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  • 1.
    Barbieri, Dechristian
    et al.
    Department of Physical Therapy, Federal University of Sao Carlos.
    Srinivasan, Divya
    Department of Industrial and Systems Engineering, Virginia Polytechnic Institute and State University.
    Mathiassen, Svend Erik
    University of Gävle, Centre for Musculoskeletal Research. University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science.
    Oliveira, Ana Beatriz
    Department of Physical Therapy, Federal University of Sao Carlos.
    Neck, trunk, and upper arm posture variation during computer work at a sit-stand table in a real work setting2019Conference paper (Refereed)
    Abstract [en]

    Background: Computer work is generally associated with constrained postures and sedentary behaviors. Sit-stand tables have been suggested as an effective intervention to promote changes in gross body posture, and thus reduce sitting. However, few studies have addressed to what extent sit-stand table usage affects posture variation in other body regions. The aim of this study was to examine neck, trunk and arm postures among office workers with access to sit-stand tables.

    Methods: Twenty-four office workers (16 females, 8 males; mean age 41 (SD9) years) participated. At entry, workers received sit-stand tables, which were then used for two months. Neck and trunk flexion, and right upper arm elevation (RUA) was recorded on three consecutive days, two hours/day, during the last week of table use. Minute-to-minute variability for the three postures during sitting (CWsit) and standing (CWstand) computer work was obtained for each participant. Job variance ratios (JVR) were calculated for the actual work, and for other combinations of CWsit and CWstand by simulation1.

    Results: CWsit and CWstand were performed for 72% and 28% of the time spent at the computer. Minute-to-minute variability was larger in CWsit than in CWstand for all three postures, and the difference CWsit-CWstand was largest for RUA [median 1.7 (IQR −0.2–1.7)º], followed by trunk [1.6 (0.9–3.0)º] and neck [0.9 (0.0–3.1)º]. During actual work, JVR was between 1 and 3 for most participants. Simulations suggested that maximum variability would occur at a combination of 40–80% CWsit and 20–60% CWstand.

    Conclusion: Neck, trunk and arm posture variation during computer work can be increased by manipulating proportions of time spent sitting and standing at a sit-stand table. The tentative “optimal” proportions reported here could be a benchmark for occupational health professionals.

  • 2.
    Barbieri, Dechristian
    et al.
    Department of Physical Therapy, Federal University of São Carlos.
    Srinivasan, Divya
    Department of Industrial and Systems Engineering, Virginia Polytechnic Institute and State University.
    Mathiassen, Svend Erik
    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.
    Oliveira, Ana Beatriz
    Department of Physical Therapy, Federal University of São Carlos.
    Variation in upper extremity, neck and trunk postures when performing computer work at a sit-stand station2019In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 75, p. 120-128Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to determine the extent of upper arm, neck and trunk posture variation that can be obtained by combining seated and standing computer work, compared to performing only seated computer work. Posture data were recorded for two hours during each of three days of ordinary work from 24 office workers that had been using a sit-stand station for two months. Periods with sitting and standing computer work were identified using on-site observations, and posture means and minute-to-minute variance were determined for both. Expected minute-to-minute posture variability in different temporal combinations of sitting and standing computer work were determined by simulation, and expressed in terms of a Job Variance Ratio, i.e. the relative increase in variability compared to sitting-only work. For all three postures, mean values differed between sitting and standing computer work, and both showed a notable minute-to-minute variability. For most workers, posture variability was larger when combining sitting and standing than when sitting only, and simulations suggested to introduce more standing than what the worker currently practiced. The results indicate that introducing a sit-stand table could, for most office workers, have a positive effect on upper arm, neck and trunk posture variability.

  • 3.
    Barbieri, Dechristian
    et al.
    Department of Physical Therapy, Federal University of Sao Carlos.
    Srinivasan, Divya
    Department of Industrial and Systems Engineering, Virginia Polytechnic Institute and State University.
    Mathiassen, Svend Erik
    University of Gävle, Centre for Musculoskeletal Research. University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science.
    Oliveira, Ana Beatriz
    Department of Physical Therapy, Federal University of Sao Carlos.
    Variation in upper trapezius and wrist extensor EMG among office workers during sit-stand table use in a real work setting2019Conference paper (Refereed)
    Abstract [en]

    Background: Computer work is generally associated with constrained postures and low muscular demands. Sit-stand tables have been suggested as an effective initiative to change working postures during computer work, but the effect of this intervention on muscle activation has rarely been studied. The aim of this study was to document variation in shoulder-arm muscle activation among office workers using sit-stand tables.

    Methods: Twenty-four office workers (16 females, 8 males; age 41±9 years) participated. At entry, workers received sit-stand tables and ergonomics information, and then used the table for two months. Muscle activity of right and left upper trapezius and wrist extensors (RUT, LUT, RWE and LWE, respectively) was recorded during three consecutive days (two hours each day) in the last week of sit-stand table usage. Periods of computer work in sitting and standing positions (CWsit and CWstand, respectively) were identified by on-site observation, and synchronized with the EMG recordings. Variability (min-min SD across 1-minute bins, %MVE) was calculated for each EMG recording in CWsit and CWstand.

    Results: During the 62 minutes of EMG recorded during computer work, CWsit was performed for 72% and CWstand for 28% of the time. The mean minute-to-minute variability of trapezius EMG was larger (P<0.05) during CWsit (RUT 3.9 (SD between workers 1.6) %MVE; LUT 3.9 (SD 2.3) %MVE) than CWstand (RUT 3.0 (SD 1.5) %MVE; LUT 3.2 (SD 1.9) %MVE). The mean minute-to minute variability in RWE was also larger during CWsit (3.3 (SD 1.4) %MVE) than CWstand (2.9 (SD 1.3) %MVE). For LWE, variability did not differ between CWsit and CWstand.

    Conclusion: Sitting and standing computer work was associated with different extents of variation in shoulder-arm muscle activity. Thus, sit-stand tables may introduce beneficial exposure variation into the work of office employees.

  • 4.
    Bergsten, Eva L.
    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.
    Haapakangas, Annu
    Faculty of Health and Well-being, Turku University of Applied Sciences, Turku, Finland.
    Larsson, Johan
    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.
    Jahncke, Helena
    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.
    Hallman, David
    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.
    Effects of relocation to activity-based workplaces on perceived productivity: importance of change-oriented leadership2019In: Article in journal (Refereed)
  • 5.
    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 and Public Health Sciences, 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 Arrangements2019In: Article in journal (Refereed)
  • 6.
    Bohman, Tony
    et al.
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Bottai, Matteo
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Björklund, Martin
    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. Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden.
    Predictive models for short-term and long-term improvement in women under physiotherapy for chronic disabling neck pain: a longitudinal cohort study2019In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 4, article id e024557Article in journal (Refereed)
    Abstract [en]

    Objectives To develop predictive models for short-term and long-term clinically important improvement in women with non-specific chronic disabling neck pain during the clinical course of physiotherapy. Design Longitudinal cohort study based on data from a randomised controlled trial evaluating short-term and long-term effects on sensorimotor function over 11 weeks of physiotherapy. Participants and settings Eighty-nine women aged 31-65 years with non-specific chronic disabling neck pain from Gavle, Sweden. Measures The outcome, clinically important improvement, was measured with the Patient Global Impression of Change Scale (PGICS) and the Neck Disability Index (NDI), assessed by self-administered questionnaires at 3, 9 and 15 months from the start of the interventions (baseline). Twelve baseline prognostic factors were considered in the analyses. The predictive models were built using random-effects logistic regression. The predictive ability of the models was measured by the area under the receiver operating characteristic curve (AUC). Internal validity was assessed with cross-validation using the bootstrap resampling technique. Results Factors included in the final PGICS model were neck disability and age, and in the NDI model, neck disability, depression and catastrophising. In both models, the odds for short-term and long-term improvement increased with higher baseline neck disability, while the odds decreased with increasing age (PGICS model), and with increasing level of depression (NDI model). In the NDI model, higher baseline levels of catastrophising indicated increased odds for short-term improvement and decreased odds for long-term improvement. Both models showed acceptable predictive validity with an AUC of 0.64 (95% CI 0.55 to 0.73) and 0.67 (95% CI 0.59 to 0.75), respectively. Conclusion Age, neck disability and psychological factors seem to be important predictors of improvement, and may inform clinical decisions about physiotherapy in women with chronic neck pain. Before using the developed predictive models in clinical practice, however, they should be validated in other populations and tested in clinical settings.

