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Studies of co-occurrence of online and offline victimisation of bullying and sexual harassment and its associations to mental health outcomes among youth are scarce. To inform future study designs, the aim of this brief communication was to map co-occurrence of online and offline bullying and sexual harassment victimisation among adolescents. Data were collected in 2011 in nine schools in Northern Sweden, n = 1193 (boys = 566; girls = 627). Absolute and relative frequencies were calculated to find combinations of victimisation: one, two, three, or four forms. Reflecting a picture of the early days of online victimisation, in total fifty seven percent (57%) of adolescents were victimised. Single occurrence victimisation was 21.2% (offline sexual harassment was most common irrespective of gender), showing that most youths were victimised in a co-occurrence of two or more forms. Seven percent (7%) were victimised by all four forms of victimisation. Offline sexual harassment victimisation was present in the most common cooccurrences. Directions for future studies of victimisation and its associations to mental health outcomes are discussed. [ABSTRACT FROM AUTHOR]

Joint involvement of couples is an effective strategy to increase contraceptive use and improve reproductive health of women. However, engaging couples to understand how their gender attitudes affect their personal and family health is an idea in search of practice. This mixed-methods study explores opportunities and barriers to couples' participation in health promotion in three slums of Delhi. For each couple, surveys and semi-structured interviews were conducted with husbands and wives individually to contrast self and spousal work, time, interest in health, sources of information related to health and depth of knowledge (n  = 62). Urban poverty forces men to work long hours and women to enter part-time work in the informal sector. Paid work induces lack of availability at home, lack of interest in health information and in performing household chores and a self-perception of being healthy among men. These factors inhibit men's' participation in community-based health promotion activities. Women's unpaid work in the household remains unnoticed. Women were expected to be interested in and to make time to attend community-based health-related activities. Men recalled significantly less sources of health information than their spouse. Men and their wives showed similar depth of health-related knowledge, likely due to their spousal communication, with women acting as gatekeepers. Health promotion planners must recognize time constraints, reliance on informal interpersonal communication as a source of health information and the need to portray positive masculinities that address asymmetric gender relations. Innovative, continuous and collaborative approaches may support couples to proactively care about health in low-resource settings. [ABSTRACT FROM AUTHOR]

Background: Shift work is associated with increased risk of cardiovascular disease, but the causes have not yet been fully established. It has been proposed that the coronary risk factors are more hazardous for shift workers, resulting in a potential interaction effect with shift work. Objective: To analyse interaction effects of work schedule and established risk factors for coronary artery disease on the risk of myocardial infarction. Methods: This analysis was conducted in SHEEP/VHEEP, a case-control study conducted in two counties in Sweden, comprising all first-time cases of myocardial infarction among men and women 45-70 years of age with controls stratified by sex, age, and hospital catchment area, totalling to 4648 participants. Synergy index (SI) was used as the main outcome analysis method for interaction analysis. Results: There was an interaction effect between shift work and physical inactivity on the risk of myocardial infarction with SI of 2.05 (95% CI 1.07 to 3.92) for male shift workers. For female shift workers, interaction effects were found with high waist-hip ratio (SI 4.0, 95% CI 1.12 to 14.28) and elevated triglycerides (SI 5.69, 95% CI 1.67 to 19.38). Conclusion: Shift work and some established coronary risk factors have significant interactions. [ABSTRACT FROM AUTHOR]

Aim The aim was to analyze (i) the prevalence of online unwanted sexual solicitation (USS) victimization, (ii) predictors of online USS and (iii) the associations between online USS and depressive symptoms in Swedish pupils in grades 7–9. Methods An electronic questionnaire was disseminated in 2011 in schools in a municipality in the northern part of Sweden. Total n = 1193 (boys n = 566; girls n = 627). Logistic regression models were fitted to test the cross-sectional associations between predictors of online USS and depressive symptoms, respectively. Results One third of girls and every fifth boy reported online USS victimization. In boys, predictors associated with online USS were offline bullying and sexual harassment victimization. Only offline sexual harassment victimization was associated with online USS in girls. Girls victimized by online USS had about twice the likelihood to report depressive symptoms compared to non-victimized girls. There were no associations between online USS and depressive symptoms in boys. While offline bullying was associated with depressive symptoms in both genders, offline sexual harassment victimization increased the likelihood to report depressive symptoms in girls only. Conclusions Online USS was common among Swedish youth, particularly among girls. Schools, parents and internet safety educators should look at co-occurrence of different forms of victimization as offline victimization was a predictor of online USS. Online USS was associated with depressive symptoms in girls and may hence be a factor driving gender inequity in mental health in youth. [ABSTRACT FROM AUTHOR]

