https://www.mdu.se/

 Background:  As healthcare systems undergo rapid digital transformation digital health literacy has become a critical determinant of equitable access to health services. Immigrants often additional challenges in navigating digital health resources due to language barriers, cultural differences and structural inequalities. This study aimed to compare the experiences of immigrants in Spain and Sweden in accessing and using digital health information, and to identify strategies to enhance digital health literacy within these populations.

 Methods:  A comparative qualitative study was conducted in Sweden and Spain within the framework of the IDEAHL Project (Improving Digital Empowerment for Active Healthy Living). Participants were recruited through non-governmental organisations and community spaces supporting immigrant integration. Data were collected using semi-structured interviews, group discussions, and photovoice techniques. In Sweden, sessions were audio-recorded and transcribed verbatim, whereas in Spain, detailed field notes were taken and validated by facilitators. A comparative thematic analysis was conducted to identify commonalities and differences.

 Results:  A total of 44 immigrants (20 in Sweden and 24 in Spain) participated in the study. Across both countries, participants frequently used digital platforms such as Google and YouTube to search for health-related information. However, they encountered persistent barriers related to language, digital skills, trust in online content and access. Swedish participants emphasised empowerment and the need for culturally adapted digital tools, while Spanish participants highlighted structural barriers such as legal status. limited access to e-Health services, and reliance on traditional healthcare providers. Both groups expressed a strong need for trustworthy, accessible, and easy-to-understand digital health content, as well as greater involvement of healthcare professionals in guiding digital health use.

 Conclusions:  Improving digital health literacy among immigrant populations requires coordinated action from healthcare professionals, policymakers, and primary care providers. Strategies should include multilingual and interactive digital tools, training in critical evaluation skills, and co-design approaches that actively involve immigrants in the development of digital health solutions. The similarities observed between Spain and Sweden suggest that inclusive, person-centred strategies can be effectively adapted across diverse European contexts to promote digital equity and health system resilience.

Background While fatigue is highly reported in newly diagnosed people with Multiple Sclerosis (pwMS) and motor fatigability is reported in about 20% of non-disabled patients, relationship among them in early MS has been less studied. Objective To evaluate correlations between fatigue and motor fatigability in early pwMS, and their clinical, radiological, psychological underpinnings. Methods Relapsing pwMS aged 18-65 years, Expanded Disability Status Scale (EDSS) score <2.0, disease duration <5 years were recruited. PwMS underwent clinical, cognitive, radiological assessment. They performed a 6-minute-walking-test; fatigability was calculated as the ratio of distance walked in the final minute to the first minute (distance walking index, DWI6-1). Fatigue was evaluated through the Modified Fatigue Impact Scale (MFIS). Spearman rho examined the relationship among variables; linear regression analyses examined predictors of fatigue and fatigability. Results 70 pwMS (age 37.8+11years; female n=50, 71.4%, EDSS 1.5[1;2]) were enrolled. 15 (21.4%) reported significant levels of fatigue, 14 (20%) presented motor fatigability. Fatigue and motor fatigability were not significantly correlated with one another (rho=0.100;p=0.425) or with other clinical, cognitive, radiological features. Fatigue was related to Hospital Anxiety and Depression Scale (HADS) anxiety subscale (rho=0.375,p=0.002), Beck Depression Inventory (BDI-II) (rho=0.543;p<0.001), neuroticism (rho=0.313;p=0.006), and all subscales of MS-Quality-Of-Life 54. We did not find predictors of fatigability, while HADS-anxiety (b=0.76; p=0.003) and BDI-II (b=0.33; p=0.009) significantly predicted fatigue. Conclusions Our results support different neurobiological underpinnings for motor fatigue and fatigability and reinforce the need for a multidimensional assessment from the earliest stages of the disease, to tailor therapeutic and rehabilitation strategies.

Children’s occupational aspirations begin forming at an early age and there are multiple social, educational, and experiential factors that may affect them. These aspirations are still poorly understood in the context of presumptive labour markets, however. This study aimed to elucidate the frequency, influences, and rationale regarding the occupational ambitions of children attending grades 1–5 in elementary schools in a region of Sweden, and to compare these to expected labour market demands when they might enter the workforce. The internationally established Drawing the Future method was employed to obtain answers from 1832 pupils, who drew 409 unique occupations within about one third of all possible standard occupational classification categories for Sweden. Only six categories contained an occupation drawn by more than 4% of pupils. The drawn occupations would, if realized, lead to an exacerbation of the ten occupations predicted to have the greatest undersupply, and only alleviate a minority of the future needs of the labor market. There was a considerable absence of STEM-related occupations, and gender differences among the drawn ambitions were large. Media and online sources were stated as the most common sources of knowledge about the drawn occupations, while schools accounted for only 6%. Pupils heavily emphasized experiential factors such as “having fun” and doing “cool” and “exciting” things as a rationale for their chosen occupational ambitions. A large majority of pupils believed the labor market would present many opportunities for them, that schooling was important to achieve success in these markets, and that both genders could undertake similar occupations. Interest in continuing to post-secondary education was considerable. There were few differences among pupils with Swedish backgrounds and those with foreign backgrounds. Future research should address longitudinal changes in both ambitions and influences, as well as the effects of information-based interventions on labor market needs and demands.