  • 7.
    Coenen, Pieter
    et al.
    Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
    van der Beek, Allard J.
    Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
    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.
    Mathiassen, Svend Erik
    University of Gävle, Centre for Musculoskeletal Research. University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science.
    Calibration of self-reported physical behaviours among office workers: A compositional data analysis2019In: ICAMPAM 2019: Oral Abstracts, Maastricht: ICAMPAM , 2019, article id O.11.2Conference paper (Refereed)
    Abstract [en]

    The aim of this study was to develop and evaluate calibration models to predict objectively measured time spent sitting, standing and walking during office work from self-reported time-use compositions using a compositional data analysis (CoDA) approach. Ninety-nine office workers (49 women) at the Swedish Transport Administration participated in an intervention study on relocation to activity-based offices. At baseline and at a 3-months follow-up, physical behaviours (sitting, standing and walking) at work were assessed for five days using a thigh-mounted accelerometer (Actigraph) and by self-report (IPAQ). The time-use composition of the three behaviours was expressed in terms of isometric log-ratios (ILR). Calibration models predicting accelerometry-based time-use from self-reported compositions were constructed using linear regression on baseline data, and then validated using follow-up data. The accelerometer data showed that, on average, workers spent 69.9% of their day sitting, 23.7% standing, and 6.4% walking. The corresponding percentages for self-reports were 71.7%, 21.6%, and 7.4%, respectively. Non-calibrated self-reports were biased: the RMS errors obtained from the ILRs expressing sitting, standing and walking were 0.73, 1.09 and 1.05, respectively. Calibration models reduced these errors by 45% (sitting), 56% (standing), and 76% (walking). Validation of the calibration models using follow-up data from the same workers showed calibration remained equally effective; RMS errors were reduced by 55% (sitting), 58% (standing), and 75% (walking). In conclusion, calibration models for compositional time-use data were effective in reducing bias in self-reported physical behaviours at work, and the models remained effective when used on new data from the same workers. Calibrated self-reports may represent a cost-effective method for obtaining physical behaviour data with a satisfying accuracy in large-scale cohort and intervention studies.

  • 8.
    Degerstedt, Frida
    et al.
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden; Umeå Center for Gender Studies, Umeå University, Umeå, Sweden.
    Enberg, Birgit
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
    Keisu, Britt-Inger
    Umeå Center for Gender Studies, Umeå University, Umeå, Sweden.
    Björklund, Martin
    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. Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
    Inequity in physiotherapeutic interventions for children with Cerebral Palsy in Sweden - a national registry study.2019In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of this study was to investigate the distribution of physiotherapeutic interventions for children with Cerebral Palsy in Sweden from an equity perspective, considering sex, country of birth and geographical region.

    METHOD: This national cross-sectional registry study includes children with Cerebral Palsy aged 0-18 years who participated in 2015 in the Swedish national quality registry, the Cerebral Palsy follow-up program, CPUP. Comparisons and associations between physiotherapeutic interventions and sex, country of birth and geographical regions were conducted using Chi2 and logistic regression analysis, controlling for cognitive level, level of motor function, age group and dominating symptom.

    RESULTS: Of the 2855 participants, 2201 (79%) had received physiotherapy. Children born in Sweden had 1.60 times higher odds (95% CI 1.10-2.33) of receiving physiotherapy compared with children born in foreign countries. Distribution of physiotherapeutic interventions differed significantly between geographical regions. No associations between sex and physiotherapeutic interventions were observed.

    CONCLUSION: The results of this study indicate inequity in care in Sweden towards children with Cerebral Palsy born in other counties. Further, physiotherapeutic interventions were not equally distributed in different.

  • 9.
    Domkin, Dmitry
    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.
    Forsman, Mikael
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.; KTH Royal Institute of Technology, Stockholm, Sweden.
    Richter, Hans O.
    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.
    Effect of ciliary-muscle contraction force on trapezius muscle activity during computer mouse work2019In: European Journal of Applied Physiology, ISSN 1439-6319, E-ISSN 1439-6327, Vol. 119, no 2, p. 389-397Article in journal (Refereed)
    Abstract [en]

    The present study aimed to identify whether or not an increase in ciliary-muscle contraction force, when the eye-lens is adjusted for viewing at a near distance, result in an increase in trapezius muscle activity, while performing a natural work task. Twelve participants, ranging in age from 21 to 32 years, performed a computer-mouse work task during free gaze conditions. A moving visual target was tracked with a computer mouse on a screen placed at two different distances from the eyes, 25 cm and 50 cm. Tracking performance, eye accommodation, and bilateral trapezius muscle activity were measured continuously. Ciliary-muscle contraction force was computed according to a formula which takes into account the age-dependent, non-linear relationship between contraction force of the ciliary muscle and the produced level of eye accommodation. Generalized Estimating Equations analyses were performed. On the dominant hand side and for the nearest screen distance, there was a significant effect of ciliary-muscle contraction force on the trapezius muscle activity (p<0.001). No other effects were significant (p>0.05). The results support the hypothesis that high visual demands, during computer mouse work, increase ciliary muscle contraction force and contribute to a raise of the sustained level of trapezius muscle activity. The current study specifically clarifies the validity of the relationship between ciliary-muscle contraction force and trapezius muscle activity and demonstrates that this relationship is not due to a general personal trait. We conclude that a high level of ciliary muscle contraction force can contribute to a development of musculoskeletal complaints in the neck-shoulder area.

  • 10.
    Gilson, Nicholas
    et al.
    The University of Queensland, Australia.
    Hall, Caitlin
    The University of Queensland, Australia.
    Holtermann, Andreas
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    van der Beek, Allard
    VU University Medical Centre, Amsterdam, The Netherlands.
    Huysmans, Maaike
    VU University Medical Centre, Amsterdam, The Netherlands.
    Mathiassen, Svend Erik
    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.
    Straker, Leon
    Curtin University, Perth, Australia.
    Sedentary behaviour and physical activity in blue collar workers: a systematic review of accelerometer studies2019Conference paper (Refereed)
  • 11.
    Gupta, Nidhi
    et al.
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    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.
    Dumuid, Dorothea
    Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, Adelaide, SA, Australia.
    Vij, Akshay
    Institute for Choice, University of South Australia, Adelaide, Australia.
    Lund Rasmussen, Charlotte
    National Research Centre for the Working Environment, Copenhagen, Denmark; Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
    Birk Jørgensen, Marie
    Department of Forensic Science, University of Copenhagen, Copenhagen, Denmark.
    Holtermann, Andreas
    National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
    Movement behavior profiles and obesity: a latent profile analysis of 24-h time-use composition among Danish workers2019In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497Article in journal (Refereed)
    Abstract [en]

    Background/objectives

    An element of obesity prevention is increasing total physical activity energy expenditure. However, this approach does not incorporate the balance of various movement behaviors—physical activity, sedentary behaviors and sleep - across domains of the day. We aimed to identify time-use profiles over work and leisure, termed ‘movement behavior profiles’ and to investigate their association with obesity.

    Subjects/methods

    Eight-hundred-and-seven workers completed (a) thigh accelerometry and diaries to determine their 24-h composition of behaviors (sedentary and standing, light physical activity and moderate-to-vigorous physical activity at work and leisure, and time in bed) and (b) obesity measurements. Movement behavior profiles were determined using latent profile analyses of isometric log-ratios of the 24-h composition, and labeled according to animal movement behavior traits. Linear models were applied to determine the association between profiles and obesity.

    Results

    Four profiles were identified, labeled as “Chimpanzees” (n = 226), “Lions” (n = 179), “Ants” (n = 244), and “Koalas” (n = 158). “Chimpanzees” work time was evenly distributed between behaviors while their leisure time was predominantly active. Compared to Chimpanzees, “Lions” were more active at work and sedentary during leisure and spent more time in bed; “Ants” were more active at work and during leisure; “Koalas” were more sedentary at work and leisure and spent similar time in bed. With “Chimpanzees” as reference, “Lions” had least favorable obesity indicators: +2.0 (95% confidence interval [CI] 0.6, 3.4) %body fat, +4.3 cm (1.4, 7.3) waist circumference and +1.0 (2.0, 0.0) Body Mass Index (BMI), followed by “Koalas” +2.0 (0.4, 3.7) %body fat, +3.1 cm (0.1, 6.0) waist circumference, and +0.8 (−0.30, 1.94) BMI. No significant differences were found between “Chimpanzees” and “Ants”.

    Conclusions

    Movement behavior profiles across work and leisure time-use compositions are associated with obesity. Achieving adequate balance between work and leisure movement behaviors should be further investigated as a potential obesity prevention strategy.

