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  • 1.
    Ahmadi, Fereshteh
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Criminology, Social Work.
    Cetrez, Önver Andreas
    Department of Psychology of Religion, Faculty of Theology, Uppsala University, 75120 Uppsala, Sweden.
    Zandi, Saeid
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Criminology, Social Work.
    Living through a Global Pandemic: A Cross-Sectional Study on the Psychological Resilience of the University Population in Iran2023In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 20, no 6, article id 4844Article in journal (Refereed)
    Abstract [en]

    Aims: This study aimed to describe and understand the individual and social dimensions of resiliency among Iranian academics as professionals during the early wave of the ongoing pandemic. Furthermore, we aimed to emphasize the cultural context in our analysis. Method: A cross-sectional survey design was adopted. We used convenient sampling, administered through an online survey, among academics at Iranian universities (n = 196, 75% women). We employed the CD-RISC 2 instrument, items on life meaning, and a modified version of Pargament’s RCOPE instrument (Meaning, Control, Comfort/Spirituality, Intimacy/Spirituality, and Life Transformation). Results: The results revealed a strong level of resilience among men (M = 5.78) and women (M = 5.52). Self-rated health was rated as excellent, very good, or good among a majority (92%) of the participants, more so among men. Family was one of the factors that most strongly gave life meaning, followed by friends, work/school, and religion/spirituality. There was a strong correlation between self-rated health and life as part of a greater whole, being alone, and listening to the sounds of the surrounding nature. Conclusions: Both personal and social levels of resilience and meaning-making are seen in the results, with an ability to balance between obstacles and resources. Cultural practices are interdependent, which also include the individual and social dimensions of resiliency and meaning-making.

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    Living through a Global Pandemic
  • 2.
    Arakelian, Erebouni
    et al.
    Uppsala universitet, Anestesiologi och intensivvård.
    Hellman, Therese
    Uppsala universitet, Arbets- och miljömedicin.
    Svartengren, Magnus
    Uppsala universitet, Arbets- och miljömedicin.
    Experiences of the initial phase implementation of the STAMINA-model in perioperative context addressing environmental issues systematically: A qualitative study2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 9, article id 3037Article in journal (Refereed)
    Abstract [en]

    (1) Background: Challenges in perioperative settings put demands on staff working with systematic work environment management. A support model, STAMINA (Structured and Time-effective Approach through Methods for an Inclusive and Active working life), was implemented in a hospital in Sweden, to help staff address environmental issues systematically. The aim was to describe the experiences of the initial phase of implementation of the adapted STAMINA model in perioperative context. (2) Methods: Qualitative individual interviews were held with 14 managers and employees (three men and 11 women). Data were analysed by systematic text condensation. (3) Results: Five themes were identified: Limited knowledge of the model and the implementation process; scepticism, lack of confidence in the model and a passive attitude; the model offered increased participation; the culture in the organization-to understand one's role as employees and managers; and endurance and feedback are key factors for success in the implementation process. (4) Conclusions: Scepticism turned to positive attitude by recognising that the STAMINA model offered increased participation. In order to have successful implementation, the organisational culture must be taken into consideration by giving the employees increased responsibilities and timely feedbacks. Role description, goal definition, feedback, and sticking to one model are key factors for success.

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    FULLTEXT01
  • 3.
    Arakelian, Erebouni
    et al.
    Uppsala universitet, Anestesiologi och intensivvård.
    Paulsson, Sofia
    Uppsala universitet, Arbets- och miljömedicin.
    Molin, Fredrik
    Uppsala universitet, Arbets- och miljömedicin.
    Svartengren, Magnus
    Uppsala universitet, Arbets- och miljömedicin.
    How Human Resources Index, Relational Justice, and Perceived Productivity Change after Reorganization at a Hospital in Sweden That Uses a Structured Support Model for Systematic Work Environment Management2021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 21, article id 11611Article in journal (Refereed)
    Abstract [en]

    To facilitate systematic work environment management, which should be a natural part of business development, a structured support model was developed. The Stamina model has previously been used in Swedish municipalities, showing positive results. The aim was to study how the Human Resources Index (HRI), relational justice, short-term recovery and perceived productivity changed in a recently reorganised perioperative setting in a hospital in Sweden that uses a structured support model for systematic work environment management. A longitudinal design that took measurements at four time points was used in a sample of 500 employees in a perioperative hospital department. The results for the overall sample indicated a positive trend in the HRI (Mt1 = 48.5, SDt1 = 22.5; Mt3 = 56.7, SDt1 = 21.2; p < 0.001). Perceived health-related production loss (Mdt1 = 2, IQR = 3; Mdt3 = 0, IQR = 3; p < 0.001) and perceived work environment-related production loss (Mdt1 = 2, IQR = 3; Mdt3 = 0, IQR = 4; p < 0.001) showed major improvements. Short-term recovery showed a minor improvement (Mt1 = 2.61, SDt1 = 1.33; Mt3 = 2.65, SDt3 = 1.22; p = 0.872). In conclusion, the implementation of the Stamina model, of which the HRI constitutes an important part, seems to be a helpful tool to follow-up on work environment processes, and minimise production losses due to health and work environment-related issues.

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  • 4.
    Bergsten, Eva L.
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Wijk, Katarina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research. Centre for Research and Development, Region Gävleborg/Uppsala University .
    Hallman, David
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Implementation of Activity-Based Workplaces (ABW)—The Importance of Participation in Process Activities2022In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, no 21, article id 14338Article in journal (Refereed)
    Abstract [en]

    Relocation to new office solutions such as activity-based workplaces (ABW) has increased but satisfaction with the ABW among employees varies, and the importance of participation in the relocation process is unclear. This study aimed to examine the association between employees’ extent of participation in the implementation process activities and satisfaction with the relocation to ABW. Data were collected from 699 employees in a Swedish governmental agency 3-months prior to, 3-months and 9-months after relocation to the ABW. Questionnaires were used to assess participation in process activities and perceived satisfaction with knowledge about working in ABW, office rules, and information and support during the process. Participation in activities was significantly associated with higher overall satisfaction with knowledge, office rules, information and support, and effects were generally more pronounced as the number of attended activities increased. Satisfaction also increased among non-participants, although without reaching the same levels as participants. Our results show the importance to offer and facilitate a high participation in the relocation process activities to obtain satisfaction with a relocation to ABW.

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  • 5.
    Bergsten, Eva L.
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Wijk, Katarina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research. Centre for Research and Development, Region Gavleborg/Uppsala University; Uppsala University.
    Hallman, David
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Relocation to activity-based workplaces (ABW) – importance of the implementation process2021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, article id 11456Article in journal (Refereed)
    Abstract [en]

    Activity-based workplaces (ABW) have been implemented in many organizations to offer office flexibility and decrease facility costs. Evaluations of the ABW implementation process are rare. The study aimed to examine the ABW relocation process of two offices in a Swedish governmental agency and to explore factors that influence the implementation process and satisfaction with it. Qualitative or quantitative data were collected on process variables (context, recruitment, reach, dose delivered, dose received, satisfaction), barriers and facilitators to the process were explored in focus group interviews, and immediate outcomes (perceived knowledge, understanding office rules, satisfying information and support) were measured by questionnaire before and after the relocation. The evaluation showed that recruitment was unsatisfactory and reach insufficient—and participation in activities was thus low for both offices. However, intended changes improved. Unclear aims of ABW, lack of manager support and, lack of communication were some of the reported barriers to participation, while a well-planned process, work groups, and program activities were facilitators. Thus, to increase satisfaction with the relocation, our results suggest that recruitment should be thoroughly planned, taking these factors into account to increase participation. This knowledge may be useful for planning and designing successful ABW relocations and evaluations.

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  • 6.
    Bergström, Gunnar
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research. Karolinska institutet.
    Gustafsson, Klas
    Karolinska institutet.
    Aboagye, Emmanuel
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Marklund, Staffan
    Karolinska institutet.
    Aronsson, Gunnar
    Stockholms universitet.
    Björklund, Christina
    Karolinska institutet.
    Leineweber, Constanze
    Stockholms universitet.
    A resourceful work environment moderates the relationship between presenteeism and health. A study using repeated measures in the Swedish working population2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 13, article id 4711Article in journal (Refereed)
    Abstract [en]

    The objective of this study was to investigate if the psychosocial work environment moderates the proposed negative impact of presenteeism on future general health. We expect that the negative impact of presenteeism on general health is weaker if the psychosocial work environment is resourceful, and more pronounced if the environment is stressful. Data were derived from the 2008&ndash;2018 biennial waves of the Swedish Longitudinal Occupational Survey of Health (SLOSH). The final analytic sample consisted of n = 15,779 individuals. We applied repeated measures regression analyses through generalized estimating equations (GEE). Results from the autoregressive GEE models showed statistically significant interaction terms between presenteeism and all four investigated moderators, i.e., job demands, job control, job support and job strain. The results indicate that the psychosocial work environment moderates the negative association between presenteeism and general health and illustrates a buffering effect of the psychosocial work environment. A possible explanation for these results may be that psychosocially resourceful work environments give room for adjustments in the work situation and facilitate recovery. The results also indicate that by investing the psychosocial work environment employers may be able to promote worker health as well as prevent reduced job performance due to presenteeism.

  • 7.
    Berthelsen, Hanne
    et al.
    Malmö University.
    Muhonen, Tuija
    Malmö University.
    Bergström, Gunnar
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research. Karolinska institutet.
    Westerlund, Hugo
    Stockholm University.
    Dollard, Maureen F.
    University of South Australia.
    Benchmarks for Evidence-Based Risk Assessment with the Swedish Version of the 4-Item Psychosocial Safety Climate Scale2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 22, article id 8675Article in journal (Refereed)
    Abstract [en]

    The purpose of the present study was to validate the short version of The Psychosocial Safety Climate questionnaire (PSC-4, Dollard, 2019) and to establish benchmarks indicating risk levels for use in Sweden. Cross-sectional data from (1) a random sample of employees in Sweden aged 25&ndash;65 years (n = 2847) and (2) a convenience sample of non-managerial employees from 94 workplaces (n = 3066) were analyzed. Benchmarks for three PSC risk levels were developed using organizational compliance with Occupational Safety and Health (OSH) regulations as criterion. The results support the validity and usefulness of the Swedish PSC-4 as an instrument to indicate good, fair, and poor OSH practices. The recommended benchmark for indicating good OSH practices is an average score of &gt;12.0, while the proposed cutoff for poor OSH practices is a score of &le;8.0 on the PSC-4. Scores between these benchmarks indicate fair OSH practices. Furthermore, aggregated data on PSC-4 supported its reliability as a workplace level construct and its association with quantitative demands, quality of leadership, commitment to the workplace, work engagement, job satisfaction, as well as stress and burnout. Thus, the Swedish version of PSC-4 can be regarded as a valid and reliable measure for both research and practical use for risk assessment at workplaces.

