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  • 1.
    Adamsson, Mathias
    et al.
    Jönköping University, School of Engineering, JTH, Civil Engineeering and Lighting Science.
    Laike, Thorbjörn
    Lund University, Sweden.
    Morita, Takeshi
    Fukuoka Women's University, Fukuoka, Japan.
    Seasonal variation in bright daylight exposure, mood and behavior among a group of office workers in Sweden2018In: Journal of Circadian Rhythms, ISSN 1740-3391, E-ISSN 1740-3391, Vol. 16, article id 2Article in journal (Refereed)
    Abstract [en]

    The purpose of the study was to investigate seasonal variation in mood and behavior among a group of office workers in Sweden (56°N). Thirty subjects participated in this longitudinal study. The subjects kept a weekly log that included questionnaires for ratings of psychological wellbeing and daily sleep-activity diaries where they also noted time spent outdoors. The lighting conditions in the offices were subjectively evaluated during one day, five times over the year. There was a seasonal variation in positive affect and in sleep-activity behavior. Across the year, there was a large variation in the total time spent outdoors in daylight. The subjects reported seasonal variation concerning the pleasantness, variation and strength of the light in the offices and regarding the visibility in the rooms. Finally, the subjects spent most of their time indoors, relying on artificial lighting, which demonstrates the importance of the lighting quality in indoor environments. 

  • 2.
    Beckhusen, Benedict
    Jönköping University, Jönköping International Business School, JIBS, Informatics.
    Mobile Apps and the ultimate addiction to the Smartphone: A comprehensive study on the consequences of society’s mobile needs2016Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    The smartphone is omnipresent and is cherished and held close by people. It allows for constant connection within a digitally connected society, as well as for many other purposes such as leisure activity or informational purpose. Within the Information Systems studies deeper investigation is required as to what impact this “taken – for – granted” mobile access to information and mobile apps has for individuals and society and if a “technological addiction”can be developed when using the smartphone for everything during the day on such a constant basis.

    The aim of this study was to understand the role of the smartphone in society and to shed light on this unclear relationship between the constant use of a smartphone and its development towards an addictive quality. To reach a conclusion, in depth – interviews were conducted with participants about their relationship to the smartphone and their smartphone use based on questions derived from literature on mobile communication technologies and the types of digital addictions existing.

    The results are that the smartphone is a device that seamlessly integrates into our daily lives in that we unconsciously use it as a tool to make our daily tasks more manageable, and enjoyable. It also supports us in getting better organized, to be in constant touch with family and friends remotely, and to be more mobile which is a useful ability in today’s mobility driven society.

    Smartphones have been found to inhabit a relatively low potential to addiction. Traits of voluntary behaviour, habitual behaviour, and mandatory behaviour of smartphone use have been found. All of these behaviours are not considered a true addiction. In the end, it seems that the increase of smartphone use is mainly due to the way we communicate nowadays digitally,and the shift in how we relate to our social peers using digital means.

  • 3.
    Darin-Mattsson, Alexander
    et al.
    Karolinska Institutet, Solna, Sweden; Stockholm University, Sweden .
    Andel, Ross
    School af Aging Studies, University of South Florida, Tampa, USA; International Clinical Research Center, St. Anne’s University Hospital, Brno, Czech Republic .
    Fors, Stefan
    Karolinska Institutet, Solna, Sweden; Stockholm University, Sweden.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Karolinska Institutet, Solna, Sweden; Stockholm University, Sweden.
    Are Occupational Complexity and Socioeconomic Position Related to Psychological Distress 20 Years Later?2015In: Journal of Aging and Health, ISSN 0898-2643, E-ISSN 1552-6887, Vol. 27, no 7, p. 1266-1285Article in journal (Refereed)
    Abstract [en]

    Objective: To assess occupational complexity in midlife in relation to psychological distress in older adulthood (69+ years) and explore the role of socioeconomic position.

    Method: Baseline data from the Swedish Level of Living Survey and follow-up data from the Swedish Longitudinal Study ofLiving Conditions of the Oldest Old were combined, resulting in 20+ years of follow-up. Data were analyzed using ordered logistic regressions.

    Results: Higher occupational complexity was associated with less psychological distress 20 years later adjusted for age, sex, follow-up year, hours worked the year before baseline, and psychological distress at baseline. Higher socioeconomic position yielded the same pattern of results. Socioeconomic position partially accounted for the association between occupational complexity and psychological distress.

    Discussion: With social gradient not easily amenable to modification, efforts to increase engagement at work may offer a viable option to attenuate the influence of work environment on psychological distress later in life.

  • 4.
    Elgmark Andersson, Elisabeth
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Larsen, Louise B.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    A modified Job Demand, Control, Support model for active duty police2017In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 58, no 3, p. 361-370Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The Job Demand Control Support model (JDCS) is one of the most widely used theoretical models relating job characteristics to health and wellbeing.

    OBJECTIVE: This study aimed to assess the predictive power of the JDCS model for determining job satisfaction and fatigue in uniformed Swedish police. An additional aim was to determine if predictive power of the model would be improved with the addition of two occupation specific items.

    METHODS: Questionnaire data, based upon the Swedish Work Environment Survey were collected from Swedish police (n = 4244). A hierarchical multiple regression analysis was run to explore the predictive value of the model and to determine if the additional variables improved predictive power with respect to job satisfaction and fatigue.

    RESULTS: Regression analysis demonstrated that the JDSC model had high predictive power in relation to job satisfaction and fatigue. Job demands was the strongest predictor of fatigue (14%), while support was the strongest predictor of job satisfaction (12%). The addition of exposure to threats significantly improved predictive power for both job satisfaction and fatigue, while addition of shift work did not significantly affect predictive power of the model.

    CONCLUSIONS: Workplace interventions to address issues related to job satisfaction and fatigue in police should focus on maintaining a bearable level of job demands and provision of adequate support.

  • 5.
    Falkenberg, Helena
    et al.
    Department of Psychology, Stockholm University.
    Fransson, Eleonor
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Westerlund, Hugo
    Stress Research Institute, Stockholm University.
    Head, Jenny
    University College London.
    Short- and long-term effects of major organisational change on minor psychiatric disorder and self-rated health: Results from the Whitehall II study2013In: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 70, no 10, p. 688-696Article in journal (Refereed)
    Abstract [en]

    Objective To investigate short- and long-term effects of major organisational change on minor psychiatric disorder and self-rated health for women and men in different employment grades.

    Methods Minor psychiatric disorder and self-rated health among 6710 British civil servants (1993 women and 4717 men) in three employment grades from the Whitehall II study were examined from 1985 to 1988 under stable employment conditions. The short-term effects of organisational change were investigated in 1991–1993 after a time of major restructuring aiming at increasing the influence of market forces in the civil service and the long-term effects were investigated in 1997–1999.

    Results Those who had experienced organisational change and those who anticipated organisational change reported more negative short-term health effects (minor psychiatric disorder and poor self-rated health) compared with those who reported no change. No major differences were found depending on employment grade or gender. The negative health effects had diminished during 1997–1999 for those who reported that a major change had happened before 1991–1993. Those who anticipated an organisational change in 1991–1993 still reported more ill-health in 1997–1999 (both minor psychiatric disorder and self-reported health) than those in the comparison group.

    Conclusions The results indicate that organisational change affects employees’ health negatively in the short term but also that it is possible to recover from such negative effects. As it was not possible to discern any definite difference between the gender and grades, the results point at the importance of working proactively to implement organisational change for women and men at all levels.