  • 12.
    Gupta, Nidhi
    et al.
    The National Research Centre for the Working Environment, Denmark.
    Hallman, David
    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.
    Dumuid, Dorothea
    Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia.
    Vij, Akshay
    Institute for Choice, University of South Australia, North Sydney, Australia.
    Lund Rasmussen, Charlotte
    The National Research Centre for the Working Environment, Denmark.
    Birk Jørgensen, Marie
    The National Research Centre for the Working Environment, Denmark.
    Korshøj, Mette
    The National Research Centre for the Working Environment, Denmark.
    Holtermann, Andreas
    The National Research Centre for the Working Environment, Denmark.
    Physical-behavior profiles and aerobic capacity: A latent profile analysis of 24-hour time-use composition among Danish workers2019In: ICAMPAM 2019: Oral Abstracts, Maastricht: ICAMPAM , 2019, article id O.11.4Conference paper (Refereed)
    Abstract [en]

    Introduction Obtaining a balance between exercise and recovery is an established approach in Exercise Science to improve aerobic capacity. However, it is unknown how different 24-h time-use profiles depicting a balance between physical behaviors (i.e. physical activities, sedentary behavior and sleep) across main domains of the day are associated with aerobic capacity. We aimed to identify such 'physical-behavior (PB) profiles' and to investigate their association with aerobic capacity. Methods Workers (n=807) participated in thigh-accelerometry to determine 24-h time-use composition of physical activity, sedentary and standing during work and leisure, as well as time in bed. Åstrand submaximal cycle ergometer test was used to estimate aerobic capacity. The PB profiles were determined using latent profile analysis of isometric log-ratios representing the 24-hour composition. Linear models were applied to determine the cross-sectional association between physical-behavior profiles and aerobic capacity. Results Four PB profiles were identified that were labeled based on animal traits; Chimpanzees (n=226), Lions (n=179), Ants (n=244), and Koalas (n=158). Compared to Chimpanzees (at work, in mins; sedentary=197, standing=145, physical activity=117; and at leisure in mins; physical activity=114, standing=121, time in bed= 440); Lions were more active at work, sedentary at leisure and spent more time in bed; Ants had more physical activity at work and similar physical activity and time in bed at leisure; Koalas were more sedentary at work and leisure and spent more time in bed. Compared to Chimpanzees, Koalas had lower aerobic capacity (mlO2/kg/min): -3.7 (95%CI -6.0,-1.5), followed by Lions -3.6 (-5.5,-1.7) and Ants -1.8 (-3.7,- 0.1). Conclusions Physical-behavior profiles based on 24-h time-use composition are associated with aerobic capacity. Obtaining a balance between physical behaviors at work and leisure may be a promising approach for improving aerobic capacity.

  • 13.
    Haapakangas, Annu
    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.
    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.
    The effects of moving into an activity-based office on communication, social relations and work demands – A controlled intervention with repeated follow-up2019In: Journal of Environmental Psychology, ISSN 0272-4944, E-ISSN 1522-9610, Vol. 66, article id 101341Article in journal (Refereed)
    Abstract [en]

    When organizations adopt activity-based workplaces (ABWs), improved interaction is a common goal. Yet, few controlled longitudinal studies have been conducted on the effects of ABWs on interaction, social relations and work demands. The aim of this natural intervention study was to investigate the effects of moving into an ABW on satisfaction with communication, on social relations (i.e., social support and social community) and on work demands (i.e., quantitative demands, emotional demands and work pace) 3 months and 12 months after the relocation. The study included four offices which relocated into an ABW and one control office that did not. Questionnaire data from 408 respondents were analyzed with linear mixed models. Satisfaction with communication and the sense of belonging to a community had decreased 3 and 12 months after the relocation. Work pace was not affected while small, mostly short-term, negative effects on social support, quantitative demands and emotional demands were only observed among employees who had moved to ABWs from private offices. Differences between office sites were also observed. The results suggest that, to avoid negative outcomes, organizations moving to ABWs should focus on solving difficulties in locating colleagues at the office and on supporting particularly workers from private offices in adopting activity-based working.

  • 14.
    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.
    Holtermann, Andreas
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Björklund, Martin
    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. Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden.
    Gupta, Nidhi
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Nørregaard Rasmussen, Charlotte D.
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Sick leave due to musculoskeletal pain : determinants of distinct trajectories over 1 year2019In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246Article in journal (Refereed)
    Abstract [en]

    Purpose

    This study aimed to identify sub-groups of workers with different trajectories of sick leave due to musculoskeletalpain over 1 year, and to investigate the extent to which the identified trajectories are associated with personal, occupational,lifestyle, and pain-related factors at baseline.

    Methods

    Data on 981 blue- and white-collar workers were analyzed in the DPHACTO cohort (2012–2014). The numberof days on sick leave due to pain was reported using text messages at 4-week intervals across 1 year. Latent class growthanalysis was used to distinguish sub-groups with different trajectories of sick leave. A web-based questionnaire at baselinewas used to assess personal, occupational (physical and psychosocial), lifestyle, and pain-related factors. Multinomial regressionmodels were constructed to determine associations between baseline factors and trajectories of sick leave (referencingno sick leave), with adjustment for potential confounders.

    Results

    Four distinct sub-groups were identified, with trajectories of sick leave due to pain ranging from no sick leave(prevalence 76%; average 0.5 days/year) to some days and increasing sick leave due to pain over 1 year (2%; 89 days/year).The increasing trajectory of sick leave was associated with higher perceived physical exertion, more time in manual work,less social community and influence at work, less leisure-time physical activity, smoking, and more severe symptoms (e.g.,multisite pain, low back pain intensity, and pain interference).

    Conclusions

    We identified four distinct trajectories of sick leave due to musculoskeletal pain. The sub-group with increasingsick leave due to pain was associated with several modifiable physical and psychosocial factors at work and outside work,which may have implications for prevention.

  • 15.
    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.

  • 16.
    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.

  • 17.
    Heiden, Marina
    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.
    Zetterberg, Camilla
    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.
    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.
    Nylén, Per
    Swedish Work Environment Authority, Stockholm, Sweden.
    Hemphälä, Hillevi
    Division of Ergonomics and Aerosoltechnology, Design Sciences, Lund University, Lund, Sweden.
    Validity of a computer-based risk assessment method for visual ergonomics2019In: International Journal of Industrial Ergonomics, ISSN 0169-8141, E-ISSN 1872-8219, Vol. 72, p. 180-187Article in journal (Refereed)
    Abstract [en]

    Objective

    To describe the development of a computer-based risk assessment method for visual ergonomics, and assess its face validity, content validity, and internal consistency.

    Methods

    The risk assessment method contained a questionnaire for the worker, an evaluation form for the evaluator, a section of follow-up questions based on the worker's responses, and a section for recommended changes, including an overall risk assessment with respect to daylight, lighting, illuminance, glare, flicker, work space, work object and work postures, respectively. Forty-eight trained evaluators used the method to perform 224 workplace evaluations. Content validity of the method was assessed by the completeness and distribution of responses, and internal consistency was assessed by Cronbach's alpha, Spearman's rank correlation between items and indices, and exploratory factor analysis.

    Results

    The proportion of missing values in items was generally low (questionnaire: 0–2.3%; evaluation form: 1.4–4.1%). In the questionnaire, items about double vision, migraine and corrective lenses had limited information content. Cronbach's alpha and item-index correlations for the indices frequency of eyestrain, intensity of eyestrain, visual symptoms, lighting conditions, frequency of musculoskeletal discomfort and intensity of musculoskeletal discomfort were satisfactory. Based on the factor analysis, suggestions for improving some of the indices were made.

    Conclusion

    Our findings suggest that this computer-based method is a valid instrument for assessing risks in the visual work environment. By incorporating subjective ratings by the worker as well as objective measurements of the work environment, it provides a good basis for recommendations with respect to daylight, lighting, work surfaces/material, and work object.

    Relevance to industry

    Visual environment factors, such as glare, can cause eyestrain, headache and musculoskeletal discomfort. This method satisfies the need of a valid tool for determining risks associated with the visual work environment. It contains both worker's ratings and objective measurements, and is designed to be used in different types of work.

  • 18.
    Heiden, Marina
    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.
    Zetterberg, Camilla
    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.
    Trunk and upper arm postures in paper mill work2019In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 70, p. 90-96Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to assess postures andmovements of the trunk and upper arm during paper mill work, and to determinethe extent to which they differ depending on method of assessment. For each oftwenty-eight paper mill workers, postures and movements were assessed duringthree full shifts using inclinometer registration and observation from video. Summary metrics for each shift, e.g.,10th, 50th, and 90th posture percentile, were averagedacross shifts and across workers. In addition, the standard deviation between workers,and the standard deviation between shifts within worker were computed. The resultsshowed that trunk and arm postures during paper mill work were similar to otheroccupations involving manual materials handling, but the velocity of armmovements were lower. While postures determined by inclinometry and observationwere similar on a group level, substantial differences were found betweenresults obtained by the two methods for individual workers, particularly for extremepostures. Thus, measurements by either method on individuals or small groupsshould be interpreted with caution.

