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  • 51.
    Johansson, Amanda
    et al.
    Umeå University.
    Nordin, Steven
    Umeå University.
    Heiden, Marina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Sandstrom, Monica
    Umeå Unversity.
    Symptoms, personality traits, and stress in people with mobile phone-related symptoms and electromagnetic hypersensitivity2010In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 68, no 1, p. 37-45Article in journal (Refereed)
    Abstract [en]

    Objective: Some people report symptoms that they associate with electromagnetic field (EMF) exposure. These symptoms may be related to specific EMF sources or to electrical equipment in general (perceived electromagnetic hypersensitivity, EHS). Research and clinical observations suggest a difference between mobile phone (MP)-related symptoms and El-IS with respect to symptom prevalence, psychological factors, and health prognosis. This study assessed prevalence of EMF-related and EMF-nonrelated symptoms, anxiety, depression, somatization, exhaustion, and stress in people with MP-related symptoms or EHS versus a population-based sample and a control sample without EMF-related symptoms. Methods: Forty-five participants with MP-related symptoms and 71 with EHS were compared with a population-based sample (n=106) and a control group (n=63) using self-report questionnaires. Results: The EHS group reported more symptoms than the MP group, both EMF-related and EMF-nonrelated. The MP group reported a high prevalence of somatosensory symptoms, whereas the EHS group reported more neurasthenic symptoms. As to self-reported personality traits and stress, the case groups differed only on somatization and listlessness in a direct comparison. In comparison with the reference groups, the MP group showed increased levels of exhaustion and depression but not of anxiety, somatization, and stress; the EHS group showed increased levels for all of the conditions except for stress. Conclusion: The findings support the idea of a difference between people with symptoms related to specific EMF sources and people with general EHS with respect to symptoms and anxiety, depression, somatization, exhaustion, and stress. The differences are likely to be important in the management of patients. (C) 2010 Elsevier Inc. All rights reserved.

  • 52.
    Rashid, Mamunur
    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.
    Kristofferzon, Marja-Leena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Heiden, Marina
    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.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Uppsala, Sweden.
    Factors related to work ability and well-being among women on sick leave due to long-term pain in the neck/shoulders and/or back: a cross-sectional study2018In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 18, no 1, article id 672Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Musculoskeletal pain is one of the leading causes of sick leave, especially among women, in Western countries. The aim of the present study was to identify factors associated with work ability and well-being, respectively, among women on sick leave due to long-term pain in the neck/shoulders and/or back.

    METHODS:

    A cross-sectional study with a correlational design was conducted on women who were sick-listed due to long-term pain in the neck/shoulders and/or back. A total of 208 participants responded to a survey comprising eight instruments: Multidimensional Pain Inventory scale, General Self-Efficacy scale, Sense of Coherence scale, Coping Strategies Questionnaire, Demand-Control-Support Questionnaire, Hospital Anxiety and Depression Scale, Work Ability Index and Life Satisfaction questionnaire. Multiple linear regression analyses were performed to identify factors associated with work ability and well-being, respectively.

    RESULTS:

    Women who more strongly believed they would return to the same work had greater work ability (β = 0.39, p < 0.001), whereas women with higher pain intensity (β = - 0.30, p < 0.001) and higher job strain (β = - 0.12, p < 0.05) had lower work ability. Women with higher self-efficacy rated greater well-being (β = 0.14, p < 0.05). As the women's scores for depression increased, their well-being decreased by 48%, which was statistically significant (p < 0.001). The regression models for work ability and well-being were significant (p < 0.001), and their adjusted R- square values were 48% and 59%, respectively.

    CONCLUSIONS:

    The study suggests that the factors beliefs to be back at the same work, pain intensity and job strain are predictive of work ability. Moreover, the factors self-efficacy and depression seem to be predictive of well-being. The findings highlight factors that should be considered by health care professionals and policy-makers to guide attempts to reduce sick leave.

  • 53.
    Rashid, Mamunur
    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.
    Kristofferzon, Marja-Leena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Heiden, Marina
    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.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Predictors of work ability among women on long-term sick leave due to musculoskeletal pain2017In: NES2017 conference proceedings / [ed] Anna-Lisa Osvalder, Mikael Blomé and Hajnalka Bodnar, 2017, p. 140-Conference paper (Refereed)
    Abstract [en]

    Background: Musculoskeletal pain is one of the leading causes of sick leave (SL), especially among women in Sweden and in other western countries. It is, therefore, important to know which health- and work-related factors are associated with work ability (WA) among women with long-term musculoskeletal pain.

         Purpose: The aim of this study was to determine whether there is any association between self-efficacy, anxiety, depression, sense of coherence, job strain, support at work, pain intensity, physical activity, beliefs to be back at the same work, coping strategies, and WA.

