Mammographic screening in Sami speaking municipalities and a control group. Are early outcome measures influenced by ethnicity?

Objectives. Female citizens of Sami (the indigenous people of Norway) municipalities in northern Norway have a low risk of breast cancer. The objective of this study was to describe the attendance rate and outcome of the Norwegian Breast Cancer Screening Program (NBCSP) in the Sami-speaking municipalities and a control group. Study design. A retrospective registry-based study. Methods. The 8 municipalities included in the administration area of the Sami language law (Sami) were matched with a control group of 11 municipalities (non-Sami). Population data were accessed from Statistics Norway. Data regarding invitations and outcome in the NBCSP during the period 2001–2010 was derived from the Cancer Registry of Norway (CRN). The NBCSP targets women aged 50–69 years. Rates and percentages were compared using chi-square test with a p-value<0.05 as statistical significant. Results. The attendance rate in the NBCSP was 78% in the Sami and 75% in the non-Sami population (p< 0.01). The recall rates were 2.4 and 3.3% in the Sami and non-Sami population, respectively (p<0.01). The rate of invasive screen detected cancer was not significantly lower in the Sami group (p=0.14). The percentage of all breast cancers detected in the NBCSP among the Sami (67%) was lower compared with the non-Sami population (86%, p=0.06). Conclusion. Despite a lower risk of breast cancer, the Sami attended the NBCSP more frequently than the control group. The recall and cancer detection rate was lower among the Sami compared with the non-Sami group

Iron status and prevalence of hereditary haemochromatosis in a multiethnic population in northern Norway : the SAMINOR study, the Sør-Varanger study, the Tromsø V study

Iron status is influenced by several factors such as nutritional factors and blood loss. Tron deficiency is one of the most severe and important nutritional deficiencies in the world today, both in industrialised as well as developing countries [1-3]. In normal subjects the total daily loss of iron is balanced by an equivalent amount of iron absorbed from the diet. When this equilibrium is disturbed, due to lack of or too much iron, iron deficiency or overload are established. Iron deficiencies are caused by several factors as menstrual losses in fertile women, occult bleeding or a diet low in iron [4]. Iron deficiency affects several body functions even when anaemia has not developed [5]. Immune status and morbidity of all age groups are adversely affected by iron deficiency. On the other hand, iron overload can cause organ damage in severe cases [6]. Inheritance e.g. hereditary haemochromatosis thallasemia major and blood transfusion can cause severe iron accumulation. Homozygosis for the C282Y mutation of the candidate gene for haemochromatosis (the HFE gene) is a common genetic mutation, occurring in 0.3 to 0.7 % of white persons of northern European descent [7-10]. In 1995 a comprehensive health survey programme (HUNT) was conducted in Nord-Trøndelag, a county in the middle of Norway, incorporated a large screening for HH [li]. In total 65 717 (69.8%) people participated. The prevalence of hereditary haemochromatosis was 0.34% in women and 0.68% in men. Previous screening of haemochromatosis indicate that the grade of HH is increasing northward, and that hereditary haemochromatosis is most pronounced among people of north European affiliation [12]. It is even suggested that is a Viking disease [13]. In Norway iron has been added to food products since 1972. In 2002 this supplementation was removed because of concerns about iron overload in that part of the population with hereditary haemochromatosis. Recent data describing the iron status in a Norwegian population has not been collected. In northern Norway iron measurement in a large population sample has not been performed. The population in northern Norway consists mainly of a mixture of people of Sâmi, Kven and Norwegian origin. There has been substantial interaction between the Såmi and non-Såmi population for several decades. Nutrition, socioeconomic development and general health status have a major influence on iron status [14-16]. These issues can lead to differences in iron levels among groups [17]. The main aims of this research were to evaluate the iron status in ethnically and geographic diverse populations in northern Norway and in addition investigate the prevalence of hereditary haemochromatosis and iron overload in the same populations

Democratic Reflections : To what extent do representatives mirror their constituents, and how does it affect the challenges modern, representative democracy are facing?

