Kristina Jönsson

Nuclear localization of γ-tubulin affects E2F transcriptional activity and S-phase progression

We show that the centrosome‐ and microtubule‐regulating protein γ‐tubulin interacts with E2 promoter binding factors (E2Fs) to modulate E2F transcriptional activity and thereby control cell cycle progression. γ‐Tubulin contains a C‐terminal signal that results in its translocation to the nucleus during late G1 to early S phase. γ‐Tubulin mutants showed that the C terminus interacts with the transcription factor E2F1 and that the E2F1–γ‐tubulin complex is formed during the G1/S transition, when E2F1 is transcriptionally active. Furthermore, E2F transcriptional activity is altered by reduced expression of γ‐tubulin or by complex formation between γ‐tubulin and E2F1, E2F2, or E2F3, but not E2F6. In addition, the γ‐tubulin C terminus encodes a DNA‐binding domain that interacts with E2F‐regulated promoters, resulting in γ‐tubulin‐mediated transient activation of E2Fs. Thus, we report a novel mechanism regulating the activity of E2Fs, which can help explain how these proteins affect cell cycle progression in mammalian cells.—Höög, G., Zarrizi, R., von Stedingk, K., Jonsson, K., Alvarado‐Kristensson, M. Nuclear localization of γ‐tubulin affects E2F transcriptional activity and S‐phase progression. FASEB J. 25, 3815–3827 (2011). www.fasebj.org

Health systems research in Lao PDR: capacity development for getting research into policy and practice

BackgroundLao PDR is a low-income country with an urgent need for evidence-informed policymaking in the healthcare sector. During the last decade a number of Health Systems Research (HSR) projects have been conducted in order to meet this need. However, although knowledge about research is increasing among policymakers, the use of research in policymaking is still limited.MethodsThis article investigates the relationship between research and policymaking from the perspective of those participating in HSR projects. The study is based on 28 interviews, two group discussions and the responses from 56 questionnaires.ResultsThe interviewees and questionnaire respondents were aware of the barriers to getting research into policy and practice. But while some were optimistic, claiming that there had been a change of attitudes among policymakers in the last two years, others were more pessimistic and did not expect any real changes until years from now. The major barriers to feeding research results into policy and practice included an inability to influence the policy process and to get policymakers and practitioners interested in research results. Another barrier was the lack of continuous capacity development and high-quality research, both of which are related to funding and international support. Many of the interviewees and questionnaire respondents also pointed out that communication between those conducting research and policymakers must be improved.ConclusionThe results show that in the case of Lao PDR, research capacity development is at a crucial stage for implementing research into policy and practice. If research is going to make a consistent impact on policymaking in the Lao health care sector, the attitude towards research will need to be changed in order to get research prioritised, both among those conducting research, and among policymakers and practitioners. Our findings indicate that there is awareness about the barriers in this process.

Stakeholder perceptions of aid coordination implementation in the Zambian health sector

In this study, we analysed stakeholder perceptions of the process of implementing the coordination of health-sector aid in Zambia, Africa. The aim of coordination of health aid is to increase the effectiveness of health systems and to ensure that donors comply with national priorities. With increases in the number of donors involved and resources available for health aid globally, the attention devoted to coordination worldwide has risen. While the theoretical basis of coordination has been relatively well-explored, less research has been carried out on the practicalities of how such coordination is to be implemented. In our study, we focused on potential differences between the views of the stakeholders, both government and donors, on the systems by which health aid is coordinated. A qualitative case study was conducted comprising interviews with government and donor stakeholders in the health sector, as well as document review and observations of meetings. Results suggested that stakeholders are generally satisfied with the implementation of health-sector aid coordination in Zambia. However, there were differences in perceptions of the level of coordination of plans and agreements, which can be attributed to difficulties in harmonizing and aligning organizational requirements with the Zambian health-sector plans. In order to achieve the aims of the Paris Declaration; to increase harmonization, alignment and ownership--resources from donors must be better coordinated in the health sector planning process. This requires careful consideration of contextual constraints surrounding each donor.