  • 19.
    Helgadóttir, Björg
    et al.
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Svedberg, Pia
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Mather, Lisa
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Lindfors, Petra
    Department of Psychology, Stockholm University, Stockholm, Sweden.
    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. Unit of Intervention and Implementation Research for Worker Health, The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Blom, Victoria
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; The Swedish School of Sport and Health Sciences, Stockholm, Sweden.
    The association between part-time and temporary employment and sickness absence: a prospective Swedish twin study2019In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 29, no 1, p. 147-153Article in journal (Refereed)
    Abstract [en]

    Background: Sickness absence (SA) is becoming a major economic problem in many countries. Our aim was to investigate whether type of employment, including temporary employment or part-time employment, is associated with SA while controlling for familial factors (genetic and shared environment). Differences between men and women and across employment sectors were explored.

    Methods: This is a prospective twin study based on 21 105 twins born in Sweden 1959-85. The participants completed a survey in 2005 with follow-up of SA (≥15 days), using register data, until end of 2013. The data were analyzed with logistic regression, with results presented as odds ratios (OR) with 95% confidence intervals (CI).

    Results: Temporary employment involved higher odds of SA (OR=1.21 95% CI=1.04-1.40) compared to full-time employment. Both part-time workers (OR=0.84 95% CI=0.74-0.95) and the self-employed (OR=0.77 95%CI=0.62-0.94) had lower odds of SA. Stratifying by sex showed lower odds for part-timers (OR=0.82 95% CI=0.73-0.94) and self-employed women (OR=0.65 95% CI=0.47-0.90), but higher odds for men in temporary employment (OR=1.33 95% CI=1.03-1.72). Temporary employees in county councils (OR=1.73 95% CI=1.01-2.99) and municipalities (OR=1.41 95% CI=1.02-1.96) had higher odds while part-timers employed in the private sector had lower odds (OR=0.77 95% CI=0.64-0.93). Familial factors did not confound the association between employment type and SA.

    Conclusions: Employment type is associated with SA, with temporary employment involving a higher risk compared to permanent full-time employment while both part-time employment and self-employment involved a lower risk. The associations vary between women and men and across sectors.

  • 20.
    Huysmans, Maaike A.
    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. Department of Public and Occupational Health, Vrije Universiteit Amsterdam; Research Center for Insurance Medicine, AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands.
    Srinivasan, Divya
    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. Virginia Polytechnic Institute and State University, Blacksburg, USA.
    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.
    Consistency of sedentary behavior patterns among office workers with long-term access to sit-stand workstations2019In: Annals of Work Exposures and Health, ISSN 2398-7308, Vol. 63, no 5, p. 583-591Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Sit-stand workstations are a popular intervention to reduce sedentary behavior (SB) in office settings. However, the extent and distribution of SB in office workers long-term accustomed to using sit-stand workstations as a natural part of their work environment are largely unknown. In the present study, we aimed to describe patterns of SB in office workers with long-term access to sit-stand workstations and to determine the extent to which these patterns vary between days and workers. METHODS: SB was objectively monitored using thigh-worn accelerometers for a full week in 24 office workers who had been equipped with a sit-stand workstation for at least 10 months. A comprehensive set of variables describing SB was calculated for each workday and worker, and distributions of these variables between days and workers were examined. RESULTS: On average, workers spent 68% work time sitting [standard deviation (SD) between workers and between days (within worker): 10.4 and 18.2%]; workers changed from sitting to standing/walking 3.2 times per hour (SDs 0.6 and 1.2 h-1); with bouts of sitting being 14.9 min long (SDs 4.2 and 8.5 min). About one-third of the workers spent >75% of their workday sitting. Between-workers variability was significantly different from zero only for percent work time sitting, while between-days (within-worker) variability was substantial for all SB variables. CONCLUSIONS: Office workers accustomed to using sit-stand workstations showed homogeneous patterns of SB when averaged across several days, except for percent work time seated. However, SB differed substantially between days for any individual worker. The finding that many workers were extensively sedentary suggests that just access to sit-stand workstations may not be a sufficient remedy against SB; additional personalized interventions reinforcing use may be needed. To this end, differences in SB between days should be acknowledged as a potentially valuable source of variation.

  • 21.
    Jackson, Jennie
    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.
    Srinivasan, Divya
    Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, Virginia, USA.
    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.
    Consistent individual motor variability traits demonstrated by females performing a long-cycle assembly task under conditions differing in temporal organisation2019In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126Article in journal (Refereed)
    Abstract [en]

    Low motor variability (MV) during repetitive work has shown association with higher risk for developing work-related musculoskeletal disorders (MSDs). Whether consistent individual MV characteristics exist across working conditions remains unknown. This study aimed to determine if individual MV traits were consistent during complex assembly work performed under conditions differing in temporal organisation.

    Fifteen women performed cyclic-assembly under four conditions differing in pace and organisation (line-type, batch-type). Variability of trapezius muscle activity and upper arm elevation was quantified. Total MV variance was partitioned into components attributable to subjects, days and conditions.

    For all metrics, a non-zero between-subjects variance was found, indicating consistent individual MV traits across conditions. Variance between subjects was higher for EMG MV metrics compared with kinematic metrics.

    Our results showed individuals exhibited consistent MV traits across working conditions differing in pace and production process, and support continued research into MV as a possible individual risk factor for MSDs.

  • 22.
    Jaldemark, Ulrika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational Health Science.
    Företagshälsovårdens erfarenheter av förebyggande arbete mot arbetsrelaterad psykisk ohälsa: En intervjustudie av anställda vid en intern företagshälsovård i norra Sverige2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Sammanfattning Jaldemark Ulrika (2019). Företagshälsovårdmedarbetares erfarenheter av förebyggande arbete mot arbetsrelaterad psykisk ohälsa: En intervjustudie av anställda vid en intern företagshälsovård i norra Sverige. Projektkurs Arbetshälsovetenskap 15hp, Högskolan i Gävle.  Bakgrund: Långtidssjukskrivningar på grund av arbetsrelaterad psykisk ohälsa förekommer trots Arbetsmiljölagen och systematiskt företagshälsoarbete. Kunskap om hur arbetsrelaterad psykisk ohälsa kan förebyggas och motverkas är därför en viktig fråga för att minska sjukskrivningar hos yrkesverksamma.  Syfte: Syfte med denna studie var att undersöka och beskriva erfarenheter av förebyggande arbete mot arbetsrelaterad psykisk ohälsa hos anställda inom en intern företagshälsovårdsinstitution i norra Sverige. Metod: Studien utgick från en kvalitativ ansats och inkluderade fem stycken semistrukturerade intervjuer som analyserades med en kvalitativ innehållsanalys. Resultat: Ur resultatet lyftes tre kategorier och åtta underkategorier fram vilka ansågs ha en betydelse för det förebyggande arbetet mot arbetsrelaterad psykisk ohälsa. De tre huvudkategorier som framkom var; “Företagshälsans inre organisering av det förebyggande arbetet”, “Företagshälsans relation med kundföretagets chef” och “Företagshälsans relation med kunden”. De åtta subkategorierna som kom fram var; “holistisk människosyn, “arbeta i team”, “samarbete med externa aktörer”, chefens ansvar”, “använda rätt verktyg”, “skapa förtroende”, “fångar upp risker i arbetsmiljön tidigt” och “få snabb hjälp med redan uppkomna problem”.  Slutsats: Det främsta resultatet av att studera de anställdas erfarenheter av förebyggande arbete mot arbetsrelaterad psykisk ohälsa är betydelsen av att kombinera företagshälsans inre organisering av det förebyggande arbetet, företagshälsans relation med kundföretagets chef och företagshälsans relation med kunden. Nyckelord: Arbetsrelaterad psykisk ohälsa, förebyggande arbete, företagshälsovård.

  • 23.
    Johansson, Elin
    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.
    Mathiassen, Svend Erik
    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.
    Bolin, Malin
    Department of Social Sciences, Mid Sweden University, Sundsvall, Sweden.
    Olofsdotter, Gunilla
    Department of Social Sciences, Mid Sweden University, Sundsvall, Sweden.
    Equal health at work?: Protocol for an observational study of work organisation, workload and musculoskeletal complaints among women and men in grocery retail2019In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055Article in journal (Refereed)
  • 24.
    Johansson, Elin
    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.
    Mathiassen, Svend Erik
    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.
    Lund Rasmussen, Charlotte
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Lyskov, Eugene
    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.
    Hallman, David
    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.
    Compositional analysis of sedentary behavior and physical activity during work and leisure among male and female office workers2019Conference paper (Other academic)
    Abstract [en]

    Objective: To determine the extent to which male and female office workers differ in their time-use composition of sitting behaviors (SB) and physical activity (PA) during work and leisure.

    Methods: SB and PA was measured using thigh-worn accelerometers for up to 8 full days in 77 male and 104 female office workers. Daily time-use compositions during work and leisure were described in four exhaustive categories, i.e. sitting in short (<30  min) and long (≥30 min) bouts, standing, and active behaviors. Following a compositional data analysis procedure, isometric log-ratios (ilr) were calculated to express time in sitting relative to non-sitting, short relative to long sitting bouts, and standing relative to active behaviors. Differences between sexes (men and women) and domains (work and leisure) were examined on the basis of these ilrs using ANOVA.

