Leverage points for addressing marine and coastal pollution: A review.

Despite an increasing understanding of the issue of marine pollution, humanity continues on a largely unsustainable trajectory. This study aimed to identify and classify the range of scientific studies and interventions to address coastal and marine pollution. We reviewed 2417 scientific papers published between 2000 and 2018, 741 of which we analysed in depth. To classify pollution interventions, we applied the systems-oriented concept of leverage points, which focuses on places to intervene in complex systems to bring about systemic change. We found that pollution is largely studied as a technical problem and fewer studies engage with pollution as a systemic social-ecological issue. While recognising the importance of technical solutions, we highlight the need to focus on under-researched areas pertaining to the deeper drivers of pollution (e.g. institutions, values) which are needed to fundamentally alter system trajectories.

Leverage points to foster human-nature connectedness in cultural landscapes.

Calls for a reconnection to nature and the biosphere have been growing louder over the last decades. Cultural landscapes are rapidly changing, posing a threat to ecosystems and biodiversity, but also to human-nature connections. Human-nature connectedness may be a potential lever to shift the unsustainable trajectory that we are currently proceeding, but is also negatively influenced by it. To concretize the call for a reconnection to nature, we used the leverage points perspective on five empirical case studies with focus on human-nature connectedness. Based on the synthesis of our yearlong work, in this perspective paper, we propose four leverage points to foster a sustainability transformation: (1) maintain and enhance the structural diversity of landscapes, (2) maintain and enhance economically and ecologically sustainable small-scale agriculture, (3) strengthen sense of place and (4) strengthen sense of agency in actors. Intervening in these leverage points could be effective to foster human-nature connectedness and ultimately contribute towards a sustainable trajectory. We further argue that the interconnection between leverage points is equally important as their systemic depth.

[Bullying as health hazard among school children]. / Mobning som sundhedstrussel blandt store skoleelever.

The objective was to analyse bullying in relation to sociodemographic factors, health, well-being, and health behaviours. The study is the 1998 Danish contribution to the international WHO-coordinated study Health Behaviour in School-aged Children. It includes 5,205 11-15 year-old students from a random sample of 55 schools who answered a standardized questionnaire. Twenty-five percent were bullied several times during the academic year, most frequently among the youngest students, and independent of sex; 32% bullied others, boys more frequently than girls; the frequency increased with age. Bullying was associated with low social class. Bullying varied considerably among schools. The victims had more problems as regards health, well-being and self-esteem; they smoked and drank less than others. Those who bullied others also had more problems but to a much smaller extent than the victims. They had higher levels of risk behaviours such as smoking, drinking, and seat-belt avoidance, and were less satisfied with school. In conclusion, victims of bullying have a very high proportion of health problems, poor well-being and low self-esteem. To bully others is significantly associated with health risk behaviours.

[Injuries among 11-15 year old children]. / Tilskadekomst blandt 11-15-årige.

The objective is to describe the one year incidence rate of self-reported injuries, their causes, where they happened, and their consequences within the age group 11-15 years. Four thousand and forty-six students from a random sample of 45 schools answered a standardized questionnaire about health and health behaviour. This report regards injuries treated by a doctor or a nurse. During one year, 28% were injured, 12% more than once; 12% needed medical treatment such as a plaster cast, stitches, surgery or staying in a hospital; 16% missed at least one full day in school. The injury incidence rate increases with age among boys but not among girls. The proportion with more than one injury increases by age among girls but not boys. The proportion who receive hospital treatment is higher among boys than girls. The proportion who stay home from school because of the injury increases with age among both girls and boys. Five percent are injured at home, 5% at school, 9% are injured at a sport facility, and 4% in the street/road. Ten percent report a sports injury, 4% an injury by falling, and 3% by riding a bicycle. Most common injuries are sprain/strain/pull of a muscle (9%), broken or dislocated bone (6%), and cuts (3%). In conclusion, the incidence of self-reported injuries is much higher than the hospital-reported. More research about injury-mechanisms and more preventive efforts are needed.

Mutations in the TP53 gene and protein expression of p53, MDM 2 and p21/WAF-1 in primary cervical carcinomas with no or low human papillomavirus load.

Several studies have focused on the role of p53 inactivation in cervical cancer, either by inactivating mutations in the TP53 gene or by degradation of the p53 protein by human papillomavirus (HPV). In this study, primary cervical carcinomas from 365 patients were analysed for presence of HPV using both consensus primer-sets and type-specific primer-sets. Nineteen samples were determined to have no or low virus load, and were selected for further analyses: mutation screening of the TP53 gene using constant denaturant gel electrophoresis (CDGE) followed by sequencing, and protein expression of p53, MDM2 and p21 using immunohistochemistry (IHC). Mutations in the TP53 gene were found in eight samples (42%). Elevated p53 protein expression was significantly associated with presence of a mutation (P < 0.007). P21 protein expression was detected in 16 of the 19 carcinomas. No p21 expression was seen in normal cervical tissue. Two samples, both with wild-type p53, had elevated MDM2 expression. Compared with a previous study from our group, of mainly HPV-positive cervical carcinomas, in which only one sample was found to contain a TP53 mutation, a significantly higher mutation frequency (P < 0.001) was found among the carcinomas with no or low virus load. Although p53 inactivation pathways are not detected in every tumour, our study supports the hypothesis that p53 inactivation, either by binding to cellular or viral proteins or by mutation, is essential in the development of cervical carcinomas.

