During the past decade, tangible sensor technologies have matured and become less expensive and easier to use, leading to an explosion of innovative musical designs within video games, smartphone applications, and interactive art installations. Interactive audio has become an important design quality in commercially successful games like Guitar Hero , and a range of mobile phone applications motivating people to interact, play, dance, and collaborate with music. Parallel to the game, phone, and art scenes, an area of music and health research has grown, showing the positive results of using music to promote health and wellbeing in everyday situations and for a broad range of people, from children and elderly to people with psychological and physiological disabilities. Both quantitative medical and ecological humanistic research show that interaction with music can improve health, through music’s ability to evoke feelings, motivate people to interact, master, and cope with difficult situations, create social relations and experience shared meaning. Only recently, however, the music and health field has started to take interest in interactive audio, based on computer-mediated technologies’ potential for health improvement. Here, we show the potential of using interactive audio in what we call interactive musicking in the computer-based interactive environment Wave. Interactive musicking is based on musicologist Christopher Small’s concept “musicking”, meaning any form of relation-building that occurs between people, and people and things, related to activities that include music. For instance, musicking includes dancing, listening, and playing with music (in professional contexts and in amateur, everyday contexts). We have adapted the concept of "musicking" on the design of computer-based musical devices. The context for this chapter is the research project RHYME. RHYME is a multidisciplinary collaboration between the Centre for Music and Health at the Norwegian Academy of Music, the Oslo School of Architecture and Design (AHO), and Informatics at the University of Oslo. Our target group is families with children with severe disabilities. Our goal is to improve health and wellbeing in the families through everyday musicking activities in interactive environments. Our research approach is to use knowledge from music and health research, musical composition and improvisation, musical action research, musicology, music sociology, and soundscape studies, when designing the tangible interactive environments. Our focus here is interaction design and composition strategies, following research-by-design methodology, creating interactive musicking environments. We describe the research and design of the interactive musicking environment Wave, based on video documentation, during a sequence of actions. Our findings suggest some interactive audio design strategies to improve health. We base the design strategies on musical actions performed while playing an instrument, such as impulsive or iterative hitting, or sustainable stroking of an instrument. Musical actions like these can also be used for musicking in everyday contexts, creating direct sound responses to evoke feelings that create expectations and confirm interactions. In opposition to a more control-oriented, instrument and interface perspective, we argue that musical variation and narrative models can be used to design interactive audio, where the audio is seen as an actor taking many different roles, as instrument, co-musician, toy, etc. In this way, the audio and the interactive musicking environments will change over time, answering with direct response, as well as nose-thumbing and changing response, motivating creation, play, and social interaction. Musical variation can also be used to design musical backgrounds and soundscapes that can be used for creating layers of ambience. These models create a safe environment and contribute to shared meaning.

Our voice and body are important parts of our self-expression and self-experience for all of us. They are also essential for our way to communicate and build relations cross borders such as abilities, ages, locations and backgrounds. Voice, body and tangibility gradually become more important for Information and Communication Technology (ICT), due to increased development of tangible interaction and mobile communication. The voice and tangible interaction therefore also become more important for the fields of Assistive Technology, Health Technology and Universal Design. In this paper we present and discuss our work with voice and tangible interaction in our on-going research project RHYME. The goal is to improve health for families, adults and children with disabilities through use of collaborative, musical, tangible and sensorial media. We build on use of voice in Music Therapy, knowledge from multi-sensory stimulation and on a humanistic health approach. Our challenge is to design vocal and tangible interactive media that are sensorially stimulating. Interactive media that through use, can reduce isolation and passivity and increase empowerment for all the users. We use sound recognition, generative sound synthesis, vibrations and cross-media techniques, to create rhythms, melodies and harmonic chords to stimulate voice-body connections, positive emotions and structures for actions.

