Objective: The objective of this study was to from a gender perspective, explore elementary school teacher' experiences of their work situation, and identify conditions that could be health risks. Participants: Eighteen female teachers who work in an elementary school in Northern Sweden. Method: Thematic interviews were conducted using an interview guide. The interviews were tape-recorded and transcribed verbatim. Qualitative content analysis was used to analyse the transcribed text and interpretations were made within gender theory. Results: Four categories emerged: "Squeezed between dream and reality", "Effort to keep up with demands", "We can make it together" and "The school needs men's qualities". The categories were linked together with the theme "A struggle for time to teach". The theme describes the conflict between the teachers' ambitions to teach and create a stimulating learning environment versus the increased need for behaviour control that took time from classroom work. Beside work at the school, the teachers carried a large burden of domestic work.Conclusions: Teachers' work includes both endless demands and great joy. Their work is structured within the schools gender system in which caring duties are subordinated despite a growing demand for behaviour control. Traditional gender roles affect their domestic work load.

Aim: To analyse how health risk behaviours (HRB) are clustered and associated with parental background and family wealth among Swedish boys and girls.

Methods: Data were collected from Health Behaviour in School-aged Children (HBSC),a global cross-sectional survey for 1997/98, 2001/02, and 2005/06. A total of 11,972 boys and girls in grades 5, 7, and 9 participated in the study. The pupils were categorised in subgroups according to parental background: Swedish (80.0%), mixed (10.6%), and foreign (9.4%). Cluster analyses were used to identify HRB profiles. Multinomial logistic regression analysis was used to estimate associations between cluster allocation, parental background, and family affluence.

Results: In total 11,232 pupils were identified and allocated to five cluster profiles, half of them in the cluster profile of low-risk behaviour. The most disadvantaged cluster was multiple HRB, which was characterised by high prevalence of smoking, drunkenness, low physical activity, and high soft-drink consumption. The cluster profile of multiple HRB was associated with both mixed background and foreign background in girls and with mixed background in boys.. The cluster profile of inadequate tooth brushing was associated with foreign background in both boys and girls. The cluster profiles of multiple HRB and inadequate tooth brushing were associated with low family affluence in girls.

Conclusions: The cluster profiles of multiple HRB and inadequate tooth brushing were associated with parental foreign extraction in boys and girls and with low family affluence in girls. Prevention programmes based on identified clusters of HRB, including consideration of impact of socio-demographic indicators, are needed.

This study aimed to analyze how bullying involvement is associated with the distribution of parental background and with subjective health complaints (SHC) among Swedish boys and girls. Data were collected from the World Health Organization, Health Behavior in School-aged Children (WHO/HBSC) survey, measurement years 1997/1998, 2001/2002 and 2005/2006. A total of 11,972 boys (50.6 %) and girls (49.4 %) in grades five, seven and nine participated in the study. The adolescents were categorized in subgroups according to parental background: Swedish (80.1 %), mixed (10.5 %) and foreign(9.7 %). Multivariate logistic regressions were used to estimate remaining risk of SHC in the categories of bullying involvement. The frequencies of bullying involvement once or more were: none involved (74.8 %), victims (10.6 %), bullies (10.3 %) and bully/victims (4.4 %). Six out of ten involved in bullying were boys. Boys of foreign background were more involved as bullies compared to boys of mixed or Swedish background. Girls of foreign background were more involved in all three categories of bullying than girls of mixed or Swedish background. Increased risk of SHC was estimated among all adolescents involved in bullying, with highest OR in the category of bully/victims, OR 3.95 (CI 3.13–4.97) for the boys and OR 4.51 (CI 4.51–6.40) for the girls. The multivariate models were stable even after adjustment for socio-demographics. There are some associations between bullying involvement and parental background. Regardless of parental background, family affluence, family structure and gender, all adolescents involved in bullying are at increased risk of SHC.