Background

Quantitative assessment of the general population’spreferences for preventative Multiple Sclerosis (MS) care can provideimportant insights into which treatments should be prioritized fornewly diagnosed patients. The aim of this study was to assess thepreferences of the general population in Italy regarding preventativeMS care.

Methods

Potential respondents received an invitation to participate ina digital survey (January 2025) via research panels in Italy. Participants assessed the most important treatment attributes, includingcognitive training, physical activity, disease-modifying drugs, andemotional support. The survey included an introductory section, abest-worst scaling (BWS) type 2 experiment, and demographicquestions. Each respondent answered to 13 hypothetical choicequestions as part of the BWS.

Results

A total of 500 individuals completed the digital questionnaire. The most favoured attribute was cognitive training. With themost favoured levels individual neuropsychology with a therapist,standardised Best-Worst score (std BW) 0.34, followed by homebased computerized training (std BW 0.24) and cognitive groupexercise with other MS patients (std BW 0.22). Conversely, the leastpreferred attribute was disease-modifying drugs. With the leastfavoured levels, in-hospital infusions (std BW -0.31), waiting to startdisease-modifying drugs with follow-up assessments after 6 months(std BW -0.26). The Latent class analysis revealed four preferencepatterns. In classes 1 (with the average class probability of 30%) and 4(19%), Physical activity was the most important attribute. Cognitivetraining was the most important attribute for class 2 (32%). While inclass 3 (17%), Disease modifying drugs holds the greatest importance.

Conclusions

The general population’s preferences for preventativeMS care highlight the importance of individual neuropsychology witha therapist and home-based computerized training. These findings arecrucial for informing treatment prioritization in clinical practice.Further research is needed to compare these preferences with those ofMS patients and healthcare professionals to ensure alignment andoptimize treatment strategies.

Objectives This study aimed to explore what intervention specificities or attributes newly diagnosed individuals with multiple sclerosis (MS) find important and to explore possible reasons behind their evaluations.Design A stepwise approach began with a systematic literature review to identify significant attributes. Patients with MS then assessed these attributes through an online survey, which included a ranking exercise and open-ended questions. Finally, the results were evaluated by the clinical team to select the most relevant factors for personalised care.Setting and participants From June 2023 to December 2023, all consecutive patients referred to the MS Center of Careggi University Hospital were screened for inclusion. Following recruitment, cognitive and physical assessments were administered at the Don Gnocchi Centre. All participants were interviewed by an experienced neuropsychologist.Procedures Participants were enrolled in the RELIABLE clinical trial, which included a ranking exercise and open-ended question. In the ranking exercise, patients prioritised levels of treatment attributes: treatment effects, methods of intervention, type of monitoring, monitoring, mode and mental support. The open-ended questions addressed the reasons behind the level rankings.Results Participants' rankings revealed the most important levels of each attribute. The highest-ranked method of intervention was disease-modifying treatment, which received 164 points. For mental support, individual psychotherapy was deemed most important with 149 points. Preservation of cognitive function, a key treatment effect, received 144 points. Clinical check-ups were the top type of monitoring with 129 points. Lastly, the hybrid mode of monitoring (half remote/half in-person) was ranked with 77 points. Open-ended responses provided insights into the reasons behind these preferences, emphasising the importance of maintaining mobility, cognitive function and emotional well-being. The clinical team evaluated these findings, confirming that the selected attributes were both clinically relevant and aligned with patient priorities. This evaluation process ensured that the treatment specificities chosen for individualised care were comprehensive and reflective of patient needs.Conclusions By identifying and prioritising key treatment attributes, this research highlights the multifaceted nature of MS management and emphasises the importance of aligning treatment options with patient preferences. Addressing these factors through further quantitative preference assessments is essential for preventative MS care, improving patient outcomes and promoting a more patient-centred approach to treatment.