         Methods: A cross-sectional study was conducted on women with long-term pain who were on SL. Inclusion criteria: (i) age 18-65 years, (ii) SL: ≥ 1 months, (iii) SL: ≥ 50%, (iv) pain in neck, shoulder or back (≥ 3 months), and (v) understanding Swedish. Exclusion criteria: (i) rheumatoid arthritis, (ii) multiple sclerosis, (iii) stroke, (iv) cancer, (v) Parkinson, (vi) bipolar disease, (vii) schizophrenia, (viii) pregnancy. In spring 2016, self-administered questionnaires were sent out to 600 women who were receiving time-loss benefits according to the Swedish Social Insurance registers. Out of these, a total of 208 participants responded and were included in the analysis. For assessing the predictors and the outcome, seven instruments were used: General Self-Efficacy, Hospital Anxiety and Depression Scale, Demand-Control-Support Questionnaire, Sense of Coherence, Multidimensional Pain Inventory, Coping Strategy Questionnaire and Work Ability Index. Two of the predictors, physical activity and beliefs to be back at the same work, were measured by single questions. Multiple linear regression analyses were performed to detect which of the factors were associated with WA.

         Results: Women who more strongly believed that they would return to the same work within 6 months had higher WA (β= 0.39, p < .001), whereas women with higher pain intensity (β= -0.28, p < .001) and higher job strain (β= -0.12, p < .05) had lower WA. The results did not change when age, cohabitant, economic situation and social support were controlled for in the analysis. The regression model was significant (p < .0001), and its adjusted R- square was 48%.

         Discussion and practical implications: Women’s positive beliefs are associated with higher WA in accordance with previous studies. Our study also found that pain intensity and high job strain are associated with reduced WA. The results suggest that health care providers and employers should take women’s beliefs to be back at the same work into account for supporting them to return to work. Furthermore, the focus of rehabilitation program should be on women suffering from high pain intensity to increase WA.

         Conclusion: This study showed that beliefs to be back at the same work, pain intensity and job strain might be predictors of WA. Further studies are needed to identify if these predictors are also important for WA among women with long-term pain who are at work.

     

    Key words: Factors, ability to work, sickness absence, women and pain

  • 54.
    Rashid, Mamunur
    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.
    Kristofferzon, Marja-Leena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Sweden .
    Heiden, Marina
    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.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Sweden .
    Work ability, well-being and return-to-work among women in Gävleborg on sick leave due to long-term pain in the neck/shoulders and/or back2018In: FALF KONFERENS 2018 Arbetet – problem eller potential för en hållbar livsmiljö?   10-12 juni 2018 Gävle: Program och abstracts / [ed] Per Lindberg, Gävle: Gävle University Press , 2018, p. 68-Conference paper (Refereed)
    Abstract [en]

    Background

    Sickness absence due to long-term musculoskeletal pain (MSP) is a common phenom-enon in Sweden as well as in other European countries. Sick leave due to MSP (i.e. pain in the neck/shoulders and/or back) is higher among women than among men; therefore, women can be considered as a vulnerable group.

    Aim

    The overall aim is to identify factors of importance for work ability, well-being and return to work among women of working age who are on sick leave due to long-term pain in the neck/shoulders and/or back. The project includes three empirical studies.

    Methods

    The project was a result of a joint collaboration between the University of Gävle and the Swedish Social Insurance Agency in Gävleborg. Initially, a postal survey was sent to 600 women in Gävleborg who were receiving time-loss benefits during spring 2016. The inclusion criteria were: women aged 18-65 years, ≥ 50% sick leave from service, sick leave ≥ 1 month due to pain in the neck/shoulders and/or back (≥ 3 months) and understanding the Swedish language. The exclusion criteria were: rheumatoid arthritis, multiple sclerosis, stroke, cancer, Parkinson, bipolar disease, schizophrenia and preg-nancy. After 12 months, a follow-up survey was sent to the 208 women who answered the survey at baseline, and 141 responded.

    Results

    Study-I aimed to identify factors associated with work ability and well-being among women on sick leave. The results showed that beliefs to be back at the same work, pain intensity and job strain correlated with work ability. Self-efficacy and depression correlated with well-being. Study-II aimed to compare work ability and well-being over time, among women who returned to work (RTW) versus women who remained on sick leave in one year. The findings indicated that out of 141 women, 94 did RTW and 47 remained on sick leave. The group that RTW improved in work ability as well as well-being over time, whereas the group that remained on sick leave tended to decline over time in well-being. Study-III aims to identify predictors of RTW among women on sick leave. The analysis is under way. This project highlights factors that should be considered by health care professionals and policy-makers to guide attempts to reduce sick leave in this vulnerable group.

  • 55.
    Rashid, Mamunur
    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.
    Kristofferzon, Marja-Leena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Uppsala University, Uppsala, Sweden.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Uppsala University, Uppsala, Sweden.
    Heiden, Marina
    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.
    Factors associated with return-to-work among people on work absence due to long-term neck or back pain: a narrative systematic review2017In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 7, no 6, article id e014939Article, review/survey (Refereed)
    Abstract [en]

    OBJECTIVE:

    The purpose of this narrative systematic review was to summarise prognostic factors for return to work (RTW) among people with long-term neck/shoulder or back pain.

    METHODS:

    A systematic literature search was performed through three databases (Medline, CINAHL and PsycINFO) for studies published until February 2016. Only observational studies of people on work absence (≥2 weeks) due to neck/shoulder or back pain were included. The methodological quality of the included studies was assessed using guidelines for assessing quality in prognostic studies on the basis of Framework of Potential Biases. Factors found in the included studies were grouped into categories based on similarities and then labelled according to the aspects covered by the factors in the category.

