group discussions at the community health worker (CHW) conference, telephone interviews, document analysis, and a workshop on results dissemination. Results: Enabling determinants influencing the implementation process of Inuuneritta II positively were high motivation among adopters, local prevention committees supporting community health workers, and the initiation of the central prevention committee. In contrast, constraining determinants were ambiguous program aims, high turnovers, siloed budgets and work environments, and an inconsistent and neglected central prevention committee. Conclusion: Inuuneritta II provided a substantial framework for an integrated health policy approach. However, having a holistic and comprehensive program enabling an integrated approach is not sufficient. Inuuneritta II’s integrated approach does not harmonise with the government’s inflexible organisational structure resulting in insufficient implementation. Læs mere

Consultancy | Rådgivning

Evaluering af Grønlands Sundhedsreform: Oplevede og målbare effekter 2017

Formålet med denne evaluering af Sundhedsreformen er at gøre status på den ledelsesmæssige oplevelse af organiseringen af sundhedsvæsenet efter den fulde implementering af regionaliseringen. Dette er gjort dels gennem dokumentanalyse af en stor mængde rapporter, notater og oversigter fra Sundhedsled… Formålet med denne evaluering af Sundhedsreformen er at gøre status på den ledelsesmæssige oplevelse af organiseringen af sundhedsvæsenet efter den fulde implementering af regionaliseringen. Dette er gjort dels gennem dokumentanalyse af en stor mængde rapporter, notater og oversigter fra Sundhedsledelsen, og dels gennem 17 kvalitative interviews med repræsentanter fra regions-, område- og sundhedsledelse, der har været med til at gennemføre regionaliseringen, samt med enkelte medarbejdere fra forskellige sektorer og regioner med erfaring fra før og efter reformen. Læs mere

Consultancy | Rådgivning

A scoping review: Well-being among indigenous children and youth in the Arctic – with a focus on Sami and Greenland Inuit

Children and young people from the Inuit and Sami populations in the Nordic countries can be identified as a vulnerable group. Young Sami and Inuit experience a higher degree of violence, abuse, suicidal thoughts and suicide rates compared to their peers in the majority populations in the Nordic cou… Children and young people from the Inuit and Sami populations in the Nordic countries can be identified as a vulnerable group. Young Sami and Inuit experience a higher degree of violence, abuse, suicidal thoughts and suicide rates compared to their peers in the majority populations in the Nordic countries. Their living conditions are in most cases influenced by a limited access to welfare benefits such as the healthcare system, social services and educational opportunities. Career prospects in the Arctic region are also narrow compared to the more densely populated and central regions in the Nordic countries. In order to understand and act upon the challenges the populations face, an in-depth and systematic review of the existing literature and experiences of children’s and youth’s well-being and their existing living conditions in the Arctic Region is essential. Læs mere

Research | Forskning - peer review

A prospective national cohort study assessed the development of health-related quality of life (HRQoL) and symptoms in adult patients undergoing treatment and care for advanced cancer in Greenland. HRQol was examined by EORTC QLQ-C30 version 3.0 questionnaire monthly for 4 months. Changes over time… A prospective national cohort study assessed the development of health-related quality of life (HRQoL) and symptoms in adult patients undergoing treatment and care for advanced cancer in Greenland. HRQol was examined by EORTC QLQ-C30 version 3.0 questionnaire monthly for 4 months. Changes over time and between-group comparisons were examined. Of 58 patients included in the study, 47% completed the questionnaire four times. Functioning was generally high, and improved social functioning was observed after 1 and 2 months. The highest symptom score was for fatigue followed by pain and nausea/vomiting. A high score for financial problems remained unchanged during the entire period. Patients with higher income had reduced pain intensity (p = .03) and diarrhoea (p = .05) than patients with income below the poverty line. After 1 month, reduction in pain intensity was observed for Nuuk citizens compared with non-Nuuk citizens (p = .05). After 2 months, non-Nuuk citizens reported improved social functioning compared with Nuuk citizens (p = .05). After 3 months, Global Health in Nuuk citizens was improved compared with non-Nuuk citizens (p = .05). An important clinical finding was that patients' needs for support are related to social status, and geographical factors should be taken into account when planning palliative care. Læs mere