Background

A more digitalised world comes with the promise to improve people’s lives. Therefore, it is essential that policymakers also align digital interventions with initiatives to empower citizens and strengthen their digital health literacy. The aim of this study was to explore the views of Swedish policymakers regarding the potential and barriers of a European strategy to strengthen digital health literacy. 

Method

Representatives from Swedish governmental agencies and regions were purposively approached by email to ask them to participate in online workshops to discuss the potential and barriers of developing a European strategy to strengthen digital health literacy. 

Results

The results highlight the need for a national strategy to strengthen digital health literacy. The findings point to critical areas for improvement, ethical and social considerations, and the importance of inclusive and accessible health information online. Participants identified vulnerable groups requiring targeted support to enhance their digi- tal health literacy, particularly those at risk of digital exclusion. Participants emphasised the importance of consider- ing various combinations of conditions or problems that people may have, urging policymakers to adopt a nuanced approach to enhance digital literacy. 

Conclusions

There is a critical need for policymakers to strengthen digital health literacy in the population to ensure health equity in relation to digitalisation opportunities. Policymakers advocate for a dedicated national strategy, sup- porting policymakers to prioritize digital health literacy. Tailoring information, enhancing digital support for preven- tion, and considering ethical implications are reported as important aspects to improve digital health literacy.

Background

When selecting samples for patient preference studies, it may be difficult or impractical to recruit participants who are eligible for a particular treatment decision. However, a general public sample may not be an appropriate proxy.

Objective

This study compares preferences for rheumatoid arthritis (RA) preventive treatments between members of the general public and first-degree relatives (FDRs) of confirmed RA patients to assess whether a sample of the general public can be used as a proxy for FDRs.

Methods

Participants were asked to imagine they were experiencing arthralgia and had screening tests indicating a 60% chance of developing RA within 2 yrs. Using a discrete choice experiment, participants were offered a series of choices between no treatment and 2 unlabeled hypothetical treatments to reduce the risk of RA. To assess data quality, time to complete survey sections and comprehension questions were assessed. A random parameter logit model was used to obtain attribute-level estimates, which were used to calculate relative importance, maximum acceptable risk (MAR), and market shares of hypothetical preventive treatments.

Results

The FDR sample (n = 298) spent more time completing the survey and performed better on comprehension questions compared with the general public sample (n = 982). The relative importance ranking was similar between the general public and FDR participant samples; however, other relative preference measures involving weights including MARs and market share differed between groups, with FDRs having numerically higher MARs.

Conclusion

In the context of RA prevention, the general public (average risk) may be a reasonable proxy for a more at-risk sample (FDRs) for overall relative importance ranking but not weights. The rationale for a proxy sample should be clearly justified.

Highlights

•Participants from the general public were compared to first-degree relatives on their preferences for rheumatoid arthritis (RA) preventive treatments using a discrete choice experiment.

•Preferences were similar between groups in terms of the most important and least important attributes of preventive treatments, with effectiveness being the most important attribute. However, relative weights differed.

•Attention to the survey and predicted market shares of hypothetical RA preventive treatments differed between the general public and first-degree relatives.

•The general public may be a reasonable proxy for an at-risk group for patient preferences ranks but not weights in the disease prevention context; however, care should be taken in sample selection for patient preference studies when choosing nonpatients.

Introduction: Research on young children’s occupational aspirations and the factors shaping them is still limited, especially in early interventions addressing gender disparities in high-status fields like STEM.

Methods: This is the first study in Sweden utilizing the Drawing the Future method, surveyed 1,832 children (aged 5–13) from 28 schools in Skåne region of southern, asking them to draw their dream jobs. This exercise was conducted in a classroom setting and facilitated by their class teacher.

Results: Significant gender differences emerged, revealing distinct stereotypical patterns in children’s future occupational aspirations and influencing factors. Only three occupations—footballer, doctor, and police officer—were popular among both genders. Girls preferred people- or animal-centered roles, while boys leaned toward jobs involving “things” (p < 0.001). Girls felt they could pursue similar careers as boys, but boys showed more skepticism (p < 0.001). Influence patterns also varied by gender: 25% of girls were inspired by mothers, while 45% of boys were inspired by fathers (p = 0.02). Beyond immediate family, girls often sought career information from acquaintances, while boys turned to media (p < 0.001). STEM interest was limited, with “game developer” being the only STEM job on boys’ lists. Additionally, a larger proportion of boys ranked STEM subjects among their top 10 favorite school subjects, while girls preferred crafts, art, and English (p < 0.001).

Discussion: These findings highlight the need for early, unbiased, evidence-based career interventions and policies to broaden children’s awareness of diverse job options and opportunities in the labor market.