Background: Negative impact on health from school disturbance due to asymmetric power relations such as discrimination and offensive treatment are frequent problems among students. This study sought to analyze associations between occurrence of discrimination at school, participation and psychosomatic problems. Methods: Pupils in grades 6–9 in ten schools in a northern Swedish municipality participated in the study. The frequency of discrimination at school was measured by six items: sex; culture or ethnicity; disability; religion beliefs; sexual preferences; and any other form of discrimination. The Social and Civic Objectives Scale (SCOS) was used for an estimation of the level of participation. The pupils’ health was measured by the PsychoSomatic Problem (PSP) scale. Multivariate logistic regression models were used for estimation of increased risk of PSP. The formula Z=d/s (d)was used to test mediation. Results: Two thirds of the boys and three fourths of the girls reported occurrences of discrimination at schools (p = 0.001). Discrimination was a mediating factor between participation and PSP among boys and girls as the mediating formula Z=d/s (d) was > + 2 SD, –2.59 for boys and –39.27 for girls. Independent of each other, low participation and discrimination were associated with increased risk of PSP. Conclusion: Discrimination was a mediating factor between participation and PSP. The mediating effectwas stronger in girls than in boys. There is a need for school health promotion programsfocusing on participation in terms of democratic processes, communication and cooperation in the classroom.

Objective: The general aim of this study was to explore the associations between foreign extraction and subjective health complaints (SHC) among school-aged children in Sweden. Methods: Data were obtained from the global cross-sectional survey Health Behaviour in School-aged Children (HBSC), 1997/1998, 2001/2002, and 2005/2006. A total of 11,972 pupils in grades 5, 7 and 9 participated in the survey. Logistic regression analyses were used to estimate remaining risk of SHC among the subgroups of pupils. The analyses were adjusted for socio-demographic indicators, grade and measurement year. Results: Parental background: Swedish n = 9,585, mixed n = 1,263, and foreign n = 1,124. The results showed an increased risk of SHC among girls with a foreign background OR 1.27 (95% CI 1.04-1.55) compared with girls with a Swedish background and among girls in single-adult households OR 1.42 (95% CI 1.20-1.67) compared with girls in two-adult households. No such differences were shown among boys. Conclusions: A significantly increased risk of ill health remained in girls of foreign background after adjustment for socio-demographic indicators, grade and measurement year. © 2011 Swiss School of Public Health.

Introduction: Violence in a broad sense among youth is common and there is some evidence that there are groups of youth who are victims of more than one form of violence. More knowledge is needed in terms of patterning of subgroups of poly-victimization. The aim was to explore if there are distinct subgroups of youth with particular patterns of violence victimization.

Method: Survey data from a Swedish sample (n = 1,569) of 14-16-year-olds were used (females 48.4%). Measures were physical violence, threat of physical violence, bullying, sexual harassment, and cyber bullying and harassment in the past six months as well as lifetime physical violence. Latent Class Analysis (LCA) was used to identify subgroups of youth with particular violence victimization patterns. Model fit assessment was based on model parsimony, theoretical justification and fit indices criteria (the Akaike information criterion and the Bayesian information criterion).

Result: A three-latent-class model was selected: 1. Poly-victims with high probabilities of being victimized by a multitude of different types of violence (girls 47.6%). 2. Overall low probabilities of violence victimization (girls 47.5%). 3. High probabilities of victimization of sexual harassment off- and online as well as bullying online (girls 65.6%).

Discussion: Three distinct subgroups of violence victimization in youth was evident in the data. There was a greater representation of girls in the purely sexualized violence sub-group. Further research and preventive programs should acknowledge that young people who are victims of one type of violence are likely also to be victims of other types of violence.

Abstract: The interdisciplinary research project “Challenging gender” was a joint effort by members of two Swedish universities. Researchers were grouped by five different themes, while together they became “the Arena”. The present authors’ theme focused on normalization processes, and included gender researchers from literary studies, sociology, social work, and public health studies. The purpose of this chapter is to explore what it is to challenge normalization processes as researchers; the context is interdisciplinary gender research under a neo-liberal regime. To deepen their understanding of what the process has occasioned, the researchers used “collective biography”, a memory-work method developed by Bronwyn Davies, who led the researchers’ work of writing down their memories prompted by experience of striations and of lines of flight. In this chapter the memories so produced are discussed in the light of Virginia Woolf’s A room of one’s own.  Thanks to the financial resources the project was able to muster, we were able to create the kind of collective “room” where we could take the opportunity to be creative and challenge structural patterns – but equally where we could give vent to our frustration at these same patterns. Our memories seemed to waver between fragile but uplifting flashes of optimism and a feeling that nothing would work, and not only just the one or the other – always somewhere in between. Our theoretical understanding of normality grew out of that most dangerous of ideas: that we should open our minds to the unpredictable, the non-normalizing, to whatever could be different