    RESULTS:

    Nine longitudinal prospective cohort studies and one retrospective study fulfilled the inclusion criteria. From these, five categories of factors were extracted. Our findings indicate that recovery beliefs, health-related factors and work capacity are important for RTW among people with long-term neck or back pain. We did not find support for workplace factors and behaviour being predictive of RTW.

    CONCLUSIONS:

    Our findings suggest that recovery beliefs, perceived health and work capacity may be important targets of intervention for people with long-term neck or back pain. However, more high-quality prospective studies are needed to confirm the results and improve our understanding of what is needed to facilitate RTW in this population.

  • 56.
    Richardsson, Linda
    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.
    Wiitavaara, Birgitta
    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.
    Heiden, Marina
    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.
    Boman, Eva
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Psychology, Psychology.
    Att arbeta på distans – möjligheter och konsekvenser för universitetslärare2018In: FALF KONFERENS 2018 Arbetet – problem eller potential för en hållbar livsmiljö?   10-12 juni 2018 Gävle: Program och abstracts / [ed] Per Lindberg, Gävle: Gävle University Press , 2018, p. 118-Conference paper (Refereed)
    Abstract [sv]

    Bakgrund

    Universitets- och högskoleväsendet har under de senaste årtiondena genomgått stora förändringar. Den teknologiska utvecklingen och ökade konkurrensen nationellt och internationellt har lett till högre krav på effektivitet, produktivitet och tillgänglighet av personal oavsett vart de befinner sig. Arbetssituationen inom universitet- och högskole-väsendet har på detta sätt blivit mer krävande. Universitetslärare är en yrkesgrupp som i allt större utsträckning har möjlighet att arbeta på distans, och nyttjar den möjligheten regelbundet både inom och utanför ordinarie arbetstid. Trots detta är det få studier som undersökt hur undervisande och forskande personal inom högskolesektorn upplever och påverkas av distansarbete.

    Syfte

    Att undersöka hur distansarbete praktiseras av, och påverkar universitetslärare, samt att undersöka första linjens chefers upplevelser av att leda en personalgrupp som i varierande omfattning arbetar på distans.

    Metod

    Projektet innehåller fyra delstudier. Delstudie I består av en web-baserad enkätunder-sökning av hälsa, stress, återhämtning, balans mellan arbete och privatliv, arbetsmo-tivation, och förekomst av distansarbete bland universitetslärare vid svenska högskolor och universitet. Datainsamlingen pågår och förväntas vara avslutad i slutet av VT-18. I delstudie II kommer universitetslärare att följas under en arbetsvecka med mätningar av rörelsemönster, hjärtfrekvens och stresshormon. Mätningarna kommer att förläggas till en vecka då läraren arbetar minst en dag på ordinarie arbetsplats och minst en dag på annan plats, så att jämförelser av exponering kan göras inom person. Datainsamling för delpro-jekt III genomförs genom semistrukturerade intervjuer med universitetslärare för att undersöka deras upplevelser av att arbeta på, respektive utanför, ordinarie arbetsplats och vad som motiverar dem att arbeta på distans. I delprojekt IV undersöks upplevelser av att leda en personalgrupp som i varierande omfattning arbetar på distans, genom semistrukturerade intervjuer med universitetsanställda med en första linjens chefsposition.

    Resultat

    Projektet förväntas bidra med fördjupad kunskap om hur distansarbete inom universitets- och högskolesektorn relaterar till olika aspekter av hälsa och välbefinnande bland universitetslärare, och vilka effekter det får för individen att ta med sig arbetet från den ordinarie arbetsplatsen. Projektet förväntas även generera kunskap om hur universitets-anställda med en personalledande funktion upplever att leda anställda som arbetar på distans. Denna kunskap kommer att bidra till utvecklandet av rekommendationer för en hållbar arbetsmiljö, i lärarkåren och hos universitetsanställda med en personalledande funktion.

  • 57.
    Richter, Hans
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF.
    Hagberg, Mats
    Göteborgs universitet, Avdelningen för samhällsmedicin och folkhälsa.
    Toomingas, Allan
    Karolinska institutet, Institutet för miljömedicin.
    Westergren, Karl-Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF.
    Heiden, Marina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF.
    Wigaeus Tornqvist, Ewa
    Högskolan i Jönköping, Hälsohögskolan.
    Interrelationship between incident eye-and neck/scapular area symptoms2012Conference paper (Refereed)
  • 58.
    Sandlund, Jonas
    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. Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
    Srinivasan, Divya
    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.
    Heiden, Marina
    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.
    Differences in motor variability among individuals performing a standardized short-cycle manual task2017In: Human Movement Science, ISSN 0167-9457, E-ISSN 1872-7646, Vol. 51, p. 17-26Article in journal (Refereed)
    Abstract [en]

    Motor variability (MV) has been suggested to be a determinant of the risk for developing musculoskeletal disorders in repetitive work. In this study we examined whether individuals consistently differed in the extent of motor variability when performing a standardized short-cycle manual task. On three separate days, arm kinematics was recorded in 14 healthy subjects performing a pipetting task, transferring liquid from a pick-up tube to eight target tubes with a cycle time of 2.8 s. Cycle-to-cycle standard deviations (SD) of a large selection of shoulder and elbow kinematic variables, were processed using principal component analysis (PCA). Thereafter, between-subjects and between-days (within-subject) variance components were calculated using a random effects model for each of four extracted principal components. The results showed that MV differed consistently between subjects (95% confidence intervals of the between-subjects variances did not include zero) and that subjects differed consistently in MV between days. Thus, our results support the notion that MV may be a consistent personal trait, even though further research is needed to verify whether individuals rank consistently in MV even across tasks. If so, MV may be a candidate determinant of the risk of developing fatigue and musculoskeletal disorders in repetitive occupational work.

