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Background: Social-emotional development is an important part of early childhood development and appears to have a socioeconomic gradient. Going beyond conventional approaches, this study aimed to examine intersectional inequalities in social-emotional problems in three-year-old children in relation to their parents’ income, education and place of birth and to consider the implications for public health.

Methods: A cross-sectional design was used in this population-based study in Västerbotten County of Sweden with an effective sample of 8,823 children. Social-emotional problems were assessed using the parent/caregiver-report Ages and Stages Questionnaires: Social-Emotional (ASQ: SE) 36-month interval in Child Health Services over the years of 2014–2018 and linked to parents’ sociodemographic characteristics obtained from national population registers. An analysis of individual heterogeneity and discriminatory accuracy (AIHDA) approach was combined with additive binomial regression, estimating risk differences for social-emotional problems across 27 intersectional categories.

Results: In the intersectional categories where multiple dimensions of social disadvantage overlapped, average risk differences generally increased. For instance, when comparing with the most advantaged category a risk difference as high as 25.4% (95% CI 13.7 to 37.0%) was found for the children whose parents’ income was in the lowest tercile, only one parent had a higher educational level and whose parents were both born outside of Sweden. Discriminatory accuracy was estimated as moderate for the three included regression models, although it improved slightly for the model including dimensions of social disadvantage. The addition of intersectional categories provided no further significant improvement.

Conclusions: The intersectional approach used in this study improves our understanding of complex social inequalities in social-emotional problems in preschool children in northern Sweden. Consistent with the concept of proportionate universalism, the results of this study indicate that universal public health policies are needed when addressing this issue in addition to policies targeting disadvantaged groups. Research that considers individual heterogeneity and discriminatory accuracy has the potential to advance our knowledge of health inequities and increase the effectiveness of public health policy.

Aim: The aim of this work was to investigate whether leadership, person-centred care and social interactions are associated with residents' health, including cognitive impairment, neuropsychiatric symptoms, activities of daily living and health-related quality of life, and to assess whether these relationships change over a period of 5 years.

Design: A repeated cross-sectional survey study was carried out in 2014 and 2019. Valid and reliable scales were used to assess leadership, person-centred care, neuropsychiatric symptoms, cognition, activities of daily living and health-related quality of life. The study involved care units participating in both surveys (n = 182). At T1, there were 1587 residents and 1239 staff. At T2, there were 1382 residents and 1169 staff. Regression analyses were used. Interaction analyses explored changes over time, emphasising leadership and PCC as the main explanatory variables.

Results: Stability was observed over time for person-centred care in relation to health-related quality of life, neuropsychiatric symptoms, activities of daily living function and cognitive function. Person-centred care was associated with a higher level of health-related quality of life and cognitive function, and a lower level of neuropsychiatric symptoms. Leadership showed no significant association with the outcomes.

Patient or Public Contribution: Residents did not actively participate in the study, as data was obtained by proxy rating. No public was involved in the design, data collection, or dissemination plans of this study.

Sexual violence (SV) is pervasive on university campuses worldwide, with alarmingly high reported rates in sub-Saharan Africa (SSA). Despite the high reported rates of SV victimization on campuses, existing evidence has not been critically synthesized to give a comprehensive picture of the problem’s extent, common forms, risk factors, and (knowledge about) victims and perpetrators in SSA countries. We aimed to map the existing literature on SV prevalence, types, risk factors, victims, perpetrators, and consequences among university students on campuses in SSA. We included articles focusing on university students from SSA countries published in English or French language from 2014 to 2023. We identified 543 records from nine databases; Academic Search Premier; CINAHL; EMBASE; MEDLINE; PsychINFO; PubMed; Scopus; SocINDEX; and Web of Science, 82 of which met our inclusion criteria. Retrieved articles covered only one-third of the sub-Saharan region, mostly focusing on female students and victims. Prevalence of different forms of SV varied among countries; authors attributed these variations to differences in time frame, forms of SV, how they were defined, and the tools used. Young female students were identified as common victims, while male teachers and students were common perpetrators. We used the socio-ecological model to summarize risk and protective factors associated with SV victimization and listed the health, social, and economic consequences of SV victimization. Despite these consequences, victims rarely seek help, whether from informal sources or authorities. We call for comprehensive studies in SSA that include both genders and focusing on victims and perpetrators, and address service access barriers.

Introduction: Despite the increasing use of distributed healthcare teams, performance evaluation is largely lacking. This study examined rural emergency health care in Sweden to determine the effect of teams being either co-located or distributed with remote physicians accessible via telemedicine.