  • 6.
    Fristedt, Sofi
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health Science, HHJ, Quality Improvement and Leadership in Health and Welfare.
    Fransson, Eleonor
    Jönköping University, School of Health Science, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health Science, HHJ. ADULT.
    Fysisk aktivitet och träning - möjlig prevention av arbetsrelaterade belastningsbesvär2015Report (Other academic)
  • 7.
    Karlsson, Kåre J.
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ADULT. Ambulance Service, Skaraborg Hospital, Skövde, Sweden.
    Niemelä, Patrik H.
    Ambulance Service, Skaraborg Hospital, Skövde, Sweden.
    Jonsson, Anders R.
    School of Health Sciences, Borås University, Borås, Sweden.
    Törnhage, Carl-Johan A.
    Department of Paediatrics, Skaraborg Hospital, Skövde, Sweden.
    Using shoulder straps decreases heart rate variability and salivary cortisol concentration in Swedish ambulance personnel2016In: SH@W Safety and Health at Work, ISSN 2093-7911, E-ISSN 2093-7997, Vol. 7, no 1, p. 32-37Article in journal (Refereed)
    Abstract [en]

    Background: Previous research has shown that paramedics are exposed to risks in the form of injuries to the musculoskeletal system. In addition, there are studies showing that they are also at increased risk of cardiovascular disease, cancer, and psychiatric diseases, which can partly be explained by their constant exposure to stress. The aim of this study is to evaluate whether the use of shoulder straps decreases physical effort in the form of decreased heart rate and cortisol concentration.

    Methods: A stretcher with a dummy was carried by 20 participants for 400 m on two occasions, one with and one without the shoulder straps. Heart rate was monitored continuously and cortisol samples were taken at intervals of 0 minutes, 15 minutes, 30 minutes, 45 minutes, and 60 minutes. Each participant was her or his own control.

    Results: A significant decrease in heart rate and cortisol concentration was seen when shoulder straps were used. The median values for men (with shoulder straps) at 0 minutes was 78 bpm/21.1 nmol/L (heart rate/cortisol concentration), at 15 minutes was 85 bpm/16.9 nmol/L, and at 60 minutes was 76 bpm/15.7 nmol/L; for men without shoulder straps, these values were 78 bpm/21.9 nmol/L, 93 bpm/21.9 nmol/L, and 73 bpm/20.5 nmol/L. For women, the values were 85 bpm/23.3 nmol/L, 92 bpm/20.8 nmol/L, and 70 bpm/18.4 nmol/L and 84 bpm/32.4 nmol/L, 100 bpm/32.5 nmol/L, and 75 bpm/25.2 nmol/L, respectively.

    Conclusion: The use of shoulder straps decreases measurable physical stress and should therefore be implemented when heavy equipment or a stretcher needs to be carried. An easy way to ensure that staff use these or similar lifting AIDS is to provide them with personalized, well-adapted shoulder straps. Another better option would be to routinely sewn these straps into the staff's personal alarm jackets so they are always in place and ready to be used.

  • 8.
    Karlsson, Kåre
    et al.
    Borås University, School of Health Sciences, Knowledge Centre for Prehospital Care, Borås, Sweden .
    Niemelä, Patrik
    Borås University, School of Health Sciences, Knowledge Centre for Prehospital Care, Borås, Sweden.
    Jonsson, Anders
    Swedish Armed Forces, Centre for Defence Medicine, Västra Frölunda, Sweden.
    Heart rate as a marker of stress in ambulance personnel: A pilot study of the body's response to the ambulance alarm2011In: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, Vol. 26, no 1, p. 21-26Article in journal (Refereed)
    Abstract [en]

    Introduction: Studies have demonstrated the presence of stress and post-traumatic stress among ambulance personnel, but no previous research has focused on the body's reaction in the form of the change in heart rate of ambulance staff in association with specific occupational stress.

    Hypothesis: The purpose of this study is to investigate whether work as an ambulance professional generates prolonged physiological arousal that can be measured by heart rate in different situations.

    Methods: Twenty participants carried a pulse-meter in the form of a wristwatch, which continuously measured and stored their heart rate 24 hours per day for a period of seven days. All ambulance alarms that occurred during the test period were recorded in journals, and the participants completed diaries and a questionnaire describing their experiences. The alarms were divided into different phases. Correlations between heart rate in the different phases were computed.

    Results: Analysis of study data indicated a significant rise of heart rate unrelated to physical effort during an emergency alarm and response. This increased heart rate was noticed throughout the mission and it was not related to the length of experience the staff had in the ambulance profession. In addition, a non-significant trend suggested that alarms involving acutely ill children lead to an even higher increase in heart rate. In addition, this research showed that constant tension existed during sleep, while available for an emergency, indicated by a noticeable increase in heart rate during sleep at work compared to sleeping at home.

    Conclusions: A rise in heart rate was experienced during all acute emergency missions, regardless of a subject's experience, education, and gender. Missions by themselves generated a rate increase that did not seem to correlate with physical effort required during an emergency response. This study shows that working on an ambulance that responds to medical emergencies is associated with a prolonged physiological arousal.

  • 9.
    Karlsson, Kåre
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ADULT. Ambulance Services, Skaraborg Hospital, Skövde, Sweden.
    Persson Niemelä, Patrik
    Ambulance Services, Skaraborg Hospital, Skovde, Sweden.
    Jonsson, Anders
    School of Health Sciences, University of Borås, Borås, Sweden.
    Törnhage, Carl-Johan
    Department of Paediatrics, Skaraborg Hospital, Skovde, Sweden.
    Stress response in swedish ambulance personnel evaluated by Trier social stress test2019In: Journal of Health and Environmental Research, ISSN 2472-3584, Vol. 5, no 1, p. 14-23Article in journal (Refereed)
    Abstract [en]

    According to previous research, ambulance personnel often consider themselves as healthy, but at the same time several studies show that they suffer from several stress-related illnesses, take early retirement and even suffer early death. The aim of this study was to explore mental stress during the Trier Social Stress Test. Questions were whether heart rate measurement could replace cortisol concentration in saliva as an indicator of stress and if there were differences between genders. During 20 Trier Social Stress Tests heart rate and salivary cortisol concentrations were measured. Heart rate was measured every 15 seconds and salivary cortisol was collected at seven occasions. Fourteen men and six women (sixteen ambulance nurses and four paramedics) participated. A questionnaire with background data was collected. Statistical analysis used was non-parametric tests to adjust for misalignment. During the Trier Social Stress Test women had their highest salivary cortisol concentration before start of test while the maximum values for men were 10 to 20 minutes after start. In contrast, there was no difference in heart rhythm before, during and after test between genders. No correlation between heart rate and salivary cortisol was found. There was no significant difference in stress response according to personnel’s age or level of education. Women and men exhibit different hormonal stress responses when it comes to performing unfamiliar actions, something that has not been seen before. Since no correlation could be seen between heart rate and salivary cortisol concentration they cannot replace each other as indicators of stress.

  • 10. Kivimäki, Mika
    et al.
    Nyberg, Solja
    Fransson, Eleonor
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Heikkilä, Katriina
    Alfredsson, Lars
    Casini, Annalisa
    Clays, Els
    DeBacquer, Dirk
    Dragano, Nico
    Ferrie, Jane
    Goldberg, Marcel
    Hamer, Mark
    Jokela, Markus
    Karasek, Robert
    Kittel, France
    Knutsson, Anders
    Koskenvuo, Markku
    Nordin, Maria
    Oksanen, Tuula
    Pentti, Jaana
    Rugulies, Reiner
    Salo, Paula
    Siegrist, Johannes
    Suominen, Sakari
    Theorell, Töres
    Vahtera, Jussi
    Virtanen, Marianna
    Westerholm, Peter
    Westerlund, Hugo
    Zins, Marie
    Steptoe, Andrew
    Singh-Manoux, Archana
    Batty, David
    Associations of job strain and lifestyle risk factors with risk of coronary artery disease: a meta-analysis of individual participant data2013In: CMJA. Canadian Medical Association Journal. Onlineutg. Med tittel: ECMAJ. ISSN 1488-2329, ISSN 0820-3946, E-ISSN 1488-2329, Vol. 185, no 9, p. 763-769Article in journal (Refereed)
    Abstract [en]

    Background: It is unclear whether a healthy lifestyle mitigates the adverse effects of job strain on coronary artery disease. We examined the associations of job strain and lifestyle risk factors with the risk of coronary artery disease.

