Medicor 2015 #4 by Medicor MF Magazine

1#2013

medicor

2015 #4

medicinska fĂśreningenâ&#x20AC;&#x2122;s

9 Bullying at KI

student magazine

16 Mirror-touch synaesthesia 30 In the shadow of war 35 Tales of a tree surgeon

THE UNTOLD TRUTH

The problem of suicide among young adults 1

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Overture

Prelude

As December comes to an end, it is the perfect time to evaluate our progress throughout the year. The dark and cold winter offers a great opportunity to sit down, enjoy a cup of tea or coffee and revisit the most special moments of 2015. Looking at photographs can bring back forgotten memories and allow us to re-experience those sweet and enjoyable moments for a second time. I usually find it quite rewarding to put the present in the context of the past in order to see how much we have evolved and to understand whether we are on track to become that ideal person we want to become one day. It is also a good time to consider if we have successfully achieved the goals we had set at the beginning of the year - whatever they might be. Are you living according to your core values? Have you improved a certain skill that you wanted to develop? Have you achieved an important milestone this year? Have you spent time with your loved ones? Have you been grateful for what you have?

Karolinska

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In this issue we take a closer look into the problem of suicide among youth, we discuss some cases of bullying which have been occurring at KI and we get to know how civilians manage to organize their lives in an area affected by war. Moreover, we discuss about mirror-touch synaesthesia, a disorder that is usually described as a cursed superpower and we get some tips on how to make the most of Christmas time in Sweden.

KI OmbuDSPERSONS BULLYING AT KI GLOBAL HEALTH NIGHT ´15

Science SCIENCE SNIPPETS

MIRROR-TOUCH SYnaesthesia BLACK HOLES

20 Photo by Jingcheng Zhao for Medicor

BACTERIAL BUDDIES

ThE UNTOLD TRUTH

Medicor caught up with Bo Runeson to find out more about suicide and to understand the reasons that may be behind it.

Global Focus 28 30

Medicor Magasin Grundad 2006. Nionde årgången. Utges av Medincinska Föreningen i Stockholm ISSN: 1653-9796 Ansvarig utgivare: Teresa Fernandez Zafra Tryck och reproduktion: Åtta45, Solna Adress: Medicinska Föreningen i Stockholm Nobels Väg 10, Box 250, 171 77, Stockholm Utgivningsplan 2015: nr 1: mars, nr 2: maj, nr 3: oktober, nr 4: december. Kontakta Medicor: chefredaktor@medicor.nu www.medicinskaforeningen.se http://medicor.nu

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Frilansmaterial: Medicor förbehåller sig rätten att redigera inkommet material och ansvarar inte för icke beställda texter eller bilder, samt tryckfel. Upphovsman svarar för, genom Medicor publicerat, signerat frilansmaterial; denna(e)s åsikter representerar nödvändigtvis inte Medicors eller Medicinska Föreningens.

INTRODUCING DECADE ZERO IN the shadow of war Conservation, classrooms and condoms

Culture 34

SWEDISH CHRISTMAS CRASH COURSE

35 36

TALES OF A TREE SUrgEON TEDx GENERATION WHY?

38 COMICS

We hope that you will enjoy the last issue of 2015 and we look forward to see you again next year for the 10th anniversary of Medicor! Finally I would like to thank the Medicor team for making all this possible. It is such a great pleasure to be a part of it.

Sincerely, Teresa Fernandez Zafra Editor-in-Chief

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By reflecting about the past and how it has led us to our present, we can also speculate about how the present will influence our future. What can we do today for a better tomorrow? What actions can we take to make the world a better place? Am I adding value to society? What is my purpose in life? When it comes to Medicor I cannot help but think about the journey of this magazine. Medicinska Föreningen’s student magazine changed its name from Bukpressen to Medicor in 2006. In 2013, by the hand of Gustaf Drevin and Jingcheng Zhao, it relaunched itself in every aspect apart from its name. Medicor continues to be a magazine run by students for students that can be found in paper and web formats (http://medicor.nu). As the 10th year anniversary approaches, we are looking for new ways to take this magazine further and get as many students involved as possible. As an appetizer for further changes to come, we have deviated from the standard front cover, to empathize the content of the coverstory rather than the person interviewed. Moreover, we introduce a new way for students to actively participate in the magazine: the aperture section will now take the form of a photo-competition where the winning image will be featured in a subsequent issue of the magazine.

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Cover photo by Peggy Ler for Medicor 2

Anna Vidina, James Salisi, Teresa Fernandez Zafra • Layout Design |Peggy Ler, Jingcheng Zhao, Saket Milind Nigam, Andrea Montano Montes, Gustaf Drevin, Katarina Stojanovic, Iskra Pollak Dorocic, Emily Clark • Photographers | Jennifer Lees, Radek J. Góra, Nina Kirk, Jessica de Loma Olson, Teresa Fernandez Zafra, Nazira Hammoud Shahwan, John Håkansson, Parvin Kumar, Joanna Kritikou, Olivia Miossec, Sarah Marshall, Emily Clark, Helena Honkaniemi, Iskra Pollak Dorocic, Martha Nicholson, Sarolta Gabulya • Writers | Mina Saleem, Alex Browne, Camille Wilhelmi, Amanda Sundberg, Saket Milind Nigam • Proofreaders | Mikael Plymoth • Senior Comics Coordinator | Anny Truong, Eveline Shevin, Emily Clark • Comic Illustrators | Freepik.com, flaticon.com • Infographics

Aperture Lakeside Glow By Saket Milind Nigam Want to showcase your photographic talents in our magazine? Send an email to medicor@ medicinskaforeningen.se for a chance to have your own work featured in the Aperture section of an upcoming issue of Medicor!

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Smörgåsbord

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Jessica De Loma Olson & Teresa Fernández Zafra

Who is he?

12 years without a shower

If you wanted to know who is the person with most places, animals and plants named after them, who would you guess? His name is Alexander von Humboldt (1769-1859) and he was one of the greatest scientists and geographers of his time. This German scientist – also known as the “Shakespeare of Science” – has many things named after him: penguins, thirteen towns, mountains, parks, rivers, sea currents, glaciers and even a piece of the moon!

David Whitlock, a chemical engineer from MIT has not showered in 12 years. Despite what you might believe, he actually does not stink. But, how could that be? Instead of taking a shower, he sprays his body with an aerosol, which contains bacteria that can degrade the ammonia produced by sweat. This leaves his skin clean and free of odor while preserving the natural bacteria that protect the skin, which are commonly harmed by using soap-based products. He has now developed a line of products called Mother Dirt. Do you dare to give it a try?

The Madagascar hissing cockroach are YOU mad and you don’t know how to express yourself? The Madagascar hissing roach, Gromphadorhina portentosa, knows how to! This insect is one of the biggest species of cockroach, measuring between 5.1 and 7.6 cm. However, what makes it even more special is that it belongs to the group of hissing roaches. By forcing air through their respiratory openings localized on their abdomen, they are able to make a characteristic hiss when disturbed, to attract females or while fighting others.

In a blink of a tongue?

Let’s be honest. You have all tried to stick your tongue out and actually touch your nose. And I am sure most of you cannot even do that! Well then ask the giant palm salamander, Bolitoglossa dofleini. If you travel to Central America, you might be able to see how this animal shoots its tongue out with incredible power. This curious creature is capable of extending its tongue more than half of its body length. And in only 7 milliseconds; 50 times faster than a blink of an eye! If you ask Stephen Deban from the University of South Florida, this velocity cannot be explained by only muscle contraction. So then what? It is still unknown!

1,111 The second largest diamond in the world has been recently discovered in a mine in Botswana, Africa. This 1,111-carat gem is the largest to be found in more than a century, and it is roughly the size of a tennis ball. The diamond, which has not yet been evaluated, is estimated to take years to cut and polish. Although it is hard to put a prize on it at this point in time, experts are speculating that this newly found diamond could be sold for a whopping 700,000,000 SEK!!

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Kar olin ska

Photo by Andrea Montano Montes for Medicor

Kar olin ska

Having some problems?

The ombudspersons are here to help you! Medicinska Föreningen has two ombudspersons employed to help students and doctoral students that you can turn to for advice in any matter regarding problems or concerns about your education. We are both independent experts employed by Medicinska Föreningen to support you – all students of KI. By N azira Hammoud Shahwan & John Håkansson

Did you know?

We, the student ombudsperson (SO) Nazira, and the doctoral ombudsperson (DO) John, work hard to try to ensure that the rights of the students are respected by all persons responsible for education at KI. This ranges between anything from fair assessment of exams to launching investigations on discrimination or harassment of students.

During 2014, the ombudspersons handled 68 undergraduate student cases and 63 PhD student cases. The total number of students contacting the SO or the DO for general advice or questions was much higher, at about 250 emails, phone calls or drop-in contacts.

“We want to ensure that student rights are respected by all people responsible for education at KI.” The doctoral ombudsperson provides doctoral students with independent advice about rules and regulations at Karolinska Institutet, as well as assist and support doctoral students in any kind of conflict in their workplace, usually with their supervisors or other co-workers in the department. Other common problems relate to the working environment in the group or the lab, or for clinical PhD students, time made available for research which can be hard to get. 8

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One major principle guiding all activity in public administration in Sweden is the principle of public access to official documents. This right ensures transparency in the exercise of public power. Essentially this states that documents are public unless they contain specifically sensitive personal information; therefore some documents are placed under confidentiality according to law. Since universities are a public administration body, this implies that most of their documents are public, including, for example, exam results. However, since the ombudsperson is an independent authority and not part of the public administration, no documents in the possession of the ombudsperson are public documents. We maintain complete confidentiality, unless explicitly told otherwise by the student seeking advice. You also have the right to turn to the ombudsperson anonymously - that is you don’t have to give your name if you call the ombudsperson. •

Bullying @ KI By Parvin Kumar Photo by Katarina Stojanovic Interviewees: Anonymous

We spend a great deal of our time here on campus. For most of us, it is a very positive experience, whether it is for work or study. We find dignity and self-respect in what we do. In the process we build good, stable relationships with peers and supervisors alike. However in any place that seems serene on the outset, we must question if this holds true beyond the superficial examination of our social environment. Does KI have an underbelly? What does it look like? In an interest to get a sense of the answers to these questions, the correspondent put up an announcement on an group frequented by Karolinska researchers and students on a popularly used social media platform. It was as follows:

“Share your story with me”

Many of the undergraduate student cases are related to problems concerning examination and disciplinary matters, while a typical PhD student case revolves around the relationship between student and supervisor or work environment issues.