Innehåll: Flickors och pojkars ohälsomönster, Självrapporterad ohälsa, Skolan som arena för hälsa och ohälsa, Sexualiserat våld, Levnadsvanor och risktagande

There is a need for more knowledge about school as an agent for equity in health. The present study is a part of an action research project performed in a Swedish school (grade one to six) in a socially disadvantaged area. The point of departure was that young students have competences to define problems and priorities of changes in their school environment as well as being active participants in the changing process. All students participated in groups in a process of defining suggestions of health promoting changes in their school environment. The aim with the present study was to analyse obstacles for equity in health in a school health promotion project where the students have been active participants. Method: Single-sex focus group interviews (half with girls and half with boys) were conducted with students in two sets: eight interviews were performed directly after the group work at school was completed and another six interviews about a half year after the changing process had started. The students in the focus group interviews were recruited from all classes and ages at the school. The interviews were analyzed with a grounded theory approach. Results: The preliminary results showed that power relations within the group of boys, between the groups of boys and girls, and within the group of girls were obstacles for equity in health. Categories such as harassment, injustice, responsibility taking, homosociality and gender based violence have been developed.Conclusions: Young students can be active participants in the work for a healthy environment at school but the staff at school must consider the unequal power relations between the students and to work with the social climate in general to a higher degree to be successful in reducing inequity among young students.

This chapter focuses on the way in which organizations and legislation, despite their explicit intentions, nevertheless promote normative inequality, maintaining sexual harassment as an apparently inevitable part of schooling. Peer sexual harassment is found to be both frequent and pervasive in Swedish schools and is more or less expected as an everyday hassle that students have to handle. This chapter highlights the social and discursive pre-conditions that, despite laws and policies, let behaviours related to sexual harassment continue to take place at a high frequency. These behaviours function as an obstacle for change toward a safe school environment, which is free from discriminating behaviours. Drawing on previous research, this chapter shows the gap between manifest legislation and common practices at school. The method is interpretive and critical, in the sense that it is a sustained discussion of questions being raised by earlier studies. The following six aspects of the discursive normalization processes that collaborate to make sexual harassment a common and concealed phenomenon in Swedish schools are: 1) Not including genderbased violence as a specific domain in the national public health policy; 2) Sexual harassment being invisible in school surveys; 3) Sexual harassment being invisible in anti-bullying programmes; 4) Ignorance of power and gender perspectives in schools; 5) The normalization of asymmetric power relations as a hindrance to victims speaking up and taking action; and 6) Lack of a common understanding and definition of sexual harassment.

The aim of this study was to enhance the understanding of young girls' experiences of peer sexual harassment in elementary school and of normalizing processes of school-related sexualized violence. Six focus group interviews with girls in Grade 1 through 6 were carried out in an elementary school in the northern part of Sweden. A content analyses showed that young girls experienced verbal, nonverbal, and sexual assault behaviors at school. Sexual harassment as a concealed phenomenon and manifest within a romantic discourse were themes found in the analysis. A conclusion is that schools have to acknowledge behaviors related to sexual harassment as a potential problem even in young ages and develop methods to approach the subject also for this age group.

Förord

Den här rapporten är en delrapport inom projektet Ungas Hälsosamma Utveckling. Det

är ett treårigt projekt som finansieras av Folkhälsoinstitutet 2009-2011. Regeringen

uppmärksammade att barns och ungdomars psykiska hälsa har försämrats under de

senaste decennierna och gav Statens folkhälsoinstitut i uppdrag att fördela 50 miljoner

kronor till sex kommuner för att utveckla det lokala sektorsövergripande hälsofrämjande

arbetet för barn och ungdomar

1. Östersunds kommun är en av dessa kommuner

som har fått projektmedel för att öka kunskaperna om hur vi ska kunna främja barns

och ungdomars psykiska hälsa.

Rapporten bygger på data från den enkätstudie som delades ut till alla elever i årskurs

6-9 i Östersunds kommunala skolor och en friskola i januari 2011.

Vi presenterar data för alla skolor sammantaget, men de som vill veta mer om hur det

ser ut på den enskilda skolan kan kontakta Björn Wickström på barn- och utbildningsförvaltningen,

Östersunds kommun, för mer information.