  • 59.
    Straker, Leon
    et al.
    Curtin University, Perth.
    Abbott, Rebecca
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Heiden, Marina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. 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, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Toomingas, Allan
    Institute of Environmental Medicine, Karolinska Institutet.
    Sit-stand desks and sedentary behavior in Swedish call centre workers2012In: Be active 2012, 2012, p. S94-Conference paper (Refereed)
    Abstract [en]

    Introduction: Adults spend approximately 8 to 9 hours of the day in sedentary behavior and much of this is gathered at work. The rising level of occupational sedentary behavior is both a public health and occupational health concern due to the emerging evidence regarding the deleterious effect that sedentary behavior has on health, independent of physical activity. In the occupational setting, sit-stand desks have been purported to offer a means of reducing sedentariness. This study aimed to investigate whether or not use of sit-stand desks and awareness of the importance of postural variation and breaks are associated with the pattern of sedentary behavior in call centre workers.

    Method: The data came from a cross-sectional observation study of fifteen Swedish call centres, carried out in 2002–2003. Ten operators were randomly selected from each of the call centres and invited to participate. Inclinometers recorded ‘seated’ or ‘standing/walking’ episodes of the operators over a full work shift. Differences in sedentary behavior based on desk type (categorized as ‘sit-stand’ or ‘sit’) and awareness of the importance of posture variation and breaking up seated computer work within those using a sit-stand desk were assessed by non-parametric analyses.

    Results: Four operators declined to participate and 15 operators had inclinometer recordings that were not of sufficient quality. Of the remaining 131 operators, 90 (68.7%) worked at a sit-stand desk. Working at a sit-stand desk, as opposed to a sit desk, was associated with a modest reduction in the time seated (78.5 vs 83.8%, p = 0.010), and less time taken to accumulate 5 minutes of standing/walking (36.2 vs 46.3 minutes, p = 0.022), but no significant difference to sitting episode length or the number of switches between sitting and standing/walking per hour. Ergonomics awareness had no significant association with any sedentary behavior pattern variable among those using a sit-stand desk.

    Conclusion: Use of sit-stand desks was associated with better sedentary behavior in call centre workers, however ergonomics awareness did not enhance the effect. The growing number of people in occupations dominated by sedentary work and the clear evidence of the importance of sedentary behavior as a key lifestyle risk factor support the need to develop effective interventions. Sit-stand desks may be an important remedy in this endeavor, particularly in office settings, while ergonomics awareness may be able to contribute to further changes in sedentary behavior if improved and supported by the work organization.

  • 60.
    Straker, Leon
    et al.
    School of Physiotherapy, Curtin University, Perth.
    Abbott, Rebecca
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Heiden, Marina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. 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, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Toomingas, Allan
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Sit-stand desks, ergonomics awareness and sedentariness in Swedish call centres2012Conference paper (Refereed)
  • 61.
    Straker, Leon
    et al.
    School of Physiotherapy, Curtin University, Perth, Australia.
    Abbott, Rebecca
    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.
    Heiden, Marina
    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.
    Toomingas, Allan
    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.
    Sit-stand desks in call centres: associations of use and ergonomics awareness with sedentary behavior2013In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 44, no 4, p. 517-522Article in journal (Refereed)
    Abstract [en]

    Objective. Sedentary behavior is an independent risk factor for obesity, diabetes, and all cause mortality. With adults in occupational settings spending two thirds or more of their time in sedentary behavior, novel strategies are required to intervene with occupational sitting. To investigate whether or not use of sit-stand desks and awareness of the importance of postural variation and breaks are associated with the pattern of sedentary behavior in office workers.

    Method. The data came from a cross-sectional observation study of Swedish call centre workers. Inclinometers recorded ‘seated’ or ‘standing/walking’ episodes of 131 operators over a full work shift. Differences in sedentary behavior based on desk type and awareness of the importance of posture variation and breaks were assessed by non-parametric analyses.

    Results. 90 (68.7%) operators worked at a sit-stand desk. Working at a sit-stand desk, as opposed to a sit desk, was associated with less time seated (78.5 vs 83.8%, p=0.010), and less time taken to accumulate 5 minutes of standing/walking (36.2 vs 46.3 minutes, p=0.022), but no significant difference to sitting episode length or the number of switches between sitting and standing/walking per hour. Ergonomics awareness was not associated with any sedentary pattern variable among those using a sit-stand desk.

    Conclusion. Use of sit-stand desks was associated with better sedentary behavior in call centre workers, however ergonomics awareness did not enhance the effect. Further investigation into how best to intervene with occupational sitting is required.

  • 62.
    Toomingas, Allan
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Forsman, Mikael
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. 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, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Heiden, Marina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Nilsson, Tohr
    Department of Public Health and Clinical Medicine, Umeå university.
    Variation between seated and standing/walking postures among male and female call centre operators2012In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 12, p. 154-Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of the present study was to assess variation in gross body posture amongst male and female call centre operators using whole-day registrations of seated and standing/walking periods, analyzed and described by a number of novel variables.