    Methods: We pooled individual-level data from 7 cohort studies comprising 102 128 men and women who were free of existing coronary artery disease at baseline (1985–2000). Questionnaires were used to measure job strain (yes v. no) and 4 lifestyle risk factors: current smoking, physical inactivity, heavy drinking and obesity. We grouped participants into 3 lifestyle categories: healthy (no lifestyle risk factors), moderately unhealthy (1 risk factor) and unhealthy (2–4 risk factors). The primary outcome was incident coronary artery disease (defined as first nonfatal myocardial infarction or cardiac-related death).

    Results: There were 1086 incident events in 743 948 person-years at risk during a mean follow-up of 7.3 years. The risk of coronary artery disease among people who had an unhealthy lifestyle compared with those who had a healthy lifestyle (hazard ratio [HR] 2.55, 95% confidence interval [CI] 2.18–2.98; population attributable risk 26.4%) was higher than the risk among participants who had job strain compared with those who had no job strain (HR 1.25, 95% CI 1.06–1.47; population attributable risk 3.8%). The 10-year incidence of coronary artery disease among participants with job strain and a healthy lifestyle (14.7 per 1000) was 53% lower than the incidence among those with job strain and an unhealthy lifestyle (31.2 per 1000).

    Interpretation: The risk of coronary artery disease was highest among participants who reported job strain and an unhealthy lifestyle; those with job strain and a healthy lifestyle had half the rate of disease. A healthy lifestyle may substantially reduce disease risk among people with job strain.

  • 11.
    Kivimäki, Mika
    et al.
    Department of Epidemiology and Public Health, University College London, London, UK.
    Virtanen, Marianna
    Finnish Institute of Occupational Health, Helsinki, Tampere, and Turku, Finland.
    Kawachi, Ichiro
    Harvard School of Public Health, Department of Society, Human Development and Health, Boston, MA, USA.
    Nyberg, Solja T.
    Finnish Institute of Occupational Health, Helsinki, Tampere, and Turku, Finland.
    Alfredsson, Lars
    Centre for Occupational and Environmental Medicine, Stockholm County Council, Sweden.
    Batty, G. David
    Department of Epidemiology and Public Health, University College London, London, UK.
    Bjorner, Jakob B.
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Borritz, Marianne
    Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark.
    Brunner, Eric J.
    Department of Epidemiology and Public Health, University College London, London, UK.
    Burr, Hermann
    Federal Institute for Occupational Safety and Health, Berlin, Germany.
    Dragano, Nico
    Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
    Ferrie, Jane E.
    Department of Epidemiology and Public Health, University College London, London, UK.
    Fransson, Eleonor I
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Hamer, Mark
    Heikkilä, Katriina
    Knutsson, Anders
    Koskenvuo, Markku
    Madsen, Ida E H
    Nielsen, Martin L
    Nordin, Maria
    Oksanen, Tuula
    Pejtersen, Jan H
    Pentti, Jaana
    Rugulies, Reiner
    Salo, Paula
    Siegrist, Johannes
    Steptoe, Andrew
    Suominen, Sakari
    Theorell, Töres
    Vahtera, Jussi
    Westerholm, Peter J M
    Westerlund, Hugo
    Singh-Manoux, Archana
    Jokela, Markus
    Long working hours, socioeconomic status, and the risk of incident type 2 diabetes: a meta-analysis of published and unpublished data from 222 120 individuals.2015In: The Lancet Diabetes and Endocrinology, ISSN 2213-8587, E-ISSN 2213-8595, Vol. 3, no 1, p. 27-34Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Working long hours might have adverse health effects, but whether this is true for all socioeconomic status groups is unclear. In this meta-analysis stratified by socioeconomic status, we investigated the role of long working hours as a risk factor for type 2 diabetes.

    METHODS: We identified four published studies through a systematic literature search of PubMed and Embase up to April 30, 2014. Study inclusion criteria were English-language publication; prospective design (cohort study); investigation of the effect of working hours or overtime work; incident diabetes as an outcome; and relative risks, odds ratios, or hazard ratios (HRs) with 95% CIs, or sufficient information to calculate these estimates. Additionally, we used unpublished individual-level data from 19 cohort studies from the Individual-Participant-Data Meta-analysis in Working-Populations Consortium and international open-access data archives. Effect estimates from published and unpublished data from 222 120 men and women from the USA, Europe, Japan, and Australia were pooled with random-effects meta-analysis.

    FINDINGS: During 1·7 million person-years at risk, 4963 individuals developed diabetes (incidence 29 per 10 000 person-years). The minimally adjusted summary risk ratio for long (≥55 h per week) compared with standard working hours (35-40 h) was 1·07 (95% CI 0·89-1·27, difference in incidence three cases per 10 000 person-years) with significant heterogeneity in study-specific estimates (I(2)=53%, p=0·0016). In an analysis stratified by socioeconomic status, the association between long working hours and diabetes was evident in the low socioeconomic status group (risk ratio 1·29, 95% CI 1·06-1·57, difference in incidence 13 per 10 000 person-years, I(2)=0%, p=0·4662), but was null in the high socioeconomic status group (1·00, 95% CI 0·80-1·25, incidence difference zero per 10 000 person-years, I(2)=15%, p=0·2464). The association in the low socioeconomic status group was robust to adjustment for age, sex, obesity, and physical activity, and remained after exclusion of shift workers.

    INTERPRETATION: In this meta-analysis, the link between longer working hours and type 2 diabetes was apparent only in individuals in the low socioeconomic status groups.

    FUNDING: Medical Research Council, European Union New and Emerging Risks in Occupational Safety and Health research programme, Finnish Work Environment Fund, Swedish Research Council for Working Life and Social Research, German Social Accident Insurance, Danish National Research Centre for the Working Environment, Academy of Finland, Ministry of Social Affairs and Employment (Netherlands), Economic and Social Research Council, US National Institutes of Health, and British Heart Foundation.

  • 12. Knutsson, Anders
    et al.
    Alfredsson, Lars
    Karlsson, Berndt
    Åkerstedt, Torbjörn
    Fransson, Eleonor
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Westerholm, Peter
    Westerlund, Hugo
    Breast cancer among shift workers: results of the WOLF longitudinal cohort study2013In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 39, no 2, p. 170-177Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aim of this study was to investigate whether shift work (with or without night work) is associated with increased risk of breast cancer.

    METHODS: The population consisted of 4036 women. Data were obtained from WOLF (Work, Lipids, and Fibrinogen), a longitudinal cohort study. Information about baseline characteristics was based on questionnaire responses and medical examination. Cancer incidence from baseline to follow-up was obtained from the national cancer registry. Two exposure groups were identified: shift work with and without night work. The group with day work only was used as the reference group in the analysis. Cox regression analysis was used to calculate relative risk.

    RESULTS: In total, 94 women developed breast cancer during follow-up. The average follow-up time was 12.4 years. The hazard ratio for breast cancer was 1.23 [95% confidence interval (95% CI) 0.70-2.17] for shifts without night work and 2.02 (95% CI 1.03-3.95) for shifts with night work. When including only women >60 years of age, the risk estimates were 1.18 (95% CI 0.67-2.07) for shifts without night work, and 2.15 (95% CI 1.10-4.21) for shifts with night work.

    CONCLUSIONS: Our results indicate an increased risk for breast cancer among women who work shifts that includes night work.