Enkätstudien är longitudinell, dvs. vi delar ut enkäten till samma elever under tre år.

Det betyder att vi kan göra analyser och dra slutsatser om samband på ett annat sätt

än som är möjligt i tvärsnittsstudier.

En av de viktigaste saker för att kunna göra vetenskapliga studier av enkäter är att

svarsfrekvensen är tillräckligt hög. Tack vare skolornas engagemang, både bland

personalen och bland eleverna, har vi tillräckligt många svarande för att kunna göra

statistiska analyser. Men trots en relativt hög svarsfrekvens totalt var det några

enskilda skolor där den inte var tillräckligt hög för att göra enskilda återkopplingar.

Vi återkommer med ytterligare en enkät i januari 2012 och hoppas då på ett gott

samarbete och en tillräckligt hög svarsfrekvens på samtliga skolor.

I arbetsgruppen har också folkhälsosamordnare Sofie Bergman och verksamhetscontroller

Göran Qvarnström från kommunledningsförvaltningen ingått. Vi som

har genomfört studien tackar så mycket för visat intresse och hoppas att ni ska

kunna få nytta av resultaten i ert fortsatta arbete.

Det här är en rapport med några av resultaten från en enkät om

skolelevers arbetsmiljö och hälsa. Enkäten delades ut till elever i

tio skolor i klass 6-9 i Östersunds kommun i slutet av HT 2009

och i början av VT 2010. Frågorna handlar t ex om hur eleverna

mår, inflytande i skolan, krav, stöd från lärare, kamratrelationer,

trakasserier och levnadsvanor. Alla frågorna som ställdes redovisas

inte i den här rapporten, men alla skolor i kommunen erbjuds

möjligheten att ta del av resultaten från flera frågor. De har också

möjlighet att få resultaten från den egna skolan.

Rapporten vänder sig i första hand till alla elever som deltog i studien,

men även till föräldrar, skolpersonal och andra intresserade.

Vi som har gjort studien arbetar i ett projekt som heter Ungas

Hälsosamma Utveckling. Det är ett treårigt projekt (2009-2011)

som finansieras av regeringen och som syftar till att öka kunskapen

om barns och ungdomars psykisk hälsa och välbefinnande.

Vi hoppas att rapporten ska kunna bli en del i skolans arbete

för en hälsofrämjande arbetsmiljö.

INTRODUCTION

Violence against girls and women is a global problem, not only for the victim herself, but also for society in general (Garcia-Moreno, 2002). In the case of women with children, violence is also a problem for these children. A multi-country study on violence against women in 15 sites and 10 different countries, mainly low-income, shows that there are wide variations in prevalence between and among settings (World Health Organization, 2005). The differences were not only between countries but also between rural and urban areas within a country, with overall levels of violence against women consistently higher in rural than in urban settings. This means that we need to take space and place into account in studies of violence against girls and women. To date, the links between place and sexual violence against girls and women is an understudied area. Indeed, as Sandberg (2013) notes, the study of intimate partner violence and other forms of sexual violence in rural settings, in particular, may in fact be a blind spot in intersectional research.She calls fora consideration of how place may intersect with such constructs as class, ethnicity, race, gender, and sexuality. To this list we would add age, with the idea that addressing violence against girls and young women is a particularly critical concern in relation to ensuring safety and security for a new generation. The urban condition and life in the city as studied in relation to migration, housing, social supports, and violence itself (including sexual violence) is typically taken up in research that ranges from a focus on townships and informal settlements in the Global South through to thestudy of urban sites in the Global North. However, while the trend for people to live in urban spaces is increasing, this does not mean that there are no social issues that need to be addressed in rural settings; in the context of declining resources and state provisioning, rural life presents its own challenges. There is also a discursive construction of the rural areas that is characterized by higher rates of sick leave, higher unemployment, and the migration of young people away from the area. Added to this is the perception that rurality does not contribute to the economic development of the country (Nyhlén, 2013, Eriksson, 2008). This way of describing the rural can be regarded as an act of othering in that it positions rurality as the other in relation to the urban/center. In this way center and periphery are somehow interdependently constructed. Urbanization itself is built on the premise that resources are taken from the periphery and used in the center (Andersson, Ek & Molina 2008).We stress the importance of asking questions about what it means to study rurality and about how we can create research that goes beyond images of a declining rurality, not forgetting in this process, to ask questions about how rurality is gendered. The purpose, then, of this chapter is to address the necessity of understanding violence against young girls and women by theorizing the relationships between and among place, gender, and violence, particularly in relation to rurality. We do this by first contextualizing our arguments, focusing on three country contexts—Canada, South Africa, and Sweden. We then address three particularly important areas: (1) place-based gender and ethnic regimes, (2) rural vulnerabilities, and (3) local policy enactment.

