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Children and youth inactivity and sedentary at school is increasing. This means that some of the students have a significant unhealthy lifestyle with physical inactivity, which in turn implies risks of suffering from various diseases, including obesity, type 2 diabetes and cardiovascular disease, all related to a sedentary lifestyle. To prevent illness, it is important that children and young people early get a positive attitude towards physical activity.

The purpose of this study was to study the causes of child and adolescent physical inactivity in school, based on teachers 'and parents' perspectives.

A qualitative research has been selected. To achieve the study objectives, the author has conducted seven semi-structured interviews, with an appropriate choice of five teachers and two parents with children in school. Data was analyzed with a manifest content analysis.

The results show that teachers and parents felt that physical activity is a protective factor for children's health. There are several reasons for physical inactivity in students today, blah new technologies, various transportation facilities and family finances. Some measures that can reduce the physical inactivity, for example be to increase sports lesson 'time and by starting with children and young people's interest to make them feel joy in moving, which increases the interest in physical activity.

The conclusion of this work is that children's movement is important for their health. Children and youth in elementary school in need of physical activity so that they feel good. Both schools and parents have a responsibility to promote children's physical activity so that they can preserve their health, before improving their learning ability, have more energy and to manage the school in a good way.

A work can be a risk or a protection factor and the demands it puts on the employee can have different consequences. Work environment includes both physical and psychosocial work environment, the physical part is about noise, ventilation and light. The psychosocial work environment is about social support, influence and demands. Work environment is an important pillar in public health because people spend a lot of time in their work. The purpose of this study is to describe the prison guards experience their work environment. The Demand-Control-Support-model have been used in this study as theoretical perspective.

To get the purpose answered, a qualitative method was done with a goal-directed selection where five prison guards were interviewed individually. All the interviews were semi-structured and recorded then transcribed, and afterwards analysed. The interview person who was interviewed are working in the same prison and have worked there for different amount of time.

The results showed that the interview persons felt that the management put a high pressure even if they are short of staff and nothing has changed even if the staff remarks it. The psychosocial work environment for the interview persons was that the work is psychologically stressful because of the high demands from the management and even the daily threat from the inmates. But the interview persons felt that collaboration among the colleagues is so good that the job satisfaction increase.

Keywords: Demand-Control-Support model, Prison guard, Qualitative method, Work environment.

Background: Stress can have both positive and negative effects on the human body. Prolonged stress without recovery can lead to public health issues. The use of social media is increasing among young people. Even lot of use of social media can lead to serious consequences. The stress-vulnerability model has been applied to this study as a theoretical framework.

Aim: The aim of the study was to study if there is a relationship between use of social media and stress among high school students. 

Method: A quantitative study with a cross-sectional design was conducted among high school students. Convenience selection was used, with a response rate of 100 precent among 105 respondents. Spearman's rho correlation was used to analyze the relationship. Three research questions were formulated to answer the purpose of the study.

Result: The majority of respondents use social media for at least three hours per day. Three out of four respondents experience daily stress. The study showed a weak positive correlation between social media use and stress.

Conclusion: The study showed that almost all respondents use social media. The majority spent more than three hours per day on social media. The study also revealed a weak positive significant associations between social media and stress.

Background and aims: The impact of vitamin D concentrations on subsequent cardiovascular disease (CVD) and overall mortality has been generally examined for periods under two decades. The magnitude of the association may depend on follow-up length. We aimed to investigate the relationship between baseline vitamin D and risk of total CVD, stroke and all-cause mortality over three decades of follow-up. Secondly, we aimed to assess how follow-up affects the associations. Methods and results: Concentrations of 25-hydroxyvitamin D (25D) were measured in a population-based sample of 1227 middle-aged women using serum collected at baseline and categorized into low (lowest 25D quartile) vs high 25D status (upper three 25D quartiles). Hazard ratio (HR) of the endpoints was estimated for low 25D. The impact of follow-up was examined in intermediary analyses where follow-up was interrupted up to four times, each time decreasing it by five years. There were 596 cardiovascular events and 635 participants died. During the first 17 years, the low 25D group experienced a 29% higher CVD risk and 3.3-fold higher stroke risk after accounting for confounders. Longer follow-up diminished significantly these risks and 25D status had no contribution at 32 years. For mortality, the decline over time was less dramatic, with HR = 1.96 (1.25; 3.08) at 17 years and HR = 1.42 (1.17; 1.72) at 37 years. Conclusion: Low 25D status increased the risk for all endpoints, but a lengthy follow-up diminished these risks towards the null. The impact of follow-up depends on the outcome. Future studies of 25D and disease should use repeated 25D assessments.

Sexuality and reproduction are two central parts of human life and they are integrated into our personalities. It is therefore important to create a good foundation for sexual health and wellbeing from an early age. To see adolescents as “ready to act-individuals” and to make them more involved in open dialog discussions contributes to extended possibilities for creating and sustaining a healthy lifestyle. The school is therefore considered as an important arena for health promoting and preventive actions where most adolescents can be reached. An obligated nine years school based education was implemented in China 1986, and school based Sex education became obligated in 2002.

The study aimed to examine Chinese university student’s perceptions of Sexeducation for adolescents (10-19 years) in China and needs for changes and ongoing tendencies of development. Qualitative studies were conducted with three Chinese university students and contact was taken with a key person in China whom translated material for this study alone.

The result showed various constructions of school based Sexeducation in China and that its implementation and construction needs more support. It also showed a need for the development of influence and participation in the school based Sexeducation. A need for creating an improved communication between teachers and students was also expressed and a more salutogenic approach needs to be developed.

Through collaboration with other countries, for example Sweden, can today’s open-minded process of change benefit even more.

Sexuality is one of the most fundamental values of life as it affects our behaviors, thoughts and emotions. Young people are an especially essential group for promoting sexual health as it is during adolescents the base for our sexuality is created. The aim of this study was to examine Chinese male and female medical university student’s knowledge and ideas of sexual behavior at Chongqing Medical University in Chongqing, China. An explorative quantitative survey study was conducted at place in Chongqing. The survey study’s result showed that ideas of sexual behavior were seem to be permissive and love-based, and also bi- and homosexuality to be mainly acceptable. The Internet, books and friends were seemed as important sources for knowledge whereas few believed to have received adequate knowledge from school. It was also seemed to be a major lack of knowledge regarding STD’s and how to protect yourself as “safe periods” was believed to be an important contraceptive method. The relationship between contraception and the protection against STD seems to be obscure.