In this paper we explore how we compose sound for an interactive tangible and mobile interface, where the goal is to improve health and well-being for families with children with disabilities. We describe the composition process of how we decompose a linear beat-based and vocal sound material and recompose it with real-time audio synthesis and composition rules into interactive Scenes. Scenes that make it possible for the users to select, explore and recreate different sound worlds. In order to recreate, the users interact with the tangible interface in different ways, as instrument, play with it as a friend, improvise and create music and relax with it as ambient sounding furniture. We discuss composition techniques for mixing sound, tangible-physical and lighting elements in the Scenes. Based on observations we explore how a diverse audience in the family and at school can recreate and improvise their own sound experience and play together in open and non-therapeutic everyday situations. We conclude by discussing the possible impact of our findings for the NIME-community; how the techniques of decomposing, recomposing and recreating sound, based on a relational perspective, could contribute to the design of new instruments for musical expression.

Background: Immigrants are considered globally to be a vulnerable subpopulation. Vulnerable population groups have a higher prevalence of obesity than the general population. Despite increased immigration of people from Somalia to Sweden in recent years, little research has been undertaken about obesity and obesity-related health risks among Somali immigrants. The present study aimed to investigate the prevalence of overweight and obesity, as well as possible relationships between weight status and socio-demographic characteristics, dietary habits and physical activity (PA) among Somali immigrants in Sweden.

Methods:This quantitative cross-sectional study included 114 respondents. Data were collected by means of a questionnaire covering socio-demographic factors, PA and dietary habits. Weight and height were also measured.

Results:Of the 114 respondents, 50.9% had a body mass index (BMI) of 25 or above.In bi-variate analysis, there were no statistically significant differences between those with a BMI below 25 and those with a BMI of 25 or more regarding PA or dietary habits. Multiple logistic regression analysis showed that female gender and being married were associated with having a BMI of 25 or above.

Conclusion: Socio-demographic factors may be more strongly associated with high BMI than PA or dietary habits among the targeted group and should be taken into account as an issue affecting Somali immigrants in Sweden that warrants further research.

Introduction: The palliative care approach aims to integrate psychosocial and existential aspects as well as relationship aspects in the care and can be used in all care contexts. In residential care, nurse assistants (NAs) are the ones who are closest to the residents, but have limited prerequisites to work in accordance with the palliative care approach. We aimed to investigate the effects of an intervention applying a palliative care approach in residential care, on NAs experience of care provision and caring climate.

Method: In this quasi-experimental study we evaluated the intervention involving NAs (n=75) and their leaders (n=9), focusing on emotional, existential and relationship aspects within the palliative care approach, in comparison with controls (n=110). Data consisted of a questionnaire that the NAs answered at three time points.

Results: In the intervention group, effects were seen concerning the NAs reports of the care provision in that they focused more on to ease for residents to narrate about their lives, and on communication with residents in what gives them meaning in life. In the intervention group effects were also seen in that the NAs rated the residents medical and nursing care needs being less met at the facility after the intervention. No effects were seen concerning the caring climate or the possibilities to provide a more person-centered care.

Conclusion: The intervention seemingly facilitated for the NAs to focus on relationship aspects with the residents. But the intervention was not sufficient to change the organizational prerequisites for the staff to provide a more person-centered care.

Background

A palliative care approach aims to integrate psychosocial and existential as well as relationship aspects in the care and is an approach that can be used in residential care. Nurse assistants are the ones who are closest to the residents but have limited prerequisites for working in accordance with the palliative care approach. We aimed to investigate the effects on nurse assistants' experiences of care provision and the caring climate of an intervention applying a palliative care approach in residential care.

Methods

An intervention involving nurse assistants (n = 75) and their leaders (n = 9), in comparison with controls (n = 110), was evaluated using a questionnaire at three points in time.

Results

In the intervention group, positive effects were seen concerning the nurse assistants' reports of the care provision in that they focused more on the residents' stories about their lives and on communicating with the residents about what gave meaning to their lives. Also, negative effects were seen when the nurse assistants rated that the residents' needs for medical and nursing care had not been met at the facility directly after the intervention. No effects were seen concerning the caring climate or the prerequisites of providing more person-centred care.

Conclusion

The intervention seemed to have encouraged the nurse assistants to focus on relationship aspects with the residents. So as not to jeopardise the NAs' well-being and to support NAs in keeping themselves involved in existential issues, their support most certainly needs to be continuous and ongoing. However, in spite of the leaders' involvement, the intervention was not sufficient for changing the organisational prerequisites for more person-centred care.

