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Background: OECD countries over the past two decades have implemented a range of labour market integration initiatives to improve the employment chances of disabled and chronically ill individuals. This article presents a systematic review and evidence synthesis on effectiveness of government interventions to influence employers’ employment practices concerning disabled and chronically ill individuals in five OECD countries. A separate paper reports on interventions to influence the behaviour of employees. Methods: Electronic and grey literature searches to identify all empirical studies reporting employment effects and/or process evaluations of government policies aimed at changing the behaviour of employers conducted between 1990 and 2008 from Canada, Denmark, Norway, Sweden and the UK. Results: Few studies provided robust evaluations of the programmes or their differential effects and selection of participants into programmes may distort the findings of even controlled studies. A population-level effect of legislation to combat discrimination by employers could not be detected. Workplace adjustments had positive impacts on employment, but low uptake. Financial incentives such as wage subsidies can work if they are sufficiently generous. Involving employers in return-to-work planning can reduce subsequent sick leave and be appreciated by employees, but this policy has not been taken up with the level of intensity that is likely to make a difference. Some interventions favour the more advantaged disabled people and those closer to the labour market. Conclusions: Future evaluations need to pay more attention to differential impact of interventions, degree of take-up, non-stigmatizing implementation and wider policy context in each country. [ABSTRACT FROM AUTHOR]

Background The aim of the present study was to compare the cross-sectional association between smoking and depressive symptoms among adolescents between Sweden and Italy, two countries historically characterized by different norms about tobacco use and different tobacco control efforts. Methods A cross-sectional study including 3283 adolescents 15–16 years of age participating in the Swedish KUPOL study and 1947 same-age adolescents from the Italian BE-TEEN study. Current smoking was defined as any smoking in the past 30 days. Depressive symptoms were assessed using the Centre for Epidemiological Studies Depression Scale for Children (CES-DC) and the internalizing score of the Strengths and Difficulties Questionnaire (SDQ). Country differences were explored in stratified and interaction analyses. Results Current smoking was associated with a 2- to 3-fold increased odds of depressive symptoms among Swedish adolescents using both CES-DC and SDQ internalizing scale. Among Italian adolescents, slightly lower increased odds of 1.5–2.5 for depressive symptoms with smoking were found using the CES-DC but not the SDQ scale. Both multiplicative and additive interactions for country were significant. The association between smoking and depressive symptoms was weaker among Italian compared with Swedish adolescents for both scores. Conclusions Countries with different tobacco norms and control show different associations between smoking and depressive symptoms in adolescence, probably due to different psychosocial profiles of smokers. These findings need to be considered when planning tobacco prevention programmes, e.g. by focusing on early detection of mental health distress among adolescents in settings with declining smoking prevalence and restrictive tobacco control environments. [ABSTRACT FROM AUTHOR]

Background The number of seriously injured unprotected road users has increased during implementation of a road safety policy Vision Zero. The aim of the study is to identify factors associated with the increase in serious injuries among cyclists and pedestrians (even single pedestrian accidents) that occurred in an urban road space in a Swedish region 2003–17. The urban road space includes roads, pavements and tracks for walking and cycling. Methods Data were retrieved from STRADA (Swedish Traffic Accident Data Acquisition) and NVDB (National Road Database). Descriptive statistics and logistic regression with odds ratios for sex, age and part of road space were assessed. Results The number of seriously injured cyclists and pedestrians more than doubled from 2003 to 2017, with the greatest increase for pedestrians. Older age increased the probability of serious injury since 2012 for the group ≥ 80 years and since 2015 for the group 65–79 years. No significant effect of sex. Most injuries occur in areas not transformed by Vision Zero. Conclusions An increasing number of elderly persons in the generation born in the 1940s and increased life expectancy are important factors. There is a need to increase road safety measures that also promote active mobility. [ABSTRACT FROM AUTHOR]

Background: Sweden provides a free school lunch to every child in the compulsory (9-year) school system. It consists of a hot meal, a salad buffet, bread and a beverage. The Education Act states it must be free of charge (since 1997) and ‘nutritious' (since 2011). No standards/limits are specified but voluntary guidelines for serving of the school meal exist. We describe how school meal quality has changed since 2011. Methods: A random sample of schools were contacted in spring 2011 and invited to use a novel web-based instrument to evaluate school meal quality. In spring 2013, the participating schools (N= 191) were encouraged to use it again and 97 did. The outcomes were measures of quality including food provision/choice, adherence to serving guidelines and, using validated food-based criteria, nutritional quality. Results: No change was seen in the proportion offering alternative options daily, but a vegetarian option was significantly more widely available in 2013. Adherence to all but one of the studied serving guidelines improved, although this reached significance for only a small number. Adherence to two of the four nutrient criteria improved significantly. Conclusion: Two years after the introduction of new legislation, school meal quality in Sweden has improved modestly. The effect of the law itself is difficult to separate from other influences, including the effect of monitoring. Extended follow-up of schools will allow us to evaluate the longer-term changes and effects on health, learning and equality in health. [ABSTRACT FROM AUTHOR]

Aims: To analyse the hypothesis that a gradual deregulation of traveller allowances, starting in 2001 and ending in 2004, on alcoholic beverages changed consumer behaviours that ultimately led to an increase in alcohol consumption in southern Sweden between in 2005 compared with 1999. Methods: The data for this general population random sample prospective cohort study with repeated measurements were collected in 1999 (T1) and in 2005 (T2) in the county of Scania, analysing the answers from 8612 individuals, who at T1 were alcohol consumers and 18–80 years old. Results: Aggregate age-adjusted general mean alcohol consumption did not change significantly between T1 and T2. Significant downward changes were found in a number of demographical and socioeconomic sub-groups. Generalized linear model analyses indicated that the uptake of buying alcohol from a private person was associated with significantly higher consumption (P < 0.001). No longer buying alcohol from a private person, consuming illicitly distilled spirits or buying alcohol abroad were significantly associated with lower consumption at follow-up. Interaction effects between changing consumer behaviours were also identified. Conclusion: The deregulation of the cross-border trade of alcohol into Sweden did not, within our sample, lead to an increase in consumption. There were, however, significant decreases in consumption levels within different socio-demographic sub-groups. In relation to changing consumer behaviours both upward and downward shifts in drinking trends were observed. [ABSTRACT FROM AUTHOR]

The article discusses the use of the Advocacy Coalition Framework (ACF) to study developments in Swedish nuclear energy policy in the 1970s and 1980s. It explores hypotheses about advocacy coalition stability, and analyzes the motivations explaining policy change in the wake of the 1979 Three Mile Island accident and the 1986 Chernobyl disaster. It notes that the study confirms patterns of coalition stability and shows that interests and political learning were important in explaining policy change in the case. It states that theoretical implications derived from the study call for further specification of basic ACF concepts, and posit the intensity and breadth of political conflict.

This article focuses on three countries with distinct policies toward motherhood and work: Germany, Sweden and the United States. We analyze the length of mothers' time out of paid work after childbirth and the short-term career consequences for mothers. In the United States, we identify a career punishment even for short timeout periods; long time-out periods increase the risk of a downward move and reduce the chances of an upward move. In Germany, long time-out periods destabilize the career and, the longer the leave, the greater the risk of either an upward or downward move. In Sweden, we find a negative effect of time out on upward moves. Hence, even in "woman-friendly" Sweden, women's career prospects are better if they return to paid work sooner rather than later. [ABSTRACT FROM AUTHOR]