    Methods: Body postures, identified as either seated or standing/walking, were recorded using inclinometers throughout an entire work shift for 43 male and 97 female call centre operators at 16 call centres. Data were analyzed using an extensive set of variables describing occurrence of postures, switches between postures, posture similarities across the day, and compliance with posture recommendations.

    Results: The majority of the operators, both male and female, spent more than 80% of the shift in a seated posture. The average number of switches between seated and standing/walking or vice versa was 10.4 per hour. Female operators spent, on average, 11% of the day in periods of sustained sitting longer than 1 hour; male operators only 4.6% of the day (p=0.013). Only 38% of the operators followed current standard recommendations of having an uninterrupted break from seated work, lasting a minimum of 5minutes within a one hour of work and only 11% of operators had a 10 minute (or longer) uninterrupted break. Substantial variation between operators was observed in many variables. Since work tasks were essentially similar across operators and were expected to be similar across days, this indicates individual differences in working technique.

    Conclusions: The dominance of seated work for extended periods indicates that efforts should be made at call centres to introduce more gross physical variation during the work day. Appropriate and effective initiatives for realizing this intervention need to be identified

  • 63.
    Toomingas, Allan
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Hagberg, Mats
    Occupational & Environmental Medicine University of Gothenburg.
    Heiden, Marina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Richter, Hans
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Westergren, Karl Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Wigaeus Tornqvist, Ewa
    School of Health Sciences, Jönköping University.
    Incidence and risk factors for symptoms from the eyes among professional computer users2012In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 41, no Suppl. 1, p. 3560-3562Article in journal (Refereed)
    Abstract [en]

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

  • 64.
    Toomingas, Allan
    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. Karolinska Institutet.
    Hagberg, Mats
    Göteborgs Universitet.
    Heiden, Marina
    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.
    Richter, Hans
    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.
    Westergren, Karl-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.
    Wigaeus Tornqvist, Ewa
    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. Jönköping University, School of Health Sciences.
    Risk factors, incidence and persistence of symptoms from the eyes among professional computer users2014In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 47, no 3, p. 291-301Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Symptoms from the eyes are common among computer users. Knowledge is scarce about these problems, however.

    OBJECTIVES:

    The aim was to study risk-factors, incidence and persistence of eye-symptoms among professionally active computer users.

    METHODS:

    This was a questionnaire based prospective study where 1283 males and females from different professions and companies answered a baseline questionnaire about individual factors and working conditions, e.g. duration of daily computer work, comfort of screen work, psychosocial factors. Subjects were at baseline and 10 follow-ups asked about the number of days with eye-symptoms during the preceding month.

    RESULTS:

    The incidence-rate of symptoms persisting minimum three days was 0.38/person-year. A multivariate Hazard-ratio model showed significant associations with extended continuous computer work, tasks with high demands on eye-hand coordination, low level of control, visual discomfort, female sex and nicotine use. Eye-symptoms at baseline was a strong risk factor for new symptoms.

    CONCLUSION:

    The incidence of eye-symptoms among professional computer users is high and related to both individual and work-related factors. The organization of computer work should secure frequent breaks from near-work at the computer screen. The severity of vision-related problems could in field studies be quantified by asking for the persistence of symptoms.

  • 65.
    Trask, Catherine
    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. Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
    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.
    Rostami, Mehdi
    Collaborative Biostatistics Program, School of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
    Heiden, Marina
    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.
    Observer variability in posture assessment from video recordings: the effect of partly visible periods2017In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 60, p. 275-281Article in journal (Refereed)
    Abstract [en]

    Observers rank partly visible postures on video frames differently than fully visible postures, but it’s not clear if this is due to differences in observer perception. This study investigated the effect of posture visibility on between-observer variability in assessments of trunk and arm posture.  Trained observers assessed trunk and arm postures from video recordings of 84 pulp mill shifts using a work sampling approach; postures were also categorized as ‘fully’ or ‘partly’ visible.  Between-worker, between-day, and between-observer variance components and corresponding confidence intervals were calculated. Although no consistent gradient was seen for the right upper arm, trunk posture showed smaller between-observer variance when all observers rated a posture as fully visible. This suggests that, partly- visible data, especially when observers disagree as to the level of visibility, introduces more between-observer variability when compared to fully visible data.  Some previously-identified differences in daily posture summaries may be related to this phenomenon.

  • 66.
    Trask, Catherine
    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.
    Rostami, Mehdi
    Collaborative Biostatistics Program, School of Public Health, University of Saskatchewan.
    Heiden, Marina
    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.
    Variance components of observed postural exposure - the effect of partly visible periods2016Conference paper (Refereed)
    Abstract [en]

    Background. Previous studies have shown that video-based observation of postures that are only partly visible leads to different daily summary values than when postures are fully visible. However, the source of these differences is unclear. The purpose of this study was to estimate the between-observer variance of trunk and arm posture estimates (relative to within- and between-worker variance), and to investigate the effect of visibility on this observer variability of trunk and arm postural exposure estimates.

    Methods. Video recordings were made of 28 pulp mill workers for three full shifts each. Trunk and arm postures were then estimated by trained observers using a work sampling approach; posture images were also assessed as being “fully” or “partly” visible. REML techniques were used to estimate the between-worker, between-day and betweenobserver components of variance at different visibility levels; Wald-based confidence intervals and p-values were used to determine sources of variation.

