Introduktion: Sexuella övergrepp är ett omfattande folkhälsoproblem som för med sig stora samhällsekonomiska kostnader samtidigt som det får en rad allvarliga psykosociala hälsoproblem för offren. I Sverige är den mest utsatta gruppen unga tjejer och majoriteten av sexuella övergrepp bland unga begås av jämnåriga förövare. Trots det saknas forskning kring sexuella övergrepp bland unga jämnåriga. Studien syftar därför till att studera förekomst, bakgrundsfaktorer och hälsoaspekter av utsatthet för sexuella övergrepp av en jämnårig och undersöka om det förekommer könsskillnader gällande olika hälsoaspekter.   Metod: Studien är en tvärsnittsstudie som baseras på datamaterial som samlades in till den nationella kartläggningen ”våld mot barn 2016”, med ett deltagarantal på 4741 elever (ca 15-17 år).  Studien presenterar beskrivande statistik som prevalenser och korsanalyser (Chi-2-test). Binära logistiska regressioner har gjorts för att analysera om utsatthet för sexuella övergrepp av jämnårig är relaterat till specifika bakgrundsfaktorer samt olika hälsoaspekter. Till sist justerades bakgrundsfaktorer och hälsoaspekter genom multivariata logistiska regressionsanalyser för att kontrollera för kön, boendesituation, funktionsnedsättning, föräldrarelaterade faktorer, födelseland och familjeekonomi. Resultat: Nästan var tredje flicka och knappt var tionde pojke har utsatts för sexuella övergrepp av en jämnårig. De bakgrundsfaktorer som är starkt relaterade till sexuella övergrepp av jämnårig är att vara flicka, ha en funktionsnedsättning, ha en förälder med egna problem och att inte bo med båda sina föräldrar. Var femte elev som hade utsatts för sexuella övergrepp av en jämnårig var samtidigt multiutsatt. De som utsatts för sexuella övergrepp av jämnåriga hade sämre utfall i alla hälsoaspekter än de som inte utsatts för det och alla hälsoaspekter var vanligare hos flickor jämfört med pojkar. Slutsats: Majoriteten av alla typer av sexuella övergrepp begås av en jämnårig samtidigt som sexuella övergrepp av jämnårig sågs ha oberoende effekt på mental hälsa. En femtedel av de som utsatts för sexuella övergrepp av jämnårig är dock multiutsatta och behöver uppmärksammas mer då tidigare forskning visat att den här gruppen är extra sårbar och drabbas av psykisk ohälsa i större utsträckning än de som inte är multiutsatta. Den här studien har bidragit med kunskap om en grupp som tidigare inte har studerats enskilt och den här nya kunskapen kan komma till användning i det våldspreventiva arbetet på alla nivåer i samhället.

Background: Agenda 2030 is newly launched, thus little research has been conducted about the implementation at the municipal level. To increase the Sustainable Development Goals (SDGs) feasibility requires understanding which elements can facilitate the policy implementation process with the goal of healthy and sustainable societies. Aim: The aim of the study is to investigate the officials’ experiences of implementing the Agenda 2030 at the municipal level. Methods: A qualitative method with an inductive approach was used to address the study aim. A purposive sampling of participants was conducted, and a semi-structured interview was used as the data collection method. In total, ten informants from ten different municipalities participated. A manifest content analysis was conducted to analyze the collected data. Result: The implementation strategies that were used for mobilizing the community to achieve the Agenda 2030 could be divided into internal and external strategies. The internal strategies focused on knowledge enhancing activities and the integration of the SDGs into municipal existing steering documents. The external strategies focused on establishing partnerships and involving the local citizen in the community development. Conclusion: The experiences of the officials indicated that health promotion approaches, and the guiding principles can be valuable tools for municipalities to facilitate the policy implementation process related to Agenda 2030.