Contact information Nazira Hammoud Shahwan Student ombudsperson E-mail: so@medicinskaforeningen.se Phone: 08-524 830 73 John Håkansson Doctoral student ombudsperson E-mail: do@medicinskaforeningen.se Phone: 08-524 830 72 Visiting address: MF Solna, Nobels väg 10

“If you have been the victim of harassment or bullying on campus or at work in Karolinska, I’d like to know. I’m doing a small project on some anecdotes of what goes on in Karolinska.” 9

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Kar olin ska

Kar olin ska Firstly a little background on why I chose to ask such the question. In the dark core of the human experience lies our capacity to inflict torment when we have the power. It can be for a means like getting more done with fewer resources or, as in a particularly cruel variant, simply because we can. The enabler is a skew in power relations. A bully is an expert at

I’m doing a small project on some anecdotes of what goes on in Karolinska recognizing leverage and using it to gain control over others to achieve his desired ends. It is unilateral, abusive and often cruel. The 2015 World Health Organization survey on bullying put Sweden as one of the best ranking countries when it comes to bullying and harassment. Less than 1 in 20 Swedish children experience bullying. Scandinavia and Sweden can take pride in our contribution to recognizing, quantifying and dealing with bullying globally. One of the most prolific anti-bullying programmes used in USA was designed by a Swedish professor, Dan Olweus at the University of Bergen, Norway. Bullying does not seem to be a pressing issue in Sweden so what is the need for this investigation? We only need to ask ourselves this: During our time in Karolinska as students or employees have we not heard of that one story where a colleague got a little too close for comfort? Perhaps somebody experienced burnout from being overworked? Karolinska is a prestigious medical Institution with a plethora of hierarchies within; power structures that enable it to function and take its place as the premiere Medical Sciences Institution of Sweden. Being as such separates it from Swedish Society. We are talking about elites in a high pressure environment. Resources are dealt out strictly on an inanely perceived principle of productivity. That principle which has given us the adage ‘Publish or Perish’. The word perish does after all sum up our primal fears. What could that translate to when taken together with the oft encountered skew in power relations? I did get a response from a couple of victims. They were all glad to speak about their experiences to somebody. There was one example of workplace sexual harassment and one related to 10

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an abusive relationship with a supervisor. It may be a bit of a stretch to group sexual harassment and work place stress under the bullying category. However, my aim was to show how a perceived leverage can be used by people to reach their ends. One of the victims was called Amy (not her real name). It had been just days into her new stint at KI. The perpetrator was an exchange student and a medical doctor. Amy was approached by this exchange student everyday with amorous messages. In the course of work he obtained her phone number and then the messages changed from amorous to explicit. While this had greatly upset Amy, the decision to report his behavior was not an easy one to make for her. She was rudely shocked by his behavior and feared for her safety in case he was angered by her. Nonetheless, Amy found the state of matter too disruptive to her peace of mind and she reported the perpetrator to her supervisor. Her supervisor informed her that it was a clear case of sexual harassment and

For me there were striking differences between both the stories I came across in accordance with KI sexual harassment policy they had to start investigations on the matter. She had saved the explicit text messages and these were handed over to the investigators. The matter was brought up to the dean and the ombudsman. When I heard Amy’s story I was heartened at the response that KI gave to Amy and the perpetrator of harassment. He was fired on the spot when they decided it was in fact sexual harassment. Victoria (not her real name) was a Masters student in Karolinska. She spoke to me about a bullying incident that occurred with her thesis project supervisor. The project suffered from unexpected disruptions and a lack of clear communication between Victoria and her supervisor, her story was one that rang quite familiar to me. Indeed a common problem in academia where outlined outcomes and research goals are confused by poor leadership or execution. In Victoria’s case, during several meetings she would be reduced to tears because her supervisor was extremely rude and often per-

sonally attacked her using such words as ‘lazy’ and ‘dull’. It became quite clear by the end of the interview, from her exasperated tone as she recounted some particularly unpleasant meetings and noxious exchanges, that it was good she no longer had that particular working relationship. Victoria had been pushed to her limits by the professor’s behaviour and was not able to cope with the pressure. She was not able to finish her Master’s degree thesis and has instead elected to start working as a programmer at a start-up. For me there were striking differences between both the stories I came across. One was bullying of a more sexual nature and the other more about the abuse of power. The case related to sexual harassment was perhaps more swiftly dealt with because of the legal structures in place which address such incidents. Perhaps a case of verbal abuse is much more difficult to pin down as one that actually constitutes inequity. The outcomes were also largely different owing to the decisions the victims took with regards to getting support from the relevant authorities. Sweden enjoys a pioneer status in employee and student welfare. It excels in promoting an egalitarian work atmosphere. Workers and students are mandatorily represented by unions who in turn sponsor ombudsmen who investigate maladministration or exposure to inequity. In fact, the word ombudsman was adopted by the English language from its Nordic cousins. The ombudsmen retain a large degree of independence from the institutions they work for, and therefore have no conflict of interest in carrying out their duties toward employees or students exposed to inequity. Karolinska like all Swedish organizations has such structures in place to safeguard its students, researchers and employees. Victoria agreed with me during the con-

Bullying is a heinous activity which has no place in a modern institution such as Karolinska. However, human nature tends to be self-serving, making it necessary for individuals to remind themselves to regulate their interactions accordingly. In a book intended to communicate his life’s work, Columbia University Professor of Psychology, Walter Mischel, highlights the two systems that are concurrently at work in the human psyche. One that is ‘hot’ and impulsive and the other ‘cool’ and cerebral. People in power often act on ‘hot’ self-serving impulses and often neglect the consequences this might have on their employees or students. Adopting an increasingly cool and cerebral method of leadership could in fact be more effective at getting to the root of the problem which is usually along the lines of investing in greater supervision, communication and clarity. He also writes about the idea where the more we are connected to our future selves, the more we are deterred from taking part in unethical conduct such as bullying. This is mainly because we tend to see that over time the consequences of these actions may in fact catch up with us, that it is not necessarily sustainable or in the true spirit of our imagined selves. In her book titled Mindset, Carol Dweck, a distinguished Professor of Psychology at Stanford University talks about two predominant mindsets prevalent in society. The fixed mindset predicates that the qualities of a person are fixed or static

and that no amount of intervention or effort may improve a situation. The growth mindset is one that embraces intervention, innovation and effort to achieve positive change or growth. The minsets manifest themselves in subtle ways and in the case of bullying she says that it is at the pinnacle of judgement with a high doze of

KI has a zero-tolerance policy, such incidents should technically not be happening at all the fixed mindset. Bullying is about judging oneself to be superior to another and thus feeling entitled to treating others badly. Often this may play out in a work setting; bullying can be used to shift the blame of frustrated goals from the leadership to the executive organs of the team. An employer or supervisor with a fixed mindset that judges a student or employee to be of limited caliber or prone to certain mistakes can promote dysfunctional behavior, especially when evoked within a ‘hot’ impulsive self-serving system that

resides in our psyche; the outcome can be quite disastrous. What I set out to show with this piece was that even in a highly structured, regulated and modern Institution such as Karolinska, bullying and sexual harassment does exist. This study can, by no means, say how much of this is happening in Karolinska but admittedly, this is an observation based on anecdotal evidence. However, taking into consideration that our organization has a zero-tolerance policy, such incidents should technically not be happening at all. What can we do to help? It is prudent to keep in mind that help is there when you need it. There are helplines 24/7 at our disposal whether we are a student, employee or supervisor that can put us in touch with professionals trained to listen and advise us on a good course of action. The supervisors and administrators themselves can be our greatest allies and we should be careful where possible to exhaust all possible channels. We can keep in mind what burnout symptoms are and be astute when they manifest in ourselves and our colleagues. We need to be mindful of the archaic self-serving nature of human beings and modulate our interactions where necessary with an emphasis on a cool and cerebral leadership style. Last but not least, it is crucial to keep in mind that compassion goes a long way in preserving humanity and dignity as well as acting as a social lubricant that improves efficiency and functionality even in professional settings. •

One was bullying of a more sexual nature and the other more about the abuse of power versation that she could have sought more help from relevant channels regarding the difficulties she faced, but such was the effect of her experience that it robbed her of any motivation to seek redress.

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medicor

Kar olin ska Kar olin ska

Kar olin ska

Global Health Night 2015 A dynamic and interactive event dedicated to Global Health

By N ina Kirk Photo by Gustaf Drevin

The impressive Aula Medica has never felt as full as it was on Wednesday 28th October. The weather was beginning to turn into the fearsome Swedish winter everyone warns about, and as delegates peeled off their jackets and checked them into the cloakroom, others queued to register and receive the small round badge emblazoned with the global health logo, worn with pride. The concept of a night to celebrate issues surrounding Global Health was conceived earlier this year by a group of innovative medical students, supported by the Swedish Organisation of Global Health (SOGH) and Institute for Indian Mother and Child (IIMC). This inaugural event was billed as “a dynamic and interactive event, dedicated to Global Health” and it was undoubtedly a great success. Following the opening speech by Vinod Diwan from the Department of Epidemiology, Dr Helena Nordenstedt gave an impassioned description of her career to-date. Graduating from Karolinska in 2007, she gained a PhD in Epidemiology and Surgery, becoming an expert in Oesophageal Reflux Disease. However after completing her training in gastroenterology, she was captivated by the topic of Global Health and went to work for Médecins Sans Frontières (MSF) on several projects, most recently with the Ebola crisis. Changing career tracks, she now conducts research in the area of global health and is re-training as an internal medicine specialist. She gave the audience of po12

tential future Global Health workers, snippets of clinical information, grounding her talk in reality. She described an example of when she sent a child home with a broken leg. When she returned to the village for follow up she found that the child had not been resting in bed as advised, but was running on the fractured leg completely unaided. Luckily, the child’s leg was not damaged, but the story reminded us of the importance of context when it comes to healthcare. Perhaps in Sweden, patients want to recuperate at home as soon as they are able, but in this particular setting, with no one to ensure the child followed the recommendations, this story could have had a very different ending, and it provided a valuable lesson to us all.

a medical doctor and a PhD in biomedical informatics, Dr Lundin seems like the perfect person to help create a web microscope and a mobile microscopy app, MoMic. The portable microscope digitalises pathology samples into images, which can be processed to identify abnormalities and analysed by partners in better-resourced settings. With more than 100 million malaria tests performed each year and many countries suffering from a shortage of pathologists, delays in diagnostic services can cost lives. This means that technological advances such as these have the capacity to enhance treatment of infectious diseases such as malaria, saving lives in the process. A truly inspiring idea, translating improved patient care into lives saved.