    Results: At work, time spent sitting in short bouts, long bouts, standing, and active was, on average, 34%, 36%, 22% and 8% among men and 31%, 37%, 24% and 8% among women. Corresponding proportions during leisure were 34%, 25%, 28% and 13% among men and 29%, 28%, 31% and 12% among women. Time spent sitting relative to non-sitting differed significantly between work and leisure (ilr sitting-vs-non-sitting, partial eta squared=0.09, p<0.01). During leisure, men used proportionally more time than women in short sitting bouts (ilr short-vs-long, partial eta squared=0.06, p<0.01) and spent more time in active behaviors relative to standing (ilr standing-vs-active, partial eta squared=0.04, p<0.01). No significant sex differences were observed during work (p>0.05).

    Conclusions:  The leisure behavior observed among men is probably more beneficial for health than that observed for women. However, both men and women spent a major proportion of their time sitting, both at and outside their office work, and they were, in general, only little active. Thus, both men and women could benefit from interventions to reduce SB and increase PA both at work and during leisure.

  • 25.
    Kaltenbrunner, Monica
    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.
    Mathiassen, Svend Erik
    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.
    Bengtsson, Lars
    University of Gävle, Faculty of Engineering and Sustainable Development, Department of Industrial Management, Industrial Design and Mechanical Engineering, Industrial Management. University of Gävle, Center for Logistics and Innovative Production.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Sciences, Caring Science.
    Lean maturity and quality in primary care2019In: Journal of Health Organisation & Management, ISSN 1477-7266, E-ISSN 1758-7247, Vol. 32, no 2, p. 141-154Article in journal (Refereed)
    Abstract [en]

    Purpose - The purpose of this paper is to 1) describe Lean maturity in primary care using a questionnaire based on Liker’s description of Lean, complemented with observations, and 2) determine the extent to which Lean maturity is associated with quality of care measured as staff-rated satisfaction with care and adherence to national guidelines. High Lean maturity indicates adoption of all Lean principles throughout the organization and by all staff.

    Design/methodology/approach - Data were collected using a survey based on Liker’s four principles, divided into 16 items (n = 298 staff in 45 units). Complementary observations (n = 28 staff) were carried out at four units.

    Findings - Lean maturity varied both between and within units. The highest Lean maturity was found for ‘adhering to routines’ and the lowest for ‘having a change agent at the unit’. Lean maturity was positively associated with satisfaction with care and with adherence to national guidelines to improve healthcare quality. 

    Practical implications - Quality of primary care may benefit from increasing Lean maturity. When implementing Lean, managers could benefit from measuring and adopting Lean maturity repeatedly, addressing all Liker’s principles and using the results as guidance for further development.

    Originality/value - This is one of the first studies to evaluate Lean maturity in primary care, addressing all Liker’s principles from the perspective of quality of care. The results suggest that repeated actions based on evaluations of Lean maturity may help to improve quality of care.

  • 26.
    Kaltenbrunner Nykvist, Monica
    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.
    Bengtsson, Lars
    University of Gävle, Faculty of Engineering and Sustainable Development, Department of Industrial Management, Industrial Design and Mechanical Engineering, Industrial Management. University of Gävle, Center for Logistics and Innovative Production.
    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.
    Högberg, Hans
    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.
    Staff perception of Lean, care-giving, thriving and exhaustion: a longitudinal study in primary care2019In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963Article in journal (Other academic)
  • 27.
    Kelson, Denean M.
    et al.
    Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, USA.
    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.
    Srinivasan, Divya
    Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, USA.
    Trapezius muscle activity variation during computer work performed by individuals with and without shoulder-neck pain2019In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 81, article id 102908Article in journal (Refereed)
    Abstract [en]

    This study aimed at determining the extent to which individuals with neck-shoulder pain and non-symptomatic individuals differ in muscle activation patterns, when performing computer work, as quantified by exposure variation analysis (EVA). As a secondary aim, we also aimed to quantify the day-to-day reliability of EVA variables describing trapezius muscle activation in a non-symptomatic control group. Thirteen touch-typing computer users (pain: n=5, non-symptomatic: n=8) completed three pre-selected computer tasks in the laboratory.

    Upper trapezius muscle activity was recorded using electromyography and analyzed using EVA with five amplitude and five duration categories. Individuals with neck-shoulder pain spent less time at low amplitudes and exhibited longer uninterrupted periods of muscle activation compared to their non-symptomatic counterparts. Thus, non-symptomatic workers tended to switch between exposure levels more often than individuals with pain. For a majority of EVA variables, ICCs ranged from 0.6 to 0.9, and between-days coefficients of variation were between 0.4 and 2.2.

  • 28.
    Long, Jennifer
    et al.
    School of Optometry and Vision Science, UNSW Sydney 2052 AUSTRALIA.
    Richter, Hans
    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.
    Visual ergonomics on-the-go2019In: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 63, no 3, p. 321-324Article in journal (Refereed)
  • 29.
    Mather, Lisa
    et al.
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Narusyte, J.
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Ropponen, A.
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Finnish Institute of Occupational Health, Helsinki, Finland.
    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. Unit of Intervention and Implementation Research for Worker Health, The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Blom, V.
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; The Swedish School of Sport and Health Sciences, Stockholm, Sweden .
    Helgadóttir, B.
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Svedberg, P.
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Sick leave due to mental disorders, morbidity and mortality: a prospective study of discordant twin pairs2019In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285Article in journal (Refereed)
    Abstract [en]

    Purpose: To investigate if sick leave due to mental disorders increases the risk of morbidity measured by inpatient and specialized outpatient care, and mortality among women and men, independent of familial factors. Methods: An open cohort study of 4979 twin pairs discordant for sick leave due to mental disorders was conducted in 2005–2013. Twins were followed up in the cause of death and national patient registries until the end of study, emigration, death, and inpatient and specialized outpatient care. Conditional Cox proportional hazard regression, adjusting for the familial factors shared by the twins, was used to calculate hazard ratios (HR) with 95% confidence intervals (CI). In case of non-proportional hazards, time-varying covariates were used. Results: Sick leave due to mental disorders increased the risk for inpatient care among men (HR: 1.90, CI 1.66–2.17) and women (HR: 1.39, CI 1.27–1.51). For men, the risk of outpatient care was higher the first 2 years (HR: 2.08, CI 1.87–2.31), after which it was attenuated (HR: 1.32, CI 1.02–1.70). For women, the HR was 1.57 (CI 1.47–1.68) for the whole study time. There was an increased risk of death among men (HR: 2.91, CI 1.70–4.99), but not among women (HR: 0.84, CI 0.53–1.35). Conclusions: Sick leave due to mental disorders was a risk factor for mortality for men only, and increased the risk of inpatient and specialized outpatient care among both women and men, but the risks were higher for men when stratifying for sex. 

  • 30.
    Mathiassen, Svend Erik
    et al.
    University of Gävle, Centre for Musculoskeletal Research. University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science.
    Johansson, Elin
    University of Gävle, Centre for Musculoskeletal Research. University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science.
    Hallman, David
    University of Gävle, Centre for Musculoskeletal Research. University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science.
    Sitting, standing and physical activity among male and female office workers of different age: behaviours examined using compositional data analysis2019Conference paper (Refereed)
    Abstract [en]

    Background. Excessive sitting is an increasing concern in working life. Negative health effects may, to some extent, be mitigated by interrupting prolonged sitting by standing or more active behaviours, like walking. Alternations between these behaviours may also influence variation in neck-shoulder-arm exposures, and thus musculoskeletal disorder risks. This study examined time spent sitting, standing and active among office workers, and determined the extent to which these behaviours differed by gender and age.

    Methods. Ninety-nine workers at a Swedish government agency (50/49 men/women; mean(SD) age 47.1(9.0) years) wore a thigh accelerometer (Actigraph GT3X) for five working days. Data were processed to give the percentage of time spent sitting in short (<30 min) and long (≥30 min) bouts, in standing, and in more active behaviours. In adding up to 100%, such data are constrained and inherently dependent. This requires further examination to be performed using Compositional Data Analysis (CoDA). Thus, Isometric Log-transformed Ratios were constructed, describing sitting vs. non-sitting (sit/nonsit), short-bout vs. long-bout sitting (shortsit/longsit), and standing vs. active (stand/active). These ratios were examined for pairwise correlations, and for associations with gender and age.

    Results. On average, workers spent 28.9%, 42.2%, 21.6%, and 7.3% time in shortsit, longsit, standing, and active. Sit/nonsit correlated negatively with shortsit/longsit (r=–0.49) and stand/active (r=–0.64); shortsit/longsit correlated positively with stand/active (r=0.19). Gender showed small associations with all three ratios (partial-ƞ2=0.01-0.03; p=0.08-0.43). Stand/active increased with increasing age (partial-ƞ2=0.07; p=0.01), while sit/nonsit and shortsit/longsit were very weakly associated with age (partial-ƞ2=0.01 and 0.01; p=0.26 and 0.40).