Bakgrund: För att bättre kunna tillgodose behoven av stöd hos sjukskrivna personer, korta ner tiden som sjukskriven och minska antalet personer som får avslag på sjukpenning behövs mer forskning inom rehabiliteringsstöd och återgång till arbete.  Det är inte fullt utrett huruvida self-efficacy, socialt stöd och socioekonomi har effekt på hälsa och arbetsförmåga över tid för en person i slutet av sin sjukskrivning. Syfte: Syftet med studien var att undersöka om self-efficacy, socialt stöd och socioekonomi predicerar hälsa, välbefinnande och arbetsförmåga för personer som är i slutet av en sjukskrivningsperiod. Metod: Studien baserades på en kvantitativ longitudinell  studie. Datamaterialet användes som en kohortstudie med två mätpunkter där 193 respondenter ingick. De predicerande variablerna self-efficacy, socialt stöd och socioekonomi mättes vid baslinjen och utfallsvariablerna självskattad hälsa, psykiskt välbefinnande och arbetsförmåga mättes vid uppföljningen.  Datamaterialet analyserades med korrelationsanalyser och logistiska regressionsanalyser i  statistikprogrammet SPSS. Resultat: En högre self-efficacy predicerade en högre självskattad hälsa (justerad OR 3,05; 95 % CI 1,30 till 7,16), ett högre psykiskt välbefinnande (justerad OR 3,00; 95% CI 1,01 till 8,91) och en högre arbetsförmåga (justerad OR; 3,63; 95% CI 1,50 till 8,80). Emotionellt socialt stöd predicerade psykiskt välbefinnande (justerad OR; 4,76; 95% CI 1,12 till 20,22). Slutsats: En högre self-efficacy predicerade en högre självskattad hälsa, psykiskt välbefinnande och arbetsförmåga hos målgruppen och emotionellt socialt stöd predicerade ett högre psykiskt välbefinnande. För framtida forskning anses att interventionsstudier och effektutvärderingar vid återgång till arbete samt faktorer som påverkar self-efficacy vid sjukskrivning studeras. / Introduction: To increase the support for those on sick leave, shorten the time of sick leave and reduce the number of people who have been refused social insurance despite reduced work ability,  more research on support of rehabilitation and return to work is required. It is not fully explored whether self-efficacy, social support and socioeconomics have an effect on health and work ability, it is therefore appropriate to study the health factors of those who have been on sick leave for a long period of time. Aim: The aim of this study was to investigate whether self-efficacy, social support, and socioeconomics predict health, wellbeing, and work ability for people who are at the end of a period of sick leave. Method: The study were based on quantitative longitudinal study. The data material was used as a cohort with two measuring points (N = 193). The predictive variables self-efficacy, social support and socioeconomics as well as the outcome variables self-rated health, mental wellbeing and work ability was analyzed with correlation analysis and logistic regression analysis, in the statistical program SPSS. Result: Higher self-efficacy predicted higher self-rated health (adjusted OR 3,05; 95% CI 1,30 to 7,16), higher mental wellbeing (adjusted OR 3,00; 95% CI 1,01 to 8,91) and higher work ability (adjusted OR; 3,63; 95% CI 1,50 to 8,80). Emotional social support predicted higher mental wellbeing (adjusted OR; 4,76; 95% CI 1,12 to 20,22).    Conclusion: Higher self-efficacy predicted higher self-rated health, mental wellbeing and work ability in the target group, and emotional social support predicted higher mental wellbeing. For future research, intervention studies and effect evaluations of returning to work and factors that affect self-efficacy on sick leave need to be studied.

Introduction/background: Epidemics of infectious diseases (ID) are re-occurring now more often and spreads faster into many different parts of the world due to globalization. The increasing evidence of climate change and man-made events have shown impacts to increase the emergency and re-emerging of animal- borne IDs. Studies claims that background factors of these IDs are biological, environmental and human-lifestyle related changes. The pathogen Lassa fever virus (LASV) is a zoonotic organismthat circulates in rodent reservoirs, and the animal´s hosts are rodent species (rats) of the genus Mastomys natalensis. Mastomys natalensis is primarily the reservoir species of the animal-borne disease of Lassa fever (LF) which is most prevalent in west Africa, particularly in Nigeria. Lassa fever (LF) has limited information with under-documented cases, its health effect on pregnant women especially in Nigeria is within the rural areas of Edo, Ondo, Delta, Ebony, Bauchi, Taraba and Plateau states where maternal mortalities are higher.  Aim: The overarching aim of this thesis is to analyse and discuss the health effects of Lassa fever occurrence and outcomes on pregnant women in Nigeria, with emphasis on the maternal mortality and fatality during pregnancy. Method: A statistical and systematic review was performed from retrospective studies of case series, case-control, observational and cohort studies of patients in Nigeria (pregnant women with gestation ages of pregnancy from 2 weeks –32 weeks) that tested positive to LASV. Publication status and publication date was applied for the inclusion of respective studies by electronic searches via Web of Science, Google scholar, MEDLINE and PubMed. Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines (PRISMA) was used to illustrate the flow of relevant articles in my study. R-commander and R-Studio software was used to analyze the data and to find the causal significant relationship between LF and maternal mortality using “Linear regression and linear model plot”. Result: The total number of full-text and Peer-view publications on Lassa fever virus cases was 1 609 articles. 94 articles out of the 1 609 articles were eligible for full text revision. Exclusion criteria finally yielded 6 studies that were relatively relevant to my study. However, 3 out of the 6 articles were statistically reviewed to know the influence of Lassa fever and the risk of maternal mortality during pregnancy.  Conclusion: Lassa fever occurrence have significantly shown potential increase in the severity of maternal mortality, and is predominant among pregnant women from 39 - 45 years old in Nigeria especially within the risk endemic areas of Ondo, Edo, Ebony and Bauchi states showing significant long-term diseases on LF affected pregnant women, such as encephalopathy, acute kidney dysfunction and acute kidney failure that leads to further health problems or complications like coma and sensorineural deafness.