Healthy lifestyles are an important condition for creating a positive health and dietary habits, physical activity and stress are factors that affect health. As a result of recent changes in society people's lifestyles have changes through unhealthy diet, physical inactivity, and stress has increased. Changing lifestyles have affected public health, and to invest in these areas in public health work can provide significant health benefits. Västmanland County Council operates a project to promote healthy behavior. The project includes "Kom i form gruppen" which is a group that focuses on nutrition, physical activity and stress. The aim was to investigate participants' experiences of participation in "Kom i form gruppen" and if the participation has affected their lifestyles. To answer the purpose, a qualitative approach with interviews used. The result shows that the content of the meetings has not identified any new knowledge. Participation has provided awareness and motivation and appreciation of food habits have been affected varied between participants. The participants' exercise habits have been affected by regular exercise occasions and everyday physical activity. Effect of stress has not been made, but they try to think about to rush less. Lack of time and stress, however, perceived as an impediment to healthy living.

Among children and adolescents, only two out of ten achieve the recommendations for physical activity, differences in physical activity are mainly related to socioeconomic status. Children and adolescents of low socioeconomic status are less physically active and are also underrepresented in sports associations. The sports movement is the largest social movement in Sweden and is described as available to everyone who want to participate. However, the cost of sports participation has increased in recent years and described as one of the factors why children and adolescents’ participation differs. Fellowship and solidarity in sports associations create Sense of coherence (SOC). With this background, the study aimed to investigate the experiences of representatives of children's and adolescents' sports with regard to the association's work for equal inclusion from a socio-economic perspective.

The study used a qualitative method with six semi-structured interviews. The informants were selected based on a purposive sampling with the criteria of having a board position in a sports association in Västmanland. Collected data was transcribed and then analyzed using a manifest qualitative content analysis which contributed to the study´s results with two categories; Enabling equal participation and structural conditions of sports associations. The results show the active work of sports associations to enable lasting participation for both existing and new members. As well as how associations' work relates to guidelines for approved grants for activities and significant resources for developing work with equality. 

The work to enable participation from a socioeconomic perspective varies among the sports associations, although it clarified that it is difficult to reach out to the socioeconomically weak groups. The associations try to meet the conditions of their members and find alternative solutions to enable membership.

Today's career choices and ambitions impose different demands on the individuals than in the past. In a labour market that demands flexibility and responsibility, the individuals are expected to be able to work almost anytime and from anywhere. These factors have contributed to an imbalance between work and family life that can trigger various forms of illness. In this study, I investigate how parents of young children perceive their mental health in relation to the balance between work and family life. This is achieved through a study that employs qualitative methods and data collection based on six individual semi-structured interviews, where the material is then analysed based on a manifest content analysis. The results show that today’s parents are well aware of the imbalance between their work and family life, and that this negatively affects their health in several ways, ranging from stress and anxiety to sleep problems and personal conflicts. To address this imbalance the parents creates routines, shared responsibilities at home, and allow personal time for leisure, in an attempt to create a form of control over this imbalance. The conclusion of this study is that parent’s experience that they have to have routines at work and family life, where the parents have lower demands on their own health.

Physically demanding work in middle-aged and ageing employees is associated with poor physical functioning. Also younger employees have limitations in their daily functioning, but there is no research on the associations between physically demanding work and physical functioning during early careers. This study investigated whether physically demanding work is associated with physical functioning in employees aged 18–39 years.  The data were collected in autumn 2017 from the City of Helsinki employees born in or after 1978 (n=11,459). Out of them, 5,111 responded online or via a mailed paper survey. We included those 4,585 (40% of all those invited) who had responded to all necessary questions for the present study. Physical functioning was assessed by the SF-36 questionnaire, and poor physical functioning was defined as the lowest quarter of the physical functioning score (PCS ≤48.80, total scale 1-100). Physical workload was determined with a multi-part question about factors related to work and the work environment, and the degree of perceived harm caused by them. The physical workload scores were divided into thirds. Logistic regression analysis was used to examine the associations between physically demanding work and physical functioning, while adjusting for health behaviours, sleep problems, body mass index, education and marital status.  Poor physical functioning was associated with physically moderately (OR 1.70, 95%CI 1.43-2.00) and highly (OR 3.56 [2.70-4.70]) demanding work. In addition, frequent sleep problems (OR 1.90 [1.67-2.22]), obesity (OR 1.89 [1.56-2.30]) and low education (OR 1.37 [1.10-1.71]) were associated with poor physical functioning.  Tackling physically demanding work may play a role in maintaining physical functioning (and subsequently) working capacity.

Keywords: physical functioning, work load, young workers, health behaviour

Objectives: This study aimed to systematically review the literature on the Iranian healthcare system in the time of increasing privatization. Methods: A systematic literature review was conducted using MEDLINE, CINAHL, APA PschInfo, and Cochrane databases to identify various concepts in the literature concerning the privatization of healthcare in Iran between September and November 2020. All the included articles were assessed using the John Hopkins Nursing Evidence-Based Practice Research tool. In addition, grey literature was searched using Google targeted at academic websites and key organizations and online newspapers and magazines in the Persian language. This screening resulted in a total of 70 articles, reports, and documents. The PRISMA guidelines were followed for abstracting data and assessing the quality of the studies. Results: Six health-related items were identified at the time of increased privatization in the healthcare system. These items consisted of medical establishments, accessibility, and privatization, catastrophic health expenditure (CHE), out-of-pocket payment (OOP), health inequality, privatization, and healthcare providers, and the policy and finance of privatization. Conclusions: The review identified that the process of privatization of the healthcare system in Iran occurred with poor monitoring and evaluation mechanisms. Privatization rested on neoliberal arguments, and for-profit care has worsened healthcare performance and created an unfair, expensive healthcare system of lower quality in Iran.