Objectives: The aim was to investigate the effects of an intervention that applies a palliative care approach in residential care upon nurse assistants' level of strain, job satisfaction, and view of leadership.

Method: A quasi-experimental, pretest and posttest design was used. Study circles with workshops involving nurse assistants (n = 75) and their superiors (n = 9) focusing on emotional and existential issues in palliative care were evaluated using a questionnaire answered by the nurse assistants at baseline (November 2009), post-intervention (May 2010), and six-month follow-up (November 2010) in comparison with controls (n = 110).

Results: Directly after the intervention, the job satisfaction of the nurse assistants decreased and they perceived the leadership more negatively than before the intervention. Six months later, strain as a result of criticism from residents and their superiors and having difficulty in balancing emotional involvement had decreased.

Significance of results: The intervention initially seemed to decrease the well-being of the nurse assistants, which could be the result of their increased awareness of the residents' and relatives' needs, in combination with limited support. More emphasis should be placed on the role of leadership when implementing changes in practice.

Background.  Nurse assistants working in residential care facilities need support to ensure that they provide high-quality care for the residents and support for relatives, from admission to bereavement.

Aim.  The aim was to describe the nurse assistants’ experience of how an intervention with a palliative care approach, had influenced them in their work in residential care for older people.

Participants.  Fourteen nurse assistants working in three different municipal residential care facilities.

Methods.  Data were collected by means of semi-structured individual interviews following an intervention consisting of study circles combined with workshops. The data were analysed using content analysis.

Result.  The nurse assistants felt that, through the intervention, they had gained insight into their understanding of the importance of quality of care. This included an increased awareness of, and respect for, residents’ and relatives’ needs, and an increased understanding of the importance of the outcome of encounters with residents and their relatives. After the intervention, they also felt there was increased openness and understanding between colleagues. However, the nurse assistants also expressed frustration over obstacles to implementing a palliative care approach, such as lack of resources and supportive leadership.

Conclusion.  The nurse assistants felt that the intervention was positive and encouraged them to provide more person-centred care within the framework of a palliative care approach. Although the intervention was intended to involve and support the management, it was not sufficient. Nurse assistants described lack of resources and supportive leadership. There is, therefore, a need to place greater emphasis on leadership and their support of nurse assistants so that they can provide high-quality care.

Implications for practice.  To support nurse assistants in the provision of care, clear leadership and opportunities to discuss and reflect on issues associated with care, including systematic improvement work in practice, appear to be essential to ensure high-quality care.

Periodontal pathogens, including Porphyromonas gingivalis, can form biofilms in dental pockets and cause inflammation, which is one of the underlying mechanisms involved in the development of periodontal disease, ultimately leading to tooth loss. Although P. gingivalis is protected in the biofilm, it can still cause damage and modulate inflammatory responses from the host, through secretion of microvesicles containing proteinases. The aim of this study was to evaluate the role of cysteine proteinases in P. gingivalis colony growth and development, and subsequent immunomodulatory effects on human gingival fibroblast. By comparing the wild type W50 with its gingipain deficient strains we show that cysteine proteinases are required by P. gingivalis to form morphologically normal colonies. The lysine-specific proteinase (Kgp), but not arginine-specific proteinases (Rgps), was associated with immunomodulation. P. gingivalis with Kgp affected the viability of gingival fibroblasts and modulated host inflammatory responses, including induction of TGF-β1 and suppression of CXCL8 and IL-6 accumulation. These results suggest that secreted products from P. gingivalis, including proteinases, are able to cause damage and significantly modulate the levels of inflammatory mediators, independent of a physical host-bacterial interaction. This study provides new insight of the pathogenesis of P. gingivalis and suggests gingipains as targets for diagnosis and treatment of periodontitis.

Background.  One key aspect of person-centredness is striving to understand both the patients' experiences and behaviours from their perspective. These aspects are precisely those that staff in dementia care highlight as causing them most difficulty because the people in their care have major problems expressing themselves. There is thus a need to develop a method to help the staff to achieve interpretation through reflection.