The Paris Declaration in practice: challenges of health sector aid coordination at the district level in Zambia

BackgroundThe increasing resources available for and number of partners providing health sector aid have stimulated innovations, notably, the Paris Declaration on Aid Effectiveness, which aim to improve aid coordination. In this, one of the first studies to analyse implementation of aid coordination below national level, the aim was to investigate the effect of the Paris Declaration on coordination of health sector aid at the district level in Zambia.MethodsThe study was carried out in three districts of Zambia. Data were collected via interviews with health centre staff, district managers and officials from the Ministry of Health, and from district action plans, financial reports and accounts, and health centre ledger cards. Four indicators of coordination related to external-partner activity, common arrangements used by external partners and predictability of funding were analysed and assessed in relation to the 2010 targets set by the Paris Declaration.FindingsWhile the activity of external partners at the district level has increased, funding and activities provided by these partners are often not included in local plans. HIV/AIDS support show better integration in planning and implementation at the district level than other support. Regarding common arrangements used for fund disbursement, the share of resources provided as programme-based support is not increasing. The predictability of funds coming from outside the government financing mechanism is low.ConclusionGreater efforts to integrate partners in district level planning and implementation are needed. External partners must improve the predictability of their support and be more proactive in informing the districts about their intended contributions. With the deadline for achieving the targets set by the Paris Declaration fast approaching, it is time for the signatories to accelerate its implementation.

Public health nutrition workforce development in seven European countries: constraining and enabling factors.

OBJECTIVES Little is known about current public health nutrition workforce development in Europe. The present study aimed to understand constraining and enabling factors to workforce development in seven European countries. DESIGN A qualitative study comprised of semi-structured face-to-face interviews was conducted and content analysis was used to analyse the transcribed interview data. SETTING The study was carried out in Finland, Iceland, Ireland, Slovenia, Spain, Sweden and the UK. SUBJECTS Sixty key informants participated in the study. RESULTS There are constraining and enabling factors for public health nutrition workforce development. The main constraining factors relate to the lack of a supportive policy environment, fragmented organizational structures and a workforce that is not cohesive enough to implement public health nutrition strategic initiatives. Enabling factors were identified as the presence of skilled and dedicated individuals who assume roles as leaders and change agents. CONCLUSIONS There is a need to strengthen coordination between policy and implementation of programmes which may operate across the national to local spectrum. Public health organizations are advised to further define aims and objectives relevant to public health nutrition. Leaders and agents of change will play important roles in fostering intersectorial partnerships, advocating for policy change, establishing professional competencies and developing education and training programmes.

Focal destruction and remodeling in guinea pig arthrosis

We investigated the proximal tibiae in adult, middle-aged and old (6,12, and 30 months) guinea pigs with spontaneous arthrosis by quantitative morphometry. Since the cartilage destruction develops predominantly in the medial tibial plateau, the lateral side may serve as an internal control, In established lesions, cartilage destructions were focal, surrounded by a brim of thickened cartilage that was grossly intact, but showed cell clustering, hypertrophy and increased metachromasia. Peripherally, there was a distinct transition to normal-appearing cartilage. Subjacent to the cartilage ulcerations, subchondral bone was thickened. Compared to the lateral plateau the height of the calcified cartilage increased and the surface density of the osteocartilaginous interface decreased. Marrow depletion and cysts developed below the cartilage ulcerations. Cysts seem to develop through fibrous tissue partially undergoing cartilage metaplasia in tiny noduli that subsequently coalesce, liquefy centrally and expand. Superficially, similar fibrocartilaginous proliferations result in incomplete resurfacing and small areas of subchondral resorption; in the periphery of the joint, they form osteophytes. In the guinea pig, arthrosis tissue destruction is thus accompanied by local tissue proliferation.