  • 13.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    A life-course with financial hardship and psychological distress in old age: A cohort study with Swedish data.2015Conference paper (Other academic)
  • 14.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Midlife work-related stress increases dementia risk in late-life: The CAIDE 30-year study.2015Conference paper (Other academic)
  • 15.
    Kåreholt, Ingemar
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Nilsen, Charlotta
    Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Darin-Mattsson, Alexander
    Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Andel, Ross
    School of Aging Studies, University of South Florida, Tampa, Florida, USA ; International Clinical Research Center, St. Anne’s University Hospital, Brno, Czech Republic.
    Are socioeconomic position and working conditions before retirement age related to physical function 20 years later after retirement?2015In: Differences, Inequalities and Sociological Imagination: ESA 2015 12th conference of the European Sociological Association: Abstract book, European Sociological Association (ESA). I nstitute of Sociology of the Czech Academy of Scienc es (IS CAS) , 2015, p. 107-107Conference paper (Refereed)
    Abstract [en]

    INTRODUCTION: Socioeconomic position and working situation are two factors associated to health inequalities and to each other.AIM: To study how socioeconomic position and working conditions 20+ years earlier associates to physical functioning after retirement age.DATA: Swedish nationally representative samples, from 1968, 1981, and 1991 were re-interviewed 1992, 2002, and 2011 (76+) with 20-24 years follow-up time (women, n=431; men, n=450).METHOD: Ordered logistic regressions, censored normal regression, and ordinary OLS regressions will be used.VARIABLES: Physical function: Self-reported mobility, objective tests of lung function and general physical function.Socioeconomic position: Education, income, cash margin, social class based on occupation, and an index based on all measures.Psychosocial working conditions: job control, psychological demands, high strain (low control+high demands) and work complexity regarding data (information), people, and substantive (general) complexity.Controls: age, sex, follow-up year, mobility at baseline, and hours worked.RESULTS: Job control, work complexity with data and people and all measures of SEP, were significantly associated to the three measures of physical function. Controlling for working conditions, the only significant associations was between general physical function and cash margin and the socioeconomic index respectively. When controlling for socioeconomic position, job control was significantly associated to less limitations in mobility and general physical functioning, substantive complexity and complexity with data were associated to less mobility limitations.CONCLUSIONS: Both socioeconomic position, work related stress, and work complexity were associated to physical function in old age, but only partly independent of each other. The strongest single factor is job control.

  • 16.
    Larsen, Louise B.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Factors related to musculoskeletal disorders in Swedish police2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Police working in active duty are subject to occupation-specific exposures in the workplace which could place them at an increased risk of developing musculoskeletal disorders. These exposures include the requirement to wear a duty belt and body armour as well as sitting for long periods in fleet vehicles. It is well recognised that the development of musculoskeletal disorders is multifactorial and that both physical and psychosocial workplace factors must be considered when addressing this issue.

    Aim: The overall aim of this thesis was to increase knowledge related to musculoskeletal disorders in Swedish police by exploring the prevalence of pain and its relationship to physical and psychosocial factors in the work environment.

    Methods: Studies included in this thesis were conducted using different quantitative methods. Studies I and II were based on data from a self-administered online survey, distributed to all police officers working in active duty. Descriptive statistics and regression analyses were used to document the prevalence of musculoskeletal pain and the effects of exposure variables (physical and psychosocial) and covariates on multi-site pain. Study III was conducted using a three-dimensional gait analysis system incorporating two force plates to explore the effect of different load carriage systems on kinematic and kinetic variables. Study IV included the same three conditions as in Study III but investigated sitting postures and comfort. A pressure mat was utilised to determine contact pressure and contact area while sitting in and driving police vehicles while a survey was used to measure experienced discomfort related to the vehicle seat. Non-parametric statistical tests were used to investigate differences between load carriage conditions in Studies III and IV.

    Results: The results of this thesis revealed that the most frequently reported musculoskeletal disorder among Swedish police working in active duty was lower back pain (43.2%) and that multi-site musculoskeletal pain (41.3%) was twice as prevalent as single-site pain (19.7 The physical workplace factor with the greatest association to multi-site musculoskeletal pain was found for individuals reporting discomfort experienced from wearing duty belts (OR 5.42 (95% CI 4.56 – 6.43)). The psychosocial workplace factor with the greatest association to multi-site musculoskeletal pain was found for individuals reporting high-strain jobs (OR 1.84 (95% CI 1.51 – 2.24)). Wearing body armour, or body armour combined with a load-bearing vest, resulted in less rotation of the trunk when compared to not wearing any equipment. Wearing a thigh holster and load-bearing vest allowed for a greater range of rotation in the right hip compared to the standard load-bearing condition, which incorporated a belt-mounted hip holster. Kinetics of the ankle joints were greater for both load carriage conditions compared to the control condition. Discomfort ratings revealed a clear preference for the alternate load-carriage condition. The lower back was found to be the body region with most experienced discomfort (30.5; IQR 11 - 42 mm). Pressure data demonstrated that wearing a thigh holster and load-bearing vest resulted in less pressure in the lower back when compared to the standard load carriage condition. At the same time, contact pressure in the upper back increased followed by a decrease in contact area.

    Conclusion: Musculoskeletal pain is a considerable problem among Swedish police with lower back pain being the most frequently reported pain site. Multi-site musculoskeletal pain was found to be more common than single-site pain and both physical and psychosocial factors were associated to multi-site musculoskeletal pain. Of the exposures studied in this thesis, duty belts and high strain jobs were found to have the greatest association to musculoskeletal pain. The use of load-bearing vest and thigh holster were found to affect levels of discomfort, especially while driving. Also, range of motion in the trunk and right hip was affected by wearing mandatory equipment.

  • 17.
    Larsen, Louise B.
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Elgmark Andersson, Elisabeth
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Tranberg, Roy
    Department of Orthopaedics, Institute of Clinical Sciences, University of Gothenburg, PO Sahlgrenska University Hospital, Gothenburg, Sweden.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Multi-site musculoskeletal pain in Swedish police: associations with discomfort from wearing mandatory equipment and prolonged sitting2018In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 91, no 4, p. 425--433Article in journal (Refereed)
    Abstract [en]

    Purpose: Musculoskeletal disorders are considered as a major issue affecting the health and well-being of active duty police. Discomfort from wearing mandatory equipment and sitting for long periods of time in fleet vehicles are workload factors linked to musculoskeletal disorders in police. This study aims to determine the prevalence of multi-site musculoskeletal pain among Swedish police and to explore the possible association to discomfort experience when wearing mandatory equipment and sitting for long periods in fleet vehicles.

    Methods: In this cross-sectional study responses from 4185 police were collected through a self-administered online survey including questions about physical work environment, mandatory equipment and musculoskeletal pain. Multi-site pain was determined through summing pain sites from four body regions. Binomial logistic regression was performed to explore the association between multi-site musculoskeletal pain: (1) discomfort from wearing mandatory equipment and (2) sitting for long periods in fleet vehicles.

    Results: The prevalence of multi-site musculoskeletal pain at least 1 day per week within the previous 3 months was 41.3%. A statistically significant association between discomfort from wearing mandatory equipment and multi-site musculoskeletal pain was found; duty belt [OR 5.42 (95% CI 4.56–6.43)] as well as body armour [OR 2.69 (95% CI 2.11–3.42)]. Sitting for long periods in fleet vehicles was not significantly associated to multi-site musculoskeletal pain.

    Conclusion: Multi-site musculoskeletal pain is a considerable problem among Swedish police and modifying mandatory equipment to decrease discomfort is suggested as a potential means of decreasing the musculoskeletal pain experienced by many police officers. 