Aim.  The aim of this study was to explore the use of drama as a tool to support reflection among staff working in the residential care of people with dementia.

Design.  A qualitative evaluation of a programme consisting of three drama sessions with staff working in residential care (n = 10 nurse assistants).

Methods.  Data comprised observations and tape recordings of the sessions, the researchers' reflections after each session and a focus-group interview with the participants. The texts were analysed using qualitative content analysis.

Results.  The analysis showed that: (i) the exercises stimulate reflection about daily caring practice; (ii) the participants must receive extensive information about the purpose of the sessions; (iii) the research team must secure the defined frames and conditions and have practical knowledge about caring for people with dementia and (iv) the management needs to be stable, committed and supportive.

Conclusion.  Drama seems to be a valid tool to aid reflection, but several adjustments are needed concerning both the content of the sessions and the methodology. When designing a larger intervention study, it would be preferable to the sessions to be combined with staff support to effect changes in care provision resulting from their increased awareness of the residents' situation and experience.

Implications for practice.  Our results showed that drama can be a means to enhance reflection among staff in residential care for people with dementia. Further research is however needed concerning the effects for the staff's situation and nursing care quality.

Background: Persons with dementia receive health care and social services from a wide range of professional care providers during the disease trajectory, presenting risks of miscommunication, duplication and/or missed nursing interventions. Accordingly, the aim of this study was to investigate professional care providers’ views on conditions for best practice in terms of collaboration and improvement needs in the chain of care from early to end-of-life stage for persons with dementia in Sweden.

Methods: The study had a qualitative design based on three focus group interviews. A strategic sample of 23 professional care providers was included. Data were subjected to content analysis based on the three stages of dementia (early, moderate, end-of-life).

Results: The results were divided into five categories: Diagnosis is a prerequisite for specialized dementia care, Creating routines in the chain of care, Competent staff a prerequisite for high-quality care, Day care facilitates transition in the chain of care and Next-of-kin participation is a prerequisite for continuity in the chain of care. It was clear that, according to the participants, best practice in dementia care in Sweden is not achieved in every respect. It appeared that transitions of care between different organizations are critical events which need to be improved. The further the disease progresses, the less collaboration there seems to be among professional care providers, which is when the next of kin are usually called upon to maintain continuity in the chain of care.

Conclusions: The results indicate that, according to the care providers, best practice in terms of collaboration is achieved to a higher degree during the early stage of dementia compared with the moderate and end-of-life stages. Lack of best practice strategies during these stages makes it difficult to meet the needs of persons with dementia and reduce the burden for next of kin. These are experiences to be taken into account to improve the quality of dementia care. Implementation research is needed to develop strategies for best practice on the basis of national knowledge-based guidelines and to apply these strategies in the moderate and end-of-life stages.

n this article we present a novel approach for the understanding and the design of interactive health improving music technology, what we call Musicking Tangibles. The Musicking Tangibles approach represents an alternative approach to the traditional instrument, interface and switch-oriented music technology perspective. Our approach combines a humanistic, resource and empowerment oriented health approach with an aesthetic and culture based design approach towards music technology. We present four empowering and health improving qualities for the Musicking Tangibles. These qualities emphasize to: 1) Continually evoke interest and positive emotions relevant to diverse users’ interpretation of the tangibles and the situation; 2) Dynamically offer the users many roles to take, many musicking actions to make and many ways to express themselves; 3) Offer the users aesthetically consistent responses and build relevant cross-media expectations and challenges over time and space, consistent with their character; 4) Offer the users many relations to make: to people, things, experiences, events and places. Further we present and argue for some design solutions of the Musicking Tangibles ORFI, WAVE, REFLECT, and the POLLY World from the RHYME-project. In developing POLLY we have tried to put together as many design qualities as possible, to exemplify our view and current understanding.