This thesis addresses the important challenges that contemporary, representative democracies are facing, and shows how (better) representation can contribute to tackling them. In doing so, I limit the scope to one specific aspect of the research on representation, namely congruence. As such, the main question that I address in my thesis is: In what way does congruence matter for contemporary, representative democracies? To answer this question, I focus on four important challenges to contemporary democracy, namely democratic legitimacy, growing demand for direct democracy, political polarisation and emerging cleavages, and growing economic and political inequalities. In turn, I show how each of these challenges can be linked to the congruence between citizens and elites and how better representation can remedy some of the worrying developments in contemporary democracies. Specifically, this thesis contributes with four articles, which stand as independent contributions to the literature, and, in the context of this dissertation, contributes to answering the overarching research question. In the first article, An Empirical Evaluation of Explanations for Political System Support, I focus on democratic legitimacy and study which variables best predict citizens’ satisfaction with democracy. I find that, among other things, congruence is an important predictor of regime support and argue that this covariate is understudied and under-theorised in the literature on satisfaction. The second article, Procedural Congruence and the Delegate-Trustee Dilemma focuses on how elites evaluate a direct democratic procedure and whether they are congruent with citizens in their evaluations of such procedures. Using a novel survey experimental design, the article shows that elites have changing perceptions of the legitimacy of a referendum depending on whether the turnout and size of the majority are low or high. Representatives also have an outcome favourability bias. Additionally, we demonstrate that representatives are less likely to think that a referendum is legitimate compared to citizens. To understand this, we turn to the tension between the role of representatives as either trustees or delegates. The incongruence can be explained by the fact that trustees think referendums are less legitimate compared to delegates. The third article, Conditional Satisfaction: Political Support, Congruence, and the (Un)certainty of Political Marginalization, uses insights from the first paper and study the conditional relationship between citizens’ satisfaction with democracy, ideological congruence, and government type. Article III pays particular attention to the conditioning effects of coalition governments’ ideological make-up and individual-level education. The findings show that higher educated citizens are more sensitive to being ideologically distant from single-party governments compared to coalition governments. In addition, the findings also show that higher-educated citizens are more satisfied, when incongruent, as the ideological diversity of multi-party governments increases. The fourth article, Beliefs About the Income Generating Process and Social Preferences – a Comparison Between Elected Representatives and the Citizens explore how beliefs about the income generating process shape preferences for redistribution. The findings show that preferences for redistribution negatively associate with believing in meritocratic factors, both for citizens and politicians. Contrary to previous findings, the article provides evidence that the politicians’ redistribution preferences are more aligned with the less affluent compared to the more affluent and that elites want to redistribute more than citizens. Finally, the article shows that people who vote for parties on the left of the political spectrum are more congruent on income redistribution with their representatives than people on the right. The thesis contributes to the existing literature on congruence with theoretical, conceptual, empirical, and methodological advances. Theoretically, I develop an argument about how malfunctioning representation may be a source of many of the challenges discussed above. Conceptually, I develop the concept of congruence based on existing research and I contribute with two new concepts, procedural and metabelief congruence. Empirically, I show that congruence is related to satisfaction, that citizens and elites are procedurally incongruent, and that meta-beliefs shape redistribution preferences. Methodologically, I employ diverse, state-of-the-art methodological approaches such as machine learning and survey experiments administered to elites and citizens. Taken together, the dissertation highlights the importance of congruence for the challenges facing contemporary, representative democracies and argue that better functioning representation can contribute to tackling these challenges.Doktorgradsavhandlin

Gii goziha min muitalusaid ja vásáhusaid? Norgga duohtavuođa -ja soabahankommišuvnna čohkkejuvvon materiála

Mii bidjat fuomášumi movt čohkkejuvvon muitalusat ja vásáhusat stivrejuvvojit Norgga Duohtavuohta -ja soabahankommišuvnna (Truth and Reconciliation Commission, TRC) bealis. Dat leat sirdojuvvon nationála arkiivvaide. Nu movt Norgga Stuoradiggi lea cealkán, de galget jearahallamat boahtteáiggis geavahuvvot dutkamušaide. Duohtavuohta- ja soabahankommišuvnna mandáhta bokte galggai kommišuvdna ráhkadit rávvagiid movt ođđasit geavahit materiála. Seammás go materiála geavaheapmi lea dehálaš, de láktasit ođđa geavaheapmái hástalusat, sihke ehtalaččat ja stivrema ektui. Dutkkadettiin dokumeanttaid gullevaččat Duohtavuohta -ja soabahankommišuvnna materiálameannudeapmái, masa maid gullet rávvagat movt dáhtaid olahit, mii digaštallat kvaliteahta ja etihka beliid das go jearahallamat ođđasit geavahuvvojit, ja maiddái daid oamasteami ja olaheami. Digaštallama rámma leat CARE prinsihpat gullevaččat álgoálbmogiid dáhtaid stivremii ja fuomášumi etihkalaš beliide mat gusket jearahallojuvvon olbmuid vuoigatvuođaide oažžut diehtit movt jearahallanmateriála geavahuvvo ja dulkojuvvo ođđasit boahttevaš dutkamušain, ja sámiid oassálastin hábmemii ja meannudeapmái go rávvagiid galgá čuovvulit dáhtáid olaheami, oamasteami ja stivrema ektui. Dokumeanttat eai sisttisdoala dieđuid dan birra ahte muitalusat ja vásáhusat leat ain olámuttus dutkiide vaikko muitaleaddjit geasset iežaset muitalusaid ja vásáhusaid eret almmolašvuođas. Mii eat ge gávdnan dieđuid das makkár vuoigatvuohta muitaleddjiin lea diehtit movt sin muitalusat ja vásáhusat bohtet geavahuvvot dutkamušain. Min guorahallan čájeha ahte lea dárbu dárkkistit dálá rávvagiid olaheami ektui nannen dihte guovddášelemeanttaid dutkanetihkas ja álgoálbmogiid oassálastima dáhtaid stivremis