    Conclusions. Workers spending more time sitting also spent a larger part of that time in long, uninterrupted sitting bouts. However, when not sitting, these workers were more physically active than workers who sat less. These behaviours differed little by gender and age, besides older workers being relatively less active during non-sitting periods.

  • 31.
    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.
    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.
    Alternations between physical and cognitive tasks in repetitive work – Effect of cognitive task difficulty on fatigue development in women2019In: Ergonomics, ISSN 0014-0139, E-ISSN 1366-5847, Vol. 62, no 8, p. 1008-1022Article in journal (Refereed)
    Abstract [en]

    In a context of job rotation, this study determined the extent to which the difficulty of a cognitive task (CT) interspersed between bouts of repetitive, low-intensity work (pipetting) influences recovery from fatigue. Fifteen participants performed three experimental sessions, each comprising 10 repeats of a 7 min + 3 min combination of pipetting and CT. The CT was easy, moderate or hard. Surface electromyography (EMG amplitude of the forearm extensor and trapezius muscles) and self-reports was used to assess fatigability. Perceived fatigue and trapezius EMG amplitude increased during sessions. CT difficulty influenced fatigue development only little, besides forearm extensor EMG increasing more in CT3 than in CT1 and CT2. During CT bouts, fatigability recovered, and to a similar extent irrespective of CT. Thus, CT difficulty influenced recovery of perceived as well as performance fatigability to a minor extent, and may not be a critical issue in job rotation comprising alternating physical and cognitive tasks.

  • 32.
    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
    Department of Psychology, Stockholm University, Stockholm, Sweden.
    Dimberg, Kenth
    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 difficulties2019In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126Article in journal (Refereed)
    Abstract [en]

    This experimental study aimed to determine the extent to which a repetitive physical task alternatingwith a cognitive task (CT) influences stress responses and whether the CT difficulty is important. Fifteen women performed three sessions of 10 consecutive work bouts, each including a seven-minutere petitive physical task and a three-minute CT at either of three difficulty levels. Stress-related responses were assessed using heart rate variability, blood pressure, salivary alpha-amylase, salivary cortisol, perceived stress and cognitive performance.The alternating work did not result in any marked increase in perceived stress or changes in stressresponses. CT difficulty did not influence stress responses (all p>0.05), apart from alpha-amylase which was higher during the easiest CT (F= 5.34, p= 0.02). Thus, introducing cognitive work bouts into repetitive physical work did not result in increased levels of stress, suggesting this approach to be viable in job rotation.

  • 33.
    Monnier, Andreas
    et al.
    Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden; School of Education, Health and Social Studies, Dalarna University, Falun, Sweden; Swedish Armed Forces, Military Academy Karlberg, Stockholm, Sweden.
    Larsson, Helena
    Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden; Swedish Armed Forces, Headquarters, Medical Services, Stockholm, Sweden.
    Nero, Håkan
    Department of Orthopedics, Faculty of Medicine, Lund University, Lund, Sweden.
    Djupsjöbacka, Mats
    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.
    Äng, Björn O.
    Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden; School of Education, Health and Social Studies, Dalarna University, Falun, Sweden; Center for Clinical Research, Uppsala University, Falun, Sweden.
    A longitudinal observational study of back pain incidence, risk factors and occupational physical activity in Swedish marine trainees2019In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 5, article id e025150Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To evaluate the occurrence of low back pain (LBP) and LBP that limits work ability, to identify their potential early risks and to quantify occupational physical activity in Swedish Armed Forces (SwAF) marines during their basic 4 month marine training course.

    DESIGN: Prospective observational cohort study with weekly follow-ups.

    PARTICIPANTS: Fifty-three SwAF marines entering the training course.

    OUTCOMES: Incident of LBP and its related effect on work-ability and associated early risks. Occupational physical activity, as monitored using accelerometers and self-reports.

    RESULTS: During the training course, 68% of the marines experienced at least one episode of LBP. This yielded a LBP and LBP limiting work ability incidence rate of 13.5 (95% CI 10.4 to 17.8) and 6.3 (95% CI 4.2 to 10.0) episodes per 1000 person-days, respectively. Previous back pain and shorter body height (≤1.80 m) emerged as independent risks for LBP (HR 2.5, 95% CI 1.4 to 4.3; HR 2.0, 95% CI 1.2 to 3.3, respectively), as well as for LBP that limited work ability (HR 3.6, 95% CI 1.4 to 8.9; HR 4.5, 95% CI 2.0 to 10.0, respectively). Furthermore, managing fewer than four pull-ups emerged as a risk for LBP (HR 1.9, 95% CI 1.2 to 3.0), while physical training of fewer than three sessions per week emerged as a risk for LBP that limited work ability (HR 3.0, 95% CI 1.2 to 7.4). More than 80% of the work time measured was spent performing low levels of ambulation, however, combat equipment (≥17.5 kg) was carried for more than half of the work time.

    CONCLUSIONS: Incidents of LBP are common in SwAF marines' early careers. The link between LBP and previous pain as well as low levels of exercise highlights the need for preventive actions early on in a marine's career. The role of body height on LBP needs further investigation, including its relationship with body-worn equipment, before it can effectively contribute to LBP prevention.

  • 34.
    Richter, Hans
    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.
    Long, Jennifer
    School of Optometry and Vision Science, UNSW Sydney, Sydney, AUSTRALIA.
    The pitfalls of the traditional office ergonomics model in the current mobile work environment:  Is visual ergonomic health literacy the remedy?2019In: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 63, no 3, p. 447-456Article in journal (Refereed)
    Abstract [en]

    Mobile technology has revolutionised how we work. It is now relatively easy to work anywhere and anytime, but this has placed the onus on mobile (or flexible) workers to set up their own work environment for comfort and ease of use. Vision is an important driver of posture, and hence visual ergonomics principles are integral for setting up digital devices. If mobile workers do not have visual ergonomics knowledge, or are unable to apply visual ergonomics knowledge to appropriately set up their work environment, then they are at risk of developing visual-related occupational health issues due to exposure to adverse physical work environments.

    To address this potential health care issue, we propose the introduction of Visual Ergonomics Health Literacy. This would provide mobile workers (including school children) with the knowledge and skills to set up their work environment for comfort and ease of use, wherever they work. It is important to address this issue now before we have a widespread epidemic of discomfort and injury from not applying sound visual ergonomics principles to work environments.

  • 35.
    Richter, Hans
    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.
    Sundin, Sofia
    Long, Jennifer
    School of Optometry and Vision Science, UNSW Sydney, Australia; Jennifer Long Visual Ergonomics, Katoomba, NSW, Australia.
    Visually deficient working conditions and reduced work performance in office workers: Is it mediated by visual well-being and health?2019In: International Journal of Industrial Ergonomics, ISSN 0169-8141, E-ISSN 1872-8219, Vol. 72, p. 128-136Article in journal (Refereed)
    Abstract [en]

    Introduction: The main purpose of this cross-sectional study was to investigate whether visual well-being and health act as a mediating factor between perceived visual ergonomic working conditions and self-rated visual performance among office workers who perform administrative tasks and computer-based work at the Swedish Tax Agency.

    Methods: A questionnaire was sent to 94 office workers addressing: 1) perceived visual quality of the visual display units; 2) prevalence of eye symptoms; and 3) self-rated visual performance. Eighty-six persons (54 women (63 %), 31 men (36 %), and 1 of unspecified sex) answered the questionnaire. Multiple regression analysis investigated the association between visual ergonomic working conditions and visual performance, with and without visual well-being and health as a mediator.

    Results: The group mean of the Indexed survey questions indicated reasonably good quality visual ergonomic working conditions, a relative absence of eye symptoms, and acceptable self-rated visual performance. Results from multiple regression analysis showed a significant association between perceived visual ergonomic working conditions and self-rated visual performance (r2 = 0.30, β = 0.327, p < 0.01). When visual well-being and health was used as a mediator, the association between perceived visual ergonomic working conditions and self-rated visual performance remained the same (r2 = 0.32, β = 0.315, p < 0.01).

    Discussion: It was surprising to discover that self-rated visual performance  was independent of visual health and well-being. Possible explanations include exposure factors not included in the current study, such as dry air and sensory irritation in eyes, psychosocial stress, time spent performing near work activities or time exposed to visually deficient working conditions. The strong connection between satisfaction with visual ergonomics work conditions and productivity found in this study has implications for workplace profitability and staff satisfaction. If productivity of office workers is improved by better visual ergonomics work conditions, then managers within workplaces may be able to improve work outcomes by optimizing the physical work environment.