The aim of this study was to explore school nurses’ experience of challenges related to documenting schoolchildren’s psychosocial health in Sweden. Six focus group discussions were carried out. Areas for discussions included questions about situations, especially challenging to document as well as what constrains and/or facilitates documenting psychosocial health problem issues. Qualitative content analysis was used for interpreting the data. The analysis resulted in one overarching theme: having to do one’s duty and being afraid of doing wrong; and three subthemes: uncertainty related to one’s own ability, concerns related to future consequences, and strategies to handle the documentation. School nurses relying on their intuition and using a structured documentation model may increase the opportunities for a reliable documentation. To further develop their professional skills with regular, clinical supervision can be of great importance. This in turn may increase contributions to research and development for the benefit of schoolchildren’s psychosocial health.

Background: Reports from research have shown that mental illness has increased dramatically in recent years and is currently one of the biggest problems among Swedish children and adolescents.

Aim: The aim of this study was to describe how Swedish school nurses experience their work with schoolchildren who have mental illness

Method: Data were gained by individual interviews with school nurses (n = 10) and were analyzed by using manifest qualitative content analysis.

Results: The results of the study showed that school nurses used various tools when working with schoolchildren who have mental illness. The working tools were regular health talks, motivational interviewing, individual counseling, family counseling, creating trust, and affirming the child's confidence. 

Conclusion: Results of the study demonstrate the need for further research on schoolchildren's experience of getting help and support from the school nurse. 

BACKGROUND: Though many staff gain satisfaction from working with people with dementia in residential facilities, they also experience significant stress. This is a serious issue because this in turn can affect the quality of care. There is, however, a lack of instruments to measure staff strain in the dementia-specific residential care environment, and the aim of this study, accordingly, was to develop the "Strain in Dementia Care Scale."

METHODS: The instrument was developed in three steps. In the first step, items were derived from six focus group discussions with 35 nurses in the United Kingdom, Australia, and Sweden concerning their experience of strain. In the second step, a preliminary 64-item scale was distributed to 927 dementia care staff in Australia and Sweden, which, based on exploratory factor analysis, resulted in a 29-item scale. In the final step, the 29-item scale was distributed to a new sample of 346 staff in Sweden, and the results were subjected to confirmatory factor analysis.

RESULTS: The final scale comprised the following 27 items producing a five-factor solution: Frustrated empathy; difficulties understanding and interpreting; balancing competing needs; balancing emotional involvement; and lack of recognition.

CONCLUSIONS: The scale can be used (a) as an outcome measurement in residential care intervention studies; (b) to help residential facilities identify interventions needed to improve staff well-being, and, by extension, those they care for; and ((c) to generally make more salient the critical issue of staff strain and the importance of ameliorating it.)

BACKGROUND: The focus of education in nursing has changed over time with a decreased focus on biomedicine and an increased focus on nursing science. It is therefore important to investigate whether these changes are also reflected in the students' conceptions and expectations of the programme over time.

OBJECTIVES: The aim of the study was to describe and compare two cohorts of students entering the nursing programme with 10year in between (2003 and 2013), regarding their demographic background, reasons for wanting to become a registered nurse, expectations of the programme and perceptions of the nursing profession.

DESIGN AND SETTING: The study was a descriptive cross-sectional cohort study carried out at a university in southern Sweden.

PARTICIPANTS: In all, 177 nursing students participated in the study, 89 from the 2003 cohort and 88 from the 2013 cohort.

METHODS: Data were collected at the start of the programme using a questionnaire consisting of predefined and open-ended questions. The responses were statistically analysed and compared.

RESULTS: The students' reasons for wanting to become a registered nurse remained stable over the 10-year period. The main reason stated by the students in both cohort was humanitarian, i. e wanting to help others. The students' expectations regarding both the programme and the nursing profession had, however, changed significantly from a biomedical to a nursing orientation in the 10-year perspective.

CONCLUSIONS: The change in the students' preconceptions of the nursing education towards increasing importance of nursing science indicates the beginning of a paradigm shift.

Omvårdnadens grunder – Hälsa och ohälsa belyser omvårdnadens betydelse ur såväl ett salutogent och förebyggande, som ett behandlande och vårdande perspektiv. I boken har 33 svenska forskare bidragit med beskrivningar av det aktuella kunskapsläget utifrån sin egen, och andras, forskning inom respektive område. Flertalet författare är sjuksköterskor med doktorsexamen.