Opening

Presentation at the 8th annual Forum for Development Cooperation with Indigenous Peoples, which commenced the 18th-19th of October 2007. The Centre for Sámi Studies hosted the conference at the University of Tromsø, Norway. Full conference report available at http://hdl.handle.net/10037/2995</a

The Násávárre Indigenous–Industry Dialogue: Knowledges and Agency in the Permit Process

This paper offers an insight into a single case study, the permit process of the Nasa mountain – Násávárre mining case in Nordland County, Norway. At Násávárre, the Chinese-owned mining company Elkem plans to open a pit mine to extract quartz. The area in question has the highest reindeer density in Nordland County, and the proposed mining operation would affect five Indigenous Sámi reindeer herding districts on both the Norwegian and the Swedish side of Sápmi. Despite incentives aimed at improving corporate respect for Indigenous rights such as the OECD Due Diligence Guidance, Indigenous peoples often face asymmetric power relations and uneven playing fields, particularly in terms of costs and capacity to respond to corporate positions on and understandings of Indigenous knowledges and rights. The knowledge base of this encounter, as it is experienced by the reindeer herders, can be discussed in terms of structural and agential factors. Our analysis focuses on the extent to which the reindeer herders have been enabled to engage with Elkem, with a particular emphasis on the reindeer herders’ experience of how their knowledges have been assessed by the company. The work is based on a review of case documents

Comprehending the mandate and interactions of land tenure reform in Finnmark, Norway

The land management arrangement – the Finnmark Estate (FeFo) established in Finnmark County - the northernmost county of Norway, is built on indigenous right claims, which implies that particular values, norms and principles are constitutive for and underpin FeFo as an institution. Still, the involved actors - FeFo and the two appointing bodies of the FeFo board - the Sami Parliament and the Finnmark County Council - have not developed a joint understanding of how to address these principles in order to strengthen the focus of FeFo governance. Based on earlier data compiled from investigations about FeFo and the two appointing bodies of the FeFo board, we focus on the relationship between the three institutions in order to explain challenges of cooperation between the three parties concerning the management of land and recourses by FeFo, and how they seek to minimize conflict and contribute to governability. Drawing on the concept of interactive governance, we analyse this governing system in terms of orders of governance by looking into whether the parties have deliberated and developed a set of meta-governance principles that can help in making hard substantive governance choices easier. We will discuss the challenges that may arise between two political bodies, one with a territorial defined mandate and the other with a mandate to secure Sami rights, and a governance and management body with a mandate to cooperate in a situation of high-level conflict

Territorial reforms, mobilisation, and political trust: a case study from Norway

The focus of this study is the political trust implications of territorial reforms, approaches to territorial reform, and the effects of the mobilisation of political-territorial collective identities. We focus on the political trust effects of political-territorial mobilisation grounded on territorial reforms, and of voluntary and forced structural reforms. The case examined is that of Norway, a country characterised by high levels of trust before a recent county reform. Utilising four survey waves from 2013 to 2019, we measure trust in national politicians both pre- and post-reform, giving us a quasi-experimental design. The findings indicate that political trust was not affected by whether the reform was forced on counties or they accepted it voluntarily. However, political trust was negatively affected by forced structural reforms in combination with regionalism, i.e., mobilisation of political-territorial collective identities. This finding provides new insight about how territorial reforms may affect political trust.publishedVersio

Sagt om kommisjonen: intervjudata og foreløpige funn

Artikkel i publikasjonen Om den norske sannhets- og forsoningskommisjonen: foreløpige funn