Although the prevention of unfavourable health behaviour among young people has high priority in public health, the possibility of finding risk factors at school has not been sufficiently studied. The objective of this study was to find predictors among young pupils for later unfavourable health behaviour, with special focus on school-related factors.A three-year prospective study was started in 1994 including 279 pupils (141 girls and 138 boys) from different socioeconomic areas. The pupils answered a comprehensive questionnaire in grade six and grade nine. The non-response rate was negligible. The best predictors for health behaviour among boys and girls in grade nine were factors related to earlier health/health behaviour. The results also indicated that school-related factors could predict future health behaviour, especially in relation to low physical activity among girls.The school has an important role to play in identification of future unfavourable health behaviour among pupils at the school, both directly through recognising school-related risk factors and also indirectly through paying special attention to pupils with unfavourable health/health behaviour. Our findings indicate the need for more research in younger ages, as negative health behaviour already seems to be established at 12 y of age.

Background: It is a recurrent finding that adolescent girls report psychological symptoms in a higher degree compared with boys. The explanations for this difference vary, but the psychosocial school environment has never been a focus in these explanations. The aim of this study was to analyse whether psychosocial factors at school were associated with a high degree of psychological symptoms among boys and girls in grade nine, with a special focus on sexual harassment. Methods: The study was based on a cross-sectional study including 336 pupils (175 girls and 161 boys) in grade nine (about 15 years old), who answered an extensive questionnaire. The non-response rate was negligible (<1%). Logistic regression analysis was used to analyse whether school-related factors (teacher support, classmate support, sexual harassment), body image, and parental support were associated with a high degree of psychological symptoms. Results: Sexual harassment at school was associated with a high degree of psychological symptoms among girls. Conclusions: Sexual harassment must be acknowledged as a negative psychosocial school environmental factor of importance for the high degree of psychological ill-health symptoms among girls compared with boys.

Aims: This study analysed the effects of psychosocial factors at school on pupils' health and self-worth from a longitudinal perspective. Methods: A three-year prospective study was started in 1994, including 533 pupils (261 girls, 272 boys) from 25 different classes in grades 3 and 6. With age-adjusted questionnaires the changes in self-perceived health were compared with changes in psychosocial school environmental factors. Results: The girls in the older cohort reported a negative health development with decreased self-worth and increased somatic and psychological symptoms. Significant gender differences in ill health, but not in self-worth, developed, especially in the older cohort. A multiple regression analysis showed that a negative development of psychosocial factors at school, measured as control, demand, and classmate problems, was associated with poorer health and self-worth among the pupils. A trichotomization of the psychosocial variables at school indicated a possible causal relationship between psychosocial factors and ill health and self-worth. Conclusions: The negative development in pupils' health and self-worth could partly be explained by the more unfavourable psychosocial environment that prevails at school at the senior level. The public health implications of our study can be summarized as the need for schools to improve pupils' social situation at school in relation to their work situation as well as to pay special attention to the school situation of girls at senior level.

Sexual harassment has become so frequent and ubiquitous in schools that these behaviours have become normalised and expected. In order to prevent the re-enactment and perpetuation of this problem, it is important to explore processes that contribute to its existence. A high school sexual harassment lawsuit in Sweden is used as a case study to illustrate ways that might explain how sexual harassment is normalised at the organisational level. A thematic analysis has been used to identify themes and subthemes. The results show a multi-layered web of factors and practices related to sexual harassment at the organisational level in the school. In order to change a school’s culture from one where sexual harassment is normalised, multiple needs must be addressed: organisational weaknesses must be strengthened; adults enact their responsibility to change the situation; and awareness of the relationship between sexual harassment, gender, and power needs to be increased.

