Knowledge

Keyword: seafarers

paper

Pre-diabetes remission in lifestyle-mediated coaching of seafarers with newly diagnosed pre-diabetes

Olaf Chresten Jensen, Nailet Delgado Mujica, Maite Duque, Alejandro Martinez, Erik Haarløv, Finn Gyntelberg

Seafarers and fishers have inequity in health at work, with a higher risk of having metabolic syndrome. They are at increased risk of developing prediabetes, which can be reversed to normoglycemia based on the evidence from other industries. This study aims to educate and activate seafarers and fishermen with the support of coaches to reverse their prediabetes to stop the further development of diabetes type 2.
Methods
Random samples of seafarers and fishermen with newly diagnosed prediabetes and HbA1c levels ranging from 5.7%-6.4% from the maritime medical health examinations constitute the study population in a 16-week prediabetes coaching program. In addition to monthly Zoom meetings, they are asked to provide weekly reports via questionnaires on personal measurements and improvements in physical activity and diets.
Results
The preliminary data from 2 maritime clinics (n=405) show prevalences of prediabetes 18.8%, 36.4%, and 49.2% in the ages 20-29, 30-49, and 50+ years respectively, all p-values < 0.02. Analysis of the clinical data from the maritime health clinics and the questionnaires from the seafarers collected weekly will formulate the effect of the intervention. Summarizing data from various national prediabetes coaching fora will be the evidence base for remission of prediabetes. Conclusions A significant portion of seafarers have prediabetes with the potential to achieve remission of their pre-diabetes by eating healthy and being physically active. The goals are to lose at least 5%–7% of their starting weight, be accustomed to doing at least 150 min. of physical activity weekly, and follow a pre-diabetes-relevant dietary plan.

International Journal of Travel Medicine and Global Health / 2024
Go to paper
paper

Hindered, Overlooked, and Undervalued: Gender Equality in Nordic Blue Economies

Josefin Ekstedt, Kristina Svels, Magnus Boström, Madeleine Gustavsson, Kristen Ounanian, Katrina Rønningen, Milena Arias Schreiber, Sunniva Midthaug Solnør, Cecilia Österman*

The Nordic countries are ranked among the most gender equal countries worldwide. Equality, political, and civil rights, leading to the high participation of women in the workforce, have paved the way for this egalitarian view. However, women remain the minority in managerial positions in general, and they are also strongly underrepresented in many male‐dominated sectors of the blue economy. The aim of this article is to introduce and discuss gender equality in the blue economy, and to assess the status of gender research in the Nordic context. To achieve this, a purposive interdisciplinary literature review resulted in three encompassing themes on how women’s participation is hindered, overlooked, and undervalued. Using these themes as an analytical lens, we propose that the underlying mechanisms are similar within fisheries, aquaculture, and maritime transportation in how they affect women’s participation. Still, there is a lack of statistics and research within parts of the blue sector. To move forward, there needs to be a shift in focus from policy to practice. One starting point could be to implement current knowledge, e.g., regarding workplace design and tailoring equipment to fit a diverse workforce. We call for scaling up best practices and evaluating policy performance and effectiveness. These are prerequisites for sustainable recruitment and retention of the blue sector workforce and the only way forward for countries aspiring to be truly gender equal.

Ocean and Society / 2024
Go to paper
book

At få sjælen med: En narrativ analyse af danske containersøfolks erindringer, fortidsbrug og identitetskonstruktioner