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  • 8.
    Berthelsen, Hanne
    et al.
    Malmö universitet.
    Westerlund, Hugo
    Stockholms universitet.
    Bergström, Gunnar
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research. Karolinska institutet.
    Burr, Hermann
    Federal Institute of Occupational Safety and Health (BAuA), 10317 Berlin, Germany.
    Validation of the Copenhagen Psychosocial Questionnaire Version III and Establishment of Benchmarks for Psychosocial Risk Management in Sweden.2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 9, article id E3179Article in journal (Refereed)
    Abstract [en]

    This study presents the Swedish standard version of the Copenhagen Psychosocial Questionnaire, COPSOQ III, and investigates its reliability and validity at individual and workplace levels with the aim of establishing benchmarks for the psychosocial work environment. Cross-sectional data from (1) a random sample of employees in Sweden aged 25-65 years (N = 2847) and (2) a convenience sample of non-managerial employees at 51 workplaces (N = 1818) were analysed. Internal consistency reliability was evaluated as well as the effects of sex, work sector and blue/white-collar work. Population benchmarks and mean scores for major occupational groups were computed based on weighted data. ICC(1) and ICC(2) estimates were computed to evaluate aggregation to the workplace level and Pearson inter-correlations to evaluate construct validity at individual and aggregated levels. The reliability and scale characteristics were satisfactory, with few exceptions, at both individual and workplace levels. The strength and direction of correlations supported the construct validity of the dimensions and the amount of variance explained by workplace justified aggregation to the workplace level. The present study thus supports the use of COPSOQ III for measurement at the workplace level and presents benchmarks for risk management as well as for research purposes.

  • 9.
    Bjuhr, Marie
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Welmer, Anna-Karin
    Karolinska institutet.
    Lindberg, Magnus
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Sjölund, Britt-Marie
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Incentives behind and experiences of being active in working life after age 65 in Sweden2022In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, no 23, article id 15490Article in journal (Refereed)
    Abstract [en]

    Since individual and societal expectations regarding the possibility of an extended working life after the expected retirement age are increasing, research on sustainable working life combined with healthy ageing is needed. This study explores the incentives behind and experiences of an extended working life after the expected retirement age of 65 among Swedish people. The inductive qualitative content analyses are based on 18 individual semi-structured interviews among persons 67–90 years old with varying characteristics and varying experiences of extended working lives. The analyses revealed that working contributed to (1) sustained internal resources, i.e., cognitive function, physical ability and increased vigor; (2) sustained external resources, i.e., social enrichment, better daily routines and economic benefits; (3) added meaningfulness to life, i.e., being needed, capability and satisfaction with working tasks. Meanwhile, having flexible working conditions enabled a satisfying balance between work and leisure. Altogether, these different aspects of overall health and working life were interpreted as contributing to increased feelings of vitality, the innermost dimension of health. Conclusions: regardless of biological age, our results indicate that being able to remain active in working life can be beneficial to vitality and could make these results valuable for both health-care personnel and employers.

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  • 10.
    Bjärntoft, Sofie
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Hallman, David
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Mathiassen, Svend Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Larsson, Johan
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Jahncke, Helena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Occupational and individual determinants of work-life balance among office workers with flexible work arrangements2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 4, article id 1418Article in journal (Refereed)
    Abstract [en]

    Flexible work arrangements permitting workers to work anytime and anywhere are increasingly common. This flexibility can introduce both challenges and opportunities for the organisation, as well as for worker work-life balance (WLB). This cross-sectional study aimed to examine the extent to which occupational factors (organizational, leadership and psychosocial) and individual work-related behaviours (over-commitment, overtime work and boundary management) are associated with WLB, and whether these associations are modified by the perceived level of flexibility at work (i.e., control over when, where, and how to do the work). In total, 2960 full-time office workers with flexible work arrangements at the Swedish Transport Administration participated. Associations were determined using linear regression analyses with adjustment for covariates. The strongest negative associations with WLB were found for over-commitment, quantitative job demands, expectations of availability, and overtime work. Strongest positive associations were found for boundary management, information about organizing work, social support, and relation-oriented leadership. Perceived flexibility was positively associated with WLB, and interacted with several of the examined factors, buffering their negative associations with WLB. Results suggest that WLB can be promoted by organizational initiatives focusing on minimizing excessive job demands, increasing psychosocial resources, supporting boundary management, and enhancing perceived flexibility.

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  • 11.
    Boström, Maria
    et al.
    Karolinska institutet.
    Björklund, Christina
    Karolinska institutet.
    Bergström, Gunnar
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research. Karolinska institutet.
    Nybergh, Lotta
    Karolinska institutet.
    Schäfer Elinder, Liselotte
    Karolinska institutet.
    Stigmar, Kjerstin
    Lunds universitet.
    Wåhlin, Charlotte
    Karolinska institutet; Linköpings universitet.
    Jensen, Irene
    Karolinska institutet.
    Kwak, Lydia
    Karolinska institutet.
    Health and work environment among female and male Swedish elementary school teachers - A cross-sectional study2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 1, article id E227Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND OBJECTIVES: Changes in teachers' work situation in Sweden since the 1990s may have contributed to an increase in common mental disorders (CMDs) and burnout. However, there is a lack of research in this field. The aim was to describe how Swedish elementary school teachers experience their health, organizational and social work environment, and the psychosocial safety climate at the workplace, and especially differences and similarities between female and male teachers.

    MATERIALS AND METHODS: Data were collected with the COPSOQ, OLBI, UWES and PSC-12 from 478 elementary teachers, 81.0% of them women, from twenty schools. The response rate was 96.4%.

    RESULTS: Teachers reported relatively good general health but experienced high stress, high work pace and emotional demands, low influence at work and a poor psychosocial safety climate. These factors were especially prominent among female teachers. Both women and men experienced good development possibilities and high work engagement.

    CONCLUSIONS: The results of this study can help us to develop a more sustainable work environment for female and male teachers. A more sustainable work environment might attract more people to the profession and incentivize existing teachers to remain in the profession.

  • 12.
    Brusaca, Luiz Augusto
    et al.
    Department of Physical Therapy, Federal University of São Carlos.
    Barbieri, Dechristian
    Department of Physical Therapy, Federal University of São Carlos.
    Mathiassen, Svend Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Holtermann, Andreas
    National Research Centre for the Working Environment, Copenhagen.
    Oliveira, Ana Beatriz
    Department of Physical Therapy, Federal University of São Carlos.
    Physical behaviours in Brazilian office workers working from home during the COVID‐19 pandemic, compared to before the pandemic: A compositional data analysis2021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 12, article id 6278Article in journal (Refereed)
    Abstract [en]

    Work from home has increased greatly during the COVID-19 pandemic, and concerns have been raised that this would change physical behaviours. In the present study, 11 Brazilian office workers (five women, six men; mean [SD] age 39.3 [9.6] years) wore two triaxial accelerometers fixed on the upper back and right thigh continuously for five days, including a weekend, before COVID-19 (September 2019), and again while working at home during COVID-19 (July 2020). We determined time used in five behaviours: sedentary, standing, light physical activity (LPA), moderate-to-vigorous activity (MVPA), and time-in-bed. Data on these behaviours were processed using Compositional Data Analysis, and behaviours observed pre-COVID19 and during-COVID19 were compared using repeated-measures MANOVA. On workdays during-COVID19, participants spent 667 minutes sedentary, 176 standing, 74 LPA, 51 MVPA and 472 time-in-bed; corresponding numbers pre-COVID were 689, 180, 81, 72 and 418 minutes. Tests confirmed that less time was spent in bed pre-COVID19 (log-ratio -0.12 [95%CI -0.19; -0.08]) and more time in MVPA (log-ratio 0.35, [95%CI 0.08; 0.70]). Behaviours during the weekend changed only marginally. While small, this study is the first to report objectively measured physical behaviours during workdays as well as weekends in the same subjects before and during the COVID-19 pandemic.

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  • 13.
    Cetrez, Önver Andreas
    et al.
    Uppsala universitet.
    Zandi, Saeid
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Criminology, Social Work.
    Ahmadi, Fereshteh
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Criminology, Social Work.
    When a pandemic strikes: Resilience of Swedish academics in the face of coronavirus2022In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, no 20, article id 13346Article in journal (Refereed)
    Abstract [en]

    Background: The COVID-19 pandemic hit the world with severe health consequences, affecting some populations more than others. One understudied population is the academic community. This study, part of a larger project looking at COVID-19 in Sweden and internationally, aims to understand the individual and collective dimensions of resilience among academics in Sweden during the early wave of the pandemic. Method: A quantitative research design was applied for this cross-sectional study. We used simple random sampling, administered through an online survey, on academics at Swedish universities (n = 278, 64% women). We employed the CD-RISC 2 (the Connor–Davidson Resilience Scale) to measure personal/individual resilience, additional items for social/collective resilience, and a meaning-making coping instrument (meaning, control, comfort/spirituality, intimacy/spirituality, life transformation). Results: The results revealed a strong level of personal/individual resilience among men (M = 6.05) and a level just below strong among women (M = 5.90). By age group, those 35–49-year-olds showed strong resilience (M = 6.31). Family was the dominant social/collective resilience factor, followed by friends, nature, work/school, and, lastly, religion/spirituality. There was a positive and significant correlation between self-rated health and personal/individual resilience (r = 0.252, p = 0.001) and positive but weak correlations and negative significant correlations between personal/individual resilience and religious coping methods. Conclusions: During the pandemic, the family took priority in meaning-making, which is an interesting change in a strong individual-oriented society such as Sweden.