Immigration affects life and health in many different ways. The purpose of this study was to identify and analyze female Iranian immigrants' perception of various factors that influence their health over time. Data collection was based on semistructured interviews with 10 female Iranianimmigrants. Baseline interviews were conducted in 1996, with follow-up interviews in 2002. The results suggest that during the first decade after migration, female immigrants may overcome some health-related factors such as experiences of traumatic events. Other health determinants such as unemployment or experiences of discrimination and racism, however, were observed even two decades after migration.

Background: Community and health orientation to immigrants is one of the health promotion efforts conducted across the country and is also statutory. Despite this, they do not hold the same quality in each county, which is required to give immigrants the same opportunities to integrate themselves in the new contest.

Aim: The purpose of the study is to examine how sectors experience social and health information for immigrants and people with non-Nordic ancestry and the conditions for implementation of social and health information in the native language.

Method: A qualitative method was used to answer the questions of the study. Qualitative semi-structured interviews were used. The sample consisted of ten interviewees and all respondents are sectors with different professions, that work with immigrant integration.

Results: The results of the study show that existing social and health orientation is perceived to provide both opportunities and difficulties in terms of both perspectives, the actors working with it and immigrants participating. Continuous development, increased resources and needs-based efforts are needed for a successful community and health orientation that helps to promote health.

Conclusion: The existing social and health orientation has two different perceived perspectives. The studied perspective was the sectors working with the orientation. Each perspective has different needs, experiences, and perceptions of the orientation. The study's findings showed that orientation in the native language will benefit and influence society as much as the individual, and that the conditions are positive despite the different levels of challenges that may be encountered.

Background: Physical activity and perceived stress affect college- and university students health. 

Aim: The aim is to study the association between physical activity and perceived stress among college- and university students in Sweden, and to investigate whether gender, age, and BMI are confounding factors regarding the association between physical activity and perceived stress.  

Method: A cross-sectional online survey was conducted among the study population students. The analytical approaches chosen were descriptive analysis, Pearson’s correlation coefficient, and multiple linear regression.

Results: According to the correlation analysis, there was a small negative significant association between physical activity and perceived stress. According to the regression analysis, there was a small negative significant association between physical activity and perceived stress, which remained after considering gender, age, and BMI.

Discussion: The association between high physical activity and low perceived stress can be explained by the protective impact physical activity has on health.

Conclusions: There was an association between physical activity and perceived stress among college- and university students. The association between physical activity and perceived stress among college- and university students remained after controlling for gender, age, and BMI. 

Background: Risk perception has been studied concerning the use of marijuana and it impacts the intention to use that specific substance.

Aim: The aim was to study the association between the perceived risk of cannabis use and cannabis use among Swedish youth after controlling for gender, age, and education. The aim was also to study whether the association between the perceived risk of cannabis use and cannabis use was different according to gender.

Method: The thesis project was based on data from the Flash Eurobarometer 330 - Youth Attitudes on Drugs.

Results: When age and education were controlled for, both among Swedish youth and among male participants, the perceived risk had an association with cannabis use - higher risk perception entailed a lower use.

Discussion: The association between the perceived risk of cannabis use and cannabis use appears to be due to the impact of risk perception on behaviour.

Conclusion: By preserving the risk perception that Swedish youth have of cannabis, it may be possible to protect them from the potential harm that cannabis use cause.

Objective: The aim of this thesis is to examine and compare the maternal mortality in three different countries; Malawi, India and United Kingdom, as well as highlighting the attributing factors and preventive steps that would reduce the maternal mortality in these countries. Methods and material: The studied design that was chosen is an ecological study which means to study the relationship between aggregated health data and exposing factors, for example a geographical area and time period. The reason of choosing this study can be seen in the relationship and the factors that contribute to maternal mortality in Malawi, India and the United Kingdom. In order to attain the objective of the thesis a variety of sources were utilized to find data, statistics and scientific articles concerning maternal mortality in all three countries.Results and conclusion: Maternal mortality is the highest in Malawi and India, while it is very low in the United Kingdom when compared with these two countries. The result shows among other things that the maternal mortality is mainly caused by direct causes both in Malawi and India and in the United Kingdom the maternal mortality is mainly from indirect causes. It is also shown that the maternal mortality in these countries have been changed over the years. It is also shown that preventive steps such as family planning, skilled attendance, obstetric emergency care and antenatal care can significantly reduce the maternal mortality rate.

ABSTRACT

The purpose of this study is to investigate the experience of work-related stress among socialworkers in financial assistance, how stress affects their well-being and how they handle stressat work. The study was based on a qualitative research method and semi-structuredinterviews were conducted with five social workers working within the same area in themiddle of Sweden. For this study, two theories have been applied, which are KASAM andCoping theory. The results of this study indicate that a large amount of work tasks, a highnumber of cases and a shortage of staff are contributing factors to the experience of stresswithin the organization. Furthermore, the study shows that help and support fromcolleagues and team leaders is seen as a strong resource that reduces the negative impact ofwork-related stress. According to the results of the study, stress can be managed by the socialworker receiving support in the form of extra staff in the event of unplanned absence,planning working days in advance, prioritizing work tasks, and having the opportunity torelax during calmer periods. Furthermore, the results show that taking several shorterbreaks, walking during the break and ending the working day earlier are seen as good stressmanagement strategies. After-work activities such as exercising, relaxing, reading a book,and watching movies were also considered important strategies for coping with work-relatedstress.

Keywords: Social workers, work-related stress, coping strategies, mental and physical well-being.

Health is today viewed as a multi-dimensional concept partly conceptualized independent from not being ill. The aim of this study was to gain knowledge of how young children perceive health. Interviews were conducted with 68 children (4-5 years), within their pre-school setting, with the help of a semi-structured interview guide. A multi-dimensional perspective represented by the health dimensions of the International Classificationof Functioning, Disability and Health (ICF) was used in a manifest deductive content analysis. The children's statements were categorized and placed under one of the four health dimensions, body, activity, participation and environment. A latent content analysis was applied to identify underlying themes in the manifest categories. The results revealed that young children perceive health as a multi-dimensional construct, largely related to being engaged, i.e. to be able to perform wanted activities and participate in a supportive every-day context. This implies that improvements of child engagement should be emphasized in health promotion and to a greater extent be the central focus of health interventions for young children.

Background: The aim of the present study was to determine whether certain background factors such as gender, education and social status were associated with an individual's knowledge of coronary heart disease (CHD) risk factors.