Michael Bennedsen Hansen

Containerfartens historiske udvikling bliver i litteraturen beskrevet som en revolution og en transformation af den internationale shippingbranche. De teknologiske og organisatoriske forandringer af livet til søs som fulgte med containerfarten har tilsvarende medført en forandring af maritime kulturer og en udfordring af de søfarendes identiteter.
Denne afhandling handler om danske containersøfolks erindringer, fortidsbrug og identitetskonstruktioner og undersøger, hvordan søfolkene fortæller sig selv i relation til deres levede erfaringer i containerfarten. Jeg analyserer i afhandlingen søfolkenes retrospektive fortidsfortolkninger som en måde at nærme mig en forståelse af de forandrede sømandsidentiteter.
Analytisk anlægger afhandlingen et subjektperspektiv, som anser fortiden for nærværende og åben i de mundtlige fortællingers fortolkninger og meningsforhandlinger af fortidens erfaringer. Jeg anskuer den narrative konstruktion af den personlige, autobiografiske, historie som identitetsdannende fortidsbrug, der udtrykker fortællerens subjektivitet. Med en erindringshistorisk tilgang til søfolkenes mundtlige fortællinger undersøger jeg, hvordan vi mennesker forstår os selv gennem de historier, vi fortæller om os selv.
Afhandlingen bygger empirisk på en række dybdegående oral history interviews med danske søfolk, der alle har erfaring inden for den internationale containerfart.
I afhandlingens analyser, viser jeg, hvordan søfolkene retfærdiggør og legitimerer deres valg om i første omgang at blive søfolk og senere at arbejde ombord på containerskibe. Jeg viser, hvordan søfolkene narrativt forhandler forskellige former for erfaret meningstab og aktivt tilskriver arbejdet og fællesskabet ombord på skibene en ny og brugbar mening. Jeg viser samtidig, hvordan den personlige historie konstrueres i dialog med kulturelt dominerende forestillinger og fortællinger. Sådanne forestillinger og fortællinger tilbyder den enkelte fortæller et tilgængeligt sprog at udtrykke sine personlige erfaringer i, men kan også virke begrænsende, hvis fortællerens erfaringer og forståelser ikke passer ind i de dominerende billeder. I sådanne tilfælde kan der opstå, hvad afhandlingen kalder en form for narrativt ubehag (discomposure), der kommer til udtryk som frustration og brud i fortællingens narrative sammenhæng.
Som en gennemgående metodisk pointe viser afhandlingen, hvordan interviewets intersubjektivitet er med til at forme den historie, som fortælles. Det personlige møde mellem fortæller og historiker og interviewets kulturelle kontekster indvirker på forskellig vis på den konstruerede historie. Fremfor at hævde en neutral og objektiv interviewsituation, tager afhandlingen i stedet konsekvensen af denne intersubjektivitet og skriver det konkrete møde mellem søfolkene som fortællere og mig som interviewer ind som en integreret del af den historiske fremstilling. Dette er både et narrativt greb og et metodisk valg, der skal sikre transparens ved at give læseren indblik i, hvordan historierne og mine tolkninger er blevet til.
Afhandlingen yder med sin tilgang og sine analyser flere bidrag til den eksisterende litteratur. Gennem de personlige fortællinger får vi større indsigt i søfolkenes levede liv og deres erfaringer med containerfartens historiske udvikling. Afhandlingen giver et menneskeligt perspektiv på historien om den internationale containerfart, der bidrager til vores viden om udviklingens identitetsmæssige betydning for de mænd og kvinder, som gennemlevede de historiske forandringer ude ombord på skibene.
Afhandlingen er en virksomhedshistorie, der tager oral history alvorligt både som forskningsfelt, metode og genre. Afhandlingen bidrager med sin erindringshistoriske tilgang til oral history til den fornyede samtale mellem forskningsfelterne oral history og virksomhedshistorie. Afhandlingen bringer metodiske og teoretiske indsigter fra den erindringshistoriske tradition ind i virksomhedshistorie og viser gennem sin egen narrative stil potentialet i en historieformidling, der sætter subjektivitet og erindring i centrum af sin analyse. Dermed bidrager afhandlingen også til den narrative vending inden for virksomhedshistorie ved ikke kun at anlægge et narrativt blik på de danske søfolks fortællinger men ved også at tage sig selv alvorligt som narrativ konstruktion.

Copenhagen Business School [Phd] / 2024
Go to book
paper

Perspectives on empowerment programs, and interventions in maritime settings: A systematic review

Sofie Buch Mejsner*, Fereshteh Baygi, Amit Timilsina, Nguen Pham Anh Tuan, Berit Misund Dahl, Leena Eklund Karlsson, Johan Lidmark, Ulrika Lödgberg, Maria Warne

Background: Evidence on workplace safety and health promotion interventions shows that the
interventions have failed to demonstrate substantial benefits for seafarers. It is therefore important to explore what is the evidence of interventions with empowering elements regarding seafarers’ safety and health. This study aims to examine what is known about health promotion interventions in a maritime setting and whether they include an empowerment perspective. And secondly, what were the effects of these efforts. Methods: We systematically searched PubMed and NLM Gateway (for MEDLINE), Institute of Scientific Information/Web of Science (ISI/WOS), and SCOPUS up to July 2022 by using standard keywords including empowerment in the maritime setting. Data extraction was done by three independent reviewers. The quality of included studies was assessed by using the critical appraisal checklists from Joanna Briggs institute. Results: From 3313 studies initially identified, 10 articles met the inclusion criteria and were included in this review. Interventions covered a wide range of topics such as educational interventions on safety, first aid training, weight management, healthy eating, sexual harassment, alcohol abuse, and cancer prevention training. None of the studies applied a specific theory or definitions of empowerment
even though their aim was to increase seafarers’ empowerment in these areas. Conclusion: The studies focused on improving the safety and health status of the seafarers, however, they had no explicit focus on participation and empowerment. Increasing research with an empowerment approach in maritime sector is recommended to enhance the feasibility and
success of the programs in this hard-to-reach occupation.