Method: In this crossover study, 17 three-person teams were video recorded during co-located and distributed simulated scenarios. Team performance in the video recordings was evaluated using the TEAM instrument.

Results: Co-located scenarios had significantly higher Total ratings for the instrument (items 1–11), in the teamwork domain (items 3–9), and in overall performance (item 12) compared with distributed scenarios (P < 0.005). Item-level analysis revealed that co-located teams were better at completing tasks on time (item 4) and showed greater adaptability to changing situations (item 7).

Conclusions: The higher rating of the performance of co-located teams underscores the challenges facing distributed teams. Given that distributed healthcare teams are a reality in rural areas in northern Sweden, education and training must be adapted to address these challenges. This adaptation is crucial for ensuring high-quality patient care by distributed teams.

Background: Obesity is a global public health issue with increasing prevalence and notable differences across population. Previous studies on body mass index (BMI) trends and inequalities have focused on overweight/obesity prevalence or average BMI changes, overlooking differences across the BMI distribution. This study investigates whether changes in BMI distribution are uniform or different over time and educational attainment.

Methods: This study is based on repeated cross-sectional surveys in Västerbotten, Sweden. Study participants were expectant parents visiting antenatal care (2010–2019) as part of the Salut Programme. During early pregnancy, 18,215 women and 17,890 male partners completed questionnaires. Quantile regression analyses were conducted to assess BMI distribution changes over time and by education for men and women.

Results: The BMI distribution for women showed a sharper increase in the upper tail in 2018/19 compared to 2010/11, whereas for men, the upper tail showed a gradual rise over years. Similar changes in BMI distributions were observed over time across both educational groups, with a notable increase in the higher BMI segments.

Conclusion: The study revealed weight gain inequalities, with higher BMI segments experiencing a disproportionately higher rise compared to others. Identifying high-risk groups in vulnerable settings will better equip decision-makers to design and implement targeted intervention strategies to reduce overweight and obesity.

BACKGROUND: Family interactions, which are always multi-faceted, are complicated further by family members with disabilities. In resource-poor settings, policies and programmes that address the needs of and challenges faced by families are often inaccessible or unavailable. Approximately 13% of the families in Tanzania have at least one member with a disability, yet family-centred research on caring for disabled children and adolescents is scarce in this context.

OBJECTIVE: The aim is to explore the needs and challenges faced by families that care for children and adolescents with physical disabilities in the Kilimanjaro Region of north-eastern Tanzania.

METHODS: This qualitative study had a constructivist grounded-theory design. In-depth interviews, using a semi-structured interview guide based on the social-capital framework, were conducted with 12 female participants aged between 24 and 80. A conceptual model of family needs, inspired by Maslow's hierarchy of needs, informed the analysis.

RESULTS: Challenging needs were grouped into five categories, which were linked to Maslow's hierarchy of needs and related to the central concept of 'adaptive adjustment': (1) 'barely surviving'; (2) 'safety needs in jeopardy'; (3) 'sociocultural protection'; (4) 'self-esteem far beyond reach', and (5) 'dreaming of self-actualisation'.

CONCLUSION: Families caring for children and adolescents with physical disabilities in north-eastern Tanzania have needs that extend beyond the available and accessible resources. Families can adjust and adapt by avoiding certain situations, accepting the reality of their circumstances and exploring alternative ways of coping. A sustainable support system, including social networks, is essential for meeting basic needs and ensuring safety.

Objectives: Chronic pain is highly prevalent in nursing home residents and often occurs with depression as well as cognitive impairment, which can severely influence and limit the expression of pain.

Methods: The present cross-sectional study aimed to estimate the prevalence of pain, depressive mood, and cognitive impairment in association with pharmacological treatment against pain and depressive symptoms among Swedish nursing home residents.

Results: We found an overall pain prevalence of 52.8%, a prevalence of 63.1% for being in a depressive mood, and a prevalence of cognitive impairment of 68.3%. Among individuals assessed to have depressive mood, 60.5% were also assessed to have pain. The prevalence of pharmacological treatment for pain was 77.5 and 54.1% for antidepressants. Prescription of pharmacological treatment against pain was associated with reports of currently having pain, and paracetamol was the most prescribed drug. A higher cognitive function was associated with more filled prescriptions of drugs for neuropathic pain, paracetamol, and nonsteroidal anti-inflammatory drugs (NSAIDs), which could indicate an undertreatment of pain in those cognitively impaired.