  • 18.
    Larsen, Louise B.
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Fransson, Eleonor I.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Psychosocial job demand and control: multi-site musculoskeletal pain in Swedish police2018In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905Article in journal (Refereed)
    Abstract [en]

    Aims

    Police have a high prevalence of musculoskeletal disorders. While physical factors contributing to this have been explored, little is known regarding the contribution of the psychosocial work environment. This study explores the association between elements of the JDC model, social support and multi-site musculoskeletal pain among Swedish police.

    Methods

    In this cross-sectional study, response from 4185 police were collected using a self-administered online survey. The survey included questions on psychosocial work environment and musculoskeletal pain, as well as several potential confounding factors. Binominal regression analyses were performed to explore the degree of association between 1) the indices for job demands, job control, social support and multi-site musculoskeletal pain and 2) the four categories of the JDC model, social support and multi-site musculoskeletal pain.

    Results

    The overall psychosocial work environment of Swedish police was characterised by low control and high social support. Police who reported active and high strain jobs were found to have an increase in the odds ratio for multi-site musculoskeletal pain (OR 1.45 (95% CI 1.08-1.94), and 1.84 (1.51-2.24) respectively). High demands, which is a component in the categories for active and high strain jobs, was also found to be associated with an increase in the odds ratio for multi-site musculoskeletal pain (OR 1.66 (1.45-1.91)). High social support was associated with a decrease in the odds ratio formulti-site musculoskeletal pain (OR 0.72 (0.57-0.86)).

    Conclusions

    Psychosocial work environment should be considered when investigating factors related to the health and wellbeing of police.

  • 19.
    Larsen, Louise B.
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Tranberg, Roy
    Department of Orthopaedics, Institute of Clinical Sciences, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Duty belt or load-bearing vest?: Discomfort and pressuredistribution for police driving standard fleet vehiclesManuscript (preprint) (Other academic)
    Abstract [en]

    Police working in active duty have a high prevalence of musculoskeletal pain, with lower back pain being the most frequently reported. As a part of uniform regulations, Swedish police are mandated to wear body armour and duty belts at all times during work. This study aimed to investigate the effect of different load carriage designs on in-vehicle sitting pressure and self-rated discomfort among police. Results showed less discomfort when wearing the alternate load carriage system incorporating a load-bearing vest and thigh holster compared to the standard load carriage system consisting of a duty belt. Pressures in the lower back were reduced when wearing the load-bearing vest whereas pressures in the upper back region increased. Relocating appointments away from the waist has the potential to improve sitting positions and the ergonomic situation for police when driving fleet vehicles.

  • 20.
    Nilsen, Charlotta
    et al.
    Karolinska Institutet and Stockholm University, Sweden.
    Agahi, Neda
    Karolinska Institutet and Stockholm University, Sweden.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Karolinska Institutet and Stockholm University, Sweden.
    Midlife work-related stress and late life physical functioning: a 20-year prospective cohort study2015In: 'Life Courses in Cross-­National Comparison: Similarities and Differences': Abstract book, 2015, p. 14-Conference paper (Other academic)
  • 21.
    Nilsen, Charlotta
    et al.
    Stockholm University, Sweden.
    Fritzell, Johan
    Stockholm University, Sweden.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Andel, Ross
    University of South Florida, USA.
    Work-related stress in midlife and all-cause mortality: the role of sense of coherence2015In: 'Life Courses in Cross-­National Comparison: Similarities and Differences: Abstract book, 2015, p. 125-Conference paper (Refereed)
  • 22.
    Nyberg, Solja T.
    et al.
    Finnish Institute of Occupational Health, Helsinki and Tampere, Finland.
    Fransson, Eleonor
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Heikkilä, Katriina
    Finnish Institute of Occupational Health, Helsinki and Tampere, Finland.
    Alfredsson, Lars
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Casini, Annalisa
    School of Public Health, Université libre de Bruxelles, Brussels, Belgium.
    Clays, Els
    Department of Public Health, Ghent University, Ghent, Belgium.
    De Bacquer, Dirk
    Department of Public Health, Ghent University, Ghent, Belgium.
    Dragano, Nico
    Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
    Erbel, Raimund
    Department of Cardiology, West-German Heart Center Essen, University Duisburg-Essen, Essen, Germany.
    Ferrie, Jane
    School of Community and Social Medicine, University of Bristol, Bristol, United Kingdom.
    Hamer, Mark
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Jöckel, Karl-Heinz
    Institute for Medical Informatics, Biometry, and Epidemiology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany.
    Kittel, France
    School of Public Health, Université libre de Bruxelles, Brussels, Belgium.
    Knutsson, Anders
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Ladwig, Karl-Heinz
    German Research Center for Environmental Health, Neuherberg, Germany.
    Lunau, Thorsten
    Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
    Marmot, Michael
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Nordin, Maria
    Department of Psychology, Umeå University, Umeå, Sweden.
    Rugulies, Reiner
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Siegrist, Johannes
    Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
    Steptoe, Andrew
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Westerholm, Peter
    Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
    Westerlund, Hugo
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Theorell, Töres
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Brunner, Eric
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Singh-Manoux, Archana
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Batty, David
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Kivimäki, Mika
    Finnish Institute of Occupational Health, Helsinki and Tampere, Finland.
    Job strain and cardiovascular disease risk factors: Meta-analysis of individual-participant data from 47,000 men and women2013In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 8, no 6, p. e67323-Article in journal (Refereed)
    Abstract [en]

    Background

    Job strain is associated with an increased coronary heart disease risk, but few large-scale studies have examined the relationship of this psychosocial characteristic with the biological risk factors that potentially mediate the job strain – heart disease association.

    Methodology and Principal Findings

    We pooled cross-sectional, individual-level data from eight studies comprising 47,045 participants to investigate the association between job strain and the following cardiovascular disease risk factors: diabetes, blood pressure, pulse pressure, lipid fractions, smoking, alcohol consumption, physical inactivity, obesity, and overall cardiovascular disease risk as indexed by the Framingham Risk Score. In age-, sex-, and socioeconomic status-adjusted analyses, compared to those without job strain, people with job strain were more likely to have diabetes (odds ratio 1.29; 95% CI: 1.11–1.51), to smoke (1.14; 1.08–1.20), to be physically inactive (1.34; 1.26–1.41), and to be obese (1.12; 1.04–1.20). The association between job strain and elevated Framingham risk score (1.13; 1.03–1.25) was attributable to the higher prevalence of diabetes, smoking and physical inactivity among those reporting job strain.

    Conclusions

    In this meta-analysis of work-related stress and cardiovascular disease risk factors, job strain was linked to adverse lifestyle and diabetes. No association was observed between job strain, clinic blood pressure or blood lipids.

  • 23.
    Palmer, Kristy
    et al.
    School of Occupational Therapy and Social Work, Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia.
    Ciccarelli, Marina
    School of Occupational Therapy and Social Work, Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Parsons, Richard
    School of Occupational Therapy and Social Work, Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia.
    Associations between exposure to Information and Communication Technology (ICT) and reported discomfort among adolescents2014In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 48, no 2, p. 165-173Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Use of Information and Communication Technologies (ICT) are common among adolescents in their daily activities. Exposure to ICT has been associated with discomfort and musculoskeletal disorders in adults, with growing concern about the potential risks to children and adolescents' physical health. OBJECTIVE: The objectives of this study were to (i) quantify self-reported discomfort and exposure to ICT among adolescents; and (ii) determine if associations exist between discomfort and levels of exposure. PARTICIPANTS: The participant group comprised 33 Australian adolescents aged 12-15 years. METHODS: The study used self-reports by participants for a one week period. Intensity and location of discomfort was reported via a written discomfort log. ICT exposure and physical activity were reported through an electronic time-use diary. RESULTS: The most common ICT types reported by participants were television, mobile phones and desktop and laptop computers. Discomfort was reported by 86% of participants. The most frequently reported areas were the legs, head/neck, back and shoulders. There was no statistical association found between ICT exposure and discomfort. The majority of participants exceeded the recommended 60 minutes per day of moderate to vigorous physical activity. CONCLUSIONS: High exposure to ICT and high prevalence of low level discomfort was reported by the participants. Participating in regular physical activity may have some protective effect against ICT-related discomfort.