Boken består dels av kapitel som fokuserar på hur man kan stärka patientens hälsa och välbefinnande, dels av kapitel som fokuserar på omvårdnad vid olika besvär. De kapitel som fokuserar på hälsa och välbefinnande handlar exempelvis om hur man kan stödja delaktighet och känslan av sammanhang samt vikten av en god miljö för omvårdnadens genomförande. De kapitel som fokuserar på omvårdnad vid olika besvär handlar exempelvis om sjuksköterskans bedömning och åtgärder, både generellt enligt omvårdnadsprocessens olika steg vid akuta situationer, men även vid olika vanligt förekommande symtom och tecken på ohälsa. Varje kapitel inleds med en övergripande beskrivning av området, orsaker till patientens besvär samt patientens upplevelse. Därefter följer en beskrivning av hur sjuksköterskan kan bedöma och hjälpa patienten med fokus på evidensbaserade omvårdnadsåtgärder.

Omvårdnadens grunder består av totalt tre publikationer utan inbördes ordning: Perspektiv och förhållningssätt, Ansvar och utveckling samt Hälsa och ohälsa. I första hand är böckerna avsedda som kurslitteratur för sjuksköterskestudenter på grundläggande nivå, men även kliniskt verksamma sjuksköterskor och andra yrkesgrupper inom hälso- och sjukvården har nytta av böckerna. Instruktioner för hur man kommer åt det digitala materialet finns på omslagets insida.

In recent years, a number of studies have demonstrated that stress and mental health problems have increased among adolescents and especially among girls, although little is still known concerning what girls experience in their everyday lives. The aim of this study was to describe the phenomenon of teenage girls’ everyday lives, as experienced by the girls themselves. A phenomenological approach of reflective lifeworld research was used, and the findings are based on eight qualitative interviews with girls aged 13–16 years. The essence of teenage girls’ everyday lives as experienced by the girls themselves can be described as consciousness regarding demands and unfairness and regarding the importance of connectedness and security. The girls are aware of the demands of appearance and success, and they are conscious of the gender differences in school and in the media that affect them. The girls are also conscious about the meaning of connectedness with friends and family, as well as the importance of the security of their confidence in friends and feeling safe where they stay. If teenage girls feel connected and secure, protective factors in the form of manageability and meaningfulness can act as a counterweight to the demands and unfairness of everyday life. For professionals who work with teenage girls, the results from this study can be important in their work to support these girls.

Bakgrund: En fungerande primärvård är viktig för invånarnas hälsa. Hälso- och sjukvården i Sverige är under stor press och sjukvårdspersonalens välbefinnande är ett omdiskuterat ämne. Många studier i primärvården lyfter fram stress och ohälsa bland personalen, medan s.k. salutogena studier, dvs. sådana som lyfter fram resurser och möjligheter, i princip saknas. Det övergripande syftet med denna studie var att belysa goda arbetsförhållanden i primärvården ur ett salutogent perspektiv.

Metod: En enkätstudie genomfördes vid samtliga 26 vårdcentraler, 18 offentliga och åtta privata, i sex kommuner i nordöstra Skåne. Enkäten riktade sig till alla anställda inom primärvården (n = 599). Frågorna omfattade olika dimensioner av arbetsförhållanden och hälsa. Som bas användes två salutogent inriktade mätinstrument: SHIS (Salutogenic Health Indicator Scale), som mäter indikatorer på hälsa, och WEMS (Work Experience Measurement Scale), med frågor om upplevelsen av arbetet och arbetssituationen. Dessa frågor kompletterades med nyskapade frågor. Dels gjordes en inledande intervjustudie, som resulterade i frågor av särskild relevans för primärvården, dels inkluderades frågor inspirerade av befintliga frågeinstrument. Index bildades utifrån de olika områdena, vilka skapades genom att frågor med logiskt samband slogs samman. Samtliga index presenteras i den här rapporten.