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  • 14.
    Edvinsson, Johanna
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Mathiassen, Svend Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Bjärntoft, Sofie
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Jahncke, Helena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Hartig, Terry
    Institute for Housing and Urban Research, Uppsala University, 75105 Uppsala, Sweden.
    Hallman, David
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    A Work Time Control Tradeoff in Flexible Work: Competitive Pathways to Need for Recovery2023In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 20, no 1, article id 691Article in journal (Refereed)
    Abstract [en]

    Work time control may offer opportunities, but also implies risks for employee recovery, influenced by increased work-related ICT use and overtime work. However, this risk–opportunity tradeoff remains understudied. This study aimed to test two different models of associations between work time control, work-related ICT use, overtime work, and the need for recovery. These models were constructed based on data on office workers with flexible work arrangements. Cross-sectional data were obtained with questionnaires (n = 2582) from employees in a Swedish multi-site organization. Regression models treated the three determinants of the need for recovery either as independent, or as linked in a causal sequence. The test of independent determinants confirmed that more work time control was associated with less need for recovery, whereas more ICT use and overtime work were associated with a higher need for recovery. In a test of serial mediation, more work time control contributed to a greater need for recovery through more ICT use and then more overtime work. Work time control also had a competitive, indirect effect through a negative association with overtime work. Our results suggest that work time control is beneficial for employee recovery, but may for some be associated with more work-related ICT use after regular working hours, thus increasing recovery needs. Policies that support work time control can promote recovery, but employers must attend to the risk of excessive use of ICT outside of regular working hours.

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    Edvinsson et al. 2023. A Work Time Control Tradeoff in Flexible Work_Competitive Pathways to Need for Recovery
  • 15.
    Georgieva, Irina
    et al.
    Bulgarian University.
    Lantta, Tella
    University of Turku, Finland.
    Lickiewicz, Jakub
    Jagiellonian University Medical College Krakow, Poland.
    Pekara, Jaroslav
    Medical College in Progue.
    Wikman, Sofia
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Criminology, Criminology.
    Loseviča, Marina
    Latvian University in Riga, Latvia.
    Raveesh, Bevinahalli Nanjegowda
    Government Medical College, Mysore, India.
    Mihai, Adriana
    GE Palade University of Medicine, Romania.
    Lepping, Peter
    Bangor University, UK; Mysore Medical College and Research Institute, Karnataka, India.
    Perceived effectiveness, restrictiveness and compliance with containment measures against the Covid-19 pandemic: an international comparative study in 11 countries2021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 7, article id 3806Article in journal (Refereed)
    Abstract [en]

    National governments took action to delay the transmission of the coronavirus (SARS-CoV-2) by implementing different containment measures. We developed an online survey that included 44 different containment measures. We aimed to assess how effective citizens perceive these measures, which measures are perceived as violation of citizens’ personal freedoms, which opinions and demographic factors have an effect on compliance with the measures, and what governments can do to most effectively improve citizens’ compliance. The survey was disseminated in 11 countries: UK, Belgium, Netherlands, Bulgaria, Czech Republic, Finland, India, Latvia, Poland, Romania, and Sweden. We acquired 9543 unique responses. Our findings show significant differences across countries in perceived effectiveness, restrictiveness, and compliance. Governments that suffer low levels of trust should put more effort into persuading citizens, especially men, in the effectiveness of the proposed measures. They should provide financial compensation to citizens who have lost their job or income due to the containment measures to improve measure compliance. Policymakers should implement the least restrictive and most effective public health measures first during pandemic emergencies instead of implementing a combination of many restrictive measures, which has the opposite effect on citizens’ adherence and undermines human rights.

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    fulltext
  • 16.
    Greby Schmidt, Kathrine
    et al.
    The National Research Centre for the Working Environment, Copenhagen,.
    Kildedal, Rasmus
    The National Research Centre for the Working Environment, Copenhagen,.
    Lerche, Anders Fritz
    The National Research Centre for the Working Environment, Copenhagen,.
    Wilhelmsen, Maja
    The National Research Centre for the Working Environment, Copenhagen,.
    Lund Rasmussen, Charlotte
    The National Research Centre for the Working Environment, Copenhagen,.
    Mathiassen, Svend Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Straker, Leon
    School of Allied Health and enAble Institute, Curtin University, Perth.
    Holtermann, Andreas
    The National Research Centre for the Working Environment, Copenhagen,.
    Does childcare work promote cardiorespiratory fitness and health? A cross‐sectional study of Danish childcare workers based on accelerometry and heart rate measurements2021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 23, article id 12496Article in journal (Refereed)
    Abstract [en]

    Childcare workers are reported to have poor cardiorespiratory fitness and health. The Goldilocks Work Principle argues that productive work should be designed with the right composition, intensity and alternations of physical behaviors so that workers get fit and healthy. The purpose of this study was to investigate: (1) composition, (2) intensity and (3) alternations of physical behaviors during work and leisure among childcare workers. Data were collected using accelerometers and heart rate monitors over five workdays among 51 childcare workers at five Danish childcare institutions. Workers mainly spent their work time sedentary (43.0%), spent little time (0.7%) at sufficiently high cardiometabolic intensity to increase cardiorespiratory fitness and often alternated between physical behaviors (67.0% occurred in bouts of <5 min). These findings indicate that the workers have a composition of behaviors at work dominated by sedentary time, little time with high cardiometabolic intensity, and frequent alternations between behaviors. During leisure, workers spent more time sedentary (59.4%), more time at high cardiometabolic intensity (3.4%) and less time occurred in bouts <5 min (38.7%). We see a potential for promoting cardiorespiratory fitness and health of childcare workers by redesigning the way they play with the children, so that work time with high cardiometabolic intensity is increased.

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  • 17.
    Gupta, Sandra Löfving
    et al.
    Uppsala University, Region Gävleborg.
    Wijk, Katarina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research. Uppsala University; Centre for Research and Development, Region Gävleborg/Uppsala University.
    Warner, Georgina
    Uppsala University.
    Sarkadi, Anna
    Uppsala University.
    Readiness of allied professionals to join the mental health workforce: a qualitative evaluation of trained lay trauma counsellors’ experiences when refugee youth disclose suicidal ideation2021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 4, article id 1486Article in journal (Refereed)
    Abstract [en]

    The recent refugee crisis presented a huge challenge for the Swedish mental health workforce. Hence, innovative mental health workforce solutions were needed. Unaccompanied refugee minors (URM) are a particularly vulnerable refugee group. Teaching Recovery Techniques (TRT) was introduced as a community-based intervention utilising trained lay counsellors in a stepped model of care for refugee youth experiencing trauma symptoms. Professionals (e.g., teachers, social workers) can deliver the Cognitive Behavioural Therapy-based intervention after a brief training. A point of debate in this workforce solution is the readiness of trained lay counsellors to deal with potentially demanding situations like disclosure of suicidal ideation. This study aimed to explore the TRT trained lay counsellors’ experiences of procedures upon URM’s disclosure of suicidal ideation. Individual semi-structured interviews with TRT trained lay counsellors were conducted, then analysed using systemic text condensation. The analysis revealed four themes: “Importance of safety structures”, “Collaboration is key”, “Let sleeping dogs lie” and “Going the extra mile”. Dealing with suicidal ideation is challenging and feelings of helplessness occur. Adding adequate supervision and specific training on suicidal ideation using role play is recommended. Collaboration between agencies and key stakeholders is essential when targeting refugee mental health in a stepped care model.

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  • 18.
    Gustafsson, Klas
    et al.
    Karolinska Institutet.
    Marklund, Staffan
    Karolinska Institutet.
    Leineweber, Constanze
    Stockholm University.
    Bergström, Gunnar
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research. Karolinska Institutet.
    Aboagye, Emmanuel
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. Karolinska Institutet.
    Helgesson, Magnus
    Karolinska Institutet.
    Presenteeism, psychosocial working conditions and work ability among care workers - a cross-sectional Swedish population-based study2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 7, article id 2419Article in journal (Refereed)
    Abstract [en]

    Presenteeism, attending work while ill, has been examined in different contexts in the last few decades. The aim was to examine whether poor psychosocial working conditions and perceived work ability are associated with increased odds ratios for presenteeism, focusing on nursing professionals and care assistants. A cross-sectional population-based study was conducted. The selected individuals were extracted from representative samples of employees, aged 16&ndash;64, who participated in the Swedish Work Environment Surveys between 2001 and 2013 (n = 45,098). Three dimensions of psychosocial working conditions were measured: job demands, job control, and job support. Presenteeism and perceived work ability was measured. Using multiple logistic regression analyses, odds ratios for presenteeism with 95% confidence intervals (CI) were estimated. While nurses (n = 1716) showed the same presenteeism level as all the other occupation groups (n = 37,125), it was more common among care assistants (n = 6257). The odds ratio for presenteeism among those with high job demands (OR = 2.37, 95% CI 2.21&ndash;2.53), were higher among women than among men. For nursing professionals and care assistants, the odds ratios for presenteeism were highest among those with the lowest work ability level. The problems of presenteeism and low work ability among many health and care workers may be lessened by a reduction in psychosocial demands.