From the perspective of salutogenesis, schools have opportunities to create supportive environments for health and well-being, but there is a need for more knowledge about positive health determinants in the school setting. The aim of this study was to analyse adolescents' self-reported positive health and its association with supportive factors in the school environment. Data was derived from a cross-sectional study in which pupils were aged 12-16 (n=1527). A positive health scale was used to examine the association of positive health with the following determinants: classroom participation; teacher support; peer support; parental support; and personal relative affluence. Data was analysed with multiple logistic regression. The results showed that positive health was associated with classroom participation and support from teachers and parents more commonly among boys than girls. All determinants were significantly associated with pupils' positive health. The conclusion is that students' positive health is strongly associated with support from the school. Classroom participation and support are major concerns for the health of pupils, and it is essential to develop these aspects of the school environment. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the effectiveness of the DISA-programme in preventing depressive symptoms (DS) in adolescent girls, as implemented in a real-world school setting, accounting for baseline socioeconomic and psychosocial factors, and to investigate whether the effects of these baseline variables on DS differed between intervention participants and nonparticipants. In this non-randomised pragmatic trial, an electronic questionnaire was disseminated in 2011 (baseline) and 2012 (follow-up) in schools in one municipality in northern Sweden. Pupils (total n=275; intervention participants identified in the questionnaire: n=53; non-participants: n=222) were 14-15 years old at baseline. The groups were compared by means of SEM. DISA could not predict differences in DS at follow-up in this real-life setting. In the overall sample, sexual harassment victimisation (SH) at baseline was associated with DS at follow-up and the estimate for SH increased in the DISA-participants compared to the overall sample. [ABSTRACT FROM AUTHOR]

Background: Adolescents are a vulnerable group when it comes to the risk of developing depression. Preventing the onset of depressive episodes in this group is therefore a major public health priority. In the last decades, school-based cognitive-behavioural interventions have been a common primary prevention approach. However, evidence on what girls actually are allocated to such interventions when no researchers are involved is scarce., Objective: To explore how a selective cognitive-behavioural program (Depression In Swedish Adolescents) developed to prevent depression in adolescents, was implemented in a naturalistic setting in schools in northern part of Sweden. The focus was on characteristics of participants allocated to the intervention., Design: Cross-sectional baseline data on depressive symptoms, school environment and socio-economic factors were collected in 2011 by means of questionnaires in schools in a municipality in the northern part of Sweden. Intervention participants were identified in a follow-up questionnaire in 2012. Students (n=288) included in the analyses were in the ages of 14-15., Results: Sixty-six girls and no boys were identified as intervention participants. They reported higher levels of depressive symptoms, lower personal relative affluence, more sexual harassment victimization and less peer support compared to female non-participants (n=222). Intervention participants were more likely to attend schools with a higher proportion of low parental education levels and a lower proportion of students graduating with a diploma., Conclusions: The developers of the intervention originally intended the program to be universal or selective, but it was implemented as targeted in these schools. It is important for school administrations to adhere to program fidelity when it comes to what students it is aimed for. Implications for effectivenss trials of cognitive-behavioural interventions in the school setting is discussed.

Objectives: The aim was to analyse if young students could be substantive participants in a health-promoting school project. The specific aims were to analyse the changes the students proposed in their school environment, how these changes were prioritized by a school health committee and to discuss the students' proposals and the changes from a health and gender perspective., Study Design: An intervention project was carried out in an elementary school with students (about 150) in Grades 1 through 6. The intervention included small-group discussions about health promoting factors, following a health education model referred to as "It's your decision." At the last of 6 discussions, the students made suggestions for health-promoting changes in their school environment. A health committee was established with students and staff for the purpose of initiating changes based on the proposals., Methods: A content analysis was used to analyse the proposals and the protocols developed by the health committee., Results: The analysis showed 6 categories of the students' proposals: social climate, influence on schoolwork, structure and orderliness, security, physical environment and food for well-being. Their priorities corresponded to the students' categories, but had an additional category regarding health education., Conclusions: Principles that guide promoting good health in schools can be put into action among students as young as those in Grades 1 through 6. Future challenges include how to convey experiences and knowledge to other schools and how to evaluate if inequalities in health because of gender, class and ethnicity can be reduced through the focus on empowerment and participation.

Earlier studies have indicated that patients with chronic pain often have experienced physical abuse, but only a small number of population studies have demonstrated an association between abuse and chronic pain. During 1997 a population study was made in northern Sweden. Close to 15,000 people from 18-85 years of age answered a questionnaire about public health issues, including four questions about physical abuse and threats. In the present study the association between answers to these four questions and the other health questions were analyzed for men and women from 18-44 years. Almost 8% of the women and 10% of the men had been subjected to violence or threats during the past year, with higher figures for younger men and women. A strong association between violence/threats and most of the other health issues was found for both men and women. The association remained after controlling for various socioeconomic variables as well as smoking, although with somewhat lower odds ratios.