“reject a worldview based on false assumptions and media conjecture”

Moving on to the theme of maternal health, Kristina Ljungros supplied us with some sobering statistics: 800 women die every day due to maternal mortality and 220 million women worldwide do not have access to contraceptives. She talked about her research and work on these issues, including The International Planned Parenthood Federation and the hopes for improved family planning rights in all countries, for the sake of all.

Innovation in Global Health is a compelling topic, and the next speaker, Johan Lundin, with his advice to “dare to tinker, tweak, modify and innovate”, did not disappoint. With his background as

Dileep Malavankar was a late addition to the night, having been persuaded to stay in Stockholm following a visit from his native India. With his humorous observations on the historical differences in maternal care between India and Sweden he kept us enthralled with an account of

maternal healthcare issues. There is a great inequity in maternal health, a topic often underfunded and low on the list of priorities. The maternal mortality rate is roughly four times higher in the poorest countries as compared to the richest, with poor and marginalised women suffering disproportionately. Around 250 maternal deaths occurred each day in India when the country began tackling the issue in 1992. Improvements in emergency obstetric care, strengthening of the healthcare workforce and better access to medical supplies formed part of the initial drive to reduce this number. In 2005, the millennium development goals helped maintain efforts with renewed focus and funding. As the director of The Indian Institute of Public Health and head of India’s first public health university, Mr Malavankar has taken it upon himself to continue this improvement. With advances in family planning services, safer rural obstetric care and reproductive health programmes, there is no reason to believe this cannot be achieved.

intimacy from procreation has afforded people the choice of when to have children, and thus greatly impacted poverty and population. The opportunity to plan families is a global health issue, but it also extends to our own lives. One of the great motivators of human behaviour is love, the pursuit of which can affect all aspects of our lives, including the decisions we make. The cultivation of friendship and development of intimate relationships is vital, especially if the goal is to be able to contribute to work in the global health field, since these relationships will influence what we can and want to do, and when we want to do it.

“dare to tinker, tweak, modify and innovate”

The closing keynote speaker was, Taha Hirbod Alexandersson who offered some final pearls of wisdom gathered from her varied career which ranges from the lab to field-based experience and features diverse areas including education, clinical trials and project management. Drawing from these cross-disciplinary experiences she urged us to think short term as well as long term; acquiring as much knowledge as possible especially in our early careers whilst also thinking beyond our own immediate fields of work in order to apply this knowledge to the benefit of other disciplines.

Next up was the ever-popular Hans Rosling, a man who I am sure requires no introduction to the readers of this magazine. He started off testing our Global Health knowledge with questions regarding worldwide rates of childhood measles vaccination (80%) and the proportion of young girls in education (90%). Using our answers as a basis, with a very long pointer, and his famous animated bubble graphs, he explained the problem with misinformation and he urged us all to enhance our “factfulness”, or “the relaxing habit of only carrying opinions based on facts.” Thus rejecting a worldview based on false assumptions and media conjecture. Gapminder Foundation was founded by Hans and his son Ola, to help us do just this, providing statistics and data on a wide range of health related issues for almost all countries on national and international levels. Using animated graphs, like those available on Gapminder, he showed us how to improve our worldview with statistics using illustrations such as world population, which is actually plateauing rather than exponentially increasing as is often thought. Like Kristina Ljungros, Hans also spoke of the importance of family planning. The right to access to modern contraceptives, leading to the separation of

As the post talk mingle began, small groups assembled into rooms to delve deeper into specific issues. The gentle hum of chitchat grew louder as we excitedly exchanged thoughts and views. Inspiration was the main term used, and it cloaked us in a warm glow as we made our collective journeys home, discussing plans for our own forays in the field and anticipating our global health futures. •

For FURTHER INFORMATION To watch the complete stream of the night visit: http://ki.se/en/education/global-health-night-2015 Gapminder foundation website: http://www.gapminder.org/ Mobile microscopy: http://fimm.webmicroscope.net/Research/Momic/ International Planned Parenthood Federation: http://www.ippf.org/ RFSU http://www.rfsu.se/

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Science

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Science

Science Snippets By Joanna Kritikou

Cancerous parasites? In a recently published case report, a man plagued by HIV succumbed to tumors in his lungs and liver. This makes sense since HIV patients are severely immunocompromised. What was unusual, however, was that the cancer cells appeared smaller in size and turned out to be of non-human origin. The man was revealed to be simultaneously infected with Hymenolepis nana, a common tapeworm. The cells from this parasite had undergone somatic mutations causing them to transform and invade surrounding tissue causing tumorous growths in the unfortunate patient. (New England Journal of Medicine, November 2015)

You smell like Parkinson’s One day, Joy Milne started noticing a change in her husband’s smell. Six years later he was diagnosed with Parkinson’s disease. Once she joined the charity Parkinson’s UK, she met other sufferers of the disease, each with the same odor. This led researchers at the University of Manchester to test her nose and found that she could very accurately identify people with the disease just by smelling their clothes. It is thought that the sebum – an oily fluid on the skin – is altered in those suffering from Parkinson’s, producing a unique chemical. Could this be used for diagnosis? It remains to be seen! (BBC News, October 2015)

using Herpes to fight cancer The herpes simplex virus (HSV) is something no one wants to be infected with. Therefore, it might strike you as odd that a drug using HSV has not only been made (Imlygic, by Amgen Inc.) but has also been approved by the FDA. It uses a modified version of the virus to infiltrate and reduce the size of tumors in patients with malignant melanoma. HSV infects cells, hijacks the replication machinery and viral particles emerge from the cell, thereby killing it. The mere presence of the virus within the tumor will, apart from directly killing the cells, elicit a strong immune response towards the tumor. (The Guardian, October 2015)

Photo credit: Wellcome images (Flickr)

Cerebral Sexual dimorphism? The hippocampus has been thought to be disproportionately large in the brains of females, implying that women’s tendency to express themselves more outwardly emotionally than men has a neurological explanation. But are male and female brains inherently different? New research claims essentially no. This new metastudy evaluated the methods and conclusions of the 76 MRI studies looking at the hippocampal volume in over 6,000 males and females. The result: the frequent claim that women have a disproportionately larger hippocampus than men can be laid to rest. (NeuroImage, September 2015)

Photo credit: IvanClow (Flickr)

Make your own mitochondria For those of us who do not have as much time as we would like to exercise, this is great news. In a study from Karolinska Institutet, active men were exposed to one session of High Intensity Interval Training (HIIT). Thigh muscle biopsies were collected 24 hours after HIIT and revealed an extensive release of free radicals. These break down calcium channels in the muscle cells, leading to the formation of mitochondria, among other benefits. The calcium channel breakdown does not occur in muscles exposed to antioxidant, which explains why antioxidants blunt effects of endurance training. (PNAS, November 2015)

Photo credit: Sparky (Flickr)

Lasting effects of Antibiotics It is known that a harsh dose of antibiotics has vast effects on our microbiome. A recent study assessing antibiotic treatments over a year, finds that the gut microbes are especially affected. In this clinical trial, each participant was given either a placebo or one of four common antibiotics. Their feces and saliva were analyzed before and after the treatment, and their contents sequenced. While the microbiome in the mouth recovered after a week, the gut microbe diversity was severely impacted and genes implicated in antibiotic resistance were enhanced. In the era of superbugs this is an important finding that should not be overlooked in the clinic. (mBio, November 2015)

Bacterial Buddies: Are we afraid of the right things? Photo: NIAID (Flickr)

The power of the tiny little organisms that are inside and on you By Jessica de Loma Olson Concerned about that extra kilo that always haunts you, no matter how much you go to the gym? Now you can officially stop worrying. A person can have around 1 kilogram of microorganisms inside their body. Eww, right? There is no reason to be concerned; or is there? As years pass by, the importance of the concept of microbiota is exponentially growing. All those microorganisms that live inside us and on our body, sharing one same home, are known as microbiota. It includes bacteria, fungi, viruses and any microorganism possible. Even though hosting other creatures might sound awkward, it is usually totally fine. However, it is the equilibrium between all these that is important. For instance, it is known that alterations in the microbiota, especially the community in the colon, are linked to inflammatory processes, immune diseases, cancer and even depression and autism. The perfect balance between all the microorganisms inside and on our bodies is fundamental to stay healthy. For example, good bacteria are the ones helping us out with digesting our food. The problem is that on a daily basis our body is constantly exposed to threats from the exterior. Just think about how dirty a toilet might be. What not to do in a toilet Consider all the effort you make when you are desperately trying to avoid touching the toilet seat. All those difficulties to just not sit on it. Forget about this; appar-

ently this is not the worst thing you can do here. A study performed at the University of San Diego and led by S. Kelley showed that there are worse practices than that. For example, flushing the toilet with the cover up disperses bacteria as if it was an aerosol, or not washing your hands afterwards can be even more harmful by spreading fecal bacteria. So next time, remember soap might be your best ally when protecting yourself. What not to touch in your house To put it in numbers, Dr. Charles Gerba from the University of Arizona (also known as Dr. Germ) estimated that there are 50 fecal bacteria per square inch in a toilet seat. This might sound disgusting but you will reconsider where you eat and what you touch once you know other details. For example, mobile phones have 10 times more bacteria than toilets, and an office desk up to 400 times more! In addition, who has avoided kitchens in student dorms just because of the filthy kitchen towels and sponges? Be aware, these can have up to 20.000 times more bacteria than your toilet seat! What (not) to eat Infections by the bacterium Clostridium difficile are one of the main causes of diarrhea and colitis. More importantly, this type of infection is quite resistant to antibiotics and the current treatment is still tricky in some complicated cases. In light of this issue, scientists turned to the human gut microbiota to search for

the answer. So why not just change this microbiota for a healthy one? Josbert Keller’s team tried it at the University of Amsterdam. The first fecal transplantation, given by an enema or through a nasogastric tube to the stomach, actually worked. Surprisingly, this exchange of the gut microbiota was two times more efficient than antibiotics. However, it is easy to understand some of the disadvantages. The solution: poop capsules. The nonprofit stool bank OpenBiome screens fecal samples and produces poop pills. As weird as it may seem, so far this could be a feasible solution to reestablish the gut microbiota when altered.