  • 19.
    Göras, Camilla
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Department of Anesthesia and Intensive Care, Falu Hospital, SE-791 31 Falun, Sweden.
    Lohela Karlsson, Malin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research. Uppsala universitet.
    Castegren, Markus
    Uppsala universitet.
    Condén Mellgren, Emelie
    Centre for Clinical Research Västmanland, Uppsala University, SE-721 89 Västerås, Sweden.
    Ekstedt, Mirjam
    Department of Health and Caring Sciences, Linnaeus University Kalmar/Växjö, SE-392 31 Kalmar, Sweden;Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, SE-171 77 Stockholm, Sweden.
    Bjurling-Sjöberg, Petronella
    Centre for Clinical Research Sörmland, Uppsala University, SE-631 88 Eskilstuna, Sweden;Department of Public Health and Caring Sciences, Caring Science, Uppsala University, SE-752 37 Uppsala, Sweden.
    From Threatening Chaos to Temporary Order through a Complex Process of Adaptation: A Grounded Theory Study of the Escalation of Intensive Care during the COVID-19 Pandemic2023In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 20, no 21, article id 7019Article in journal (Refereed)
    Abstract [en]

    To ensure high-quality care, operationalize resilience and fill the knowledge gap regarding how to improve the prerequisites for resilient performance, it is necessary to understand how adaptive capacity unfolds in practice. The main aim of this research was to explain the escalation process of intensive care during the first wave of the pandemic from a microlevel perspective, including expressions of resilient performance, intervening conditions at the micro-meso-macrolevels and short- and long-term consequences. A secondary aim was to provide recommendations regarding how to optimize the prerequisites for resilient performance in intensive care. A grounded theory methodology was used. First-person stories from different healthcare professionals (n70) in two Swedish regions were analyzed using the constant comparative method. This resulted in a novel conceptual model (including 6 main categories and 24 subcategories), and 41 recommendations. The conclusion of these findings is that the escalation of intensive care can be conceptualized as a transition from threatening chaos to temporary order through a complex process of adaptation. To prepare for the future, the components of space, stuff, staff, system and science, with associated continuity plans, must be implemented, anchored and communicated to actors at all levels of the system.

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  • 20.
    Hallman, David
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Gupta, Nidhi
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Januario, Leticia
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Holtermann, Andreas
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Work-Time Compositions of Physical Behaviors and Trajectories of Sick Leave Due to Musculoskeletal Pain2021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 4, article id 1508Article in journal (Refereed)
    Abstract [en]

    We aimed to investigate the association between work-time compositions of physical behavior and sick leave trajectories due to musculoskeletal pain over one year. We conducted a secondary analysis using the data of 981 workers in a Danish prospective cohort (DPHACTO 2012-2014). At baseline, we assessed physical behaviors (sitting, standing, light physical activity (LIPA), and moderate-to-vigorous physical activity (MVPA)) at work and during leisure, using accelerometers. Over 1 year follow-up, workers reported sick-leave days due to musculoskeletal pain at 4-week intervals. Four distinct trajectories of sick leave were previously identified in this cohort ("no sick leave", "few days-increasing trajectory", "some days-decreasing trajectory", "some days-increasing trajectory"), and used as an outcome in multinomial regression models with work-time compositions as predictors, adjusted for compositions of behavior during leisure, age, sex, body mass index, and smoking habits. More time spent sitting relative to the other behaviors was negatively associated with the trajectory of few days-increasing sick leave (p = 0.004), while time in LIPA was positively associated with the trajectory of some days-increasing sick leave (p = 0.009). Standing and MVPA were not significantly associated with sick leave trajectories. In conclusion, work-time compositions with more sitting relative to the other behaviors had lower risk for an increasing trajectory of sick leave due to pain, while compositions with more LIPA had higher risk. This may have implications for prevention of pain-related sick leave in blue-collar workers.

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  • 21.
    Hallman, David
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Mathiassen, Svend Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    van der Beek, Allard
    Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam.
    Jackson, Jennie
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Coenen, Pieter
    Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam.
    Calibration of self-reported time spent sitting, standing and walking among office workers: a compositional data analysis2019In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 17, article id 3111Article in journal (Refereed)
    Abstract [en]

    We developed and evaluated calibration models predicting objectively measured sitting, standing and walking time from self-reported data using a compositional data analysis (CoDA) approach. A total of 98 office workers (48 women) at the Swedish Transport Administration participated. At baseline and three-months follow-up, time spent sitting, standing and walking at work was assessed for five working days using a thigh-worn accelerometer (Actigraph), as well as by self-report (IPAQ). Individual compositions of time spent in the three behaviors were expressed by isometric log-ratios (ILR). Calibration models predicting objectively measured ILRs from self-reported ILRs were constructed using baseline data, and then validated using follow-up data. Un-calibrated self-reports were inaccurate; root-mean-square (RMS) errors of ILRs for sitting, standing and walking were 1.21, 1.24 and 1.03, respectively. Calibration reduced these errors to 36% (sitting), 40% (standing), and 24% (walking) of those prior to calibration. Calibration models remained effective for follow-up data, reducing RMS errors to 33% (sitting), 51% (standing), and 31% (walking). Thus, compositional calibration models were effective in reducing errors in self-reported physical behaviors during office work. Calibration of self-reports may present a cost-e_ective method for obtaining physical behavior data with satisfying accuracy in large-scale cohort and intervention studies.

  • 22.
    Hallman, David
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Niklas, Krause
    Departments of Epidemiology and Environmental Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California, USA.
    Jensen, Magnus Thorsten
    Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark.
    Gupta, Nidhi
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Birk Jørgensen, Marie
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Holtermann, Andreas
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Objectively measured sitting and standing in workers: Cross-sectional relationship with autonomic cardiac modulation2019In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 4, article id 650Article in journal (Refereed)
    Abstract [en]

    Excessive sitting and standing are proposed risk factors for cardiovascular diseases (CVDs), possibly due to autonomic imbalance. This study examines the association of objectively measured sitting and standing with nocturnal autonomic cardiac modulation. The cross-sectional study examined 490 blue-collar workers in three Danish occupational sectors. Sitting and standing during work and leisure were assessed during 1–5 days using accelerometers. Heart rate (HR) and heart rate variability (HRV) were obtained during nocturnal sleep as markers of resting autonomic modulation. The associations of sitting and standing still (h/day) with HR and HRV were assessed with linear regression models, adjusted for age, gender, body mass index, smoking, and physical activity. More sitting time during leisure was associated with elevated HR (p = 0.02), and showed a trend towards reduced HRV. More standing time at work was associated with lower HR (p = 0.02), and with increased parasympathetic indices of HRV (root mean squared successive differences of R-R intervals p = 0.05; high-frequency power p = 0.07). These findings, while cross-sectional and restricted to blue-collar workers, suggest that sitting at leisure is detrimental to autonomic cardiac modulation, but standing at work is beneficial. However, the small effect size is likely insufficient to mitigate the previously shown detrimental effects of prolonged standing on CVD.

  • 23.
    Hallman, David
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Sato, Tatiana
    Physical Therapy Department, Federal University of São Carlos (UFSCar), São Paulo, Brazil.
    Kristiansen, Jesper
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Gupta, Nidhi
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Skotte, Jørgen
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Holtermann, Andreas
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Prolonged sitting is associated with attenuated heart rate variability during sleep in blue-collar workers2015In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 12, no 11, p. 14811-14827Article in journal (Refereed)
    Abstract [en]

    Prolonged sitting is associated with increased risk for cardiovascular diseases and mortality. However, research into the physiological determinants underlying this relationship is still in its infancy. The aim of the study was to determine the extent to which occupational and leisure-time sitting are associated with nocturnal heart rate variability (HRV) in blue-collar workers. The study included 138 blue-collar workers (mean age 45.5 (SD 9.4) years). Sitting-time was measured objectively for four days using tri-axial accelerometers (Actigraph GT3X+) worn on the thigh and trunk. During the same period, a heart rate monitor (Actiheart) was used to sample R-R intervals from the electrocardiogram. Time and frequency domain indices of HRV were only derived during nighttime sleep, and used as markers of cardiac autonomic modulation. Regression analyses with multiple adjustments (age, gender, body mass index, smoking, job-seniority, physical work-load, influence at work, and moderate-to-vigorous physical activity) were used to investigate the association between sitting time and nocturnal HRV. We found that occupational sitting-time was negatively associated (p < 0.05) with time and frequency domain HRV indices. Sitting-time explained up to 6% of the variance in HRV, independent of the covariates. Leisure-time sitting was not significantly associated with any HRV indices (p > 0.05). In conclusion, objectively measured occupational sitting-time was associated with reduced nocturnal HRV in blue-collar workers. This indicates an attenuated cardiac autonomic regulation with increasing sitting-time at work regardless of moderate-to-vigorous physical activity. The implications of this association for cardiovascular disease risk warrant further investigation via long-term prospective studies and intervention studies.

  • 24.
    Hedblom, Marcus
    et al.
    Department of Forest Resource Management, Swedish University of Agricultural Sciences, Umeå, Sweden; Department of Ecology, Swedish University of Agricultural Sciences, Uppsala, Sweden.
    Gunnarsson, Bengt
    Department of Biological and Environmental Sciences, University of Gothenburg, Gothenburg, Sweden.
    Schaefer, Martin
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Knez, Igor
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Psychology.
    Thorsson, Pontus
    Division of Applied Acoustics, Chalmers University of Technology, Gothenburg, Sweden.
    Lundström, Johan N.
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Monell Chemical Senses Center, Philadelphia, PA, USA; Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA; Stockholm University Brain Imaging Centre, Stockholm University, Stockholm, Sweden.
    Sounds of Nature in the City: No Evidence of Bird Song Improving Stress Recovery2019In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 8, article id 1390Article in journal (Refereed)
    Abstract [en]

    Noise from city traffic is one of the most significant environmental stressors. Natural soundscapes, such as bird songs, have been suggested to potentially mitigate or mask noise. All previous studies on masking noise use self-evaluation data rather than physiological data. In this study, while respondents (n = 117) watched a 360 degrees virtual reality (VR) photograph of a park, they were exposed to different soundscapes and mild electrical shocks. The soundscapesbird song, bird song and traffic noise, and traffic noisewere played during a 10 min recovery period while their skin conductance levels were assessed as a measure of arousal/stress. No significant difference in stress recovery was found between the soundscapes although a tendency for less stress in bird song and more stress in traffic noise was noted. All three soundscapes, however, significantly reduced stress. This result could be attributed to the stress-reducing effect of the visual VR environment, to the noise levels being higher than 47 dBA (a level known to make masking ineffective), or to the respondents finding bird songs stressful. Reduction of stress in cities using masking with natural sounds requires further studies with not only larger samples but also sufficient methods to detect potential sex differences.