There is a contradictory picture of Swedish girls; they are talked about as academically successful and winner at the labor market, but at the same time stressed out, have low self-esteem and high as well as increasing mental health problems. The discourse as well as the gender equality politics are (Everyone sort of know) that Sweden is a gender equal society where women and men can both work and have children, take part in society and where there is (supposed to be) freedom from men’s violence against women. This is true for some girls and women, but to fully understand the challenges and possibilities to work for a gender equal society we have to add an intersectional perspective, including several different power orders. This study will focus on high school girls in a vocational program (proxy for working class) who are invited to participate because of their lack of academic success, low self-esteem and lack of belief in the future. They are participants in a photovoice study aiming at wellbeing, academic success, safety and a positive view of the future. Their suggestions for change will guide an analysis of the high school’s role in creating a gender equality supportive environment in line with the Swedish gender equality discourse.

A school health promotion project was carried out in an elementary school in Sweden where active participation, gender equality, and empowerment were leading principles. The objective of the study was to understand challenges and to identify social processes of importance for such a project. Focus group interviews were conducted with 6 single-sex groups (7–12 year olds) in grade 1–2, grade 3–4, and grade 5–6 on 2 occasions. The analysis used a grounded theory approach. The analysis identified the core category “normalization processes of violence and harassment.” It is argued that school health promotion initiatives need to be aware of normalization processes of violence and, which may be counter-productive to the increase of empowerment and participation among all pupils.

Objectives. The aim was to analyse if young students could be substantive participants in a healthpromoting 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.

The authors analyze the association between psychosocial factors in the school environment and pupils' health and self-worth in a sample of 538 pupils (264 girls and 274 boys) in the third and the sixth grades. High control in combination with low demand at school was associated with the best health status in relation to somatic problems, stress, tiredness, and feelings of self-worth. In a multiple regression analysis, problems in relations with classmates were the most recurrent psychosocial factor associated with ill-health. Some gender differences were found in school-related health. Lack of control at school affected self-worth among girls only. In the third grade and among boys in the sixth grade, high demands were an explanatory factor for the health outcome. Foreign background, divorced parents, high achievement, and low relational orientation, as well as disorderly and rowdy classes, were also of importance for somatic ill-health and stress among girls. Older girls became more relationally oriented, while boys became more achievement-oriented. The authors conclude that the pupils' somatic health and self-worth were affected by psychosocial factors at school, even when adjustment was made for social background.

The aim of this qualitative study was to analyse gendered strategies among pupils in the negotiation of power at school, and to discuss possible implications for health. Twenty-seven single-sex focus group interviews were conducted with pupils from equal opportunity projects The interviews were analysed using grounded theory. The girls used 'alliance building' and 'resistance: in order to increase their power, while 'responsibility taking' and 'withdrawal' could mean maintained subordination. The boys used mastering techniques (various types of abuse, claiming to be the norm, acting-out behaviour, blaming the girls, choosing boys only) in self-interest to maintain their dominance. The girls' active and democratic actions far increased power could be of significant importance for their health. The boys' health would benefit if they gave up striving for power over others School health promotion needs to address the asymmetric and gendered distribution of power between pupils, as well as to challenge the existing gender regime at an institutional level.

Background: The objective of this study was to analyze how involvement in paid and unpaid work and perceived labor-related stress are re- lated to the well-being of married or cohabiting men and women in Europe. Methods: Data from the European Social Survey round two has been used. The sample consists of 5800 women and 6952 men, aged between 18 - 65 years. Exposure variables were divided into labor involvement, time spent on paid and unpaid work, and la- bor-related stress. Multiple logistic regressions with 95 % confidence interval were used. Re- sults: Women spent more hours on housework than men did, but fewer hours on paid work. Women tended to perceive higher degrees of housework-related stress than men did. Fur- thermore, women who experienced housework- related stress tended to have higher odds of reporting a low level of perceived well-being than men, while men had higher odds of report- ing a low level of perceived well-being when they experienced work/family conflicts. Conclu- sion: For both men and women, the perceptions of labor involvement are of more importance for the well-being than the actual time spent on paid and unpaid work. This implies that, when study- ing the relationship between labor involvement and well-being, perceived stress should be con- sidered.