Mobile phones have 10 times more bacteria than toilets With all this said, you might have to reconsider what you fear and what you love. Understanding more about the 100 trillion buddies – yes that is 100.000.000.000.000 - we have in and on our bodies and how they constantly interact with the environment might make the difference. Like in The Triangles’ song “Applejack”, remember sometimes the strongest and most wonderful things are those we cannot see. • 15

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Science

Science regions can be measured using fMRI scans. This has allowed the identification of mirror systems. How do mirror systems work? For example, if someone

“Don’t judge someone until you’ve walked a mile in their shoes”

Mirror-touch synaesthesia: a cursed superpower By Olivia Miossec

A rare neurological condition, mirror-touch synaesthesia has often been dismissed as fanciful. But for those living with the condition, the symptoms are all too real. “Don’t judge someone until you’ve walked a mile in their shoes” This sentence illustrates perfectly what empathy is. It is not observing someone’s emotion from a safe distance; it is transposing and experiencing those feelings within yourself. We are self-centred beings and empathy is the tool we need to survive and thrive in our hypersocial world. It allows us to automatically and unconsciously ask the questions, “What if it were me?” and, “How would that make me feel?”. On a more basic level, empathy involves mirroring the actions and feelings of those around us. When someone falls, we tend to wince. When Jenny dies, we cry alongside Forrest. Mirroring provides us with the tool to understand others and act accordingly. It is therefore essential to our social functioning. A lack of it prevents us 16

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from connecting with others, pushing us towards the margins of society. An example is individuals diagnosed with Autism Spectrum Disorder (ASD), though of course there are exceptions within that category. Yet, how about too much of a good thing? Can connecting with others be a vulnerability in itself? Indeed, there are individuals who can sense the physical, and to some extent the emotional, feelings of those around them at incapacitating levels. The condition is known as mirror-touch synaesthesia, and it is arguably as alienating and isolating as its counterpart. Mirroring is caring: a neurological

substrate for emotional empathy

The first time I read about someone suffering from mirror-touch synaesthesia

(MTS), her story sounded completely implausible. If those around her received a hug, she felt the warm embrace herself. If someone tumbled to the ground, searing pain travelled through her. It sounds other worldly. Yet, there is a scientific basis for it: mirror neurons. These special neurons were first discovered in the 1990s by an Italian research group led by Rizzoli. They were looking at the firing of single neurons in monkeys when reaching for different objects. By accident, they discovered that a specific neuron would fire when the monkey reached for a peanut as well as when the monkey watched another reach for a peanut. A monkey-see, monkey-do type of neuron. In humans, investigating single neuron activity in the brain would be an invasive, and thus impossible, procedure. However, activity in specific brain

strokes your arm, the ‘arm area’ of your somatosensory cortex will be activated. Now, if you observed someone else’s arm being stroked, on television or on the street, that same exact region will also be activated (Blakemore, 2005). So now both you, and the person being stroked, have the same regions activated. You are mirroring them. The old adage “put yourself in someone’s shoes” should be revised. You are “putting yourself in someone’s brain”! Mirroring does not however limit itself to the physical. Emotions can be shared too. Research by Schulte-Ruther et al (2007) revealed that both the insula and limbic system, known to process emotionally salient stimuli, are activated when both imitating and observing facial expressions. Thus, we are able to translate others’ expressions into our own emotions. Our ability to empathize may therefore rely on these shared affective neural systems, from physical to emotional sensations. “Their experience” becomes “our experience”. A form of google translate for the ‘human experience’. It would however be an oversimplification to qualify mirror-systems as the entire biological basis for such a complex and multi-dimensional trait as empathy. Empathy can be cognitive, involving “perspective taking” and an understanding of other’s thoughts, or it can be a more visceral emotional empathy, feeling alongside others. It is in the latter case that mirror-systems play a role.

irror-touch synaesthesia: a gift M or a curse? What happens when our mirror systems perform too well? In normal individuals, our relevant mirror systems become activated when observing sensations experienced by others. But the main distinction with MTS sufferers lies in the degree to which that system is activated. In normal individuals, our brain regions are less active when we observe a sensation than when experience it. This thus creates a distinction between our ‘self’

and the others. It lets us wince, but not double over, when we watch someone get punched in the gut. We experience the shadow of a feeling. In MTS individuals, the mirror systems are overactive. In fMRI studies initiated by Blakemore (2005), but also Banissy and Ward, have revealed that MTS participants showed higher activity in somatosensory regions than controls when watching movies clips of faces being stroked. This supports the threshold theory of MTS. According to this, over-activation of the relevant regions in MTS is strong enough to reach the threshold of conscious experience, where we appropriate the feeling of others as our own. One could initially see this condition as empowering in a world where we constantly implore for more empathy. If someone breaks their leg, or loses a parent, we feel we can truly empathize and “be there” for them when we have ourselves experienced it in our past. Mirror-touch synaesthetes may have the advantage of being able to create these conscious experiences out of thin air. Banissy & Ward (2011) support this by showing that MTS individuals tend to display greater gray matter volume in areas of the brain associated with social cognition and empathy. On the other hand, decreased tempoparietal junction gray matter volume is also observed. This is the area which allows us to distinguish our own self from others. MTS is a poisoned chalice. In absorbing the feelings of all those around them, MTS individu-

“Their experience” becomes “our experience” als become one with their surroundings, progressively losing their identity, the sum of all their conscious experiences. Whilst they can manage their best to lessen their own physical and emotional pain through the choices they make, the behaviour of others, to which they are so emotionally reactive to, is out of their reach. The only solution can then be to retreat from the social world, a similar predicament to their opposite counterpart, ASD individuals.

Embracing empathic diversity

mirror system activation its measuring scale. Indeed, according to Gazzola et al (2006), the level of empathy and emotional insight individuals possess correlates with the level of brain activation in their mirror systems. This is important to consider in that whilst the individuals may read facial expressions or recognize social cues with higher ease, they may also share the emotional reactivity endured by MTS sufferers. They may respond more intensely and involuntarily to external stimulus.

Emotional empathy may be a spectrum, and the level of mirror system activation its measuring scale Another consideration is how much all our experiences, physical or emotional, are created by our brains. These are of course stimuli-driven, but conditions such as MTS underline how subjective our own responses to these stimuli are. Maybe more interestingly, they reveal how much of the nature of these responses rely on the individuality and performance of our brain circuits. Without disregarding the socio-cultural component, there is a large biological basis that dictates our place in the empathy spectrum. Society expects us to balance the right level of empathy and indifference to succeed as well as preserve our mental wellbeing. However, some of us allocated to the left side of the spectrum, the extreme form being ASD, may find social situations to be foreign and challenging territories. Those of us allocated to the right side of the scale, the extreme form being MTS, maybe be constantly exposed and overwhelmed to the contagious emotions of others. So, don’t judge someone until you’ve felt the world through their mirror neuron system. Though bear in mind that swapping shoes is a much easier task than swap• ping brains.

Beyond simple curiosity, this neuropsychological condition, which touches around 1.6% of the population, can teach us a lot about the rest of the 98.4% (Banissy et al, 2009). Emotional empathy may be a spectrum, and the level of 17

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Science

Black holes Into the unknown? By Sarah Marshall

Lost in the abyss, deep endless space, interstellar travel, an enigmatic portal to another dimension… It begins here in science-fiction, but a black hole translates far beyond mere fantasy. With a history of contention, the answer to a debated phenomenon becomes closer and closer: what is a black hole and what occurs within? Current Understanding A black hole is a region in outer space containing a vast amount of matter with an incredibly strong gravitational field, so strong that not even light can escape. A medium-sized black hole may have a mass 20 times that of the sun, yet fit inside a sphere with a diameter of approximately 16 km (roughly the length of the Stockholm tunnelbana red line from Norsborg to Ropsten). A black hole forms when an object reaches a critical point and collapses under its own gravity. For example, when a large star has exhausted all energy and can no longer sustain itself, it collapses and the gravitational force overwhelms all other forces, creating a black hole. Proposed in 1783 by astronomer John Mitchell, it was not until much later in the 1970s that the first black hole was observed - or at least its impacts on the surrounding environment, given that the darkness cannot be directly observed.

Relativity versus Quantum Theory So, what actually happens inside a black hole? This is something that physicists have been tackling for decades. Einstein’s Theory of Relativity (published as The Foundation of the General Theory of Relativity in 1916) describes the forma18

tion and behaviour of black holes, while quantum theory, which underpins modern physics, states that no information in the Universe can ever be lost. Professor Stephen Hawking from the University of Cambridge applied quantum theory to black holes, and in 1974 found that heat radiation can escape. These small emissions of radiation, appropriately termed Hawking Radiation, could cause the black hole to shrink and ultimately evaporate. The resultant situation is an application of two contradictory but fundamental theories, causing 40 years of ongoing scientific debate.