Design: A questionnaire survey.

Methods: A questionnaire survey designed to evaluate participants' general knowledge about the risk factors for CHD was used. A total of 1011 50-year-old individuals (457 men and 554 women) from 34 Health Care Centers participated in the study.

Results: Knowledge about CHD risk factors was significantly poorer in men than in women. Low education and low socio-economic status were other factors related to poor knowledge of CHD risk factors.

Conclusion: This study showed that men with low educational level and low socio-economic status had inadequate information about the risk factors involved in CHD.

One thousand and twenty Polish men and women and 1,011 Swedish men and women aged 50 and recruited through primary health care took part in a survey relating to their knowledge of health-related behaviour, attitudes to health-related behaviour and self-reported risk behaviour. The results reveal that Poles know as much about cardiovascular risk factors as Swedes, but that Swedes feel that it is more important to change their dietary habits and to influence factors in the working environment to avoid the risk of developing CVD than did Poles. Swedes also displayed less risk behaviour than Poles and more Swedes than Poles had successfully stopped smoking. These findings suggest that differences in stages of health-related behavior that have previously been observed at an individual level may sometimes also be discerned at a national level.

The purpose of this study is to examine how the school health unit at a high school in Vastmanlands County is working to promote mental health among the students. To enable the study a qualitative method was applied in order to understand how the health unit works around the subject. Semistructured interviews was carried out with a number of persons who were identified through a targeted selection. Where all were working as a part of the school health unit at a high school in Vastmanlands County. With a manifest content analysis the collected material could show a result from those interviewed. 

The result demonstrated that there was a connection between how the mental health was affected by the physical health. In order to achieve a stable and positive health condition it required a person to be satisfied with oneself. The practical work lacked a plan of action or guidelines although personel were working actively to promote the mental health among the students. It was underlined that there was a lack of attention specifically regarding the mental health and the health promotion. The results of the health promotion work were estimated mainly via grades, students school development and changes in attending school, commitment and mood. There are development possibilities in which implementation of a plan of action or a working model could improve the health promotion work in high school. Finally this study suggests applying SESAME as a working model in the health promotion work for the health school unit in order to promote the mental health among the students. 

Background: In recent years, the mental health has decreased among adolescents. They experience stress, and this is especially most evident amongst girls in school age. The usage of internet and social media has increased since the beginning of the twenty-first century. There are previous studies proving that social media have a profound impact on individuals. Research shows that social media creates an unhealthy comparison between individuals resulting in skewed norms and the phenomena of cyberbullying is increasing. Other studies indicate that people experience it as stressful to constantly be connected. However, research has also showed that social media increases globalization as well as access to a new social context for individuals.

Aim: To investigate the occurrence and correlation between social media use and stress, the occurrence and connection of violations on social media and stress and whether there are differences in gender in social media habits and stress among adolescents in Västmanland.

Method: Quantitative method with cross-sectional design was used to analyze the occurrence and correlation between adolescent’s social media habits and stress. This study is based on data from the Survey of “Adolescent Life in Västmanland - 2017” which included 3951 students from the 9th grade of primary school and 2nd in high school.

Results: The results of this study show there is stress among adolescents, use of social medias and cyberbullying occur. There is a correlation between social media use and stress. Adolescents who use social media one or more times an hour are also “quite” or “very “stressed. Adolescents who experienced cyberbullying are more likely to be “quite” or “very” stressed. There occurs a difference in gender between adolescents that use social medias one or more times an hour. Girls use social media more frequently than boys. There are also difference in gender regarding stress, girls are more likely to be “quite” or “very” stressed.

Conclusions: A correlation can be found between high-frequency social media use and adolescents who are quite or very stressed. There is also a correlation between adolescents who experience cyberbullying and adolescents who are quite or very stressed. There different reasons for that, but subjective standards that require constant connection, an unhealthy comparison between individuals and different ruling techniques online are factors that influence.

Background: The aim of the study was to examine the construct validity of the Three-Factor Eating Questionnaire-R18 (TFEQ-R18), a measure of eating behaviour, and to evaluate cognitive restraint, uncontrolled eating and emotional eating in a sample of adolescent and young adult females of different weights. Methods: Subjects were 2 997 females, aged 17 to 20 years, who participated in a phase III human papillomavirus vaccination trial in Finland in 2004-2009. Self-administered questionnaires and weight and height measurements were used. The factor structure of the TFEQ-R18 was verified by factor analysis. Connections between measured eating behaviour and Body Mass Index (BMI) were tested using analysis of variance. Results: The original factor structure of the TFEQ-R18 was replicated: six of the eighteen items measured cognitive restraint, nine measured uncontrolled eating, and three measured emotional eating. On average, higher BMI was associated with higher levels of cognitive restraint (p < 0.001) and emotional eating (p < 0.001), but not with uncontrolled eating. Conclusion: Structural validity of the TFEQ-R18 was good in this sample of young Finnish females with a varying range of body weights. Use of the instrument as a measure of eating behaviour was thus corroborated. Connections of restrained and emotional eating with BMI were in accordance with previous findings from young females.

Folkhälsoarbete är det arbete som görs i syfte att främja hälsa samt förebygga sjukdom och skada. Folkhälsoarbete sker på både internationell, nationell och lokal nivå. Sveriges kommuner är folkhälsoarbetets nyckelaktörer på lokal nivå och har möjlighet att påverka befolkningens hälsa genom de olika sektorerna. I samband med folkhälsoarbete på lokal nivå är policyer och handlingsplaner lämpliga att implementera, då policys har visat sig ha god inverkan på folkhälsan och människors beteenden. Trots detta har Skinnskatteberg kommun i dagsläget ingen folkhälsoplan, däremot finns ett intresse av att ta fram en ny folkhälsoplan hos Skinnskattebergs kommunfullmäktige. Mot denna bakgrund syftar föreliggande studie till att undersöka kommunanställdas uppfattningar om vilket innehåll den tänkta folkhälsoplanen bör ha, och där resultatet kan ligga till grund för framtagandet av en ny folkhälsoplan. Studien har en kvalitativ ansats och är genomförd med semistrukturerade intervjuer där ett målstyrt- samt ett bekvämlighetsurval har använts. Det insamlade materialet har analyserats utifrån en manifest innehållsanalys och resulterade i två kategorier. Studiens slutsatser visar på att en folkhälsoplan bör prioritera de olika fokusområdena fysisk aktivitet, meningsfullhet, ungdomar och Agenda 2030 samt ge förutsättningar för implementering.