Resultat: Den totala svarsfrekvensen var 84 procent. Det fanns stora individuella variationer mellan de olika vårdcentralerna. Hälsotillståndet hos de anställda var i första hand associerat med återhämtning, följt av balans mellan arbete och privatliv samt individuella inre arbetsupplevelser, som t.ex. att kunna gå till jobbet med glädje och att uppleva arbetet som meningsfullt och utmanande. Egenskaper som präglar arbetsplatsen hade det tydligaste förhållandet till upplevelsen av energi på arbetet, och det mest signifikanta sambandet med feed-back var att ha en tillgänglig chef. Det fanns en positiv trend för den yngre åldersgruppen (<35 år) i upplevelsen av hälsa (SHIS). Samma grupp hade inom flera andra områden signifikant högre värden än resterande åldersgrupper, bl.a. gällande individuella inre upplevelser samt upplevelsen av feedback och arbetet som energigivare. Bland yrkesgrupperna var SHIS högt bland sköterskorna liksom upplevelsen av arbetet som energigivare. Den paramedicinska personalen upplevde självbestämmande såväl som möjlighet till reflektion på arbetet i störst utsträckning, medan den administrativa personalen tillsammans med läkarna upplevde högst grad av feedback på arbetet.

Slutsats: Studien ger en grund för arbetsrelaterade insatser i syfte att stärka de funna salutogena faktorerna, samt för att öka de anställdas deltagande i framtida hälsofrämjande arbete. Varje vårdcentral har genom studien goda möjligheter att arbeta vidare med de egna resultaten.

Based on one-to-one interviews and focus group interviews with management representatives, trade union representatives, and blue- and white-collar workers this article investigates how the global financial crisis was handled in Swedish industry. In the light of the crisis agreement signed between trade union IF Metall and company representatives how can the implementation of the agreement be described? How were these new conditions interpreted and how were they experienced? Three conceptual themes emerged, trust, loyalty, and principle of fair-play. Large differences were shown that were related to attitudes towards blue- and white-collar workers, recognition of work, and the size of the town.

This chapter provides a synthesis of three earlier published studies (Garmy et al. 2012^a; Garmy et al. 2012^b; Garmy et al. 2013) (survey I) as well as previously unpublished results from a survey conducted in 2013 among students aged 16 (survey II).

Objective: The aim was to investigate the effects of sleep, television use and texting and computer habits on overweight, enjoyment of school and feelings of tiredness at school in school-age children and adolescents.

Methods: This cross-sectional study was conducted in Sweden on schoolchildren aged 6, 7, 10, 14 and 16. A questionnaire which had been satisfactorily tested for validity and reliability was distributed to the children (n=3011 in survey I; n=204 in survey II).

Results: Children who slept less than the median length of time reported enjoying school to a lesser degree. Fewer hours of sleep were found to be associated with having a bedroom television, using the television or computer more than 2 hours a day, being tired at school, and having difficulties in sleeping and waking up. Overweight and obesity were found in 15.8% of the study population; obesity alone was found in 3.1%. Relationships between lifestyle factors and overweight were studied using multivariate logistic regression analysis. Having a bedroom television and using the television more than 2 hours per day were found to be associated with overweight, but using the computer more than 2 hours a day was not. About 61% of the students aged 16 reported checking Facebook or social media at least once a day, and 27% reported doing so more than 10 times a day. One fourth of the students aged 16 had a habit of sending or receiving text messages at night at least once a week. Texting at night and frequent checking of Facebook and social media sites were related to sleep problems.

Conclusions: Educating schoolchildren and their parents regarding matters of optimal sleep and how media habits affect sleep, overweight and learning is considered an important task.

Background: Supporting positive mental health development in adolescents is a major public health concern worldwide. Although several school-based programs aimed at preventing depression have been launched, it is crucial to evaluate these programs and to obtain feedback from participating adolescents. This study aimed to explore adolescents’ experiences with a School-based cognitive-behavioral depression prevention program. Methods: Eighty-nine adolescents aged 13–15 years were divided into 12 focus groups. The focus group interviews were analyzed using qualitative content analysis. Results: Three categories and eight subcategories were found to be related to the experience of the school-based program. The first category, intrapersonal strategies, consisted of the subcategories of directed thinking, improved self-confidence, stress management, and positive activities. The second category, interpersonal awareness, consisted of the subcategories of trusting the group and considering others. The third category, structural constraints, consisted of the subcategories of negative framing and emphasis on performance. Conclusions: The school-based mental health program was perceived as beneficial and meaningful on both individual and group levels, but students expressed a desire for a more health-promoting approach.