Leading Physicists Seek Solutions Over the last 5 years particularly, there have been assertions that in fact not only radiation but also information escapes a black hole. As the thinking became more and more difficult to follow, the search for consensus was needed. In August of this year, physicist Professor Laura MersiniHoughton from the University of North Carolina coordinated a one-week conference held at KTH Royal Institute of Technology Stockholm bringing together 32 of the world’s leading physicists. Arranged in conjunction with Nordita and the University of Cambridge, the conference provided a unique opportunity to seek a so-

lution to this contentious and paradoxical question among physicists.

Where are we now? And the result? Hawking proposed that black holes don’t actually envelope and lose physical information. Hawking has suggested that a form of 2D hologram is created, storing the information within the membrane of the black hole. Hawking said, “The information about ingoing particles is returned, but in a chaotic and useless form. This resolves the information paradox. But for all practical purposes, the information is lost.” This theory resonates with that posed by the winner of the 1999 Nobel Prize in Physics, Professor Gerard ‘t Hooft of Utrecht University. Information that enters the black hole is in fact not lost, therefore does not violate the fundamental principle of quantum theory. Has science clarified misconceptions among the general public? Perhaps not quite yet, but the leading physicists are continuing to strive for answers and consensus. As Professor Stephen Hawking said during his public lecture in Stockholm prior to the conference, “If you feel you are in a black hole, don’t give up. There’s a way out.” • 19

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SUICIDE: Story by Jennifer Lees Photo by Peggy Ler 20

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THE UNTOLD TRUTH 21

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Cover S tor y

e was a good student in high school. He played by the rules and didn’t get into too much trouble. The “average kid” - some might say. Like most of his friends, he went on to study at university and life seemed to be on track. He got himself a girlfriend, was sailing through his classes and had a good group of friends. Life was simply peachy until – inexplicably – it wasn’t. He started partying too much, drinking much more than usual and experimenting with drugs. His sleeping patterns changed and he started missing lectures. Failing grades accompanied a 10kg weight gain in the span of just a few months. He gave up on old hobbies and became a source of great concern for his girlfriend. He knew something felt wrong, but he couldn’t put his finger on it. There was a dramatic uncontrollable change taking place and the associated discomforting feelings began seeping into every dimension of his life. Unable to corral or explain these feelings, he continued with life as usual pushing any negative thoughts to the back of his mind. It wasn’t until he woke up confused in a hospital bed that it dawned on him that supressing his feelings was not an appropriate way to go through life. Suddenly it all came back to him, he had tried to take his life after coming home from a disappointing night out. Whilst in the hospital, he spoke to a psychiatrist about the event and everything leading up to it. He had 22

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You don’t commit suicide, you die by suicide…

been suffering from Borderline Personality Disorder (BPD) and would now benefit from appropriate medical treatment. Although the case presented here did not have fatal consequences, suicide continues to be a problem and every year, many people sadly decide to take their own lives.

Suicide: What’s going on?

Suicide continues to be a major public health concern all over the world, as it affects all age groups, all genders and a vast array of different cultures. Globally, suicide rates seem to be somewhat stable or even decreasing. Yet, it is still the fourth leading cause of premature death in people aged 15-49. In Sweden, suicide is the leading cause of premature death and the number of cases have been increasing in recent years (Institute of Health Metrics and Evaluation, 2013). For instance, the number of deaths per 100 000 people has risen from 10 to 14 among people aged 15-24 years old over the past 14 years. If we take a look at other countries in Scandinavia we can see that they also have higher rates of suicide than the global average. No one is sure why the rates are higher in Scandinavian countries prompting us to meet with Dr. Bo Runeson (Department of Clinical Neuroscience, Karolinska Institutet)

to discuss the current increase in mental health illness among young adults. A professor of psychiatry who specializes on suicide research, Runeson is also the Chairman of the Stockholm County Council’s regional care program for suicidal patients and works as a senior physician in the Affective Centre of Northern Stockholm Psychiatry. He has authored several books and contributed immensely to our understanding of suicide and the risk factors underlying it.

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Cover S tor y

Around 6 % of undergraduates and 4 % of graduate students in 4-year colleges report seriously considering attempting suicide in the past year and nearly half of these people did not tell anyone

It was a cold and windy November morning when I met Professor Bo Runeson at his office in Sankt Göran’s Psychiatric Department, but that didn’t seem to dampen either of our spirits. I met him as I came out of the lift and he was rushing from one room to the other. I was early for our appointment, and I think I gave him a bit of a startle. Nevertheless, he was very welcoming and hospitable. He looked younger than I was expecting for someone with such a long list of achievements and he was much taller than I anticipated. He was very friendly and eager to share his knowledge on the topic, despite the fact that he is rarely interviewed in English. A trained psychiatrist, Runeson made his first entry into research when he became inspired to put his clinical observations into scientific context. He started his scientific career by conducting psychological autopsies. He described these to me as “systematic interviews with people close to a suicide victim, such as friends and family members, to find out exactly what happened to the deceased and why it happened”. He would have in depth conversations with people that knew the victim in order to build up a profile of what their mental state was like before they died. “It’s almost unheard of for people to die by suicide without having a motive or underlying conditions,” he told me. Conducting these types of inter24

views over the years have lead Runeson to conclude that many suicide victims who are young adults usually presenting an undiagnosed form of mental illness.

Why is this happening?

Runeson explained that people who die by suicide are usually struggling with some form of mental illness. Depression is the most prevalent underlying mental condition in victims of suicide, which is not always severe in nature and could also range between mild and moderate. However, if left undiagnosed, individuals can really suffer and may fail to cope with every day life. Other common undiagnosed mental illnesses affecting suicide victims include borderline personality disorder, schizophrenia and bipolar disorder. The reality is that these disorders are very challenging to diagnose, especially in young adults. This is because these conditions can manifest unusual or atypical symptoms ranging from risky sexual behaviour to binge drinking and therefore can be confusing to pinpoint. Moreover, with regards to the more serious illnesses, such as bipolar disorder and schizophrenia, the symptoms begin to develop in young adulthood, around the age of 20, a period of life where a great deal of change is already going on.

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- American College Health Association Risk factors

Around 6 % of undergraduates and 4 % of graduate students in 4-year colleges report seriously considering attempting suicide in the past year and nearly half of these people did not tell anyone (American College Health Association). This alarmingly high rate of suicidal thoughts among young adults has prompted Runeson and his team to extensively research the risk factors of suicide and mental illness. He noticed that medical and nursing students having higher rates of depression and suicidal thoughts compared to those working. It is unclear whether this pattern appears in all university students, but if it does, we are facing a huge public health problem. Runeson postulates that around 50% of all high school graduates go on to further education and up to 1 in 5 students report having depression at some point in time. Of those who have depression, there will be a sizeable number of individuals who attempt suicide. Consequently, we could see a steady rise in the suicide rate as the number of university admissions increases. Runeson suggests that the reasons for the high rate of depression and suicidal thoughts in students may be explained by the stress and pressure put on attainment, which plays on people’s vulnerabilities. He gives the example of medical students, which as a group, are generally high achievers so they put a lot of stress 25

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If you feel that you may be struggling, there are some common symptoms to recognise that may help you to seek assistance - Feeling sad for a prolonged period of time (usually more than 2 weeks) - Difficulties to keep up with the workload or problems with concentration - Problems with appetite, either an increase or decrease in appetite - Less interest in engaging in social activities

If you meet several of these criteria, it is possible that you may be suffering from depression. It is important that you do NOT simply self-diagnose. Rather, book an appointment with the student councillor. They may be able to help you there directly or advise you on your next step. on themselves to be the best and generally struggle to accept failure. Another example is those who go to university because it is expected of them by their family and by society. After a period of

Up to 1 in 5 students report having depression at some point time, some may come to realize that university was not meant for them, and then find themselves dealing with uncertainty and struggling to get any support from home. Another important factor may be moving from home to university, which comes with a number of changes ranging from familial separation to the challenges associated with establishing new social networks. This can lead to feelings of isolation and hopelessness, especially if one does not know where to turn to - be it for social support or for professional help. Another risk factor for suicide is gender. Runeson has found that female students were about two times more likely to report these symptoms than their male counterparts, however, very few actually attempted suicide. Men are more impulsive and tend to think more short term, which makes them more likely to carry through with suicide. He explained that 26

“men are more likely to deny the situation and turn to alcohol and narcotics to ‘fix’ the problem, while women are more likely to have a supportive social network and therefore more likely to seek help”. An emerging area of research is now focusing on the risk of suicide in transgender and gender non- conforming individuals. 41% of individuals who identify as transgender have reported to have attempted suicide at some point in their lives. Compared this to general population of gender conforming individuals where 4.6% have reported attempting suicide (American Foundation of Suicide Prevention, 2014).

Getting help

Where to turn to get help and how to navigate the health care system is a very important issue. It’s not surprising that young adults are often unfamiliar with the health care system, as they have never had to deal with it before. This can make people reticent to get help, or even unaware of the help available. These observations have been documented in some of Runeson’s earlier studies. He explains that “it’s not just navigating the healthcare system what can be troubling. Having a first episode of depression or panic disorder in its own can be distressing and may not even be obvious to the person or their close family and friends”. Runeson points out

that “anyone can be affected, even someone who has never had any mental health issues before. Everyone experiences pain and the pain felt varies from person to person”. There are common events that can lead to depression or anxiety, such as a break up, monetary issues, disappointment in the workplace or with university grades. It is normal to have periods of sadness that may lead to mild depression or anxiety. Unfortunately though, up to 42% of people suffering from a mental illness do not seek help, and of those half have attempted suicide at some point (Cheung & Dewa, 2007). These harrowing statistics bring home the reality of suffering from a mental illness and the importance of recognising when someone is in need of help. What is encouraging, however, is that here at Karolinska Institutet, students are invited to talk about any issues that they are experiencing with their course and

programme leaders. Runeson says that both his colleagues and him welcome psychiatry students to come forward with any issues they may have be. Changes can also be seen outside the university setting, where some important developments have genuinely aided the field of mental health. Access to mental health care has increased greatly over the recent decades and now you can even contact the psychiatric department at the hospital directly if you feel the problem is more urgent. One achievement that Runeson and his department are particularly proud of is Psykiatrisk Akut Mobilitet or PAM, which is a mobile acute emergency unit to support individuals. It looks much like an ambulance, but it deals only with mental health issues. It is staffed with two psychiatric nurses who have full real-time access to medical records so that the care is of high quality. Instead of being visited by the police, a mental distressed individ-

ual would get more appropriate attention from the PAM. In addition to helping individuals, PAM hopes to help reduce the stigma of mental illness.