  • 24.
    Siegrist, Johannes
    et al.
    Department of Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany .
    Dragano, Nico
    Department of Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany .
    Nyberg, Solja
    Finnish Institute of Occupational Health, Helsinki, Finland .
    Lunau, Thorsten
    Department of Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany .
    Alfredsson, Lars
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Erbel, Raimund
    Department of Cardiology, West-German Heart Center Essen, University Duisburg-Essen, Essen, Germany .
    Fahlén, Göran
    The National Agency for Special Needs Education and Schools, Härnösand, Sweden .
    Goldberg, Marcel
    Versailles-Saint Quentin University, Versailles, France; Inserm U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France .
    Jöckel, Karl-Heinz
    Institute for Medical Informatics, Biometry, and Epidemiology, University Duisburg-Essen, Essen, Germany .
    Knutsson, Anders
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Leineweber, Constanze
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Magnusson Hanson, Linda
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Nordin, Maria
    Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden .
    Rugulies, Reiner
    National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Public Health and Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
    Schupp, Jürgen
    German Institute for Economic Research, Berlin, Germany.
    Singh-Manoux, Archana
    Department of Epidemiology and Public Health, University College London, London, UK; Inserm U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France.
    Theorell, Töres
    Stress Research Institute, Stockholm University, Stockholm, Sweden .
    Wagner, Gert
    German Institute for Economic Research, Berlin, Germany; Max Planck Institute for Human Development, Berlin, Germany.
    Westerlund, Hugo
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Zins, Marie
    Versailles-Saint Quentin University, Versailles, France; Inserm U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France .
    Heikkilä, Katriina
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Fransson, Eleonor
    Jönköping University, School of Health Science, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health Science, HHJ. ADULT. Stress Research Institute, Stockholm University, Stockholm, Sweden; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Kivimäki, Mika
    Department of Epidemiology and Public Health, University College London, London, UK; Finnish Institute of Occupational Health, Helsinki, Finland.
    Validating abbreviated measures of effort-reward imbalance at work in European cohort studies: The IPD-Work consortium2014In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 87, no 3, p. 249-256Article in journal (Refereed)
    Abstract [en]

    Background: Effort-reward imbalance (ERI) is an established conceptualisation of work stress. Although a validated effort-reward questionnaire is available for public use, many epidemiological studies adopt shortened scales and proxy measures. To examine the agreement between different abbreviated measures and the original instrument, we compared different versions of the effort-reward scales available in 15 European cohort studies participating in the IPD-Work (Individual-participant-data meta-analysis in working populations) consortium.

    Methods: Five of the 15 studies provide information on the original (‘complete’) scales measuring ‘effort’ and ‘reward’, whereas the 10 remaining studies used ‘partial’ scales. To compare different versions of the ERI scales, we analyse individual-level data from 31,790 participants from the five studies with complete scales.

    Results: Pearson’s correlation between partial and complete scales was very high in case of ‘effort’ (where 2 out of 3 items were used) and very high or high in case of ‘reward’, if at least 4 items (out of 7) were included. Reward scales composed of 3 items revealed good to satisfactory agreement, and in one case, a reward scale consisting of 2 items only demonstrated a modest, but still acceptable degree of agreement. Sensitivity and specificity of a composite measure, the ratio of effort and reward, comparing partial versus complete scales ranged between 59–93 and 85–99 %, respectively. Complete and partial scales were strongly associated with poor self-rated health.

    Conclusion: Our results support the notion that short proxy measures or partial versions of the original scales can be used to assess effort-reward imbalance.

  • 25. Sun, Q.
    et al.
    Xia, J.
    Foster, J.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD. School of Occupational Therapy and Social Work, Curtin University, Australia.
    Lee, H.
    Pursuing Precise Vehicle Movement Trajectory in Urban Residential Area Using Multi-GNSS RTK Tracking2017In: Transportation Research Procedia, Elsevier, 2017, Vol. 25, p. 2361-2376Conference paper (Refereed)
    Abstract [en]

    Close-to-reality vehicle movement trajectory data can be useful in many transport and geography studies when precise vehicle localization or timing is required in the application. Vehicle kinematic tracking by GPS (Global Positioning System) varies in the data accuracy depending on some factors such as the receiver capability, satellites availability. Nevertheless, advanced positioning techniques offer possibilities to enhance the tracking data quality. In this paper, the high performance of multi-GNSS (multiple Global Navigation Satellite Systems) with Real-time Kinematic (RTK) solution was investigated aiming to pursue precise vehicle movement trajectory in an urban residential area of Australia. We systematically compared vehicle kinematic recordings between different positioning solutions by multi-GNSS and GPS-only approaches. Different elevation cut-off angles ranging from 5 - 35° were applied to simulate satellites' availability in different sky view conditions. The results showed that the multi-GNSS approach outperformed conventional GPS positioning in availability and positioning accuracy, and RTK solution at 10Hz generated ideal vehicle movement trajectory suitable for driving behaviours studies.

  • 26.
    Tengelin, Ellinor
    Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg.
    Creating proactive boundary awareness - Observations and feedback on lowerlevel health care managers’ time commitments and stress2012Licentiate thesis, comprehensive summary (Other academic)
    Abstract [en]

    Aim. The aim of this thesis was to deepen the knowledge concerning health care managers’ everyday work experiences and their handling of stress and balance.

    Background. Health care managers’ work is characterized by daily hassles, conflicting perspectives, and unclear boundary setting. They could therefore use support in boundary and stress management.

    Methods. A qualitatively driven mixed methods approach was used. Qualitative interviews, focus groups and workplace observations were used for data collection in Study I. Physiological stress indicators, stress self-assessments, workplace observations and interviewing were used in Study II. Analyses were mainly carried out on the interview data, using grounded theory methodology (Study I) and conventional content analysis (Study II).

    Results. Paper I shows that a first step in managers’ boundary setting is to recognize areas at work with conflicting expectations and inexhaustible needs. Strategies can then be formed through proactive, continuous negotiating of their time commitments. These strategies, termed ‘boundary approaches’, are more or less strict regarding the boundary setting at work. Paper II shows that nonnormative, interactive feedback sessions could encourage understanding and meaningfulness of previous stress experiences through a two-step appraisal process. In the first appraisal in the study, feedback was spontaneously reacted on, while in phase two it was made sensible and given meaning. However, during the sessions, some obstacles appeared to managers’ learning about their stress, preventing a second appraisal of the feedback.

    Conclusions. Awareness and continuous negotiation regarding boundary dilemmas can be effective as a proactive stress management tool among managers. Further, non-normative feedback on stress indicators may initiate key 3 processes of sensemaking which can aid managers’ stress management by increasing awareness and supporting learning about their stress. Proactive boundary awareness is a concept leading to better understanding of lower-level managers’ management of their time commitments and stress, which can be supported by continuous reflection, feedback situations and a supportive context.

  • 27.
    Tengelin, Ellinor
    et al.
    Sahlgrenska akademin, Göteborgs universitet.
    Arman, Rebecka
    Sahlgrenska akademin, Göteborgs universitet.
    Wikström, Ewa
    Sahlgrenska akademin, Göteborgs universitet.
    Dellve, Lotta
    Sahlgrenska akademin, Göteborgs universitet.
    Regulating time commitments in healthcare organizations: Managers’ boundary approaches at work and in life2011In: Journal of Health Organisation & Management, ISSN 1477-7266, E-ISSN 1758-7247, Vol. 25, no 5, p. 578-599Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this paper is to explore managers' boundary setting in order to better understand their handling of time commitment to work activities, stress, and recovery during everyday work and at home.