["Sense of coherence", social class and health in a Danish population study]. / "Sense of coherence", socialgruppe og helbred i en dansk befolkningsundersøgelse.

The objectives are a) to present Antonovsky's concept Sense of Coherence (SOC) and his 13-item SOC-scale, b) to describe the distribution of SOC in a random sample of five age groups in the Danish population, and c) to study the association of SOC to sex, age, social class, and health. The Danish Longitudinal Health Behaviour Study (DLHBS) collected self-administered questionnaire data from a random sample of the population born in 1975, 1965, 1940, 1930, and 1920. The baseline study took place in 1990, response rate 71%, n = 2,858. The article reports data from the first follow-up in 1994, response rate 86% of the survivors, n = 2,352. SOC shows no gender differences; it is significantly lower in the youngest age group and increases with age. SOC is highest in the highest social classes. Poor SOC is associated with poor self-rated health and high prevalence of symptoms. Poor SOC is associated with high prevalence of long-term illness among respondents older than 50 years of age.

[Smoking among 11-15 year-old adolescents, 1984-1994]. / Rygevaner blandt 11-15-årige, 1984-1994.

The objectives are to describe smoking habits among 11-15-year olds in Denmark in the period 1984-1994 and to describe the association between smoking and social background factors. The article reports data about children at the age of 11, 13 and 15 years from four cross-sectional studies in 1984-1985, 1988, 1991 and 1994 (n = 678, 1667, 1860 and 4046) based on stratified random samples of schools. Data were collected by standardized questionnaires. Median age for first smoking experience changed from approx 12 years in 1984-1985 to approx. 14 years in 1994. The proportion of smokers among 15 year-olds is almost unchanged from 1984 to 1994. In 1994, the proportion of smokers is respectively 2% and 4% among 11 year-old girls and boys, 16% and 11% among 13 year-old girls and boys, and 33% and 25% among 15 year-old girls and boys. The proportion of girls and boys in the three age groups respectively who smoke every day is 0%, 1%, 3%, 4%, 17%, and 11%. In conclusion, smoking habits among children changed considerably from the 1950's to 1980's. The smoking habits have not changed much since the 1980's apart from a slight delay in first smoking-experience.

[Which pensioners receive home help? A sociomedical survey of 1,261 persons 70-95 years of age]. / Hvilke pensionister får hjemmehjaelp? Socialmedicinsk undersøgelse af 1.261 70-95-årige.

The aim of the article is to describe variables associated with use of home help. A random sample of 1,261 non-institutionalised elderly persons aged 70-95 years in four communes answered a questionnaire on their health and social situation during the winter 1986/87. Twenty-five percent receive home help: 13%, 26% and 49% in the age groups 70-74, 75-79, and 80-95, respectively. Among those living alone more males than females receive home help (41% vs. 35%), as compared with those not living alone (M: 12%, F: 22%). Individuals receiving home help are characterised by reduced functional capacity; reduced vision, hearing, and memory; reduced quality of life resources (e.g. lonlieness, depression, no future plans). The proportion receiving home help is independent of social class but decreases with increasing income. It is also independent of the extent of the informal social network and the frequency of contacts, however, those receiving home help receive more help from children and kin. A multivariate analysis shows that functional capacity, age, and income are the main predictors. Eight percent think they need (more) home help, 24% among those already using this service and 3% among non-users. In conclusion, home help in Denmark seems to be provided to the oldest elderly persons with the poorest physical and psychological functional abilities.

[Permanent central venous catheter in pediatric oncology]. / Permanente centrale venekatetre i paediatrisk onkologi.

Thirty-eight permanent central venous catheters were introduced in 28 children as part of the intensive chemotherapeutic treatment for malignant disease. These catheters were employed partly for administration of medicine and partly for sampling blood for control. The total duration of life with a catheter was 7,303 days. On an average, 27 chemotherapeutic agents were administered, 172 supplementary injections and 56 blood samples were performed via the central venous catheter per child. In the present investigation, a frequency of infection of 0.27/100 catheter days was found and an incidence of non-infectious complications resulting in removal of the catheter or adjustment of the catheter of 0.16/100 catheter days. The authors consider that employment of a permanent central venous catheter in paediatric oncology represents considerable progress and that this should be employed in all children to be submitted to prolonged treatment with cancer chemotherapy.