Thoughts for the future

While there have been some great steps forward in the field of psychiatry in recent years, there is still work to be done. There is a shortage of physicians, psychologists and nurses in psychiatric care, which opens up a great deal of possibilities for anyone who is interested in the field. Runeson says that if you want to engage in an area where things are being improved, now it is the time to take action. There are also developing fields in psychiatric research such as epidemiology, biological research and psychological research. Runeson’s concludes that it’s a very rewarding, broad and stimulating field and encourages those who are interested to get involved. •

Contact information for help Student Health Centre: Tel: 08-524 835 70 E-mail: studenthalsan@ki.se Psychotherapist: Kristina Fredriksson Tel: 08-524 835 61 Mind Suicide Hepline: Tel: 90101 www.mind.se 117 Vårdguiden: Tel: 02-0220060

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Global Focu s

Introducing Decade Zero Article and photo by Iskra Pollak Dorocic

If we had started then, the world would have needed to reduce its carbon emissions by only 2% per year until 2005. This would have provided ample time to slowly start developing and introducing replacement technologies. If you’ve been paying any attention lately, you know that this is not what happened. Instead, the world has been pumping more and more carbon into the atmosphere. In 2013, global CO2 emissions were 61% higher than they were in 1990. And since this buildup is cumulative, the situation we find ourselves today is more dire. This inevitable environmental downfall is not happening by accident. As Klein describes in her latest book, the environment movement fell prey to really bad timing. At the same time as the first global agreements to cut emissions were signed, parallel agreements were initiated to increase global trade. In 1992, the first United Nations Earth Summit took place. That same year, the North American Free Trade Agreement was signed, followed by the World Trade Organization in 1994. Each time governments agreed on new carbon targets, they would simultaneously cancel it out by agreeing to increase global trade.

A revived environmental movement is gaining ground. Just in time for the United Nations Climate Change Conference 2015 (COP21) in Paris, the renowned journalist and thinker Naomi Klein came to Stockholm to speak about how the world found itself in the midst of climate change, and what we should do to avoid the worst. “Is it really possible to be bored by

the end of the world?” asks Naomi Klein at the beginning of her documentary about climate change. Klein admits that she, like many of us, used to feel so overwhelmed and pessimistic about the topic that it was easier just to ignore it. It’s not that we don’t believe climate change is happening, but what can one individual really do to make an impact? We all know the little things we should be doing: buy energy efficient light bulbs, recycle, don’t waste paper on printing, bike instead of drive, eat less meat, and on and on. But are we really going to save the planet by simply buying the latest “green” product on the market and turning off the lights? 28

No, argues Naomi Klein, the awardwinning journalist who wrote This Changes Everything: Capitalism vs the Climate. Klein recently visited Stockholm to premiere the documentary of the same name and to participate in a discussion at Kulturhuset with Johan Rockström, Professor in Environmental Science at Stockholm University and the Executive Director of the Stockholm Resilience Centre. “Because we’ve procrastinated for two and a half decades, and because we’ve allowed emissions to increase by 60%, if we are going to stay within that very limited carbon budget, we now need to take radical action”, starts Klein. Her powerful book describes in detail how the world got to point of skyrocket-

ing carbon emissions. It’s largely a political problem, rather than a scientific one. Virtually all scientists agree that climate change is occurring due to human actions: of the more than 4,000 academic papers published over 20 years, 97% agree that climate change is humancaused. The first scientific findings demonstrating that burning carbon could be warming the planet were published in the late 1950s. The claim was widely accepted worldwide, to the point that the first major international meeting to set specific targets for emission reductions took place in 1988, and was attended by hundreds of scientists and politicians from 46 countries. The meeting concluded that countries should cut emissions 20% by 2005.

Trade agreements hugely increased global production and transport of goods. Now products made in China would be encouraged to travel to the other side of the world, boosting carbon emissions manifold. By 2007, China became responsible for two thirds of the annual increase in global emissions - but half of that was due to producing goods for export.

It’s largely a political problem, rather than a scientific one There is a major difference between the free trade agreements and the environmental agreements: only one is legally binding. Free trade is protected by the law, while the environmental agreements are basically based on the honor system. While private companies can now sue national governments over laws that impose on their profits (such as anti-pollution measures), not much happens if countries break their promises to lower emissions. One might wonder is there even a point of having environmental agreements? That is not even the worst part, as Klein goes on, “not only do fossil fuel companies receive $775 billion to $1 trillion in annual global subsidies, but they pay nothing for the privilege of treating our shared atmosphere as a free waste dump.”

Two possible future paths exist. Either we stay on the road we’re on, deal with the problem only when it gets really bad, and invest in new technologies then. Or we stop extracting what’s in the ground now, and develop new technologies now. “There is a danger of treating this as just a technocratic problem”, argues Klein.

Klein calls the present “decade zero”, the last decade to take decisive action against climate change Yes, we might find technologies to handle some of the problems which will increasingly come up (oil spills, smog, floods, just to name a few), but simultaneously we are also finding new and more damaging ways of extracting fossil fuels (fracking, arctic drilling). Also, “what that does not confront is the role of vested interests, power and corruption, and the need for really deep political and economic change.” Climate change is not a problem that can be solved by markets or industry, rather it will need a great restructuring of our political, economic, and social systems, argues Klein. Instead of global trade agreements, the change will come from local action, communities which are sustainable and self-sufficient, and more worker’s rights. Klein calls the present “decade zero”, the last decade to take decisive action against climate change. If we don’t, global temperature will likely increase by more than 2°C causing disastrous effects on the environment. While Klein’s book is particularly factual and clear in presenting historical and current events, the accompanying documentary gives us a much more human reaction to environmental disasters happening worldwide. In it, Klein with director and partner Avi Lewis interview communities directly impacted by the huge industrial undertakings in their backyards – from Indigenous communities in Northern Canada taking on the tar sands, to farmers in India battling huge coal-powered plants, to city-dwellers in China living in smog-plagued streets. One thing that becomes painfully clear is that most of the communities comprising the so-called “sacrifice zones” of environmental destruction are poor and in a difficult positions to make their voices heard. “Environmentalism of the poor has urgency, they are fighting for their survival.”

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Klein emphasizes that a mobilized population is crucial to drive governments to implement policy changes. Small victories are being won, in large part due to public demands. Shell, the huge multinational oil and gas company, has abandoned its plans to drill in the Arctic; Keystone XL, a transcontinental pipeline which proposed to carry crude oil from Northern Canada to Southern US, has been called off; and some of the largest fossil fuel economies, such as the oil-rich Canadian province of Alberta, are planning to introduce a carbon tax. Sweden, especially, has been on the forefront. A serious discussion is taking place at the governmental level, proposing Sweden to become the first fossil fuel free state in the world, and this is a result of bottom-up movements. It’s clearly worth supporting the various initiatives, from divestment campaigns to government petitions. The United Nations Climate Change Conference 2015 (COP 21), which is taking place in Paris this December, aims to finally make a binding and universal agreement on climate, including all the nations of the world. Such meetings have largely been a failure in the past, but it feels different this time. “Political will for Paris climate deal is unprecedented”, writes the Guardian newspaper. Will politicians commit to real changes this time? To this, Klein makes a point hard to argue against: “it’s easier to change the human system, than to change the laws of nature”. •

2°C: the widely-agreed upon limit of temperature increase by end of this century, beyond which the world would face disastrous environmental consequences 565 gigatons: scientific estimate of how much CO2 the atmosphere can still handle to stay within 2°C limit 2,795 gigatons: the amount of CO2 that will be released if we extract and burn the proven reserves of fossil fuel known today

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Global Focu s

In the shadow of war

Children with disabilities are at risk in eastern Ukraine

Life under occupation

Photo by: By UNICEF Ukraine (фото_183)

By R adek J. Góra

Nowadays, we are compelled to embrace every moment that is not chopped by the gunshots. I don’t like that; I don’t care which flag billows from the city hall

Konstiantynivka is the last stop for all trains coming from Kiev. Likewise, it is an easternmost town under Ukrainian government control. Areas to the east from this settlement are run by the separatists, aiming for revival of Novorossiya – a historical land to the north of the Black Sea. Among the supporters of either side there are thousands of civilians, dreaming of peaceful lives without bullets passing over their heads. How do they manage to coexist with soldiers living next door? “Living here is a nightmare! It’s not a life, it’s a torture”, says Yulia, an inhabitant of the Donbass area, an industrial region located in the East of Ukraine. “People don’t want to go out of their homes, merely listening from which side the noises of shots and bomb explosions are coming. Since the war broke out I haven’t slept well a single night. It was a very difficult decision for me and my dear family, but we had to leave our hometown”, continues Yulia .