Research | Forskning

This article focuses on the methodology of the project Ageing in the Arctic (AgeArc) – Wellbeing, Quality of Life and Health Promotion among Older People in Greenland, and how the use of a collaborative approach aims at integrating ageing research, practices and policies to the benefit of the Greenl… This article focuses on the methodology of the project Ageing in the Arctic (AgeArc) – Wellbeing, Quality of Life and Health Promotion among Older People in Greenland, and how the use of a collaborative approach aims at integrating ageing research, practices and policies to the benefit of the Greenlandic society. Thus, the aim of the article is to discuss how collaboration between research and practice can be an important factor in sustainable development of welfare solutions for older people in Greenland. In the project we study ageing policy, homecare, institutions, professional practices and municipal administration of these as well as older people’s health, well-being, everyday life and historical perceptions of the roles of older people in Greenland. Moreover, researchers and municipalities collaborate on developing policies, initiatives within municipalities and civil society as well as creating network across the municipalities and between municipal administrations and civil society. In addition to this, we develop educational material for healthcare workers and professionals and work to create more public awareness about ageing in Greenland. We present three examples of our collaborative methods and discuss how the approach influences development and implementation of specific co-creation projects involving researchers, professionals and citizens on equal terms. Læs mere

Research | Forskning - peer review

Background: During past decades the formerly active lifestyle in Greenland has become sedentary, and the intake of traditional food has gradually been replaced with imported food. These lifestyle and dietary habits may affect pregnant women. Aim: To describe age and regional differences in reproduct… Background: During past decades the formerly active lifestyle in Greenland has become sedentary, and the intake of traditional food has gradually been replaced with imported food. These lifestyle and dietary habits may affect pregnant women. Aim: To describe age and regional differences in reproductive factors, lifestyle and diet among Greenlandic pregnant women in their first trimester. Methods: A cross-sectional study during 2013–2015 including 373 pregnant women was conducted in five Greenlandic regions (West, Disko Bay, South, North and East). Interview-based questionnaires on reproductive factors, lifestyle and dietary habits were compared in relation to two age groups (median age ≤28 years and >28 years). Results: In total, 72.4% were Inuit, 46.6% had BMI >25.0 kg/m2, 29.0% were smoking during pregnancy and 54.6% had used hashish. BMI, educational level, personal income, previous pregnancies and planned breastfeeding period were significantly higher in the age group >28 years of age compared to the age group ≤28 years of age. In region Disko Bay, 90.9% were Inuit, in region South more had a university degree (37.9%) and region East had the highest number of previous pregnancies, the highest number of smokers during pregnancy and the most frequent intake of sauce with hot meals and fast-food. Conclusions: Overall a high BMI and a high smoking frequency were found. Age differences were found for BMI and planned breastfeeding period, while regional differences were found for smoking and intake of sauce with hot meals and fast-food. Future recommendations aimed at pregnant women in Greenland should focus on these health issues. Læs mere

Research | Forskning - peer review

I denne artikel beskrives orkestreringen af plejepersonales arbejdsliv på medicinske afsnit gennem måle og tasteaktiviteter ved computere. Computerne, som plejepersonale anvender til bl.a. tastning af patienternes vitale værdier, er mere end neutrale maskiner til identifikation af udvikling af sygel… I denne artikel beskrives orkestreringen af plejepersonales arbejdsliv på medicinske afsnit gennem måle og tasteaktiviteter ved computere. Computerne, som plejepersonale anvender til bl.a. tastning af patienternes vitale værdier, er mere end neutrale maskiner til identifikation af udvikling af sygelighed og dødelighed. Computerne er politisk implementeret med ambitioner om at fremme kosteffektiv patientsikker kommunikation på tværs af professioner og sektorer om et stigende antal ældre patienter og borgere. Men i et hverdagsliv kan der være uoverensstemmelse mellem de politiske ambitioner og plejepersonalets arbejdsliv. Plejepersonalet kan blive presset på tid, hvis computeren definerer, at ældre medicinske patienter med aldersrelaterede skæve vitale værdier skal måles hver ½ time. Læs mere