    Design/methodology/approach: The paper has qualitatively-driven, mixed method design including observational data, individual interviews, and focus group discussions. Data were analyzed according to Charmaz' view on constructivist grounded theory.

    Findings: A first step in boundary setting was to recognize areas with conflicting expectations and inexhaustible needs. Second, strategies were formed through negotiating the handling of managerial time commitment, resulting in boundary-setting, but also boundary-dissolving, approaches. The continuous process of individual recognition and negotiation could work as a form of proactive coping, provided that it was acknowledged and questioned.

    Research limitations/implications: These findings suggest that recognition of perceived boundary challenges can affect stress and coping. It would therefore be interesting to more accurately assess stress, coping, and health status among managers by means of other methodologies (e.g. physiological assessments).

    Practical implications: In regulating managers' work assignments, work-related stress and recovery, it seems important to: acknowledge boundary work as an ever-present dilemma requiring continuous negotiation; and encourage individuals and organizations to recognize conflicting perspectives inherent in the leadership assignment, in order to decrease harmful negotiations between them. Such awareness would benefit more sustainable management of healthcare practice.

    Originality/value: This paper highlights how managers can handle ever-present boundary dilemmas in the healthcare sector by regulating their time commitments in various ways.

  • 28.
    Tengelin, Ellinor
    et al.
    Sahlgrenska akademin, Göteborgs universitet.
    Kilman, Alma
    Eklöf, Mats
    Sahlgrenska akademin, Göteborgs universitet.
    Dellve, Lotta
    Sahlgrenska akademin, Göteborgs universitet.
    Chefskap i sjukhusmiljö: Avgränsning och kommunikation av egen stress2011Report (Refereed)
    Abstract [en]

    In the development of health promoting hospital organizations, 1st line managers hold a key position through their closeness to practice and integrated response-bility for practice, economy and staff. The purpose of this report is to contribute to the development of sustainable supportive structures that can strengthen managers’ own working conditions and their opportunities to balance their commitment and stress at work. The two studies describes managers’ (a) approaches to demarcations in manager practice, (b) perceived opportunities to communicate stress and problems in their organization, and (c) suggestions regarding how managers’ stress can be handled and how early signs of stress can be guarded in health care organizations. Each study started with qualitative interviews (n=10, n=6). Thereafter, the results were discussed with 1st line managers (n=71) in 13 focus groups, regarding interventions and changes.

    Study 1. Strategies for demarcations between work tasks and life spheres were more or less flexible, firm, or permeable. They were characterized by different level of controlling and adapting to the present situation, others’ needs or one’s own needs. These strategies were seldom outspoken. Further, they were resulting mainly from personal experience, which made the managers ask for increased external support in boundary-setting regarding working conditions that were constantly changing and difficult to demarcate.

    Study 2. Communication of stress within the organization was hindered be-cause the system was perceived to oppress problem descriptions. Fear was expressed that the higher levels in the organization considered lower level managers’ communication about their stress a failure. That could risk losing one’s reputation and career possibilities. One’s nearest manager was seen as the most important channel for meeting and managing stress. Surveys and other stress measuring methods require an open climate to handle the information received, and that actions are taken to address potential problems.Focus groups. Supportive structures that can improve managers’ own working conditions and their opportunities to balance commitment and stress at work concern:

    • Possibilities for communicating stress and problem descriptions through elaborated “manager to manager”-dialogues; rewarding communication of problem descriptions in the line organization; dialogue-based development projects to influence values and culture; and an overview over the recruiting process in practice
    • Efforts to increase one’s self-awareness and handling strategies through supervision; room for recurrent dialogues with manager colleagues; and health status dialogues with occupational health service that address individual sustainability in the manager work
    • Clarity regarding responsibility, resources and guidelines for manager responsibility in the organization; increased direct support by resource functions; and a recruitment process permeated by a health promoting perspective

    Results from this report can be used as knowledge base when formulating policies and plans for actions in order to prevent, discover, and adjust stress and exhaust-tion among managers in public health care organizations.

  • 29.
    Tennstedt, Frida
    et al.
    Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Mastoraki Karlsson, Linnea
    Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Barns intryck av omgivningen på en ortopedteknisk avdelning: -      En kvalitativ studie om hur barn uppfattar miljön och mötet på en ortopedteknisk avdelning2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: To achieve good child centered care in the field of prosthetics/orthotics, information about how children perceive a meeting with a prosthetist/orthotist is needed. Knowing children’s thoughts, opinions and suggestions about the situation can help increase knowledge about how to set up the environment and meetings. Aim: The aim of this study is to investigate how children experience the interactions with health professionals and the environment when meeting a prosthetist or orthotist. Method: A qualitative method called “draw and tell” was used. Eight children aged between 6 to 12 years were interviewed after a meeting with a prosthetist/orthostist. The interviews were transcribed and a content analysis was performed. Result: Too much talk without engaging the child and long waiting times were found as negative factors and activities such as books and toys and that the prosthetist/orthotist was kind were found as positive factors during the meeting. Multiple suggestions were given about what kinds of activity could be available to children when waiting these included computer games and books. Conclusion:  This study shows that it is important for a prosthetist/orthoptist to engage children in the meetings and that possibilities for activities are available when children are waiting to see the clinician.

     

    Keywords: Children’s experience, Prosthetics, Orthotics,  Enviroment, Consultation

  • 30.
    Toomingas, Allan
    et al.
    Högskolan i Gävle.
    Hagberg, Mats
    Occupational & Environmental Medicine University of Gothenburg.
    Heiden, Marina
    Högskolan i Gävle.
    Richter, Hans
    Högskolan i Gävle.
    Westergren, Karl Erik
    Högskolan i Gävle.
    Wigaeus Tornqvist, Ewa
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Incidence and risk factors for symptoms from the eyes among professional computer users2012In: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 41, no Supplement 1, p. 3560-3562Article in journal (Refereed)
    Abstract [en]

    Personal computers are used by a majority of the working population in their professions. Little is known about risk-factors for incident symptoms from the eyes among professional computer users. The aim was to study the incidence and risk-factors for symptoms from the eyes among professional computer users. This study is a part of a comprehensive prospective follow-up study of factors associated with the incidence of symptoms among professional computer users. 1531 computer users of different professions at 46 companies were invited, whereof 1283 answered a baseline questionnaire (498 men; 785 women) and 1246 at least one of 10 monthly follow-up questionnaires. The computer work-station and equipment were generally of a good standard. The majority used CRT displays. During the follow-up period 329 subjects reported eye symptoms. The overall incidence rate in the whole study group was 0.38 per person-year, 0.23 in the subgroup of subjects who were symptom free at baseline and 1.06 among subjects who reported eye symptoms at baseline. In the bivariate analyses significant associations were found with all explanatory variables, except BMI. The reduced multivariate model showed significant associations with extended computer work, visual discomfort (dose-response), eye symptoms at baseline (higher risk), sex (women=higher risk) and nicotine use. The incidence of eye problems among professional computer users is high and related to both individual and work-related factors.