  • 25.
    Helmersson Bergmark, Karin
    et al.
    Stockholms universitet.
    Bergmark, Anders
    Stockholms universitet.
    Findahl, Olle
    University of Gävle, Faculty of Education and Business Studies, Department of Humanities, Media and communication studies.
    Extensive Internet Involvment: Addiction or Emerging Lifestyle?2011In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 8, no 12, p. 4488-4501Article in journal (Refereed)
  • 26.
    Januario, Leticia
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science.
    Karstad, Kristina
    National Research Centre for the Working Environment, Copenhagen, Dk.
    Rugulies, Reiner
    National Research Centre for the Working Environment, Copenhagen, Dk.
    Bergström, Gunnar
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Holtermann, Andreas
    National Research Centre for the Working Environment, Copenhagen, Dk.
    Hallman, David
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Association between psychosocial working conditions and perceived physical exertion among eldercare workers: a cross-sectional multilevel analysis of nursing homes, wards and workers2019In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 19, article id 3610Article in journal (Refereed)
    Abstract [en]

    This cross-sectional multilevel study aims at investigating the associations between psychosocial working conditions of different workplace levels and perceived physical exertion among eldercare workers. Data were obtained from the ‘Danish Observational Study of Eldercare work and musculoskeletal disorderS’ (DOSES) study, including 536 eldercare workers, nested in 126 wards and 20 nursing homes. Psychosocial working conditions were measured by the Copenhagen Psychosocial Questionnaire (COPSOQ). The physical workload was measured with a self-administered scale (0–10) rating perceived physical exertion. Multilevel linear mixed models were used to determine associations of psychosocial conditions between nursing homes, wards, and workers with physical exertion. Most of the variance in the perceived physical exertion was explained by differences between workers (83%), but some variance was explained by wards (11%) and nursing homes (6%). Workers employed in nursing homes with low influence (p = 0.01) and poor leadership (p = 0.02), and in wards with high quantitative demands (p = 0.03), high work pace (p < 0.001), and low justice (p = 0.01) were at increased risk of reporting higher physical exertion. The strongest associations were found for low influence, low quality of leadership, and high work pace at nursing homes and ward levels. In conclusion, improving specific psychosocial working conditions at nursing home and ward levels may be of particular importance to reduce excessive physical workload in eldercare workers

  • 27.
    Keus van de Poll, Marijke
    et al.
    University of Gävle, Faculty of Engineering and Sustainable Development, Department of Building Engineering, Energy Systems and Sustainability Science, Environmental Science. Karolinska institutet.
    Bergström, Gunnar
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research. Karolinska institutet.
    Jensen, Irene
    Karolinska institutet.
    Nybergh, Lotta
    Karolinska institutet.
    Kwak, Lydia
    Karolinska institutet.
    Lornudd, Caroline
    Karolinska institutet.
    Lohela-Karlsson, Malin
    Uppsala University; Centre for Clinical Research, Region Västmanland-Uppsala University.
    Cost-effectiveness of a problem-solving intervention aimed to prevent sickness absence among employees with common mental disorders or occupational stress2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 14, article id 5234Article in journal (Refereed)
    Abstract [en]

    The cost-benefit and cost-effectiveness of a work-directed intervention implemented by the occupational health service (OHS) for employees with common mental disorders (CMD) or stress related problems at work were investigated. The economic evaluation was conducted in a two-armed clustered RCT. Employees received either a problem-solving based intervention (PSI; n = 41) or care as usual (CAU; n = 59). Both were work-directed interventions. Data regarding sickness absence and production loss at work was gathered during a one-year follow-up. Bootstrap techniques were used to conduct a Cost-Benefit Analysis (CBA) and a Cost-Effectiveness Analysis (CEA) from both an employer and societal perspective. Intervention costs were lower for PSI than CAU. Costs for long-term sickness absence were higher for CAU, whereas costs for short-term sickness absence and production loss at work were higher for PSI. Mainly due to these costs, PSI was not cost-effective from the employer's perspective. However, PSI was cost-beneficial from a societal perspective. CEA showed that a one-day reduction of long-term sickness absence costed on average €101 for PSI, a cost that primarily was borne by the employer. PSI reduced the socio-economic burden compared to CAU and could be recommended to policy makers. However, reduced long-term sickness absence, i.e., increased work attendance, was accompanied by employees perceiving higher levels of production loss at work and thus increased the cost for employers. This partly explains why an effective intervention was not cost-effective from the employer's perspective. Hence, additional adjustments and/or support at the workplace might be needed for reducing the loss of production at work.

  • 28.
    Larisch, Lisa-Marie
    et al.
    The Swedish School of Sport and Health Sciences (GIH).
    Bojsen-Møller, Emil
    The Swedish School of Sport and Health Sciences (GIH).
    Nooijen, Carla F. J.
    The Swedish School of Sport and Health Sciences (GIH).
    Blom, Victoria
    The Swedish School of Sport and Health Sciences (GIH).
    Ekblom, Maria
    The Swedish School of Sport and Health Sciences (GIH).
    Ekblom, Örjan
    The Swedish School of Sport and Health Sciences (GIH).
    Arvidsson, Daniel
    Department of Food and Nutrition and Sport Science, University of Gothenburg.
    Fridolfsson, Jonathan
    Department of Food and Nutrition and Sport Science, University of Gothenburg.
    Hallman, David
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Mathiassen, Svend Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Wang, Rui
    The Swedish School of Sport and Health Sciences (GIH).
    Kallings, Lena
    The Swedish School of Sport and Health Sciences (GIH).
    Effects of two randomized and controlled multi-component interventions focusing on 24-hour movement behavior among office workers: a compositional data analysis2021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 8, article id 4191Article in journal (Refereed)
    Abstract [en]

    Intervention studies aiming at changing movement behavior have usually not accounted for the compositional nature of time-use data. Compositional data analysis (CoDA) has been suggested as a useful strategy for analyzing such data. The aim of this study was to examine the effects of two multi-component interventions on 24-h movement behavior (using CoDA) and on cardiorespiratory fitness among office workers; one focusing on reducing sedentariness and the other on increasing physical activity. Office workers (n = 263) were cluster randomized into one of two 6-month intervention groups, or a control group. Time spent in sedentary behavior, light-intensity, moderate and vigorous physical activity and time in bed were assessed using accelerometers and diaries, both for 24-h in total, and for work and leisure time separately. Cardiorespiratory fitness was estimated using a sub-maximal cycle ergometer test. Intervention effects were analyzed using linear mixed models. Despite a thorough analysis of 24-h behaviors using CoDA, no intervention effects were found, neither for behaviors in total, nor for work and leisure time behaviors separately. Cardiorespiratory fitness did not change significantly. Even though the design of the multi-component interventions was based on theoretical frameworks, and included cognitive behavioral therapy counselling, which has been proven effective in other populations, issues related to implementation of and compliance with some intervention components may have led to the observed lack of intervention effect.

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  • 29.
    Larsson, Johan
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research. LTU; LKAB.
    Vinberg, Stig
    Mittuniversitetet.
    Jahncke, Helena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Changing the Office Design to Activity-Based Flexible Offices: A Longitudinal Study of How Managers’ Leadership Behaviours Are Perceived2022In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, no 20, article id 13557Article in journal (Refereed)
    Abstract [en]

    This longitudinal study examines the impact of office type on employees’ perception of managers’ leadership behaviours, which is an unexplored area. The expanding research related to activity-based flexible offices (AFOs) has mainly focused on employees’ working conditions and health outcomes, not on the changes in leadership behaviours when moving from traditional offices to AFOs. Office workers (n = 261) from five office sites within a large Swedish government agency were included in a controlled study of a natural intervention. At four sites, traditional offices were replaced by AFOs, while workers at one site with no relocation acted as the control. The same employees rated different leadership behaviours in a web-based questionnaire at baseline and at one follow-up. The analyses showed that relocations from cell and open-plan offices to AFOs were clearly related to a decrease in the perception of relation-oriented leadership behaviours. However, coming from open-plan offices to AFOs also decreased the perception of the other leadership dimensions. As expected, the control group was stable over time in their perceptions. This emphasises the need for organisations to provide managers with prerequisites so they can keep up with behaviours that support employees’ performance and health when office designs and ways of working are changed.

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  • 30.
    Lerche, Anders Fritz
    et al.
    The National Research Centre for the Working Environment, Copenhagen, Denmark.
    Mathiassen, Svend Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Lund Rasmussen, Charlotte
    The National Research Centre for the Working Environment, Copenhagen, Denmark.
    Straker, Leon
    Curtin University, Perth, Western Australia.
    Søgaard, Karen
    Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
    Holtermann, Andreas
    The National Research Centre for the Working Environment, Copenhagen.
    Development and implementation of ‘just right’ physical behavior in industrial work based on the Goldilocks Work Principle - a feasibility study2021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 9, article id 4707Article in journal (Refereed)
    Abstract [en]

    The Goldilocks Work Principle expresses that productive work should be redesigned to comprise physical behaviors of different intensities in a composition promoting workers’ health and fitness. This study is the first to assess the feasibility of redesigning work in an industrial setting according to the Goldilocks Work Principle. We recruited workers (n=20) from a brewery in Denmark, and we conducted a participatory 16-week intervention including a workshop and two consultations. The workshop aimed to support the workers in modifying their work, while the consultations assisted the eventual implementation. Feasibility was evaluated as per three aspects: 1) developing modifications of work, 2) implementing these modifications, and 3) changing physical behavior and self-reported fatigue, pain and energy. The three aspects were addressed through records completed by the workers, measurements of workers’ physical behavior and intensity during ‘control’ workdays (i.e., usual work) and ‘intervention’ workdays (i.e. modified work), and self-reported fatigue, pain and energy level following both types of workdays. Five modifications to work were developed, and three of these five modifications were implemented. To some extent, physical behavior and intensity changed as intended during ‘intervention’ workdays compared to ‘control’ workdays. Workers were also less fatigued, had less pain, and had more energy after ‘intervention’ workdays. These results suggest that it is feasible to develop and implement modified work based on the Goldilocks Work Principle among industrial workers. However, we also identified several barriers to the implementation of such modifications.