Communication | Formidling

In a global world where climate change and a growing population increase the requirements for food, the need for fertile soil becomes a problem, especially in the tropics. New research shows that Greenlandic Glacier Rock Flour (GRF) can be used to remineralise nutrient depleted soils and thus, to so… In a global world where climate change and a growing population increase the requirements for food, the need for fertile soil becomes a problem, especially in the tropics. New research shows that Greenlandic Glacier Rock Flour (GRF) can be used to remineralise nutrient depleted soils and thus, to some extent, alleviate some of these problems. This project investigates whether GRF ́s fertility potential depends on the size of the glacier thermal regime and locations. Glacier Rock Flour was collected from different sites in Greenland, Svalbard, Alaska and Argentina for comparison. Incubation experiments were carried out by mixing 10% GRF with soil/sand in the ratio 1:1. The level of available potassium and phosphorus was measured after two and four weeks and compared to a control sample only containing the soil/sand. The analysis shows that there is a difference in the available K depending on location, while the P analysis is more inconsistent. Based on the results, the main factor for nutrient release is the particle size of the GRF, and this is mainly influenced by the thermal regime of the glacier and the bedrock. The results also show that the physical properties and soil environment affect the release of potassium and phosphorus the most. Overall, GRF from Greenland seems to be more suitable for remineralisation compared to GRF from other locations, especially when looking at the available potassium. Læs mere

Communication | Formidling

Microorganisms have been acknowledged for centuries as key influencers on their surrounding environment. Scientific research has recently been able to validate and explore this using high throughput sequencing techniques that offer the potential to efficiently investigate the biodiversity in environ… Microorganisms have been acknowledged for centuries as key influencers on their surrounding environment. Scientific research has recently been able to validate and explore this using high throughput sequencing techniques that offer the potential to efficiently investigate the biodiversity in environmental samples. Advanced DNA sequencing techniques combined with modern microbial cultivation can provide a profound conception of a microbial community’s genotypic and phenotypic characteristics from a single environmental sample. I have combined both techniques in this MSc thesis, with a focus on analysing and inferring the microbial properties of Greenlandic glacial rock flour (GRF). GRF is currently being explored as a novel soil mineraliser, due to its promising mineralogical properties and the fact it represents an abundant and sustainable resource. I therefore characterised the microbial community of both pure GRF samples, and also following blending with agricultural soils to examine any resulting consequences to the agricultural soil microbial communities. The MSc thesis begins with an introduction containing a description of GRF, the microbiology related to the subject and the techniques used in this thesis. Subsequently this is followed with a first manuscript “Taxonomic profiling of the microbial community of Greenlandic glacial rock flour - a novel soil mineraliser” describing the microbial community of GRF, and then a second manuscript “Exploring the microbial consequences of applying the Greenlandic glacial rock flour soil mineraliser to depleted agricultural soils” analysing the microbial consequences (negative and/or positive) over time associated to GRF. Lastly, overall perspectives and conclusions are presented. Læs mere

Research | Forskning - peer review

The sea ice in the Arctic has shrunk significantly in the last decades. The transport pattern has as a result partly changed with more traffic in remote areas. This change may influence the risk pattern. The critical factors are harsh weather, ice conditions, remoteness and vulnerability of nature.… The sea ice in the Arctic has shrunk significantly in the last decades. The transport pattern has as a result partly changed with more traffic in remote areas. This change may influence the risk pattern. The critical factors are harsh weather, ice conditions, remoteness and vulnerability of nature. In this paper, we look into the risk of accidents in Atlantic Arctic based on previous ship accidents and the changes in maritime activity. The risk has to be assessed to ensure a proper level of emergency response. The consequences of incidents depend on the incident type, scale and location. As accidents are rare, there are limited statistics available for Arctic maritime accidents. Hence, this study offers a qualitative analysis and an expert-based risk assessment. Implications for the emergency preparedness system of the Arctic region are discussed. Læs mere