  • 31.
    Unsworth, Carolyn A.
    et al.
    Jönköping University, School of Health and Welfare. Faculty of Health Sciences, La Trobe University, Melbourne 3086, VIC, Australia.
    Baker, Anne
    Faculty of Health Sciences, La Trobe University, Melbourne 3086, VIC, Australia.
    Driver rehabilitation: A systematic review of the types and effectiveness of interventions used by occupational therapists to improve on-road fitness-to-drive2014In: Accident Analysis and Prevention, ISSN 0001-4575, E-ISSN 1879-2057, Vol. 71, p. 106-114Article, review/survey (Refereed)
    Abstract [en]

    Objective: Driver rehabilitation has the potential to improve on-road safety and is commonly recommended to clients. The aim of this systematic review was to identify what intervention approaches are used by occupational therapists as part of driver rehabilitation programmes, and to determine the effectiveness of these interventions. Method: Six electronic databases (MEDLINE, CINAHL, Psycinfo, Embase, The Cochrane Library, and OTD-Base) were searched. Two authors independently reviewed studies reporting all types of research designs and for all patient populations, provided the interventions could be administered by occupational therapists. The methodological quality of studies was assessed using the 'Downs and Black Instrument', and the level of evidence for each intervention approach was established using 'Centre for Evidence Based Medicine' criteria. Results: Sixteen studies were included in the review. The most common type of intervention approach used was computer-based driving simulator training (n=8), followed by off-road skill-specific training (n=4), and off-road education programmes (n=3). Car adaptations/modifications were used in one of the included studies. There was significant variability between studies with regards to frequency, duration, and total number of intervention sessions, and the diagnoses of the participants. Of the four intervention approaches, there is evidence to support the effectiveness of off-road skill-specific training (with older clients), and computer-based driving simulator training (with both older clients and participants with acquired brain injury). Conclusion: Three types of intervention approaches are commonly reported, however, there is limited evidence to determine to effectiveness of these in improving fitness-to-drive. Further research is required, with clients from a range of diagnostic groups to establish evidence-based interventions and determine their effectiveness in improving these clients' on-road fitness-to-drive. Crown Copyright (C) 2014 Published by Elsevier Ltd. All rights reserved.

  • 32.
    Virtanen, Marianna
    et al.
    Finnish Institute of Occupational Health, FI-00250 Helsinki, Finland .
    Nyberg, Solja
    Finnish Institute of Occupational Health, FI-00250 Helsinki, Finland .
    Batty, David
    Department of Epidemiology and Public Health, University College London, London, United Kingdom; Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom.
    Jokela, Markus
    Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland .
    Heikkilä, Katriina
    Finnish Institute of Occupational Health, FI-00250 Helsinki, Finland .
    Fransson, Eleonor
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. ADULT. Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Stress Research Institute, Stockholm University, Stockholm, Sweden .
    Alfredsson, Lars
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden .
    Bjorner, Jakob
    National Research Centre for the Working Environment, Copenhagen, Denmark .
    Borritz, Marianne
    Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark .
    Burr, Hermann
    Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany .
    Casini, Annalisa
    School of Public Health, Université Libre de Bruxelles, Brussels, Belgium .
    Clays, Els
    Department of Public Health, Ghent University, Ghent, Belgium .
    De Bacquer, Dirk
    Department of Public Health, Ghent University, Ghent, Belgium .
    Dragano, Nico
    Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany .
    Elovainio, Marko
    National Institute for Health and Welfare, Helsinki, Finland .
    Erbel, Raimund
    Department of Cardiology, West-German Heart Center Essen, University Duisburg-Essen, Essen, Germany .
    Ferrie, Jane
    Department of Epidemiology and Public Health, University College London, London, United Kingdom; School of Community and Social Medicine, University of Bristol, Bristol, United Kingdom .
    Hamer, Mark
    Department of Epidemiology and Public Health, University College London, London, United Kingdom .
    Jöckel, Karl-Heinz
    Institute for Medical Informatics, Biometry, and Epidemiology, University Duisburg-Essen, Germany .
    Kittel, France
    School of Public Health, Université Libre de Bruxelles, Brussels, Belgium .
    Knutsson, Anders
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden .
    Koskenvuo, Markku
    Department of Public Health, University of Helsinki, Finland .
    Koskinen, Aki
    Finnish Institute of Occupational Health, FI-00250 Helsinki, Finland .
    Lunau, Thorsten
    Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany .
    Madsen, Ida
    National Research Centre for the Working Environment, Copenhagen, Denmark .
    Nielsen, Martin
    Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark .
    Nordin, Maria
    Department of Psychology, Umeå University, Umeå, Sweden .
    Oksanen, Tuula
    Finnish Institute of Occupational Health, FI-00250 Helsinki, Finland .
    Pahkin, Krista
    Department of Epidemiology and Public Health, University College London, London, United Kingdom .
    Pejtersen, Jan
    Danish National Centre for Social Research, Copenhagen, Denmark .
    Pentti, Jaana
    Finnish Institute of Occupational Health, FI-00250 Helsinki, Finland .
    Rugulies, Reiner
    National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark .
    Salo, Paula
    Finnish Institute of Occupational Health, FI-00250 Helsinki, Finland; Department of Psychology, University of Turku, Turku, Finland .
    Shipley, Martin
    Department of Epidemiology and Public Health, University College London, London, United Kingdom .
    Siegrist, Johannes
    Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany .
    Steptoe, Andrew
    Department of Epidemiology and Public Health, University College London, London, United Kingdom .
    Suominen, Sakari
    Folkhälsan Research Center, Helsinki, Finland; Department of Public Health, University of Turku, Finland; Nordic School of Public Health, Gothenburg, Sweden .
    Theorell, Töres
    Stress Research Institute, Stockholm University, Stockholm, Sweden .
    Toppinen-Tanner, Salla
    Finnish Institute of Occupational Health, FI-00250 Helsinki, Finland .
    Väänänen, Ari
    Finnish Institute of Occupational Health, FI-00250 Helsinki, Finland .
    Vahtera, Jussi
    Finnish Institute of Occupational Health, FI-00250 Helsinki, Finland; Department of Public Health, University of Turku, Finland; Turku University Hospital, Turku, Finland .
    Westerholm, Peter
    Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden .
    Westerlund, Hugo
    Stress Research Institute, Stockholm University, Stockholm, Sweden .
    Slopen, Natalie
    Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA, United States; Center for the Developing Child, Harvard University, Cambridge, MA, United States .
    Kawachi, Ichiro
    Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA, United States .
    Singh-Manoux, Archana
    Department of Epidemiology and Public Health, University College London, London, United Kingdom; Inserm U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France .
    Kivimäki, Mika
    Finnish Institute of Occupational Health, FI-00250 Helsinki, Finland; Department of Epidemiology and Public Health, University College London, London, United Kingdom; Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland.
    Perceived job insecurity as a risk factor for incident coronary heart disease: systematic review and meta-analysis2013In: BMJ. British Medical Journal, E-ISSN 1756-1833, Vol. 347, no 7921, article id f4746Article in journal (Refereed)
    Abstract [en]

    Objective To determine the association between self reported job insecurity and incident coronary heart disease.

    Design A meta-analysis combining individual level data from a collaborative consortium and published studies identified by a systematic review.

    Data sources We obtained individual level data from 13 cohort studies participating in the Individual-Participant-Data Meta-analysis in Working Populations Consortium. Four published prospective cohort studies were identified by searches of Medline (to August 2012) and Embase databases (to October 2012), supplemented by manual searches.

    Review methods Prospective cohort studies that reported risk estimates for clinically verified incident coronary heart disease by the level of self reported job insecurity. Two independent reviewers extracted published data. Summary estimates of association were obtained using random effects models.

    Results The literature search yielded four cohort studies. Together with 13 cohort studies with individual participant data, the meta-analysis comprised up to 174 438 participants with a mean follow-up of 9.7 years and 1892 incident cases of coronary heart disease. Age adjusted relative risk of high versus low job insecurity was 1.32 (95% confidence interval 1.09 to 1.59). The relative risk of job insecurity adjusted for sociodemographic and risk factors was 1.19 (1.00 to 1.42). There was no evidence of significant differences in this association by sex, age (<50 v ≥50 years), national unemployment rate, welfare regime, or job insecurity measure.

    Conclusions The modest association between perceived job insecurity and incident coronary heart disease is partly attributable to poorer socioeconomic circumstances and less favourable risk factor profiles among people with job insecurity.

1 - 32 of 32
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