Unhealthiness among youths in Sweden includes several kinds of public health problems where mental illness is increasing and affecting more and more people, resulting in, for example, deliberate self-harm. This thesis discusses the relations between self-harm and other dangerous behaviors based on the data set from Liv & Hälsa ung in Sörmland. It is a recurring total population survey about lifestyle, dangerous behaviors and health among pupils in year 7, 9 and second year at high school. The survey was answered by 2750 pupils in year 9 and 2770 pupils in year 2 at high school. Only girls in year 9 (n=1313) and year 2 (n=1384) at high school is included in this thesis. A quantitative method was used to investigate occurrence and differences among the population.

The empowerment theory is discussed, which is considered to be an important tool in order for the society to help individuals strengthen their self confidence and in that way increase the health level among youths.

The results show that it is more common that self-harming individuals are also engaged in other dangerous behaviors, such as daily smoking and shoplifting, in comparison to the control group. This could serve as an indicator that the area requires more research in order to develop future preventive measures to reduce the number of girls harming themselves.

Objective: This study set out to examine how maternal initial body mass index (BMI) and weight gain during pregnancy associate with advanced beta cell autoimmunity in the offspring. Subjects: A population-based birth cohort of 4093 children with increased human leukocyte antigen (HLA)-conferred susceptibility to type 1 diabetes (T1D) and their mothers were recruited between 1997 and 2002 in two university hospital regions in Finland. Methods: The children were monitored for T1D-associated autoantibodies at 3- to 12-month intervals. Advanced beta cell autoimmunity was defined as repeated positivity for islet cell antibodies and at least one of the other three autoantibodies (antibodies to insulin, glutamate decarboxylase and islet antigen 2). Mothers were asked to record the results of the weight measurements during their first and last visits to the antenatal clinic. The initial BMI and weight gain rate were calculated for each woman. Results: Altogether, 175 children developed advanced beta cell autoimmunity or T1D during the follow-up. Maternal BMI before pregnancy or weight gain during pregnancy was not associated with the end-point. Maternal vocational education was associated with child's smaller risk of developing advanced beta cell autoimmunity.

Skolans miljö en är avgörande faktor för folkhälsoarbete, därför är hälsofrämjande arbete i skolan viktigt att belysa. Eleverna drabbas av stress, depressioner och ökade kunskapskrav. Bestämningsfaktorer som livsstil, trygga miljöer samt sociala nätverk påverkar en individs psykiska hälsa. Skolkuratorerna ansvarar mest av all personal på skolan för det hälsofrämjande arbetet. För att främja hälsan i skolarbetet är det av betydelse att identifiera hur skolkuratorerna arbetar.Syftet med studien är att undersöka hur skolkuratorer i Eskilstuna Kommun arbetar med att främja psykisk hälsa för barn i årskurs 7-9. En kvalitativ studiedesign och en manifest innehållsanalys har använts för att uppnå syftet med studien. Skolkuratorerna i Eskilstuna kommun har intervjuats med hjälp av en semistrukturerad intervjuguide.Kuratorernas arbete styrs utifrån styrdokumentet Elevhälsan. Samarbete tillsammans med personal som skolsköterskor anses viktigt. Kuratorernas arbete med eleverna styrs kring helheten. Trivsamma miljöer, aktiviteter samt att umgås tillsammans med eleverna är något som är av betydelse. Akutsamtalen tar upp för mycket tid i det dagliga arbetet, vilket även tidigare studier belyser. Studiens slutsats visar att Elevhälsans alla resurser behöver vara mer tillgängliga på skolorna än de är i dagsläget. Den stora kuratorsträffen som sker månadsvis behöver också en samordnare för att ge den respons som behövs.

Background: Physical inactivity and sedentary behaviour are two of the main risk factors for deteriorated health, the latter is even considered a pandemic. In March 2020, the spread of Covid-19 was declared a pandemic. Considering the Covid-19 pandemic, professionals and university students were urged to work and study remotely when possible. This change in the work or study situation can affect the target group's physical activity and sedentary behaviours.

Aim: The aim of the study is to investigate possible changes in physical activity and sedentary behaviours, to analyse the relationship between the number of minutes spent on physical activity before and during the Covid-19 pandemic and also the relationship between the number of minutes spent sedentary before and during the Covid-19 pandemic.

Method: A web survey with a cross-sectional design and a quantitative approach was conducted on professionals and students with a sample of 224 respondents. A total of 194 people were included of which 133 were women, 60 men and a non-binary person. In terms of occupation, 109 were professionals and 85 were students aged between 19 and 65. The data were examined using frequency tables and analysed via Spearman's rho.

Results: A percentual decrease by 39 minutes in daily physical activity and a percentual increase in sedentary behaviour as respondents were more sedentary by 89 minutes per day during the pandemic compared to earlier. A statically significant association was deducted both in terms of physical activity and sedentary before and during the pandemic.

Since December 2019 the society has changed due to Covid-19. The rapid spread of the infection changed an entire global community and on March 20, 2020, all education located on campus was moved to distance education and came to mean a big change for university students and their study conditions. The purpose of the study was to investigate how university students perceive that the change from campus education to distance education during the Covid-19 pandemic has affected their study conditions. A qualitative method was chosen to answer the purpose of the study. Data were collected by using semi structured interviews and the selection was goal-oriented. The interviewees consisted of six university students whose campus education was changed to distance education. The collected material was analyzed with a manifest content analysis. 

The results showed that the university students perceived that the rapid change has led to worse study conditions. The lack of support from teachers and administrative staff has led to reduced motivation for distance education. The rapid change has led to worse relations between students, which has led to do worse affinity and participation in school. The conclusion of the study is that the university students perceive that the rapid change of the Covid-19 pandemic has led to changed study conditions for the university students. 