This study analysed whether gender context is important to differences in therelationship between work–family conflict (WFC) and well-being across Europe. Wehypothesised that in countries that support equality in work life and where norms supportwomen’s employment, the relationship between WFC and low well-being is weaker than incountries with less support for gender equality. Cohabiting men and women aged18–65 years from 25 European countries were selected from the European Social Survey.A multilevel analysis was conducted to investigate the relationship between well-being andWFC, and two measurements were used to represent gender context: gender equality inwork life and norms regarding women’s employment. Contrary to the hypothesis, theresults showed that the negative relationship was stronger in countries with high levels ofgender equality in work life and support for women’s employment than in countries with arelatively low level of gender equality in work life and support for traditional genderrelations. The context in which gender is constructed may be important when studying therelationship between WFC and well-being. In addition, emphasis should be placed onpolicies that equalise both the labour market and the work performed at home.

States play an important role in gender equality through policy structuring. In this case study, the aim is to explore whether changes in parental leave policies over two decades trickle down to changes in gendered time use in two polarised countries: Sweden and Spain, represented by the Basque Country. Sweden represents dual-earner countries with high relative gender equality, whereas Spain represents a south European policy model supporting a breadwinning/homemaker ideal. The results show that changes in the gendered time use among mothers and fathers in both countries are associated with changes in parental leave policies. Changes in policies directed towards increasing gender equality reduce the gender gap in time use among mothers and fathers and seem to increase gender equality within a country. From these results, the conclusion is that parental leave policies that are structured to promote or enable gender equality could reduce the gender time gap in work among mothers and fathers.

Background Shift work has been associated with an increased risk of cardiovascular disease (CVD). However, there is a need for more studies to determine whether there is an interaction between shift work and other risk factors of CVD, thereby increasing the risk of CVD in shift workers. Aims To discern whether shift work and parental mortality from myocardial infarction (MI) or sudden cardiac death (SCD) interact to increase the risk of MI in men. Methods A case-control dataset was used to assess interaction between shift work and parental history of CVD, using death from MI or SCD, or death before age 65, on an additive scale. Results were reported as relative excess risk due to interaction, attributable proportion due to interaction (AP) and synergy index (SI). Results There was an interaction between shift work and paternal mortality from MI or SCD, when both factors were present [SI = 2.39; 95% confidence interval (CI) 1.02. 5.6 and AP = 0.4; 95% CI 0.08. 0.73]. Conclusions Paternal mortality from MI or SCD interacts with shift work to increase the risk of MI in men.

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.

Purpose: Shift work has been associated with an excess risk of cardiovascular disease (CVD) and more specifically myocardial infarction (MI). The majority of the studies that found a positive association between shift work and CVD have been based on incidence data. The results from studies on cardiovascular-related mortality among shift workers have shown little or no elevated mortality associated with shift work. None of the previous studies have analysed short-term mortality (case fatality) after MI. Therefore, we investigated whether shift work is associated with increased case fatality after MI compared with day workers.Methods: Data on incident cases with first MI were obtained from case–control study conducted in two geographical sites in Sweden (Stockholm Heart Epidemiology Program and Västernorrland Heart Epidemiology Program), including 1,542 cases (1,147 men and 395 women) of MI with complete working time information and 65 years or younger. Case fatality was defined as death within 28 days of onset of MI. Risk estimates were calculated using logistic regression.Results: The crude odds ratios for case fatality among male shift workers were 1.63 [95 % confidence interval (CI) 1.12, 2.38] and 0.56 (95 % CI 0.26, 1.18) for female shift workers compared with day workers. Adjustments for established cardiovascular risk factors such as diabetes type II and socio-economic status did not alter the results.Conclusion: Shift work was associated with increased risk of case fatality among male shift workers after the first MI.

OBJECTIVES: This study analyzed the potential association between shift work and ischemic stroke. METHODS: The analysis was carried out using a nested case-control study consisting of 138 shift workers and 469 day workers from the register of the Northern Sweden Monitoring of Trends and Determinants in Cardiovascular Diseases (MONICA) study and the Vasterbotten Intervention Programme. Logistic regression analysis was used to analyze the risk estimate for day workers in a comparison with shift workers and the risk of ischemic stroke. RESULTS: The crude odds ratio for shift workers' risk of experiencing an ischemic stroke was 1.0 (95% confidence interval 0.6-1.8) for both the men and the women. The risk estimates were consistent despite the introduction of several recognized risk factors for ischemic stroke in the logistic regression models. CONCLUSIONS: In the present study, none of the findings indicated a higher risk of shift workers undergoing an ischemic stroke than day workers.