Responsibility and the United Nations' Sustainable Development Goals

This article asks what key concerns emerge from the way responsibility is framed in United Nations summit documents on the Sustainable Development Goals (SDGs) adopted in 2015. Our conceptual framework serves to make the study of SDG responsibility more systematic by distinguishing three main senses of responsibility: cause, obligation, and accountability. The framework structures our analysis of two SDG summit documents, Transforming Our World: The 2030 Agenda for Sustainable Development and the Addis Ababa Action Agenda. The article shows, first, that the causal sense of responsibility is hidden between the lines in paragraphs on poverty, debt and environmental issues. As a consequence, root causes of problems might not be appropriately addressed. Second, SDG summit documents deal predominantly with responsibility in the sense of obligation. We raise concerns with repeated consideration for national circumstances and with vague obligations for non-governmental actors. Third, with regard to accountability, we stress that quantitative indicators have unintended steering effects both before and beyond the review phase. The focus on indicators risks shadowing broader obligations, such as international human rights. In all its three senses, responsibility in key SDG documents remains state-centric with great room for state sovereignty, self-regulation and respect for national circumstances. Our framework is useful also in showing that the three senses of responsibility build on each other and that engagement with responsibility provides fruitful ground for further research.

Legitimation Challenges in Global Health Governance: The Case of Non-Communicable Diseases

Abstract Recently there has been an increasing focus on non-communicable diseases (NCDs) within global health governance discussions due to the escalation of NCDs worldwide. However, NCDs have yet to be prioritised on the global agenda. The challenges of political prioritisation are analysed with a focus on legitimation strategies and how an issue area is legitimised in relation to various groups in society, i.e. between ‘authors’ and ‘audiences’ of governance. This article identifies a number of legitimation challenges, such as the difficulties of defining the issue area and communicating it to several audiences with different needs, interests, and perceptions of what is to be prioritised. Other challenges concern the composition of actors in the field, weak legislative frameworks, and vested interests that are both part of the problem as well as the solution. These challenges are played out through normative structures, politics, and power relations, which together affect priority setting in global health.

Global and Local Health Governance: Civil society, human rights and hiv/aids

Abstract From the outset in the mid-1980s the international response to hiv/aids has been characterised by an emphasis on the human rights aspects of the pandemic, and on recognition of the pivotal role of civil society actors (csos). But how the rights-based conception of hiv/aids and the international legitimation of csos play out at the local level depends not only on the vertical coordination between global and local levels but also on government–cso relations and the understanding of the pandemic in individual countries. South Africa and Cambodia provide comparative examples of ‘glocalised’ responses to hiv/aids. Both countries were among the hardest hit in their respective regions. But, while the South African government was slow to acknowledge the severity of epidemic, the Cambodian leadership quickly initiated a comprehensive response to it. The two cases illustrate how opportunity structures at the international and national levels created different local responses to hiv/aids, with significant consequences for the epidemic over time.

Understanding the process of establishing a food and nutrition policy: the case of Slovenia

BACKGROUND There has been an increasing effort across Europe to develop national policies in food and nutrition during the last decade. However, little is known about how public health nutrition issues get on the public health agenda and the roles individuals have when these agendas are being set. OBJECTIVES The aims of this study were to scrutinise the development process of the Slovenian national food and nutrition policy, and to identify the roles and functions of individuals who have contributed to that process. METHODS This study undertook a qualitative approach. Data collection included 18 semi-structured interviews between 2007 and 2011, and grey and scientific literature search. Text analysis was based on Kingdons streams model, which involved highlighting the relationship between problem identification, policy solutions and political opportunities. Data were coded to identify the roles and functions of individuals participating in the agenda-setting process. RESULTS The analysis showed that the opportunity for the Slovenian food and nutrition policy to be developed was largely explained by a change in political circumstances, namely the accession of Slovenia to the European Union and the Common Agricultural Policy. Individuals with experience in policy development were identified because of their analytical, strategic and policy entrepreneurial skills. The analyst was responsible for communicating the key nutrition issues to policy-makers, the strategist joined international networks and promoted policy solutions from international experts including the World Health Organization, and the policy entrepreneur took advantage of the political situation to enlist the participation of previous opponents to a national nutrition policy. CONCLUSION This study found that individuals, their roles and skills, played an important role in the development of the Slovenian National Food and Nutrition Policy. The roles and functions of these individuals, which are identified in this study, may assist future endeavours to advance public health nutrition as a key political issue.