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  • 31.
    Lerche, Anders Fritz
    et al.
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Vilhelmsen, Maja
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Greby Schmidt, Kathrine
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Kildedal, Rasmus
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Launbo, Natja
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Kold Munch, Pernille
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Lidegaard, Mark
    Health & Safety Development, Novo Nordisk, Copenhagen.
    Schade Jacobsen, Sandra
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Lund Rasmussen, Charlotte
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Mathiassen, Svend Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Straker, Leon
    School of Physiotherapy and Exercise Science, Curtin University, Perth.
    Holtermann, Andreas
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Can childcare work be designed to promote high intensity physical activity for improved fitness and health? A proof of concept study of the Goldilocks principle2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 20, article id 7419Article in journal (Refereed)
    Abstract [en]

    Childcare workers are reported to have high variation in physical activity during work hours, but also to sit for about half of the workday and have almost no high intensity physical activity (HIPA). No study has investigated if their work can be re-designed to introduce HIPA, thus promoting fitness and health according to the Goldilocks principle. This study investigated the feasibility of designing pedagogical games (‘Goldilocks-games’) intended to lead to more HIPA. Heart rate was measured in nineteen childcare workers during Goldilocks-games, and compared to measurements during a regular workday. Worker perceptions of feasibility, and researcher observations of contextual factors were also collected. The Goldilocks-games (33 min) elicited significantly more HIPA (18/33 min) compared to the most active period of equal length on a regular workday (0.5/33 min). Seventy-four-percent of the childcare workers reported that it was feasible to integrate the Goldilocks-games pedagogically, and seventy-two-percent could see themselves using them. Thus, we found it possible to re-design a work task in childcare according to the Goldilocks principle so that it leads to substantial time with HIPA. The sustainability of Goldilocks-games in childcare, and their effectiveness in improving fitness and health among childcare workers, needs to be tested in further studies.

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  • 32.
    Lohela Karlsson, Malin
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research. Uppsala universitet.
    Jensen, Irene
    Karolinska institutet.
    Björklund, Christina
    Do attitudes towards work or work motivation affect productivity loss among academic employees?2022In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, no 2, article id 934Article in journal (Refereed)
    Abstract [en]

    Work motivation and job attitudes are important for productivity levels among academic employees. In situations where employees perceive problems, for example, health-related and work environment-related problems, the ability to perform at work could be affected, which may result in fewer publications, reduced quality and less research funding. Few studies, however, have paid attention to productivity loss among academic employees in order to understand how, or if, the perceived loss is affected by the reported problems, either alone or in combination with work motivation and job attitudes. To evaluate whether attitudes towards work—measured as job satisfaction, organisational commitment and work motivation—are associated with productivity loss in the workplace, a cross-sectional study was conducted. This type of design is required as performance is highly variable and is affected by changes in health and work status. This study includes employees who reported either health-related problems, work environment problems or a combination of both (n = 1475). Linear regression analyses were used to answer the hypotheses. Higher levels of motivation, job satisfaction and organisational commitment were associated with lower levels of productivity loss among employees who experienced either health-related or work environment problems. High work motivation and high commitment were significantly associated with lower levels of productivity loss among employees who experienced a combination of problems. In summary, productivity loss among academic employees is not only affected by health-related problems or problems in the work environment but also by work motivation, job satisfaction and organisational commitment; i.e., these factors seem to buffer, or moderate, the reduction in performance levels for this group of employees.

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  • 33.
    Lättman, Katrin
    et al.
    Karlstads universitet.
    Olsson, Lars E.
    Karlstads universitet, Centrum för tjänsteforskning (from 2013).
    Friman, Margareta
    Karlstads universitet, Centrum för tjänsteforskning (from 2013).
    Fujii, Satoshi
    Kyoto University, Japan.
    Perceived Accessibility, Satisfaction with Daily Travel, and Life Satisfaction among the Elderly2019In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 22, p. 1-15, article id 4498Article in journal (Refereed)
    Abstract [en]

    People are living longer than they did previously, and the proportion of older people is increasing worldwide. This rapid development will have implications for the transport system, in general, and for travel behavior and accessibility to daily activities, in particular. In recent years, both research and politics have drawn the attention of the public to issues affecting the opportunities of the elderly to participate in everyday life. The debate has so far mostly focused on health issues, with limited work having been done on the ability of the elderly to live the lives they want to considering how they travel. With this view, a theoretical model, grounded in a model of travel and subjective wellbeing was developed to explore the role of perceived accessibility in satisfaction with travel and life satisfaction. Empirical data were collected from a sample of 2950 respondents (aged 60–92) from five cities in Northern Europe (Stockholm, Helsinki, Oslo, Copenhagen, Bergen) and analyzed using partial least square structural equation modeling (PLS-SEM). The findings confirmed the link between perceived accessibility, travel satisfaction, and life satisfaction. The findings also showed the role of sociodemographic and travel attributes in perceived accessibility and satisfaction with travel, as well as the moderating effects of different age groups. We conclude that this moderating role played by age clearly indicates that we should not treat the elderly as a homogenous group in research and transport planning.

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  • 34.
    Macassa, Gloria
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science. Universidade do Porto.
    McGrath, Cormac
    Stockholms universitet; Karolinska institutet.
    Rashid, Mamunur
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science.
    Soares, Joaquim
    Mid-Sweden University.
    Structural violence and health-related outcomes in Europe: a descriptive systematic review2021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 13, article id 6998Article in journal (Refereed)
    Abstract [en]

    In recent years, there has been a revival of the term “structural violence (SV)” which was coined by Johan Galtung in the 1960s in the context of Peace Studies. “Structural violence” refers to social structures—economic, legal, political, religious, and cultural—that prevent individuals, groups and societies from reaching their full potential. In the European context, very few studies have investigated health and well-being using an SV perspective. Therefore, this paper sought to systematically and descriptively review studies that used an SV framework to examine health-related outcomes across European countries. The review included two studies each from Spain and France, one each from the UK, Ukraine and Russia, and another study including the three countries Sweden, Portugal and Germany. With the exception of one mixed-method study, the studies used a qualitative design. Furthermore, the eight studies in the review used different conceptualizations of SV, which indicates the complexity of using SV as a concept in public health in the European context. Future research that attempts to identify and standardize measures of SV is needed; the knowledge gained is hoped to inform appropriate interventions aiming to reduce the effects of SV on population health. 

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  • 35.
    Macassa, Gloria
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science. Universidade do Porto, Portugal.
    Ribeiro, Ana Isabel
    Universidade do Porto, Portugal.
    Marttila, Anneli
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science.
    Stål, Frida
    University of Gävle, Faculty of Engineering and Sustainable Development, Department of Building Engineering, Energy Systems and Sustainability Science, Environmental Science.
    Silva, José Pedro
    Universidade do Porto, Portugal.
    Rydback, Michelle
    University of Gävle, Faculty of Education and Business Studies, Department of Business and Economic Studies, Business administration.
    Rashid, Mamunur
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science.
    Barros, Henrique
    Universidade do Porto, Portugal.
    Public Health Aspects of Climate Change Adaptation in Three Cities: A Qualitative Study2022In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, no 16, article id 10292Article in journal (Refereed)
    Abstract [en]

    Climate change presents an unprecedented public health challenge as it has a great impact on population health outcomes across the global population. The key to addressing these health challenges is adaptation carried out in cities through collaboration between institutions, including public health ones. Through semi-structured interviews (n=16), this study investigated experiences and perceptions of what public health aspects are considered by urban and public health planners and researchers when planning climate change adaptation in the cities of Söderhamn (Sweden), Porto (Portugal) and Navotas (the Philippines). Results of the thematic analysis indicated that participating stakeholders were aware of the main climate risks threatening their cities (rising water levels and flooding, extreme temperatures, and air pollution). In addition, the interviewees talked about collaboration with other sectors, including the public health sector, in implementing climate change adaptation plans. However, the inclusion of the public health sector as a partner in the process was identified in only two cities, Navotas and Porto. Also, the study found that there were few aspects pertaining to public health (water and sanitation, prevention of heat-related and water-borne diseases, and prevention of the consequences associated with heat waves in vulnerable groups such as children and elderly persons) in the latest climate change adaptation plans posted on each city’s website. Moreover, participants pointed to different difficulties: insufficient financial resources, limited intersectoral collaboration for climate change adaptation, and lack of involvement of the public health sector in the adaptation processes, especially in one of the cities, in which climate change adaptation was solely the responsibility of the urban planners. Studies using larger samples of stakeholders in larger cities are needed to better understand why the public health sector is still almost absent in efforts to adapt to climate change.

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  • 36.
    Merkus, Suzanne
    et al.
    National Institute of Occupational Health, Oslo.
    Coenen, Pieter
    Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam.
    Forsman, Mikael
    School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH.
    Knardahl, Stein
    National Institute of Occupational Health, Oslo.
    Veiersted, Kaj Bo
    National Institute of Occupational Health, Oslo.
    Mathiassen, Svend Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    An exploratory study on the physical activity health paradox – musculoskeletal pain and cardiovascular load during work and leisure in construction and healthcare workers2022In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, no 5, article id 2751Article in journal (Refereed)
    Abstract [en]

    Using a novel approach, this exploratory study investigated whether the physical activity (PA) paradox extends to cardiovascular load and musculoskeletal pain. At baseline, 1-2 days of 24h heart rate was assessed in 72 workers from construction and healthcare. Workers then reported pain intensity in 9 body regions (scale 0 - 3) every 6 months for two years. Using a novel ilr structure in compositional data analysis, time spent during work and leisure above three thresholds of percentage heart rate reserve (%HRR), i.e. ≥20 %HRR, ≥30 %HRR, ≥40 %HRR, was related to the 2-year average musculoskeletal pain (sum of 9 pain scores; scale 0-27). Analyses were stratified for several important variables. Workers spending more time in physical activity at work had higher pain, while workers with more time in physical activity during leisure had less pain (i.e. the PA paradox), but none of the associations were statistically significant. Higher aerobic capacity and lower body mass index lowered the pain score among those with higher physical activity at work. This exploratory study suggests that the PA paradox may apply to musculoskeletal pain and future studies with larger sample sizes and additional exposure analyses are needed to explain why this occurs.