Journal of Transport and Health / 2024
Go to paper
paper

Perspectives on empowerment programs, and interventions in maritime settings: A systematic revie

Sofie Buch Mejsner*, Fereshteh Baygi, Amit Timilsina, Nguyen Pham Anh Tuan, Berit Misund Dahl, Leena Eklund Karlsson, Johan Lidmark, Ulrika Lögdberg, Maria Warne

Background: Evidence on workplace safety and health promotion interventions shows that the interventions have failed to demonstrate substantial benefits for seafarers. It is therefore important to explore what is the evidence of interventions with empowering elements regarding seafarers’ safety and health. This study aims to examine what is known about health promotion interventions in a maritime setting and whether they include an empowerment perspective. And secondly, what were the effects of these efforts. Methods: We systematically searched PubMed and NLM Gateway (for MEDLINE), Institute of Scientific Information/Web of Science (ISI/WOS), and SCOPUS up to July 2022 by using standard keywords including empowerment in the maritime setting. Data extraction was done by three independent reviewers. The quality of included studies was assessed by using the critical appraisal checklists from Joanna Briggs institute. Results: From 3313 studies initially identified, 10 articles met the inclusion criteria and were included in this review. Interventions covered a wide range of topics such as educational interventions on safety, first aid training, weight management, healthy eating, sexual harassment, alcohol abuse, and cancer prevention training. None of the studies applied a specific theory or definitions of empowerment even though their aim was to increase seafarers’ empowerment in these areas. Conclusion: The studies focused on improving the safety and health status of the seafarers, however, they had no explicit focus on participation and empowerment. Increasing research with an empowerment approach in maritime sector is recommended to enhance the feasibility and success of the programs in this hard-to-reach occupation. Systematic review registration number in PROSPERO: CRD42021260098.

Journal of Transport & Health / 2024
Go to paper

Autonomous Ships: A new paradigm for Norwegian shipping

Adrienne Mannov and Aske Svendsen

In this webinar, Adrienne Mannov from Aarhus University and Peter Aske Svendsen from NFA presented their research on autonomous shipping as this relates to seafaring and technology, based on their 2019 report, “Transport 2040: Autonomous ships: A new paradigm for Norwegian shipping - Technology and transformation”.

The event was organized in collaboration with MARLOG

October / 2021
Go to video
paper

Associations of age, occupation and nationality of seafarers with risk of evacuations at sea: A register-based study on Danish-flagged merchant ships

Kimmo Herttua*, Jan Vork, Jesper Bo Nielsen

Although prevention of incidents leading to evacuations at sea is of vital importance, little is known about its causal patterns and demographic determinants. We investigated therefore relationships between age, occupation and nationality and causes of evacuations. The data were obtained from the Telemedical Assistance Service (TMAS) in Denmark between 2004 and 2014 supplemented with data on all seafarers from the Danish Maritime Authority (N = 73,344). These data included information on broad age groups, occupational position and nationality. The outcomes were evacuations from any cause and in four broad categories of causes leading to evacuations. A total of 403 evacuations were reported in the 11-year study period. 27% of the evacuations were due to external causes, 19% due to diseases of the circulatory system, 14% due diseases of the digestive system and 40% from other or undetermined causes. Age-adjusted all-cause evacuation rates varied between 1.4 and 3.4 incidents per 1000 person-years in 2004–2014 for officers and between 3.3 and 20.2 incidents for non-officers. An elevated risk of evacuations was found among both officers and non-officers aged ≥50 years, compared with those aged 30–49 years with odds ratios of 2.73 (95% confidence intervals 1.66, 4.50) and 2.59 (2.03, 3.31), respectively. The odds ratios for non-officers from non-Danish European Union and from non-European Union countries compared with Danish non-officers were 1.51 (1.12, 2.04) and 0.55 (0.42, 0.71), respectively. In conclusion, working as non-officer, older age and non-Danish EU nationality were associated with a higher risk of evacuations irrespective of the cause leading to evacuation.