Conclusion: It is important to further explore the relationship between pain, depressive mood, and cognitive impairment in regard to pain management in nursing home residents.

Introduction: Caring for physically disabled children, particularly in contexts where resources are often insufficient or absent, exposes primary carers to significant psychological strain. The lack of structured mechanisms to address this psychological burden poses a considerable threat to the wellbeing of both carers and the children with disabilities under their care. However, research on the psychological wellbeing of carers in Tanzania is scarce. This study aimed to evaluate the psychological wellbeing and symptoms of anxiety and depression, along with associated factors, of carers of children, and adolescents with physical disabilities in the Kilimanjaro region.

Methods: A cross-sectional survey was conducted from November 2020 to June 2021 in the Kilimanjaro region, involving 212 carers. The Swahili versions of the WHO-5 Wellbeing Index and Hopkins Symptoms Check List-25 were used to assess psychological wellbeing and symptoms of anxiety and depression. Data were analysed using IBM SPSS Statistics V.28. Multivariable linear and binary logistic regression were used to assess the associations.

Results: More than four fifths (81%) of the carers were parents, and most of these parents were mothers (92%). Of the 212 carers, more than half (51%) exhibited poor psychological wellbeing, 42% had symptoms of anxiety, and 38% symptoms of depression. Notably, poor psychological wellbeing was significantly associated with symptoms of anxiety and depression. Results of a multivariable regression analysis indicated that extended family support was associated with better psychological wellbeing and lower odds of symptoms of anxiety and depression. A higher estimated monthly income was associated with better psychological wellbeing, and lower odds of symptoms of depression. Access to rehabilitation for the child was associated with improved psychological wellbeing and decreased likelihood of symptoms of anxiety.

Conclusion: Many carers of children, and adolescents with physical disabilities in Tanzania are at high risk of having poor psychological wellbeing, and symptoms of anxiety and depression. Support from extended-family networks is crucial in promoting good psychological wellbeing. The government in Tanzania should improve rehabilitation services, especially in disadvantaged rural areas, and integrate mental-health screening for carers in both rehabilitation programmes and primary healthcare.

INTRODUCTION: Sexual violence (SV) is highly prevalent among university campuses across the globe, despite of several initiatives implemented to address it. Several studies have been published focusing on various aspects of SV on campuses. However, no review has been retrieved from the Joanna Briggs Institute (JBI) Database, Cochrane Library or Ovid examining evidence synthesis on prevalence, risk factors, victims and perpetrators, policies, laws and universities responses to SV in sub-Saharan Africa (SSA). This review aims to map the existing literature on SV victimisation among university students in SSA, related response strategies, and identify gaps in the evidence.

METHODS AND ANALYSIS: This review will follow JBI guidelines and will be conducted from 1 July 2023 to 31 December 2023. A team of five reviewers will screen eligible documents and articles for relevance from various data sources including electronic databases such as MEDLINE, EMBASE, PsycINFO, CINAHL, Google Scholar, PubMed and websites for government and agencies. Standard information for each study will be collected and a common analytical framework for all the primary documents will be conducted.

ETHICS AND DISSEMINATION: This review will involve analysis of published data only and therefore does not require ethics approval. The results will be published in a peer-reviewed journal.

REGISTRATION: This review has been registered with the Open Science Framework.

Background: Trends in overweight and obesity among expectant parents can provide useful information about the family environment in which children will grow up and about possible social inequalities that may be passed on to them. Therefore, we aimed to assess whether the prevalence of underweight, overweight and obesity changed over time in pre-pregnant women and their male partners in northern Sweden, and if there were any educational inequalities.

Methods: This study is based on cross-sectional data from a repeated survey of the population in Västerbotten, Sweden. The study population included 18,568 pregnant women and 18,110 male partners during the period 2010–2019. Multinomial logistic regression models were fitted separately for pregnant women and male partners to assess whether the prevalence of age-adjusted underweight, normal weight, overweight and obesity had evolved between 2010 and 2019, and whether trends differed by educational level.

Results: Among women, obesity prevalence increased from 9.4% in 2010 to 11.7% in 2019. Among men, it went from 8.9 to 12.8%. Educational inequalities were sustained across the study period. In 2019, the prevalence of obesity was 7.8 percentage points (pp) (CI = 4.4–11.3) higher among women with low compared to high education. The corresponding figure for men was 6.4 pp (CI = 3.3–9.6).

Conclusions: It is not obvious that the prevalence of obesity among parents-to-be will decrease under current dispositions. Public health policies and practice should therefore be strengthened.