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  • 37.
    Militao, Elias
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science. Mittuniversitetet; Eduardo Mondlane University, Mozambique.
    Salvador, Elsa Maria
    Eduardo Mondlane University, Mozambique.
    Uthman, Olalekan
    University of Warwick, UK; Stellenbosch University, South Africa.
    Vinberg, Stig
    Mittuniversitetet.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science. Mittuniversitetet; Universidade do Porto, Portugal.
    Food insecurity and health outcomes other than malnutrition in southern Africa: A descriptive systematic review2022In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, no 9, article id 5082Article in journal (Refereed)
    Abstract [en]

    Food insecurity (FI) is one of the major causes of malnutrition and is associated with a range of negative health outcomes in low and middle-income countries. The burden of FI in southern Africa is unknown, although FI continues to be a major public health problem across sub-Saharan Africa as a whole. Therefore, this review sought to identify empirical studies that related FI to health outcomes among adults in southern Africa. Altogether, 14 publications using diverse measures of FI were reviewed. The majority of the studies measured FI using modified versions of the United States Department of Agriculture Household Food Security Survey Module. A wide range in prevalence and severity of FI was reported (18–91%), depending on the measurement tool and population under investigation. Furthermore, FI was mostly associated with hypertension, diabetes, anxiety, depression and increased risk of human immunodeficiency virus (HIV) acquisition. Based on the findings, future research is needed, especially in countries with as yet no empirical studies on the subject, to identify and standardize measures of FI suitable for the southern African context and to inform public health policies and appropriate interventions aiming to alleviate FI and potentially improve health outcomes in the region.

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  • 38.
    Mixter, Susanna
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Mathiassen, Svend Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Lindfors, Petra
    Stockholm University, Sweden.
    Dimberg, Kent
    University of Gävle, Faculty of Engineering and Sustainable Development, Department of Electrical Engineering, Mathematics and Science, Biology.
    Jahncke, Helena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Lyskov, Eugene
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Hallman, David
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Stress-related responses to alternations between repetitive physical work and cognitive tasks of different difficulties2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 22, article id 8509Article in journal (Refereed)
    Abstract [en]

    Alternating between physical and cognitive tasks has been proposed as an alternative in job rotation, allowing workers to recover from the physical work while still being productive. However, effects of such alternations on stress have not been investigated. This controlled experiment aimed at determining the extent to which stress-related responses develop during alternating physical and cognitive work, and to determine the extent to which cognitive task (CT) difficulty influences these responses. Fifteen women performed three sessions of 10 consecutive work bouts each including a seven-minute repetitive physical task (pipetting) and a three-minute CT (n-back) at one of three difficulty levels. Stress was assessed in terms of changes in heart rate variability, blood pressure, salivary alpha-amylase, salivary cortisol, perceived stress, and cognitive performance. The work session did not result in any marked stress response, and CT difficulty did not significantly influence stress, apart from alpha-amylase being higher at the easiest CT (F = 5.34, p = 0.02). Thus, according to our results, alternating between repetitive physical tasks and cognitive tasks may be a feasible alternative to classic job rotation between physical tasks only, even if the cognitive task is quite difficult. Future studies should address possible effects of the temporal pattern of alternations, and combine even other occupationally relevant tasks, preferably for extended periods of time.

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  • 39.
    Munobwa, Jimmy
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Criminology, Social Work.
    Ahmadi, Fereshteh
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Criminology, Social Work.
    Zandi, Saeid
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Criminology, Social Work.
    Davidsson, Natalie
    Faculty of Literacy, Rowan-Cabarrus Community College, Salisbury, NC 28146, USA.
    Akhavan, Sharareh
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Criminology, Social Work.
    Coping methods and satisfaction with working from home in academic settings during the COVID-19 pandemic2022In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, no 19, article id 12669Article in journal (Refereed)
    Abstract [en]

    In this paper, we examined how university staff and students coped with challenges related to working or studying from home during the COVID-19 pandemic, and the level of satisfaction with working from home. An online survey was conducted among faculty, staff, and students at universities in 24 countries (n = 674). The results show that over 80% of the respondents used multiple coping methods. Three clusters of coping methods were generated through factor analysis: (1) social and health factor, with focus on personal health and the social surrounding, (2) activity factor, i.e., being busy with work or studies, finding up-to-date information about COVID-19, while thinking about what one could do rather than what one could not do, and (3) public health factor, which meant trusting health authorities while avoiding misinformation from sources such as social media. Furthermore, 56% of the respondents were very or somewhat satisfied with working from home. Differences in the methods of coping and satisfaction with working from home highlight the need for employers to prepare for working from home beyond the COVID-19 pandemic.

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  • 40.
    Mälstam, Emelie
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science. Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, 141-52 Stockholm, Sweden.
    Asaba, Eric
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, 141-52 Stockholm, Sweden;Unit for Research, Development, and Education, Stockholm’s Sjukhem Foundation, 112-19 Stockholm, Sweden.
    Åkesson, Elisabet
    Unit for Research, Development, and Education, Stockholm’s Sjukhem Foundation, 112-19 Stockholm, Sweden;Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, 141-52 Stockholm, Sweden.
    Guidetti, Susanne
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, 141-52 Stockholm, Sweden;Women’s Health and Allied Health Professionals Theme Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, 171-76 Stockholm, Sweden.
    Patomella, Ann-Helen
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, 141-52 Stockholm, Sweden.
    The Feasibility of Make My Day—A Randomized Controlled Pilot Trial of a Stroke Prevention Program in Primary Healthcare2023In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 20, no 19, article id 6828Article in journal (Refereed)
    Abstract [en]

    Incorporating and sustaining engaging everyday activities (EEAs) in everyday life holds potential for improving health and wellbeing; thus, there is reason to explore EEAs as a behavioral change technique in stroke prevention. The aim of this study was to evaluate the feasibility of the stroke prevention program Make My Day (MMD) for people with moderate-to-high risk for stroke in a primary healthcare setting, where EEAs are utilized to promote healthy activity patterns. A randomized controlled pilot trial was designed to evaluate the feasibility of MMD. Twenty-nine persons at risk for stroke were recruited and randomized into either an intervention group (n = 14) receiving MMD or a control group (n = 15) receiving brief health advice and support with goal setting. The results suggest that MMD is feasible, with timely recruitment, overall high response rates and study completion, and sensitivity to change in key outcome measures. Moreover, the results demonstrate that the application of EEAs can be useful for promoting behavioral change in stroke prevention. Recommendations for improvements for a full-scale trial include recruiting a relevant sample, using reliability- and validity-tested outcome measures, and implementing strategies to limit missing data.

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  • 41.
    Nyman, Teresia
    et al.
    Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, SE-751 85 Uppsala, Sweden;Department of Occupational and Environmental Medicine, Uppsala University Hospital, SE-751 85 Uppsala, Sweden.
    Rhén, Ida-Märta
    School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, SE-141 57 Huddinge, Sweden;Centre for Occupational and Environmental Medicine, Stockholm County Council, SE-113 65 Stockholm, Sweden;Unit of Occupational Medicine, Institute of Environmental Medicine (IMM), Karolinska Institutet, SE-171 77 Stockholm, Sweden.
    Johansson, Peter J.
    Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, SE-751 85 Uppsala, Sweden;Department of Occupational and Environmental Medicine, Uppsala University Hospital, SE-751 85 Uppsala, Sweden.
    Eliasson, Kristina
    Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, SE-751 85 Uppsala, Sweden;Department of Occupational and Environmental Medicine, Uppsala University Hospital, SE-751 85 Uppsala, Sweden.
    Kjellberg, Katarina
    Centre for Occupational and Environmental Medicine, Stockholm County Council, SE-113 65 Stockholm, Sweden;Unit of Occupational Medicine, Institute of Environmental Medicine (IMM), Karolinska Institutet, SE-171 77 Stockholm, Sweden.
    Lindberg, Per
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Fan, Xuelong
    Unit of Occupational Medicine, Institute of Environmental Medicine (IMM), Karolinska Institutet, SE-171 77 Stockholm, Sweden.
    Forsman, Mikael
    School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, SE-141 57 Huddinge, Sweden;Centre for Occupational and Environmental Medicine, Stockholm County Council, SE-113 65 Stockholm, Sweden;Unit of Occupational Medicine, Institute of Environmental Medicine (IMM), Karolinska Institutet, SE-171 77 Stockholm, Sweden.
    Reliability and Validity of Six Selected Observational Methods for Risk Assessment of Hand Intensive and Repetitive Work2023In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 20, no 8, article id 5505Article in journal (Refereed)
    Abstract [en]

    Risk assessments of hand-intensive and repetitive work are commonly done using observational methods, and it is important that the methods are reliable and valid. However, comparisons of the reliability and validity of methods are hampered by differences in studies, e.g., regarding the background and competence of the observers, the complexity of the observed work tasks and the statistical methodology. The purpose of the present study was to evaluate six risk assessment methods, concerning inter- and intra-observer reliability and concurrent validity, using the same methodological design and statistical parameters in the analyses. Twelve experienced ergonomists were recruited to perform risk assessments of ten video-recorded work tasks twice, and consensus assessments for the concurrent validity were carried out by three experts. All methods’ total-risk linearly weighted kappa values for inter-observer reliability (when all tasks were set to the same duration) were lower than 0.5 (0.15–0.45). Moreover, the concurrent validity values were in the same range with regards to total-risk linearly weighted kappa (0.31–0.54). Although these levels are often considered as being fair to substantial, they denote agreements lower than 50% when the expected agreement by chance has been compensated for. Hence, the risk of misclassification is substantial. The intra-observer reliability was only somewhat higher (0.16–0.58). Regarding the methods ART (Assessment of repetitive tasks of the upper limbs) and HARM (Hand Arm Risk Assessment Method), it is worth noting that the work task duration has a high impact in the risk level calculation, which needs to be taken into account in studies of reliability. This study indicates that when experienced ergonomists use systematic methods, the reliability is low. As seen in other studies, especially assessments of hand/wrist postures were difficult to rate. In light of these results, complementing observational risk assessments with technical methods should be considered, especially when evaluating the effects of ergonomic interventions.