  • 36.
    Sandberg, Camilla
    et al.
    Department of Community Medicine and Rehabilitation, Umeå University.
    Crenshaw, Albert G.
    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.
    Elcadi, Guilherme H.
    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.
    Christensen, Christina
    Department of Medical Sciences, Uppsala University.
    Hlebowicz, Joanna
    Department of Cardiology, Lund University.
    Thilén, Ulf
    Department of Cardiology, Lund University.
    Johansson, Bengt
    Heart center and Department of Public Health and Clinical Medicine, Umeå University.
    Impaired skeletal muscle endurance in adults with complex congenital heart disease is associated with local muscle oxygenation2018In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754Article in journal (Refereed)
  • 37.
    Sandberg, Camilla
    et al.
    Department of Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden.
    Crenshaw, Albert G.
    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.
    Elcadi, Guilherme H.
    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.
    Christersson, Christina
    Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Hlebowicz, Joanna
    Department of Cardiology, Lund University, Lund, Sweden.
    Thilén, Ulf
    Department of Cardiology, Lund University, Lund, Sweden.
    Johansson, Bengt
    Department of Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden.
    Impaired Skeletal Muscle Endurance in Adults With Complex Congenital Heart Disease is Associated With Local Muscle Oxygenation Kinetics2018In: Circulation: Abstracts From the American Heart Association's 2018 Scientific Sessions, 2018, Vol. 138, p. A15914-, article id Suppl. 1Conference paper (Refereed)
    Abstract [en]

    Introduction: Adults with complex congenital heart disease show reduced aerobic exercise capacity and impaired skeletal muscle function compared to healthy peers. Peripheral muscle factors are presumed to be important contributors, but the mechanisms are poorly understood. Hypothesis: Muscle oxygenation is associated with reduced skeletal muscle endurance in adults with complex CHD. Methods: Sixty-four adults with complex congenital heart disease (mean age 36.9±14.8 years, females n=19) were recruited from centers specialized in congenital heart disease. Seventy-four age and gender matched healthy peers were recruited as controls. Muscle oxygen saturation was successfully determined on the anterior portion of the deltoid muscle using near-infrared spectroscopy for 57 patients and 71 controls. Measurements were made at baseline, during isotonic shoulder flexions (0-90°) to exhaustion and during 60 seconds of recovery. Results: The adults with complex CHD performed fewer shoulder flexions (38±15 vs. 69±40, p <0.001), had lower muscle oxygen saturation at rest (58±17% vs. 69±18%, p <0.001), a slower desaturation rate at exercise onset (-9.5±5.9%/sec vs. -15.1±6.5%/sec, p <0.001), and a slower resaturation rate post exercise (3.9±2.8%/sec vs. 5.4±3.6%/sec, p =0.008) compared to the controls. Conclusions: A distinct association was found between muscle oxygenation kinetics and early muscle fatigue for adults with complex CHD. Our findings may give insight to the underlying mechanisms for the reduced aerobic exercise capacity for these patients, and therefore provide implications for design of exercise training protocols in this population. [ABSTRACT FROM AUTHOR]

  • 38.
    Sandberg, Camilla
    et al.
    Heart Center and Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden; Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
    Crenshaw, Albert G.
    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.
    Elçadi, Guilherme H.
    Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden; School of Health Sciences, Örebro University, Örebro, Sweden.
    Christersson, Christina
    Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden.
    Hlebowicz, Joanna
    Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden.
    Thilén, Ulf
    Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden.
    Johansson, Bengt
    Heart Center and Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
    Slower Skeletal Muscle Oxygenation Kinetics in Adults With Complex Congenital Heart Disease2019In: Canadian Journal of Cardiology, ISSN 0828-282X, E-ISSN 1916-7075Article in journal (Refereed)
    Abstract [en]

    Background: Adults with complex congenital heart disease (CHD) show reduced aerobic exercise capacity and impaired skeletal muscle function compared with healthy peers. Peripheral muscle factors are presumed to be important contributors to the aerobic capacity, but the mechanisms are poorly understood. The aim of the present study was to investigate differences between adults with CHD and controls in muscle oxygenation kinetics at rest, and during and after exercise.

    Methods: Seventy-four patients with complex CHD (mean age 35.6 ± 14.3 years, female n = 22) were recruited. Seventy-four age- and sex-matched subjects were recruited as controls. Muscle oxygenation was successfully determined on the anterior portion of the deltoid muscle using near-infrared spectroscopy in 65 patients and 71 controls. Measurements were made at rest, during isotonic shoulder flexions (0-90°) to exhaustion, and during recovery.

    Results: The patients with CHD performed fewer shoulder flexions (40 ± 17 vs 69 ± 40; P &lt; 0.001), had lower muscle oxygen saturation (StO2) at rest (58 ± 18% vs 69 ± 18%; P &lt; 0.001), slower desaturation rate at exercise onset (−9.7 ± 5.9 vs −15.1 ± 6.5% StO2 × 3.5 s−1, P &lt;0.001), and slower resaturation rate post exercise (4.0 ± 2.7 vs 5.4 ± 3.6% StO2 × 3.5 s−1; P = 0.009) compared with the controls. Conclusions: In comparison with age- and sex-matched controls, adults with complex CHD had slower oxygenation kinetics. This altered skeletal muscle metabolism might contribute to the impaired skeletal muscle endurance capacity shown and thereby also to the reduced aerobic capacity in this population. 

  • 39.
    Sato, Tatiana
    et al.
    Physical Therapy Department, Federal University of São Carlos (UFSCar), Brazil.
    Hallman, David
    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.
    Kristiansen, Jesper
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Holtermann, Andreas
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    The association between multisite musculoskeletal pain and cardiac autonomic modulation during work, leisure and sleep - a cross-sectional study2018In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 19, no 1, article id 405Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    The prevention and rehabilitation of multisite musculoskeletal pain would benefit from studies aiming to understand its underlying mechanism. Autonomic imbalance is a suggested mechanism for multisite pain, but hardly been studied during normal daily living. Therefore, the aim of the study is to investigate the association between multisite musculoskeletal pain and cardiac autonomic modulation during work, leisure and sleep.

    METHODS:

    This study is based on data from the "Danish Physical activity cohort with objective measurements" among 568 blue-collar workers. Pain intensity scales were dichotomized according to the median of each scale, and the number of pain sites was calculated. No site was regarded as the pain-free, one site was considered as single-site musculoskeletal pain and pain in two or more sites was regarded as multisite musculoskeletal pain. Heart rate variability (HRV) was measured by an electrocardiogram system (ActiHeart) and physical activity using accelerometers (Actigraph). Crude and adjusted linear mixed models were applied to investigate the association between groups and cardiac autonomic regulation during work, leisure and sleep.

    RESULTS:

    There was no significant difference between groups and no significant interaction between groups and domains in the crude or adjusted models for any HRV index. Significant differences between domains were found in the crude and adjusted model for all indices, except SDNN; sleep time showed higher values than leisure and work time, except for LF and LF/HF, which were higher during work.

    CONCLUSION:

    This cross-sectional study showed that multisite musculoskeletal pain is not associated with imbalanced cardiac autonomic regulation during work, leisure and sleep time.

  • 40.
    Strömberg, Annika
    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.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Hagerman, Heidi
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Skytt, Bernice
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    First-line managers dealing with different management approaches2019In: Leadership in Health Services, ISSN 1751-1879, E-ISSN 1751-1887Article in journal (Refereed)
    Abstract [en]

    Purpose – The purpose of this paper is to contribute new knowledge about how first line managers (FLMs) in elderly care perceive their situation, with a focus on differences in management approaches at the intersection of the central and local parts of the organization.

    Design/methodology/approach – The present study has a qualitative approach and is part of a larger project on FLMs in elderly care. The results presented here are based on a secondary analysis of 15 of the totalof 28 interviews carried out in the project.

    Findings – Themain results are twofold: the majority of FLMs perceived differences in management approaches between local and central management; the differences caused some struggle because FLMs perceived that the management system did not support the differences. The two main aspects that caused the FLMs to struggle were differences in the foci of the management levels and difficulties in influencing the conditions ofmanagement.

    Originality/value – The results contribute to the debate on what aspects are important to sustainable management of elderly care. It is common knowledge that FLMs have a complex position, intermediate to the central, upper level management and their subordinates at the local level – levels with different foci and interests. The study contributes new knowledge about what these differences consist of and the dilemmas they cause and offers suggestions as to what can be done to reduce both energy waste and the risk of low job satisfaction.