    Results. Estimates of partly visible postures (as agreed upon by all observers) were lower than fully visible postures. However, more than 90% of trunk observations and 85% of arm observations did not have full agreement on visibility between observers. Right upper arm posture showed smaller between-observer variance when all observers rated a posture to be fully visible, as compared to all observers agreeing it was only partly visible. This suggests partly visible data introduces more methodological (i.e. between-observer) variability when compared to fully visible data. However, no significant differences in between-observer variability were found for the trunk, suggesting that other factors explain the reported differences in estimated postures between fully and partly visible data in this case.

    Discussion. Future studies involving concurrent direct measurement would determine whether there is a true difference in posture between partly visible and fully visible periods, or whether the difference between fully and partly visible periods are related to observer performance.

  • 67.
    Trask, Catherine
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. 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, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Wahlström, Jens
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Heiden, Marina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Rezagholi, Mahmoud
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Data collection costs in industrial environments for three occupational posture exposure assessment methods2012In: BMC Medical Research Methodology, ISSN 1471-2288, E-ISSN 1471-2288, Vol. 12, p. 89-Article in journal (Refereed)
    Abstract [en]

    Background. Documentation of posture measurement costs is rare and cost models that do exist are generally naïve. This paper provides a comprehensive cost model for biomechanical exposure assessment in occupational studies, documents the monetary costs of three exposure assessment methods for different stakeholders in data collection, and uses simulations to evaluate the relative importance of cost components.  Trunk and shoulder posture variables were assessed for 27 aircraft baggage handlers for 3 full shifts each using three methods typical to ergonomic studies: self-report via questionnaire, observation via video film, and full-shift inclinometer registration.  The cost model accounted for expenses related to meetings to plan the study, administration, recruitment, equipment, training of data collectors, travel, and onsite data collection.  Sensitivity analyses were conducted using simulated study parameters and cost components to investigate the impact on total study cost.

    Results. Inclinometery was the most expensive method (with a total study cost of € 66,657), followed by observation (€ 55,369) and then self report (€ 36,865). The majority of costs (90%) were borne by researchers.  Study design parameters such as sample size, measurement scheduling and spacing, concurrent measurements, location and travel, and equipment acquisition were shown to have wide-ranging impacts on costs. 

    Conclusions. This study provided a general cost modelling approach that can facilitate decision making and planning of data collection in future studies, as well as investigation into cost efficiency and cost efficient study design. Empirical cost data from a large field study demonstrated the usefulness of the proposed models.

  • 68.
    Trask, Catherine
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. 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, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Wahlström, Jens
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Heiden, Marina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Rezagholi, Mahmoud
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Modeling costs of exposure assessment methods in industrial environments2012In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 41, p. 6079-6086Article in journal (Refereed)
    Abstract [en]

    Documentation of posture measurement cost is rare and cost models that do exist are generally naïve. This paper provides a comprehensive cost model for ergonomic research, documents the monetary costs of three exposure assessment methods (inclinometry, video observation, and self-report), and discusses cost components. Trunk and shoulder posture were assessed for 27 aircraft baggage handlers for 3 full shifts each using three methods typical to ergonomics: self-report via questionnaire, observation via video film, and full-shift inclinometer registration. The model accounted for costs related to meetings to plan the study, administration, recruitment, equipment, training of data collectors, travel, and onsite data collection. Findings show that inclinometer was the most expensive method, followed by observation and then self report; the majority of costs (90%) were borne by researchers. Study design parameters such as sample size, measurement scheduling and spacing, concurrent measurements, location and travel, and equipment acquisition were shown to have wideranging impacts on costs. This study provided empirical cost data for use in cost models that can facilitate decision making and planning of future studies, and can be used to investigate cost efficiency in future studies

  • 69.
    Waleh Åström, Amanda
    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.
    Heiden, Marina
    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.
    Strömberg, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Psychology, Social work.
    Uncertainty in monetary cost estimates for assessing working postures using inclinometry, observation or self-report2017In: NES 2017 ”JOY AT WORK”: Conference Proceedings / [ed] Anna-Lisa Osvalder, Mikael Blomé and Hajnalka Bodnar, 2017, p. 160-161Conference paper (Refereed)
    Abstract [en]

    Background

    In order to optimize cost-efficiency when collecting posture data in field studies, accurate cost data are needed. A few studies have assessed costs of different measurement methods, but they did not address the uncertainty of the cost estimates. Information on the uncertainty of cost estimates is key input when deciding which method to use.

    Aim

    This study aimed atassessingthe uncertainty in estimates of costs for collecting posture data by inclinometry, observations and self-report.

    Method

    The study wasbased on data collected at a Swedish paper mill (Heiden et al. 2017)1. Using a model developed by Trask et al. (2014)2, costs were calculatedfor measuring trunk and upperarm postures of twenty-eight workers during three full shifts using inclinometers, observations from recorded videos, and workers’ self-reports from a questionnaire. For each measurement method, the uncertainty of the actually observed total cost was assessed by determining the range of costs between an assumed best case (lowest cost) and worst case (highest cost) using scenario analysis.