Sickness absence in Sweden increased sharply in the late 20^th century and hit the higher educated persons who have not previously been on sick leave. Many people spend most of their lives at work and the work environment affects employees in different ways, where the leadership is a factor affecting the health of the individual. The workplace is therefore considered to be one venue where health promotion interventions to improve health can be implemented. That leadership affects employee health is considered given, but there is not much research in this area.

The aim of the study was to examine how employees in a workplace with low levels of sickness absence feel that leadership contributes to health in the workplace. The study was based on a qualitative approach where data was collected through telephone interviews with five persons. The workplace that is being studied has a low absenteeism and is based out of a county council in Sweden.

The results show that a good leader should be available, be supportive and clear. A leader who contributes to the health trust their staff, helping to prioritize, is sensitive and caring. A conclusion that can be drawn about the results is that contributing to employee health is the same as good leadership.

Physical activity is a determinant of public health. Hence the Swedish sports movement wish to contribute to the development of sporting activities as a way to increase the number of participants and motivate people to stay physically active throughout life. A common issue in elite level sports is that many end their career before reaching their final potential.

The purpose of this study was to investigate the parent’s perspective regarding their children’s being after ending their elite effort. A qualitative method was applied and data was collected in five semi-structured interviews. The collected material was analyzed with a manifest content analysis. The result indicated that several of the children, who previously had been a part of an elite investment, had changed their lifestyle from a physically active lifestyle to a freer way of life where it is perceived to be room for spontaneity and playfulness. Everyday life nowadays includes new friends and greater focus on studies or job. Former social context focused around the sports arena are now taking place in other environments. Their previous identification with their sport has been lost and by ending their elite efforts the children's mental health declaimed, however they have later recovered to some extent. The conclusion of this study is that life has changed for the children after ending their elite effort.

BACKGROUND: A majority of doctor-patient meetings result in the patient getting a prescription. This underlines the need for a high-quality prescription process. While studies have been made on single therapeutic drug groups, a complete study of the physicians' general thought process that comprises the prescription of all drugs still remains to be made. OBJECTIVE: To identify variations in ways of understanding drug prescribing among GPs. METHODS: A descriptive qualitative study was conducted with 20 Swedish physicians. Informants were recruited purposively and their understandings about prescribing were studied in semi-structured interviews. Data were analysed using a phenomenographic approach. RESULTS: Five categories were identified as follows: (A) GP prescribed safe, reliable and well-documented drugs for obvious complaints; (B) GP sought to convince the patient of the most effective drug treatment; (C) GP chose the best drug treatment taking into consideration the patient's entire life situation; (D) GP used clinical judgement and close follow-up to minimize unnecessary drug prescribing and (E) GP prescribed drugs which are cheap for society and environmentally friendly. The categories are interrelated, but have different foci: the biomedical, the patient and the society. Each GP had more than one view but none included all five. The findings also indicate that complexity increases when a drug is prescribed for primary or secondary prevention. CONCLUSIONS: GPs understand prescribing differently despite similar external circumstances. The most significant factor to influence prescribing behaviour was the physician's patient relation approach. GPs may need to reflect on difficulties they face while prescribing to enhance their understandings.

Malaria control and prevention programs are more efficient and cost-effective when they target hotspots or select the best periods of year to implement interventions. This study aimed to identify the spatial distribution of malaria hotspots at the village level in Diébougou health district, Burkina Faso, and to model the temporal dynamics of malaria cases as a function of meteorological conditions and of the distance between villages and health centres (HCs). Case data for 27 villages were collected in 13 HCs. Meteorological data were obtained through remote sensing. Two synthetic meteorological indicators (SMIs) were created to summarize meteorological variables. Spatial hotspots were detected using the Kulldorf scanning method. A General Additive Model was used to determine the time lag between cases and SMIs and to evaluate the effect of SMIs and distance to HC on the temporal evolution of malaria cases. The multivariate model was fitted with data from the epidemic year to predict the number of cases in the following outbreak. Overall, the incidence rate in the area was 429.13 cases per 1000 person-year with important spatial and temporal heterogeneities. Four spatial hotspots, involving 7 of the 27 villages, were detected, for an incidence rate of 854.02 cases per 1000 person-year. The hotspot with the highest risk (relative risk = 4.06) consisted of a single village, with an incidence rate of 1750.75 cases per 1000 person-years. The multivariate analysis found greater variability in incidence between HCs than between villages linked to the same HC. The time lag that generated the better predictions of cases was 9 weeks for SMI1 (positively correlated with precipitation variables) and 16 weeks for SMI2 (positively correlated with temperature variables. The prediction followed the overall pattern of the time series of reported cases and predicted the onset of the following outbreak with a precision of less than 3 weeks. This analysis of malaria cases in Diébougou health district, Burkina Faso, provides a powerful prospective method for identifying and predicting high-risk areas and high-transmission periods that could be targeted in future malaria control and prevention campaigns.

The risk for an adolescent to develop risk behaviors decrease when he/she feels to be included in and to have an influence on the society. Previous research shows that opportunities for young people to feel involved in the society are limited. Every year, here 4U offers a tolerance-education to young people. This study aims to investigate whether the tolerance-education has met its objectives. The aim of the study is to investigate whether and how here 4U:s tolerance-education affected young people´s sense of participation in the society and civic-engagement and whether it led to personal development.

The study applies a qualitative method, with semi-structured interviews and applies a target selection of andolescents based on criterias that enable for the studys aim to be answered. The informants are six young people aged 16–22. A manifest content analysis has been applied to analyze the collected material. The results of the study show that young people feels that they have more opportunities and will to engage in society after the tolerance-education. It also demonstrates that the tolerance-education has contributed to young people´s opportunities for participation in the society. Furthermore, the results shows that the tolerance-education has contributed to the personal development of young people by giving them a chance to build confidence and self-esteem.