In the middle of nowhere

Photo by Pohorynsky (Own work) - GFDL (http://www.gnu.org/copyleft/fdl.html)

As she and her friends report, there are regions in the Donbass area where one can hardly find a living soul and all the houses already turned into ruins. Ci-

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vilians who decided to stay in the occupied zone must fight for their lives every day, because shops are closed and both water and power supplies are scarce. Many young people have emigrated to the neighbouring countries, belonging to the European Union, where studying and finding a decent job is much easier. The elderly are less flexible. They do not want to leave their fatherland. Being old and vulnerable, they will spend the last years of their existence in basements, having occasional breaks outside for breakfasts and dinners. As they reveal, nobody believes that the situation will improve any time in the future. Everything is expensive, prices for food and medicines have increased dramatically since last

year. “Death is in the air”, says Natasha, a 50-year-old woman from Konstiantynivka. Apparently even in the Ukrainian capital, which is not directly affected by the armed conflict, the situation seems to be tense. Many newcomers have difficulties with finding an affordable place to stay, as the price rise of accommodation and food in Kiev is evident, too. “People are forced to stay in the streets, asking the others for bread and water”, reports Alexandr, an inhabitant of the city centre. Start from scratch In the middle of 2014 the Russian and separatist forces ceased military actions in the suburbs of Sartana city, inhabited mostly by Greek minority, Ukrainian sol-

diers hid behind impregnable entrenchments, leaving all the tanks and cannons in the multiple allotments scattered around the city. Whilst officials of both sides unanimously claimed to sign the armistice, the sound of the heavy artillery can be heard from a noticeable distance. The populace of Sartana appears to get used to that, trying to organize their lives from scratches. Just one hundred metres away from the observation post of the Ukrainian police, people are gathering at the entrance to the well-known Greek tavern. The local community meets there on a daily basis to dance zorba, drink wine and celebrate the next day without new casualties. At a first glance everything here seems to be normal. Busses full of workers are heading towards Mariupol, an industrial city laying at the Sea of Azov. Women are strolling on the avenues with bags filled with goods bought in the local market. Also the museum of Azov Greek history, central sauna complex and zoo function faultlessly, giving an impression that nothing bad has ever happened in this area of tranquillity. But the truth is more upsetting. For instance, in the midOctober 2014, a rocket launched by the separatists exploded near a funeral procession, killing seven people. Living supposedly a normal life, people of Sartana remember all the deadly accidents from the past. And clamours heard in a short distance from the city only remind them that the agreement between the sides might be terminated at any time soon . A strange and silent war People from the villages near Mariupol are more and more irritated. The provinces are most affected by the military actions happening in the Donbass area. Soldiers regularly intrude into their cottages, searching for prospective saboteurs willing to confess locations of the hostile

squadrons. – They are going everywhere – asserts Dasha, a landlady from Pavlopil, a small settlement to the North of Mariupol. – They even went to the pigsty! I survived the World War II but this is much worse. We live in one country and shouldn’t fight with each other – concludes Dasha. Pavlopil and the other villages are the main targets of a silent war between Ukrainians and separatists. While the first occasionally parade through Pavlopil to express Ukrainian reign over the village, the latter is trying to recruit new members able to report actions of the govern-

Everyone became completely indifferent. Passport controls at the temporarily built sites are welcomed with impassiveness mental troops. Some of the civilians are annoyed, but the majority pretends not to see what is really happening in the area. Everyone became completely indifferent. Passport controls at the temporarily built sites are welcomed with impassiveness. People look at the screen of the TV set unaffected by the presence of several Ukrainian soldiers, looking suspiciously for anyone who could belong to the separatist groups. Nobody wants to draw attention of the people equipped with real weapons . Breaking the impasse Misha, an old miner from Mariupol, looks at the column of Ukrainian trucks with deep displeasure. – Why do they need this war? – he asks desperately. – For a long time our main worry was to have something to put in a pot. We were happy to have our families and relatives with us, here in the city. But they are gone. Nowadays, we are compelled to embrace every

moment that is not chopped by the gunshots. I don’t like that; I don’t care which flag billows from the city hall. I just want my life to be as it was before this whole conflict – concludes Misha. His opinion is shared by the Ukrainian soldiers, who often travel to other big cities, mostly in the West of the country. Life in Odessa or Lviv looks completely different. There are no overlaps between daily concerns of the people living in Western and Eastern Ukraine. – I cannot believe that. I got a permit and immediately came to Kiev for a couple of days. How is that possible that people here are crying over the exchange rate between ruble and dollar, while we, in Mariupol, have nothing to eat? – moans one of the Ukrainian battalion member. He is not far from truth. People in Western and Central Ukraine indeed lead a somewhat different life. But they did not forget what is happening in some parts of their country. They just seem to be tired of all this conflict, trying to put their lives back to order. As the political impasse is ever lasting, Western Ukrainians are helping in the conflict financially supporting the charities sending food and water supplies to the people fighting in the war. Some of them are entering the army, the others pretend to listen to the next orations given by the local politicians, claiming that the conflict will come to an end soon. But no one appears to believe that. No one trusts the words of politicians any longer, as it was them who ignite the tensions counting on the verve of young men willing to take part in a real war. The originators of the war do not live in the affected area; they went away a long time ago , leaving the lives of the fellow nationals to their fate. And in the streets of Kiev one can barely hear many insecure voices saying: ‘we should solve the conflict peacefully, we don’t want more problems.’ • 31

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Global Focu s

Conservation, Classrooms and Condoms

Why are conservation charities concerning themselves with contraceptives? Story and photos by Emily Clark

Facing global challenges of climate change, population growth, ongoing unsustainable resource use, and limited funding, sustainable development needs to be efficient and effective. With this in mind, environmental conservation organisations are implementing family planning projects, and charities traditionally known for their work in sexual and reproductive health are partnering with wildlife centres. There’s an evolving vogue for a multi-faceted, cross-sectoral, holistic approach to sustainable development known as “Population-Health-Environment”. How was PHE born? Twenty-five years ago, the United Nations Conference on Environment and Development announced 27 principles which emphasised the importance of interdisciplinary collaboration. Principle 1 stated: “human beings…are entitled to a healthy and productive life in harmony with nature. Environmental protection shall constitute an integral part of the development process and cannot be considered in isolation from it.” The recent launch of the Sustainable Development Goals (SDGs) highlighted, underlined, and put in bold the continued importance of integration between different sectors as the way of the future. Conservation organisations often find themselves in remote, rural areas of incredible biodiversity. These areas can be logistically difficult to work in, and local populations may be all too familiar with the inverse care law. By partnering with community health organisations, one can benefit from the knowledge, experience,

relationships with key stakeholders, local context and presence of the other. Partnership allows sharing of transport, offices, electricity, people, skills and support. The community may benefit from strategies for sustainable resource use alongside improved access to basic community health services. In areas with an unmet demand for contraception, being able to plan a family could improve food security, ease pressure on natural resources, and increase household income. As demonstrated by the Madagascar PHE network, synergies between the priorities of the partnering organisations may be realised. For example, integrated community meetings draw men into discussions of family planning, while bringing women into conservation efforts. Not a walk in the park Geographically and logistically, this work may be challenging. Identifying motivated people who are willing to take the responsibility of the role of community health worker can be complicated, espe-

cially in areas where schools are sparse. Ongoing support, education, follow up training as well as incentives to take part are necessary to ensure the continued success of the programme. Monitoring and evaluation of PHE outcomes is vital, however, it can be a complicated process with regards to identifying and accounting for confounders, and ensuring that as much as possible of the impact of the intervention is being measured. Madagascar: a case study Madagascar was recently thrust into the limelight by King Julian, an all-singing, all-dancing lemur. A biodiversity hotspot, it has been estimated that 95% of reptiles, 89% of plants and 92% of mammals are endemic to Madagascar (World Wildlife Fund 2015). However, the World Bank have ranked Madagascar at 206 of the 213 countries included with respect to gross national income in 2014. For comparison, Sweden ranks eleventh. According to the United Nations Human Vezo fishing pirogue

Mangrove sustainable management strategies have been implemented

Development Report in 2014, Madagascar ranks 155 of 187 countries (and Sweden 12). Life expectancy is estimated at 65 years in 2013 – as opposed to 82 years in Sweden. In rural southwest Madagacar, the Vezo population is defined by their relationship with the sea. Reliant on the ocean for food, transport, trade and with little access to any other resources, they are vulnerable. With a huge unmet demand for family planning services, couples were having more children than they would choose, putting additional pressure on limited marine resources. The reef system and mangroves were under strain not only from industrial fishing and climate change, but also due to increasing use of destructive fishing techniques to counteract the declining fish stocks. Access to health care is limited, and so women had few options if they experienced any pregnancy-related health concerns. Poor health comes hand in hand with poverty. The marine conservation organisation Blue Ventures took a grassroots approach, listening to local communities and responding to their needs. Seeing that octopus was a very valuable commodity, together with one village they decided to try a temporarily closing part of the octopus fishing ground. As octopus has a short reproductive and growth cycle, it was expected that this strategy would increase productivity. Upon reopening the reserve, octopus landings were significantly greater: a tangible, visible success story of the economic benefits of resource management, which has encouraged other neighbouring villages to copy this approach. From this, a network of 25 communities created a number of permanent marine reserves and discouraged harmful fish-

ing practices such as poison-fishing, by implementing locally enforced and legally recognised traditional laws. Additionally, introduction of alternative livelihoods, such as farming sea cucumbers and seaweed, provided an extra source of income.

educational activities regarding water, sanitation, hygiene, maternal and child health, and environmental topics are facilitated with men, women and children. Integrated educational messages are also spread through theatre and radio shows, as well as community discussions, targeting broad audiences and drawing them in to the conversation.

Meanwhile, tackling the unmet need for family planning services was achieved by training local women as community Where next? health workers in partnership with PopuPHE is greater than the sum of its parts. lation Services International. These women have become trusted and respected Integration is the future. In the words of ambassadors for health, educating their the SDGs: “sustainable development recfriends, families and neighbours about ognizes that eradicating poverty in all its avoiding sexually transmitted infections, forms and dimensions, combatting inempowering women so that they can plan equality within and among countries, pretheir pregnancies, and offering a range of serving the planet, creating sustained, inmodern contraceptives, including con- clusive and sustainable economic growth doms, the combined oral contraceptive and fostering social inclusion are linked to pill and depo-provera injections. Col- each other and are interdependent.”Could laboration with Marie Stopes Madagas- Population-Health-Environment be the car enables women to attend outreach answer to achieving the Sustainable De• clinics for long-acting reversible contra- velopment Goals? ceptives, such as hormonal implants and the intrauterine device. Concurrently, Endemic to Madagascar: the ring-tailed lemur

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Swedish Christmas Crash Course

By Helena Honkaniemi

Tales of a tree surgeon

By Martha N icholson Photo by Katarina Stojanovic

The holidays are right around the corner, and though some of you may be well aware of what that entails, not everyone is familiar with Swedish Christmas traditions. For those who are new to the country, and wish to experience this holiday to the fullest, consider this a crash course and quick guide on Swedish winter holidays.