    Results

    Observation was the most expensive method (€41499) and also showed a large uncertainty in the cost estimate (€19089–€87154). Self-reports had the lowest cost (€9156) with the smallest uncertainty (€3941–€27473). The overall cost for inclinometry was €16851 with best and worst cases €8567 and €60313, respectively. The actual costs of inclinometry and self-reports in the conducted study were reasonably close to the best case.

    Discussion

    In their study of flight baggage handling, Trask et al. (2014) concluded that inclinometry was more expensive than observation when measuring trunk and arm postures. In the present study, we found observation to be the more expensive. Given the uncertainty in cost estimates, both results are plausible. Notably, in Trask et al. (2014), video recordings were restricted to 4 hours, whereas in the present material, video recordings covered full 7 -to 12-hour shifts. The time allocated to collecting video material for observations will significantly affect the cost comparison of methods, and this may serve as an example that further investigations of separate cost components for each method are warranted.

    Conclusions

    Based on a meticulous cost assessment, we found that cost estimates for observation of working postures were the most uncertain, followed by inclinometry and self-reports. A better understanding of data collection costs and their uncertainty, and thus of how to properly identifyan optimal measurement method, requires a deeper analysis of the cost model, and of the contributions of separate cost components to the overall cost

    1 https://doi.org/10.1093/annweh/wxw0262

    2 https://doi.org/10.5271/sjweh.3416

  • 70.
    Waleh Åström, Amanda
    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.
    Heiden, Marina
    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.
    Strömberg, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Psychology, Social work.
    Uncertainty in monetary cost estimates for assessing working postures using inclinometry, observation or self-report2018In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 71, p. 73-77Article in journal (Refereed)
    Abstract [en]

    Objective: To assess uncertainty in cost estimates for collecting posture data by inclinometry, observations and self-report.

    Method: In a study addressing physical workloads at a paper mill, costs were calculated for measuring postures of twenty-eight workers during three shifts. Uncertainty in costs was assessed for all three methods as the range between an assumed best case (lowest cost) and worst case (highest cost) using scenario analysis.

    Results: The cost for observation was larger, but also more uncertain (€16506 and €89552 in the best and worst case, respectively) than that of inclinometry (€7613 - €45896). Self-report costs were both lower and less uncertain (€3743 - €23368).

    Conclusions: The extent of uncertainty in cost estimates implies that observation could be less expensive than inclinometry, e.g., in a scenario where experienced observers could use existing software, while inclinometers would have to be purchased. We propose adding uncertainty assessments to cost estimates when selecting a method for measuring working postures, and offer guidance in how to proceed in a specific setting.

  • 71.
    Waleh Åström, Amanda
    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.
    Heiden, Marina
    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.
    Strömberg, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Psychology, Social work.
    Uncertainty of cost components in assessments of working posture by different methods2018Conference paper (Refereed)
  • 72.
    Wiitavaara, Birgitta
    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.
    Heiden, Marina
    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.
    Content and psychometric evaluations of questionnaires for assessing physical function in people with low back disorders: a systematic review of the literature2018In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose was to investigate how physical function is assessed in people with musculoskeletal disorders in the low back. Specifically:

    • Which questionnaires are used to assess physical function in people with musculoskeletal disorders in the low back?
    • What aspects of physical function do those questionnaires measure?
    • What are the measurement properties of the questionnaires?

    Materials and methods: A systematic review was performed to identify questionnaires and psychometric evaluations of them. The content of the questionnaires was categorised according to the International Classification of Function, Disability and Health, and the psychometric evaluations were categorised using the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist.

    Results: The questionnaires measured disability or ability to cope in everyday life, rather than physical function as such. Different aspects of a person’s mobility and ability to attend to one’s personal care were most often included regarding activity and participation. For body functions, items about sleep and pain were most often included. The Oswestry Disability Index and the Quebec Back Pain Disability Scale showed adequate psychometric properties in most evaluations.

    Conclusions: The extent of psychometric evaluations differed substantially, as did the items included. Focus of measurement was predominantly on activities in daily life.

    • Implications for rehabilitation
    • Valid and reliable instruments that measure relevant aspects of low back disorders are needed to provide early diagnostics and effective treatment.
    • Most questionnaires need more psychometric evaluations to establish the quality.
    • The Oswestry Disability Index and the Quebec Back Pain Disability Scale showed adequate psychometric properties in most evaluations.
    • The results may be useful when making decisions about which measurement instruments to use when evaluating low back disorders.
  • 73.
    Wiitavaara, Birgitta
    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.
    Heiden, Marina
    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.
    Content and psychometric evaluations of questionnaires for assessing physical function in people with neck disorders –  A systematic review of the literature2018In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 40, no 19, p. 2227-2235Article, review/survey (Refereed)
    Abstract [en]

    Purpose: The purpose was to investigate how physical function is assessed in people with musculoskeletal disorders (MSD) in the neck. Specifically, we aimed to determine: (1) Which questionnaires are used to assess physical function in people with MSD in the neck? (2) What do those questionnaires measure? (3) What are the measurement properties of the questionnaires?

    Materials and methods: A systematic review was performed to identify questionnaires and psychometric evaluations. The content of the questionnaires was categorized according to the International Classification of Function, Disability and Health, and the psychometric properties were quality-rated using the COnsensus-based Standards for the selection of health Measurement INstruments checklist.