Marine Policy / 2021
Go to paper
paper

Does seafarers’ limited access to health care increase risk for community-acquired pneumonia requiring hospital care? A longitudinal register-based analysis

Kimmo Herttua*, Jan Vork, Tapio Paljarvi

Background: Limited access to medical care can be considered as an occupational risk of seafaring and it may predispose to developing community-acquired pneumonia (CAP) requiring hospital care. We sought to investigate the risk for CAP and other lower respiratory tract infections (LRTI) requiring hospital care among seafarers. We examined the length of hospital stay (LOS) as a proxy for severity of illness. Methods: The study population in this panel data analysis were all seafarers and a 20% random sample of economically active individuals aged 18–65 years who were residing in Denmark in 1997–2016, constituting more than 11 million person-years of follow-up. Annually-registered socio-demographic and work characteristics were linked to data on cause of hospital admissions. We used fixed-effects and zero-truncated Poisson regression to estimate the rate ratios of hospitalization for CAP and other LRTI, and compared LOS across the two populations. Results: The adjusted incident rate ratio (IRR) for CAP in seafarers compared to the economically active population was 1.42 (95% confidence interval [CI]: 1.15–1.77), whereas the IRR was 0.73 (95% CI: 0.38–1.42) for other LRTI. For LOS, the IRRs for CAP and other LRTI in seafarers were 1.08 (95% CI: 1.04–1.12) and 0.92 (95% CI: 0.83–1.01), respectively. Conclusions: Our findings indicate that seafaring was associated with an increased risk for CAP requiring hospital care. Limited access to health care may be an important contributing factor.

American Journal of Industrial Medicine / 2021
Go to paper
paper

Do Danish Maritime Doctors Value Continuous Education Initiatives?

Bygvraa, Despena Andrioti; Faurby, Mads D.; Le, Jette Videbæk; Jensen, Olaf C.

Aims and objectives: Seagoing employees must undergo medical examinations every second year. Even though International Organisations issued guidelines for these pre-employment medical examinations there is a lack of an internationally accepted continuous training programme for the maritime doctors who perform these examinations. The aim of this survey was to examine the Danish maritime doctors perceived training needs as part of a planned comprehensive maritime occupational health prevention programme.

Methods: A questionnaire based on international standards was distributed to all the maritime doctors (110) electronically in May 2017. The completed questionnaires were 46.4%. STATA was used for the statistical analysis of the data and correlations among the self-rated needs as dependent variables and the doctors characteristics were performed with Fisher exact test, with significance level at α=0.05%.

Results: The maritime doctors considered very important to receive training in “Fitness evaluation and medical examinations guidelines” (76.47%) followed by “Rules and regulations within maritime medicine” (68.63%) and “Working conditions and health risks on board” (62.75%). The number of examinations influenced their preference with those with more than 20 patients to express a more pressing need for training. Age, gender and years of practice did not have any influence in their self-rated needs. Furthermore, they pointed out flexible ways of training including distance learning and
the establishment of a webpage by the respective Authorities as one stop-shop.

Conclusion: Maritime doctors are in favour of continuous education and training. The survey may help the respective Authorities to organise such short courses on targeted topics in the country.

Health Econ Outcome Res Open Access 2017, 3:3 / 2017
Go to paper
paper

The costs of repatriating an ill seafarer: a micro-costing approach

Faurby, Mads D.; Jensen, Olaf C.; Hjarnoe, Lulu; Bygvraa, Despena Andrioti

Seafarers sail the high seas around the globe. In case of illness, they are protected by international regulations stating that the employers must pay all expenses in relation to repatriation, but very little is known about the cost of these repatriations. The objective of this study was to estimate the financial burden of repatriations in case of illness. We applied a local approach, a micro-costing method, with an employer perspective using four case vignettes: I) Acute myocardial infarction (AMI), II) Malignant hypertension, III) Appendicitis and IV) Malaria. Direct cost data were derived from the Danish Maritime Authority while for indirect costs estimations were applied using the friction cost approach. The average total costs of repatriation varied for the four case vignettes; AMI (98,823 EUR), Malignant hypertension (47,597 EUR), Appendicitis (58,639 EUR) and Malaria (23,792 EUR) mainly due to large variations in the average direct costs which ranged between 9560 euro in the malaria case and 77,255 in the AMI case. Repatriating an ill seafarer is a costly operation and employers have a financial interest in promoting the health of seafarers by introducing or further strengthen cost-effective prevention programs and hereby reducing the number of repatriations.

Health Economics Review, volume 7 / 2017
Go to paper