Intimate partner violence is the most prevalent category of violence that women are experiencing and, globally, 30% of women are estimated to have suffered physical, emotional, or sexual IPV. Nigeria lacks clear anti-IPV legislation, and the proportion of IPV has received widespread attention from a human rights perspective. This study aims to investigate whether or not women’s level of education is related to their experience of intimate partner violence. The study was a quantitative cross-sectional study that used secondary data analysis from the population-based 2018 Nigeria Demographic and Health Survey (NDHS). Data on 2728 ever-married women were used and logistic regression analysis was conducted to investigate the effect women’s level of education has on their experience of Intimate partner violence. The key findings of the results concluded that women with secondary education had higher odds of experiencing any form of intimate partner violence compared to uneducated women. Women’s education was not found associated significantly with emotional IPV. Education has a protective effect on physical IPV and sexual IPV for women with primary education. Women’s level of education had a protective effect on some aspects of the violence.

Introduction: Health behaviour is detrimental to the pathways to adulthood. Internet becomes an important way for parents to get support and to exchange information. Therefore, a scoping review and interviews with mothers had been conducted to map knowledge to investigate the extent to which the internet is being used by parents to access information relative to their adolescent’s health behaviours. Method: Scoping review was used to identify articles related to the topic. The literature search was conducted on two databases, PubMed, and PMC. In addition, semi-structured interviews conducted by telephone with mothers based in Sweden. Content analyses were used to describe common themes. Result: The searches on the PubMed and PMC electronic databases detected 274 items. Only 9 articles were relevant and matched the criteria that were relevant to the topic. Most of the studies have been conducted in developed countries such as the United States and Australia from 2004 to 2020. During semi-structured interviews, using the internet was described as a supportive tool for mothers. Conclusion: The gap was clear due to the low number of the identified articles. New studies should be conducted in developing countries. Demographic influences should be considered regarding participants recruitment for interviews.

Bakgrund: Distriktssköterskan triagerar dagligen patienter med psykisk ohälsa i primärvården. Psykisk ohälsa är mångfacetterat och till viss del tabubelagt i samhället. Detta kräver att distriktssköterskan har god kännedom om psykisk ohälsa och hur den kan uttrycka sig hos olika patienter. Distriktssköterskan behöver även ha ett holistiskt synsätt med personcentrerad vård i fokus. Syfte: Syftet med studien var att belysa distriktssköterskans erfarenheter av triagering av patienter med psykisk ohälsa inom primärvården. Metod: En kvalitativ intervjustudie med åtta distriktssköterskor/sjuksköterskor verksamma i primärvården. Analysmetoden var kvalitativ innehållsanalys. Resultat: Resultatet var tre kategorier och tio underkategorier. De tre kategorierna var: Brister i utbildning, Utmaningar vid triagering samt Brister i samverkan. Resultatet visade att distriktssköterskan behöver ha mer kunskap om psykisk ohälsa samt ha de förutsättningar som krävs för att genomföra en bra triagering såsom stödverktyg och trygghet i dialog om självmordstankar hos patienten. Distriktssköterskan behöver vara medveten om somatisering och dess påverkan i triageringen. Samarbetet mellan primärvården och öppen psykiatriska mottagningen behöver förbättras. Konklusion: För att triagering av psykisk ohälsa ska bli bättre behöver distriktssköterskan erhålla mer utbildning av psykisk ohälsa. Där har både arbetsgivare och utbildningsansvariga ett ansvar att påverka möjligheterna till triagering av psykisk ohälsa i primärvården. Distriktssköterskan behöver även ha stödverktyg för att säkerhetsställa likvärdig triagering av psykisk ohälsa i primärvården. / Background: The district nurse triage daily patients with mental illness in primary care. Mental illness is multifaceted and to some extent taboo in society. This requires that the district nurse has a good knowledge of mental illness and how it can express itself in different patients. The district nurse also needs to take a holistic approach with person-centred care in focus. Aim: The aim was the district nurse experiences with triage of patients with mental illness in primary care. Method: A qualitative research approach based on interviews with eight district nurse/nurse active in primary care. Qualitative content analysis. Result: The result was three categories and ten subcategories. The three categories were: Deficiencies in education, Challenges in triage and Deficiencies in collaboration. The results showed that the district nurse needs to have more knowledge about mental illness and have the conditions required to carry out a good triage, such as support tools and security in dialogue about suicidal thoughts in the patient. The district nurse needs to be aware of somatization and its impact on triage. The collaboration between primary care and the open psychiatric clinic needs to be improved. Conclusion: In order for triage of mental illness to improve, the district nurse needs to receive more training in mental illness. There, both employers and education managers have a responsibility to influence the opportunities for triage of mental illness in primary care. The district nurse also needs support tools to ensure equivalent triage of mental illness in primary care.