Stockholm’s woodlands are much more than meet the eye. The late Swedish Poet Laureate Tomas Tranströmer agreed, and commented on moments of blissful creativity when walking in the woods on his home island Runmarö in the outer archipelago. With this in mind, I took a look at the health and social benefits that Stockholm residents get from living in a tree friendly city.

Preparations

So, do Stockholm’s residents live healthier, happier lives as a result of living a few minutes away from a leafy forest path? Research suggests that by living close to trees does indeed lead to social, mental and physical health benefits, more cohesive communities and better air quality. This research has been used by Dr Dan Bloomfield at the University of Exeter to develop a ‘Green Prescription’. A dose of forest and outdoor engagement nature for patients with Chronic conditions can deliver physiological and psychological benefits. Other studies show that living in close proximity to woodland leads a lifestyle free of stress, anger and depression, with more room for mental composure and a higher self-esteem. Having trees nearby also encourages us to abandon sedentary lifestyles and to bravely step out into the outdoors to interact with the visually gratifying environment.

After a month of jam-packed Christmas markets and a St. Lucia’s Day celebration, it’s time to begin preparing for the real thing. Decorations do not begin to appear until the beginning of December. Even then, homes are often very humbly decorated with simple Christmas lights and candlesticks, and adorned in poinsettias and red tulips. Finally, the Christmas tree is ornamented only a few days before Christmas Eve, with juldocka or straw figurines, bells, colorful baubles and even little Swedish flags.

Food

Throughout the month of December, restaurants will serve a traditional Christmas meal, julbord, which includes pickled herring, cured salmon (gravlax), pate, crispbread (knäckebröd), ham (julskinka), meatballs with beetroot salad, lutfisk (a customary Nordic dish of dried whitefish treated with lye) and pork. Keep in mind though that 34

reservations are scarce and must be made well in advance! This holiday-themed buffet is also served on Christmas Eve in many Swedish households. It is accompanied by glögg, a delicious mulled wine served both hot and cold, and julmust, a root beer-like soda sold exclusively around Christmas time. The meal is only complete with pepparkakor, ginger snaps or cookies cut into various festive shapes, and risgrynsgröt, a sweet rice pudding containing a raisin or almond. Whoever finds the raisin or almond may either be granted one wish, or may even be married within the next year!

Christmas Eve and Christmas Day

Finally, the day has arrived! Christmas Eve, or julafton, is the main event in Nordic Christmas traditions. The true celebrations begin in the afternoon. Every year since 1959, at exactly 3 PM or 15:00, Swedish television broadcasts a Christmas cartoon featuring Donald Duck – Kalle Anka och hans vänner önskar God Jul (“Donald Duck and His Friends Wish You a Merry

Christmas”). The program has become an integral part of Swedish Christmas in the last half-century. In the evening, following the julbord, presents are distributed by tomten, a white-bearded Swedish gnome dressed in a red robe. However, in recent years the more internationally recognized Santa Claus has begun to replace this custom. Finally, some Swedes end their night with a beautiful candlelit procession to midnight mass. In the morning, many continue with church services to welcome Christmas Day, followed by a second round of Christmas food and treats. In fact, the Christmas season continues well past New Year’s Eve with Trettondedag Jul (Epiphany) on January 6th, and finally ends on January 13th with Hilarymas, or Sankt Knuds day, which is celebrated by throwing the Christmas tree out of the window and finishing the remaining Christmas sweets, ready to face a new year. So, with that, I’d like to wish you:

God Jul & Gott Nytt År!

Rob Vowles (pictured here) is a specialist tree surgeon and long time Stockholm resident. He has explored every inch of Stockholm’s diverse woodlands, with work taking him from the heart of the city and its elm trees on one day, to a secluded

pine studded island the next. The leaffree winter months are prime season for repurposing trees by pruning, monitoring risks of deadwood and ensuring the safety of tree structures. Rob explains that “urban forestry is fundamental in environments where humans and trees co-exist for the sake of safety for both the tree and us residents”. So tree surgeons have their work cut out this winter where towering pines, maples and giant oaks dominate our urban landscape. With the big freeze upon us and here to stay for another three months, how can we use this knowledge to our advantage? The social, mental and physical benefits of the forest are invaluable resources for winter Stockholm survival. When I asked Rob how to get the most from Stockholm’s woodland scenery, he tells me that the best way is to make a conscious effort to plan walks, cycles or runs into your weekends. If you’re feeling ambitious, take a hike in the visually stunning and readily accessible Tyresta National Park (tyresta.se) in the South of Stockholm. “What makes Tyresta such a special place is that it is one of the oldest untouched forests in Sweden with some truly spectacular trees”. If you can’t fit a full day of woodland wanders into your schedule, “try a relaxing stroll around Djurgården with your route ending under the epic oak tree (one of Rob’s patients) that dwarfs the castle like cafe Helin Voltaire” (helinvoltaire.com). They do a great fika too. Good clothing is essential to a day out in the woods. Stay true to the old saying “Det finns inget dåligt väder, bara dåli-

ga kläder” (there’s no such thing as bad weather, just bad clothes). Rob tells me “hardwearing kit from stores like Fjällraven (fjallraven.com) are worth the investment so you can enjoy winter woodlands to the full by going out and really getting mucky”. While we all want to make the most of Stockholm’s woodlands, glean the benefits of fresh air, enjoy the health promoting qualities and even the higher economic equality, we should turn our attention the sustainability of the woodland landscape. Tree surgeons have an important role in maintaining the health of the ecosystem and, as Rob explains, sometimes his patients have to suffer a sad but inevitable fate; “a tree falling into a state of decline can rarely be pruned to a state of recovery so instead of trying to do the impossible, we encourage the specimen to be an effective habitat for numerous birds and insects. Next time you visit your local woodland and see large dead standing trees, don’t think of them as being dangerous or untidy but look at them as a metropolis for creepy crawlies and our flying feathered friends”. •

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Photo by Samarth Vallabh (Flickr)

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By Martha N icholson & Sarolta Gabulya

Generation WHY? TEDxStockholm, the independently organised offshoot of the non-profit TED talks organisation, brought four excellent speakers to a packed-out Aula Medica this November for a discussion on Generation Y and the challenges of our time.

Born between 1980 and 2000, Generation Y is sandwiched between baby boomers and teenage adolescents. I am on of them. We remember 9/11, we have witnessed mass migration and we probably have carpel tunnel syndrome from too much mobile messaging. I wanted to know if it’s true, have we been dealt a bad hand in the fate of demography? Are we all going to be enslaved by unemployment (because we get offered internships not employment), uncultured because we have grown up hooked on digital technology and resigned to the depressing realisation that we won’t be as well off as our parents? As a long standing TED talks fan, I was delighted to get a chance to hear from the people who tell it best. The night began with an optimistic introduction to Generation Y. Our generation is considered to be the first digital natives, we are fluent in technology and yes, some of us hit the jackpot with the rise of emerging digitalisation (Zuckerberg). We are the largest youth group in history and we have always been told to follow our dreams. We are “special”. These sentiments have no doubt caused some egotism and narcissism amongst us. While optimism and multitasking are great features of this generation, we are also forced to face the consequences of our upbringing which the speakers of the night went on to address. Herman Geijer, lecturer and writer of the book Zombieöverlevnad : din guide till apokalypsen (Apart förlag AB, 2014) (Zombiesurvival: your guide for the apocalypse) started the night off. He talked about the rise of zombies in popular culture and how Generation Y can harness 36

the survival techniques that we watch in movies and read in books. How should we prepare for a zombie attack, or any real life crisis or catastrophe according to Herman? There are three things we need to do. Exercise, we have to be able to run, jump and be versatile. Strength will be key in an apocalypse. Next, learn to love thy neighbour; they will be your saving grace in times of need. Finally, nurture your communities, you need to be organized in order to survive. Herman’s dark subject matter was certainly a lesson to us all whether a zombie attack strikes or not.

for her career. As she reflected on her experiences of applying for jobs here in Sweden, Christa explained some of the barriers facing Generation Y at work. Despite her impressive education, she found that she was met with racial prejudice and discrimination by her conservative interviewers. In a personal and optimistic talk, she highlighted the possibilities that we can create by meeting and learning from new people. Christa pointed out the advantages of being unique as a main factor in the successful integration in a new community.

Next up, therapist, coach, writer and educator Patrik Wincent spoke about his career helping Generation Y with internet and information addiction. Patrick shared anecdotes about his own personal journey and realisations that led to him founding two companies; Internetakuten (Internet emergency) which helps people find the balance between the digital world and life, and Dataspelsakuten (Video game emergency) which is specialized in video game addiction. The take home message was directed at parents (or future parents), “no app can replace your lap”. Hearing of people needing professional help to get over digital addictions made me understand how much social media and gaming has shaped generation Y.

Jack Werner, journalist, blogger and debater has been coined with the modest title: “probably the most important journalist in our country right now”. He deserves the complement, especially having recently won the Swedish Grand Journalism Prize. Jack spoke about the importance of fact checking. He compared today’s information explosion to the how information looked when printing emerged. Most importantly, he talked about the disadvantages of open access publishing of our generation. Fact checking should be a priority nowadays as it was in the past. To support his opinion, he presented some fake news that had gone viral on the internet and concluded that children should be taught basic fact checking from a young age to shape the next generation of journalists.

At the mid-evening break, I learnt about the digital platform, TimeVillage (www. timevillage.org), a partner of TEDxStockholm. Their innovative idea allows people to exchange and share their time and expertise using digital coupons. I learnt that by offering to host dinner at my place and a few hours babysitting, I can receive a beginners’ lesson in Mandarin and an introduction to app programing. It was a deal! Next up, Christa Awour, an employee of the United Nations High Commission for Refugees (UNCHR) spoke about growing up in Kenya. With a very supportive upbringing, Christa had ambitious plans

To summarise the evening’s events, the talks were thought provoking and highlighted the problems that our generation is facing. I wonder what is next for our contingent and whether we will make the world a better place for generations ahead. I also wait with anticipation to see what “ideas worth spreading” TEDxStockholm will bring to the table in 2016 and recommend you sign up early to snap up a ticket. More information is available on Facebook or on the website (http://tedxstockholm.com). 37

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