  • 41.
    Widar, Linda
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science.
    Boman, Eva
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Psychology.
    Wiitavaara, Birgitta
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science.
    Heiden, Marina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science.
    Psychophysiological reactions, stress and recuperation among telecommuting academics2019Conference paper (Refereed)
    Abstract [en]

    Psychophysiological reactions, stress and recuperation among telecommuting academics

    Linda Widar*, Eva Boman, Birgitta Wiitavaara and Marina Heiden

    Department of Occupational Health Sciences and psychology, Faculty of Health and Occupational Studies  

    *corresponding author: linda.widar@hig.se

    Telecommuting is a working arrangement that is highly adopted among academic staff. This may be a cause or a consequence of expanding demands on productivity, efficiency and availability of academic staff. A previous study on white-collar workers at a government authority showed higher cardiovascular arousal during work at the office, but less recovery after working from home. To our knowledge, these findings have not been confirmed or refuted in other populations. As part of an ongoing study, we aimed to determine whether there is a difference in perceived stress and psychophysiological reactions during work at the central workplace (CW) compared to work performed away from the central workplace (OCW) among academic staff. In addition, recuperation after work performed at the two locations were compared. For each subject, saliva cortisol was collected regularly throughout each of two working days in the same work week (i.e., one full day CW and one full day OCW). Before and after each working day, the subjects rated their stress and fatigue on 100 mm Visual Analogue Scales (VAS) where higher values imply more stress and fatigue, and the difference in ratings within a day (i.e., after-before) was calculated. In the morning after each of the working days, the subjects rated how recuperated they felt on VAS where higher values imply more recuperation. Cortisol values were analyzed using repeated measures analysis of variance with Day (2 days) and Time of day (6 time points) as within-subjects effects. Self-ratings were compared using paired-samples T test. In all tests, the level of significance was p=0.05. Preliminary results show no significant differences between days in cortisol curves (F=0.62; p=0.685), stress (Dstress=2 for CW and -1 for OCW; p=0,604), fatigue (Dfatigue=7 for CW and 6 for OCW; p=0,837) and recuperation (51 for CW and 61 for OCW; p=0,094).

  • 42.
    Wiitavaara, Birgitta
    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.
    Rissén, Dag
    Region Gävleborg.
    Högberg, Hans
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Uppsala universitet.
    Psychometric testing of a short form questionnaire for measurement of health experiences among people with musculoskeletal disorders undergoing multimodal rehabilitation2019In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 5, article id e025103Article in journal (Refereed)
    Abstract [en]

    Aim

    The aim of present study was to assess if a previously suggested short-form questionnaire tested among women with non-specific neck-shoulder pain is suitable also for use among men and women with non-specific musculoskeletal disorders in any part of the body, by testing its construct validity by a confirmatory factor analysis. If not, the secondary aim was to investigate the evolving factor structure when performing an explorative factor analysis of data in the expanded sample.

    Methods

    Questionnaire data was collected in three different contexts, in primary care via eight different multimodal rehabilitation teams, in specialised care via two different specialist care centres. The sample consisted of 116 participants, male (n=29) and female (n=87) with non-specific musculoskeletal disorders.

    Data was analysed using confirmatory and exploratory factor analysis and a visual comparison between the result of the Principal Component Analysis in present study, and the results attained in a previous study with a similar aim and design.

    Results

    The confirmatory factor analyses did not end up in a model with acceptable measures for validity. Three models were tested, none of them met the criterion for an acceptable model and the goodness-of-fit statistics were not fully acceptable. The exploratory factor analysis had an only partly comparable result, compared to previous study.

    Conclusion

    The results of present study did not prove the suggested short form questionnaire to be suitable for evaluation of symptoms among men and women with non-specific musculoskeletal disorders in any part of the body. Further studies including larger samples are recommended.

  • 43.
    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 Gävleborg/Uppsala University, Gävle, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Åberg Jönsson, Fredrik
    Centre for Research and Development, Region Gävleborg/Uppsala University, Gävle, Sweden.
    Lindberg, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Centre for Research and Development, Region Gävleborg/Uppsala University, Gävle, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Perceived enabling factors and barriers for the implementation of improvements in health care in order to achieve patient-centred care: A case report from Sweden2019In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753Article in journal (Refereed)
    Abstract [en]

    Abstract Rationale, aim, and objectives More knowledge is needed regarding the complex factors and perceptions that enable the implementation of change in health care. The study aimed to examine the enabling factors and barriers encountered in the implementation of improvements in health care in order to achieve patient-centred care (PCC) and to study if there was a correlation in the extent the improvements were perceived to be implemented and the preconditions that were considered to affect them. Methods Using a mixed method design, data were gathered via a questionnaire and individual interviews with health care personnel, clinic managers, and first-line managers. The data collection and analyses were based on the framework for Promoting Action on Research Implementation in Health Services (PARiHS). Correlations between PCC improvements and preconditions for improvements were performed. Results A high level of involvement, knowledge, and adequate resources were considered important to achieve an implementation of PCC with joint responsibility. Leadership and management need to be explicit and promote continuous follow-up and feedback. Preconditions for improvement had a linear correlation with the perceived level of implementation. Knowledge-related preconditions had greatest impact on implementation. Conclusions The PARiHS framework was appropriate to use since the three components of evidence, context, and facilitation present different important preconditions in the implementation process. Evidence was the highest rated contributor since evidence-based practices in health care are necessary. It is vital that the important role of the context and facilitators is acknowledged in the implementation process to enable a successful implementation of change. There is a need to incorporate a clear strategy involving all levels in the organization. Furthermore, leaders play an important role in the implementation by facilitating communication and support and by having trust in facilitators and health care personnel. The results are applicable to other interventions implementing change in health care.

  • 44.
    Zecevic, Anna
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational Health Science.
    Företagsägares uppfattningar om arbetsmiljöarbete i mikroföretag2019Independent thesis Advanced level (degree of Master (Two Years)), 80 credits / 120 HE creditsStudent thesis
    Abstract [en]

    The purpose of the present study was to investigate and describe business owners perceptions of occupational health and safety management in micro enterprises. The data collection was conducted through qualitative interviews and the material from the interviews has been analyzed with a phenomenographic method. The similarities of the study's result are: "necessary for companies and employees", "time consuming" and "important to get help from someone who can". The differences that emerged are: "occupational health and safety management starts with the premises", "costs a lot of money", "not adapted for micro-enterprises", "occupational health and safety management is about leadership", "occupational health and safety management is complex", "occupational health and safety management does not feel amusing" and "occupational health and safety management only consists of requirements". Based on the results that have emerged from the study, the informants who work with the working environment seem to have a positive view while those who do not work with the work environment seem to have a negative view of it. The informants who work and do not work with the environment seem to work in different ways and have different priorities in the occupational health and safety management.

  • 45.
    Österlund, Catharina
    et al.
    University of Umeå, Faculty of Medicine, Department of Odontology, Clinical Oral Physiology, Umeå, Sweden.
    Nilsson, Evelina
    University of Umeå, Faculty of Medicine, Department of Odontology, Clinical Oral Physiology, Umeå, Sweden.
    Hellström, Fredrik
    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.
    Häger, Charlotte K.
    University of Umeå, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Umeå, Sweden.
    Häggman-Henrikson, Birgitta
    University of Malmö, Faculty of Odontology, Orofacial Pain and Jaw Function, Malmö, Sweden.; Scandinavian Center for Orofacial Neurosciences (SCON), Malmö, Sweden.
    Jaw-Neck Movement Integration in 6-year old Children Differs from that of Adults2019In: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842Article in journal (Refereed)
    Abstract [en]

    Background: A functional integration between the jaw and neck regions during purposive jaw movements is well described in adults, but there is a lack of knowledge of such integration during jaw function in children.; Objectives: To determine the movement integration between the jaw and neck during jaw motor tasks in 6-year-olds, whether there is a difference between children and adults.; Methods: Jaw and neck movements were recorded with an optoelectronic 3D system in 25 healthy 6-year-olds (12 girls, 13 boys) and 24 healthy adults (12 women, 12 men) during paced jaw opening-closing and self-paced gum chewing. Jaw and neck movement amplitudes, intra-individual variation in movement amplitude, ratio between neck-jaw movement amplitudes, and movement cycle time were analysed. Differences between children and adults were evaluated with Mann-Whitney U test for independent samples.; Results: Compared to adults, 6-year old children showed larger neck movement amplitudes (P=0.008) during chewing, higher intra-individual variability in amplitudes of jaw (P=0.008) and neck (P=0.001) movements, higher ratio between neck-jaw movement amplitudes for jaw opening-closing (P=0.026) and chewing (P=0.003), and longer jaw movement cycle time (P≤0.0001) during the jaw opening-closing task.; Conclusion: Despite integrated jaw-neck movements in 6-year old children, the movement pattern differs from that of adults and may be interpreted as an immature programming of jaw-neck motor behavior. The well-integrated movements observed in adults most likely develop over years, perhaps into adolescence, and needs further research including well controlled longitudinal studies to map this development in order to provide appropriate age-related clinical treatment for functional disorders. This article is protected by copyright. All rights reserved.; This article is protected by copyright. All rights reserved.

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