Background: The growing number of migrants, and refugees in particular, can have complex impacts on healthcare systems as they face pressures of responding to new healthcare needs. Refugees report lower levels of self-assessed health and psychological well-being compared to host populations, but paradoxically, many refrains from seeking care although they perceive the need to. Health promotion and improved health literacy has been identified to improve service utilization and health outcomes of refugees. Aim: Investigating perceptions of health communicators in implementing a Swedish version of the teach-back method for improved health information recall – Förstå Mig Rätt (FMR) – in the Swedish civic orientation for newly arrived refugees. Method: Semi-structured in-depth interviews were used to explore the utilization of FMR. Content analysis was used to analyze the data, and an integrated model for health literacy by Sørensen et al. guided the discussion in examining how FMR contributed to improved health literacy. Findings: Three themes emerged from the data: (i) Appreciating the impact of FMR; (ii) valuing the role of a communicator and; (iii) practical challenges of implementing FMR. The findings demonstrated an overall appreciation for the method but implicated changes in the layout for further improvements. Conclusion: FMR serves its purpose of ensuring recall and understanding of health information among newly arrived refugees attending the Swedish civic orientation. For optimal utilization, groups should be adjusted for participant educational level while further clarification on restating information, and extended time for dialogue, is recommended.

Abstract Background: Although the maternal mortality ratio has dropped globally, the ratio is still unacceptably high in many low and lower-middle-income countries, like Bangladesh. Maternal deaths can occur from preventable complications due to pregnancy and childbirth. Delivery at a health institution was proven to be one of the key interventions to minimize maternal mortality. This study aimed at investigating the associations between the socio-demographic and healthcare-related factors, and the place of delivery among ever-married women of reproductive age in Bangladesh.  Methods: A population-based cross-sectional study was conducted with 4487 ever-married women, aged 15-49 years. Data were extracted from the 2014 Bangladesh Demographic and Health Survey. To investigate the associations, multivariate logistic regression was performed.   Results: Of the 4487 ever-married women, 1794 (40%) gave birth by institutional delivery. Multivariate logistic regression showed that wealthier women, attending secondary or above education levels, and whose husbands had primary or above education were more likely to deliver at health institutions. Women who received counselling about danger signs and attended at least one or more ANC visits during pregnancy had higher odds of institutional delivery. Women living in rural areas, following Islam religion, and who were currently working were less likely to deliver at health institutions. Conclusion: The current study revealed that the socio-demographic and healthcare-related factors were associated with the place of delivery among ever-married women of reproductive age in Bangladesh.

Introduction  Research about health has become a very important part of the world today. Theres a constant need for new treatment methods and evidence. Recruitment is one of the most challenging parts of conducting a trial, especially in trials regarding mental health. The result of this is often a waste of money and resources in research. Method  This study is a systematic review and meta-analysis investigating the recruitment in randomized controlled trials on internet-based CBT interventions for depression.  Results  The recruitment rates were calculated as number of participants screened divided by number of participants randomized into the trial. The overall recruitment rates of all the trials was 54.3%. The analysis of the recruitment moderators shown that a clinical recruitment setting together with referral as recruitment personnel.