Background: Supporting positive mental health development in adolescents is an important school health concern, but there is a need to investigate the suitability of the interventions used.

Aim: The aim is to investigate the experiences of school health professionals in conducting a universal school-based programme aimed at preventing depressive symptoms in adolescents.

Methods: Twenty-two school health professionals participated in four focus groups. The interviews were analysed using qualitative content analysis.

Findings: The overall theme identified in the study consists of 'striking a balance between strictly following the manual and meeting the students' needs'. Three subthemes emerged: 'doing good and sowing seeds for the future', working with insufficient tools, and 'personal development as a professional and as an individual'.

Conclusions: School health professionals conducting the programme found it valuable in a school setting, but considered support from the school administration essential.

The aim of this cross-sectional study was to investigate the prevalence of overweight and obesity in children and adolescents (6-16 years), and relationships between being overweight and sleep, experiencing of fatigue, enjoyment of school, and time spent in watching television and in sitting at the computer. Trained school nurses measured the weight and height of 2891 children aged 6, 7, 10, 14, and 16, and distributed a questionnaire to them regarding television and computer habits, sleep, and enjoyment of school. Overweight, obesity included, was present in 16.1% of the study population. Relationships between lifestyle factors and overweight were studied using multivariate logistic regression analysis. Having a bedroom television and spending more than 2 h a day watching television were found to be associated with overweight (OR 1.26 and 1.55 respectively). No association was found between overweight and time spent at the computer, short sleep duration, enjoyment of school, tiredness at school, or difficulties in sleeping and waking up. It is recommended that the school health service discuss with pupils their media habits so as to promote their maintaining a healthy lifestyle.

Bakgrund: Att främja välmående och psykisk hälsa hos barn och ungdomar är en viktig uppgift för samhället. Psykisk ohälsa, t ex depression och ångest, innebär en försämrad livskvalitet som kan försvåra barnets kognitiva, sociala och känslomässiga funktioner. Att främja en positiv utveckling och förebygga barns och ungas psykiska ohälsa innebär både ett minskat individuellt lidande och minskade samhällskostnader. Förutsättningen är dock att förebyggande åtgärder är effektiva ur såväl hälsomässiga som ekonomiska perspektiv.

Syfte: Att utvärdera det skolbaserade programmet Disa som syftar till att förebygga depressiva symptom hos ungdomar.

Metod:

Studien, som har en kvasiexperimentell design, inkluderade pre-test, post-test och ett-års-uppföljning samt en illustrativ beräkning av interventionens implementeringskostnader. I studien deltog 62 elever i årskurs 8, samt 7 Disa-ledare.

Resultat: En majoritet av eleverna och samtliga ledare var nöjda med interventionen. Eleverna, både flickorna och pojkarna, skattade sina depressiva symtom signifikant lägre efter kursen, och för flickorna bestod denna effekt vid ett-års-uppföljningen. Implementeringskostnaderna för de första två åren var cirka 2000 kr per elev.

Slutsats: Positiva resultat av det skolbaserade programmet Disa påvisades, särskilt för flickor. Flera elever tyckte att de fått ett nytt sätt att tänka, och att stämningen förbättrades i klassen.  

Svar på frågan “Vad tyckte du om Disa-kursen?”

”Mycket bra! Bättre stämning i klassen efter det! Mysigt!” – Flicka

”Helt okej, märkte ingen skillnad efter. Mådde i och för sig inte dåligt innan heller.” – Flicka

”Den har varit bra, man har fått ett nytt sätt att tänka på.” – Flicka

”Intressant och gav perspektiv” – Pojke

”Tråkigt” - Pojke

”Bra att få tips hur man kan undvika negativa tankar snabbt!” – Pojke