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  • 42.
    Rashid, Mamunur
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science.
    Chowdhury, Mohammad Rocky Khan
    University of Monash, Australia; First Capital University of Bangladesh.
    Kader, Manzur
    Karolinska institutet.
    Hiswåls, Anne-Sofie
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science.
    Determinants of utilization of institutional delivery services in Zambia: An analytical cross-sectional study2022In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, no 5, article id 3144Article in journal (Refereed)
    Abstract [en]

    Institutional delivery at birth is an important indicator of improvements in maternal health, which remains one of the targets of sustainable development goals intended to reduce the maternal mortality ratio. The purpose of the present study was to identify the determinants of utilization of institutional delivery in Zambia. A population-based cross-sectional study design was used to examine 9841 women aged 15–49 years from the 2018 Zambia Demographic and Health Survey. A multiple logistic regression was applied to calculate odds ratios (ORs) with 95% confidence intervals (CIs) to identify determinants of utilization of institutional delivery. Sociodemographic factors were significantly associated with institutional delivery: woman’s (OR: 1.76; 95% CI: 1.04–2.99) and husband’s (OR: 1.83; 95% CI: 1.09–3.05) secondary/higher education, higher wealth index (OR: 2.31; 95% CI: 1.27–4.22), and rural place of residence (OR: 0.55; 95% CI: 0.30–0.98). Healthcare-related factors were also significantly associated with institutional delivery: 5–12 visits to antenatal care (OR: 2.33; 95% CI: 1.66–3.26) and measuring blood pressure (OR: 2.15; 95% CI: 1.32–2.66) during pregnancy. To improve institutional delivery and reduce maternal and newborn mortality, policymakers and public health planners should design an effective intervention program targeting these factors.

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  • 43.
    Scander, Henrik
    et al.
    Örebro University.
    Lennernäs, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science.
    Yngve, Agneta
    Örebro University, Uppsala University.
    Assessing time of eating in commensality research2021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 6, article id 2941Article in journal (Refereed)
    Abstract [en]

    Commensal meals seem to be related to a better nutritional and metabolic health as well as an improved quality of life. The aim of this paper was to examine to what extent research was performed using the search term commensality related to assessment of timing of meals. A scoping review was performed, where 10 papers were identified as specifically addressing the assessment of timing of commensality of meals. Time use studies, questionnaires, and telephone-and person-to-person interviews were used for assessing meal times in relation to commensality. Four of the studies used a method of time use registration, and six papers used interviews or questionnaires. Common meals with family members were the most common, and dinners late at night were often preferred for commensal activities among the working population. In conclusion, the family meal seemed to be the most important commensal meal. It is clear from the collected papers and from previous systematic reviews that more studies of commensal meals in general and about timing aspects in particular and in relation to nutritional health are essential to provide a solid background of knowledge regarding the importance of timing in relation to commensal meals. 

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  • 44.
    Scander, Henrik
    et al.
    Örebro universitet.
    Yngve, Agneta
    Örebro universitet; Uppsala universitet.
    Lennernäs, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science.
    Assessing commensality in research2021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 5, article id 2632Article in journal (Refereed)
    Abstract [en]

    This scoping review focuses on the assessment of commensality in research and attempts to identify used methods for performing research on commensality. It reflects a multidisciplinary research field and draws on findings from Web of Science Core Collection, up to April 2019. The empirical material consisted of 61 studies, whereof most were qualitative research, and some were of quantitative character, including very few dietary surveys. The findings show nine papers categorized as using quantitative approaches, 52 papers were categorized as qualitative. The results show a wide variety of different ways to try to find and understand how commensality can be understood and identified. There seems to be a shift in the very concept of commensality as well as some variations around the concept. This paper argues the need to further investigate the importance of commensality for health and wellbeing, as well as the need to gather data on health and health-related behaviors, living conditions and sociodemographic data in parallel. The review shows the broad-ranging areas where commensality is researched, from cultural and historical areas to ethnographic or anthropological areas over to dietary assessment. To complement large dietary surveys with methods of assessing who you are eating with in what environment should be a simple way to further our knowledge on the circumstances of meal intake and the importance of commensality. To add 24-h dietary recall to any study of commensality is another way of identifying the importance of commensality for dietary quality. The use of mixed methods research was encouraged by several authors as a good way forward in the assessment of commensality and its importance. 

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  • 45.
    Widar, Linda
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Wiitavaara, Birgitta
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Boman, Eva
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Psychology.
    Heiden, Marina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Psychophysiological reactivity, postures and movements among academic staff: A comparison between teleworking days and office days2021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 18, article id 9537Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to determine if psychophysiological activity, postures and movements differ during telework (i.e., work performed at home) and work performed at the conventional office. We performed twenty-four-hour pulse recordings and accelerometry measurements on 23 academic teaching and research staff during five consecutive workdays, with at least one day of telework. Additionally, we conducted salivary sampling during one day of telework, and one day of office work. Heart rate and heart rate variability indices, postural exposure and cortisol concentration were analyzed using repeated measures analysis of variance with Workplace and Time (i.e., before, during and after workhours) as within-subject effects. We found a significant interaction effect of Workplace and Time in heart rate variability indices and in the number of transitions between seated and standing postures. This shows more parasympathetic activity among academic teleworkers during telework than office work, which may indicate more relaxation during telework. They had an overall sedentary behavior at both workplaces but switched between sitting and standing more often during telework, which may be beneficial for their health.

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  • 46.
    Wijk, Katarina
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research. Centre for Research and Development, Region Gavleborg/Uppsala University; Uppsala University.
    Bergsten, Eva L.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Hallman, David
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Sense of coherence, health, well-being, and work satisfaction before and after implementing activity-based workplaces2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 14, article id 5250Article in journal (Refereed)
    Abstract [en]

    Activity-based workplaces (ABWs) are implemented with possible implications for health, well-being, and work satisfaction in the workplace. Drawing on the theoretical framework, i.e., sense of coherence (SOC), the aim was to investigate how indicators pf SOC&mdash;meaningfulness, manageability and comprehensibility&mdash;are associated with, or function as barriers or facilitators for, health, well-being and work satisfaction during relocation to an ABW. We followed the implementation of ABWs at the Swedish Transport Administration (2018&ndash;2019). Questionnaires were administered before (n = 536), 3 months (n = 409) and 9 months (n = 373) after relocation. Focus group interviews (15) were conducted before and after. Data were analyzed using repeated measures ANOVA and content analysis. Relocation to an ABW was associated with a reduced work satisfaction (physical p &lt; 0.001; psychosocial p &lt; 0.001), and minor changes in health and occupational well-being during relocation (p &gt; 0.001). The reduction in work satisfaction was smaller among employees with high meaningfulness in the relocation process (p &lt; 0.001). All SOC indicators were positively associated with overall health, well-being and work satisfaction (p &lt; 0.001). Interviews suggested that meaningfulness was facilitated by participation in the presented activities and that communication before relocation was crucial. The results indicate that organizations implementing ABWs should promote perceived meaningfulness in the process to mitigate possible declines in satisfaction with the physical and psychosocial work environment.

  • 47.
    Xu, Lijuan
    et al.
    Lishui University.
    Lou, Yan
    Lishui University.
    Li, Caifu
    Lishui University.
    Tao, Xuemei
    Lishui University.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Person-centered climate, garden greenery and well-being among nursing home residents: A cross-sectional study2023In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 20, no 1, article id 749Article in journal (Refereed)
    Abstract [en]

    Nursing home residents’ well-being is often proxy-rated in studies, and few studies have explored the association between resident-rated person-centered climate, garden greenery, and resident-rated well-being. A cross-sectional study was conducted. Questionnaire data from a convenient sample of 470 nursing home residents in a city in Southeast China in 2021 were analyzed using multiple linear regressions, with block-wise models. The instruments used were the Person-centered Climate Questionnaire-Patient version, the Nursing Home Greenery Index, and, for well-being, the EuroQol-Visual Analogue Scale, the Life Satisfaction Questionnaire, and the 9-item Patient Health Questionnaire (depression symptoms). In the unadjusted models, the person-centered climate was positively associated with general health (β 0.29, p < 0.001), person-centered climate and greenery with life satisfaction (β 0.39, and 0.18; both p < 0.001), and negatively with depression (β −0.28, and β −0.23, both p < 0.001). After adjusting for personal and nursing home characteristics, the associations between person-centered climate, greenery, and well-being remained statistically significant. The three models explained 36%, 35%, and 21% of the variance in general health, life satisfaction, and depression, respectively. This study provides knowledge on person-centered climate in long-term care and the access to greenery.

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  • 48.
    Xu, Zengwang
    et al.
    University of Wisconsin-Milwaukee, Milwaukee, WI 53201, USA.
    Jiang, Bin
    University of Gävle, Faculty of Engineering and Sustainable Development, Department of Computer and Geospatial Sciences, Geospatial Sciences.
    Effects of social vulnerability and spatial accessibility on COVID-19 vaccination coverage: A census-tract level study in Milwaukee County, USA2022In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, no 19, article id 12304Article in journal (Refereed)
    Abstract [en]

    COVID-19 vaccination coverage was studied by race/ethnicity, up-to-date doses, and by how it was affected by social vulnerability and spatial accessibility at the census-tract level in Milwaukee County, WI, USA. Social vulnerability was quantified at the census-tract level by an aggregate index and its sub-components calculated using the principal components analysis method. The spatial accessibility was assessed by clinic-to-population ratio and travel impedance. Ordinary least squares (OLS) and spatial regression models were employed to examine how social vulnerability and spatial accessibility relate to the vaccination rates of different doses. We found great disparities in vaccination rates by race and between areas of low and high social vulnerability. Comparing to non-Hispanic Blacks, the vaccination rate of non-Hispanic Whites in the county is 23% higher (60% vs. 37%) in overall rate (one or more doses), and 20% higher (29% vs. 9%) in booster rate (three or more doses). We also found that the overall social-vulnerability index does not show a statistically significant relationship with the overall vaccination rate when it is defined as the rate of people who have received one or more doses of vaccines. However, after the vaccination rate is stratified by up-to-date doses, social vulnerability has positive effects on one-dose and two-dose rates, but negative effects on booster rate, and the effects of social vulnerability become increasingly stronger and turn to negative for multi-dose vaccination rates, indicating the increasing challenges of high social vulnerability areas to multi-dose vaccination. The large negative effects of socio-economic status on the booster rate suggests the importance of improving general socio-economic conditions to promote multi-dose vaccination rates.

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