Introduction: Guinea is the third hardest hit country in the region with 2,806 cases and 1,814 deaths as of January 11, 2015 after Sierra Leone and Liberia respectively. This KAP study was conducted in three sub-prefectures of Kouroussa in the Kankan region of Guinea from 15 December 2014 to 15 January 2015. It was conducted with the general objective of examining the knowledge, attitude and practice related to Ebola prevention and care among the public of Kouroussa Prefecture. Methods: a cross-sectional study design was employed to collect quantitative data to examine knowledge, attitude and practice related to Ebola. Structured questionnaire was administered by trained data collectors who were supervised by doctors and epidemiologists from WHO and Africa Union. Data were collected from 358 individuals (93% response rate) and analyzed in STATA 13 while tables and graphs are used to display results. Results: over 96% of the respondents have ever heard about Ebola while only 76.2% believed the disease existed in Kouroussa. Avoiding physical contacts including hand shaking and contacts with body fluids, and early treatment of persons sick from Ebola were the two important prevention methods frequently mentioned (96.8% and 93.9%). Only 35.7% of respondents were found to have comprehensive knowledge about Ebola (composite of correctly accepting three methods of prevention (85%) and rejecting misconceptions (55.7%)). Conclusion: the high level of knowledge about modes of transmission and prevention methods has not positively affected the level of comprehensive knowledge about Ebola. In contrast, the prevailing high level of misconceptions surrounding Ebola was found to be responsible for a low comprehensive knowledge.

A public health work is focused on health promotion or prevention efforts, which can be done at the local level towards the individual. Addiction units is responsible for providing support and treatment to people who have an addiction or dependence on unhealthy lifestyles. They are also responsible for improving and developing their methods and tools. However, With the development of welfare technology, Social workers in addiction units, have increasingly begun to use e-health tools in treatment work.

It is related to vision-health 2015, which among other things, focuses on work in the health and care sector at the individual level. The digital work environment aims to facilitate everyday work that supports the processes in which social workers participate, which can ultimately contribute to the individual being offered digital support tools to improve their health and increase their participation.

The aim of this study was to investigate social workers’ experiences using welfare technology in the form of “e-health tools” in their work. The method was qualitative with an inductive approach where the purposeful sampling was supplemented with snowball sampling. The interviews were conducted in semi-structured form and analyzed based on a manifest qualitative content analysis. The theoretical perspective of the study consists of Antonovsky’s theory SOC, sense of coherence.

The analysis resulted in two categories with four subcategories and shows social worker’s experiences that e-health tools in treatment work contribute to increased opportunities that have facilitated motivational work and such as increased collaboration with the unit for children and families, treatment homes and occupational health care. The results also show social worker’s experiences that e-health tools in treatment work create additional challenges in the form of additional tasks and an increased situation-adapted use according to, for example, the client's mental illness.

The workplace is a central arena in a public health perspective and an environment where adults spend a large portion of their time. To work towards it, is therefore essential to promote health within a workplace. In working life health promotion work can be applied by taking in factors within the demand-control-support-model. The model describes within the study how individuals experience factors such as demand, control and social support within the work- and private life. The study applies the concepts in combinations with each other and in connection with the change from work in offices, to work placed at home. 

The aim of the study is to examine how employees in a municipality experience changes in their working conditions during the covid-19 pandemic. This thesis is a qualitative study that includes a targeted sample with six semi-structured interviews with employees at a municipality outside Stockholm. The questions in the interview were formulated according to the factors of demand, control and social support. 

The results show shortly that working from home has meant that the work can be planned more freely during the days of the week. The participants perceived/experienced support from their employer and families during the transition however some expressed that they lacked social affinity from their colleagues. The respondents express different strategies to balance private life and work, their strategies depending on pre-conditions. 

Keywords: Demand-Control-Support, Municipality, Qualitative, Work from home, Working environment. 

Sick leave due to mental ill-health, caused by poor working conditions in the social and organizational work environment is a growing problem in the society. There is a lack of research on working conditions’ impact on health from a salutogenic perspective. The purpose of this study is to investigate the extent to which perceived working conditions can be associated with self-rated health from a salutogenic perspective among warehouse workers at a workplace. The study is based on questionnaire data. Univariat- and multiple linear regressions were performed to investigate the relationship between working conditions and health. The result showed that there are significant associations between working conditions and self-rated health. The strongest associations were found with supportive working conditions, time experience, individual inner experinces, and health. This means that it is important to have a high social climate in the workplace with access to support from both colleagues and employer, that work is perceived as meaningful, to have opportunities for development, that personnel education matches the requirements for the job and that there is enough time to perform tasks without stress. Self-rated health increased with age but there were no significant differences by gender, employment status, education or ethnic background. The result has been discussed on the basis of sense of coherence (SOC) and the demand-control-support model as a theoretical perspective.

Background: Economic violence occurs in connection with other types of violence, where studies show that a large number of reported crimes that take place in close relationships also include economic violence. Research into economic violence is limited, which increases the interest in studying the area.

Aim: The aim was to investigate the knowledge of economic violence in different occupational groups as well as the differences between the occupational groups’ knowledge and whether the knowledge differs between the age groups.

Method: A quantitative approach was used in the form of a survey that was emailed to the rescue service, various non-profit associations and authorities and school staff, of which 74 employees chose to participate within 11 different professions. Those who answered the survey were between the ages of 19–67 years, with variation from a gender perspective. SPSS was used to measure differences.

Results: The results show that professionals have some knowledge about economic violence. However, there is a lack of knowledge within certain occupational groups as the analysis shows a significant difference in knowledge between the various occupational groups. The result showed that 19% of the entire sample does not have any knowledge and that there is a significant difference between the professionals, where Social Services, emergency services, women's shelters and other workplaces considered themselves to know economic violence to a greater extent than school staff, other authorities and health and care staff. Also, a significant difference between the age groups is also demonstrated, where the older group had a greater proportion of participants who considered themselves knowledgeable than (88%) the younger age group.

Conclusion: The majority of the total sample consider themselves knowledgeable. The occupational groups that work around violence in close relationships consider themselves to know economic violence to a greater extent than those who do not work around the subject. Significant differences exist between the age groups, where respondents who are under 35 years old do not consider themselves knowledgeable to the same extent as those over 35 years old where the majority consider themselves knowledgeable. 

Bakgrund: Ekonomiskt våld förekommer i samband med andra typer av våld, där studier visar att en stor del av anmälda brott som sker i nära relationer också omfattar ekonomiskt våld. Forskning inom ekonomiskt våld är begränsat vilket ökar intresset att studera området. 

Syfte: Syftet var att undersöka kunskapen om ekonomiskt våld i olika yrkesgrupper samt skillnaderna mellan yrkesgruppernas kunskap och om kunskapen skiljer sig mellan åldersgrupperna.

Metod: En kvantitativ ansats användes i form av en enkät som mejlades till bland annat räddningstjänsten, olika myndigheter, ideella föreningar samt skolpersonal, varav 74 stycken anställda valde att delta inom 11 olika yrkesverksamheter. De som besvarade enkäten var mellan åldrarna 19–67 år med variation ur ett könsperspektiv. SPSS användes för att mäta skillnader.

Resultat: Resultaten visar att yrkesverksamma besitter viss kunskap kring ekonomiskt våld. Dock råder det brist inom vissa yrkesgrupper då genomförd analys visar en signifikant skillnad i kunskap mellan de olika yrkesgrupperna. Resultatet visade att 19% av hela urvalet inte besitter kunskap och att det finns en signifikant skillnad mellan de yrkesverksamma, där Socialtjänsten, räddningstjänst, kvinnojour samt andra arbetsplatser ansåg sig kunna ekonomiskt våld i högre utsträckning än skolpersonal, andra myndigheter samt vård-och omsorgspersonal. Slutligen påvisas det dessutom en signifikant skillnad mellan åldersgrupperna, där den äldre gruppen hade en större andel deltagare som ansåg sig kunniga (88%) än den yngre åldersgruppen.

Slutsats: Majoriteten av det totala urvalet anser sig kunniga. Yrkesgrupperna som jobbar kring ämnet anser sig kunna ekonomiskt våld i en högre utsträckning än de som inte jobbar kring ämnet. Signifikanta skillnader finns mellan åldersgrupperna, där respondenter som ärunder 35 år gamla inte anser sig kunniga i lika stort utsträckning som de över 35 år gamla där majoriteten anser sig kunniga.

Health promotion is to promote healthy living, preventing diseases and change the determinants of health through various strategies. Public health work at community level associates with intersectoral, health promoting efforts and influence by legislation, governance and policy work. The purpose of this study is to examine how health professionals perceive health promotion in Aland Islands, cooperation between different actors and the development of health promotion work in Aland Islands. A qualitative method was chosen, where four professionals from Aland Government and the Aland healthcare participated in interviews. A semi-structured interview guide where used for the interviews. A manifest content analysis method was used for analysing the material from the interviews. The results show that public health work in Åland is done both by local associations and organizations, but also by law based work. The results also indicate shortcomings in the cooperation for health promotion, but the corporation is overall good. Furthermore, the opportunities for development of health promotion and public health in Aland Islands were perceived as good. Questions like physical activity, alcohol use, drugs and the health of the elderly were considered as prioritized areas to work with. The conclusion of this study is that cooperation and collaboration between other organizations, authorities and sectors of the society should be improved to maintain the health of the population in Aland Islands, and the Aland Islands autonomy could provide a basis for guiding health promotion through laws. 

The school has a responsibility to work preventively against sexual harassment. However, surveys show that students feel that sexual harassment is occurring at school, while teachers perceive their skills in sex and cohabitation as inadequate. Through #metoo, sexual harassment had a worldwide impact.

The purpose of this study is to investigate how preventive work against sexual harassment is carried out in primary school and whether sex and cohabitation education has changed since #metoo.

The study is based on a qualitative method where data has been collected through semi-structured interviews. Interviews have been conducted with five NO teachers who teach grades 6-9 from various primary schools in Stockholm County, Västmanland County and Uppsala County. A manifest content analysis was applied to analyze the interview material.

The result shows that the work against sexual harassment is mainly done during sex and cohabitation education, in the form of discussions and exercises to promote the personal integrity of the students. Teachers feel that they do not prioritize sex and cohabitation education as much as they would like. The student health team contributes to support the teachers through counseling. Teachers feel that sex and cohabitation education has changed since #metoo, with more lively discussions in the classroom about, especially regarding sexual consent. Finally, the results show that the teachers emphasize that the work against sexual harassment is important, on the other hand, they experience a need for skills development in sex and cohabitation education and a more subject-integrated teaching.

Objectives:

To assess inequity in health care financing and utilisation, its associated socio-economic variables and consequences, with focus on the impact of alternative health financing systems.

Methods

Econometric and multivariate analysis of cross-sectional and retrospective household survey data from six counties in three provinces in Central China.

Findings:

The old Cooperative Medical System (CMS) was associated with a five times less risk of financial difficulties, half the risk of care-induced debt (non-significant, 95%CI 0.2-1.1) and not one CMS participant having to forego care due to cost. CMS was associated with better health, three times less risk of illness with duration of at least one month. Other health insurance systems were associated with higher risk of illness, higher outpatient expenditure without evidence of reducing barriers to care. The elderly (60 years +) had a more than five times increased risk of illness for at least one month, (OR = 5.2, 95%CI = 3.2-8.3). The illness concentration index confirmed that the poor suffer from a higher prevalence of morbidity. The Le Grand index confirmed strong bias in utilisation favouring the rich. The Kakwani index confirmed an extremely high degree of regressivity in the financing of health services, (-0.73) for outpatient and (-0.94) for inpatient services. The New Cooperative Medical System (NCMS) differs from the old CMS in critical aspects.

Cesarean delivery (CD) rates were until recently low in rural China where the population lacked healthinsurance. In July 2003 the New Cooperative Medical Scheme (NCMS) was introduced. We report findingsfrom a health systems study carried out in the EC-funded project ‘‘Structural hinders to andpromoters of good maternal care in rural China’’ in central and western China. The purpose was toanalyze how CD rates changed with the increased level of funding of the NCMS.The research design was a natural experiment. Quantitative demographic, administrative and accountsdata for 2001–2007 were collected in five counties from the county public health bureaux, the countyNCMS offices, the county statistical offices and the Maternal and Child Health (MCH) hospitals, usinga structured data collection form. We found that the CD rates increased in four of the five counties in theperiod 2004–2007 by 36%, 53%, 61% and 131% respectively. In the fifth county the CD rate remained highat 60%. The revenue from CD made up 72–85% of total delivery fee revenue. CD fee revenue increased by97%, 239% and 408% in the three counties with available data; a higher increase than in general healthcare revenue. Our conclusion is that the design of NCMS, the provider payment systems, and therevenue-related bonus systems for doctors need to be studied to rein in the unhealthy increases in ruralCD rates.