    Results: Ten questionnaires and 32 articles evaluating measurement properties were analyzed. Most questionnaires covered only the components body functions and activity and participation, more often activity participation than body function. Internal consistency was adequate in most questionnaires, whereas responsiveness was generally low. Neck Disability Index was most evaluated, but the evaluations of all questionnaires tended to cover most properties in the checklist.

    Conclusions: The questionnaires differed substantially in items and extent to which their psychometric properties had been evaluated. Focus of measurement was on activities in daily life rather than physical function as such.

    • Implications for Rehabilitation
    • To provide early diagnostics and effective treatment for patients with neck disorders, valid and reliable instruments that measure relevant aspects of the disorders are needed.

    • This paper presents an overview of content and quality of questionnaires used to assess physical function in neck disorders, which may facilitate informed decisions about which measurement instruments to use when evaluating the course of neck disorders.

    • Most of the questionnaires need more testing to judge the quality, however the NDI was the most frequently tested questionnaire.

    • The COnsensus-based Standards for the selection of health Measurement INstruments checklist is a useful tool in relation to psychometric testing of questionnaires, but clear definitions of interpretation of the quality criteria in each study would enhance comparability of results.

  • 74.
    Wiitavaara, Birgitta
    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.
    Heiden, Marina
    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.
    Content and quality of questionnaires for assessment of physical functioning in neck disorders – A systematic review of the literature2017In: Joy at Work, NES, 2017, 2017Conference paper (Refereed)
    Abstract [en]

    Valid and reliable instruments are required in order to determine effective interventions in the treatment of musculoskeletal disorders (MSD). Today, there is a lack of consistency in use of self-report outcome measures in research and practice, which makes it difficult or impossible to compare treatment effects. The questionnaires differ widely, in content as well as quality. The focus of present study was on assessment of physical functioning among people with MSD in the neck. The aim was to investigate how physical function is assessed in people with MSD in the neck. Specifically we wanted to determine: - Which questionnaires are used to assess physical function in people with musculoskeletal disorders in the neck? - What do those questionnaires measure? - What are the measurement properties of the questionnaires?

    The study was performed as a systematic literature review in order to identify articles presenting the questionnaires and psychometric tests of them. Items included in the questionnaires were classified according to the "International Classification of Functioning, Disability and Health", ICF. Thereafter, all psychometric tests of the different questionnaires were analysed with respect to relevant quality indicators using the "Cosmin checklist".

    Included in the final analysis were 10 questionnaires and 32 articles presenting psychometric tests of them. The analysis revealed that questionnaires for measuring physical functioning in neck disorders differ substantially in items and extent to which their psychometric properties have been evaluated. Most questionnaires contained only the ICF-components body functions and activity and participation, more often activity and participation. The most psychometrically tested questionnaire was Neck Disability Index. Remaining questionnaires were tested in fewer studies and only some of the properties in the Cosmin checklist were tested for most of them.

    Questionnaires for assessment of physical function in people with neck disorders tend to focus more on the ability to engage in activities of daily life than on physical function as such. Furthermore, the measurement properties of the questionnaires have usually been evaluated in few studies. It is vital to measure aspects that are of importance for the individual wellbeing and ability to function in work and daily life when evaluating neck disorders. However, to increase the validity of the results in clinical and research studies, it is also important to include the most relevant aspects of physical function. We recommend more psychometric testing of the questionnaires, especially those that cover important aspects of the ICF categories. To ensure coverage of important aspects, validation of the questionnaires against patients and practitioners is needed.

    A review and analysis of this kind makes it easier for researchers and clinicians to select the most suitable questionnaire for their own purpose, based on the content and quality of the questionnaire.

  • 75.
    Wiitavaara, Birgitta
    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.
    Heiden, Marina
    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.
    What do questionnaires for assessment of physical functioning in neck disorders really measure?: A systematic review of the literature2016Conference paper (Refereed)
    Abstract [en]

    Background. In order to determine which interventions are effective in the treatment of musculoskeletal disorders, valid and reliable instruments are required. However, there is a lack of consistency in the use of outcome measures, both in research and in treatment, that makes comparisons difficult or impossible; the content and quality varies widely be-tween questionnaires. This study focuses on the measurements of the physical function-ing of people with MSDs. The aim of this systematic review is to investigate how physical function is measured in people with musculoskeletal disorders or chronic pain. Specifically we want to determine: (1) What instruments are used to measure physical function in people with musculoskeletal disorders or chronic pain? (2) What do those instruments measure? (3) What is the methodological quality of these instruments?

    Method. The study was performed as a systematic literature review in the data bases PubMed, Cinahl, Web of Science, and Scopus, using the same set of keywords and Bool-ean operators. The selection of relevant articles was performed by reviewing the title and abstract first, and the article text thereafter. Selected articles were classified according to the “ICF Classification of Functioning, Disability and Health.” Subsequently, articles will be examined with respect to relevant quality indicators using the “Cosmin checklist.”

    Results. 69 relevant questionnaires were found and were sorted into groups according to focus. As a first step, neck and arm-shoulder-hand questionnaires were analyzed. The ICF-classification revealed that the included items belonged to the components “body func-tions” and “activity/participation,” and the included domains varied significantly between the questionnaires. The quality of the instruments will be determined in the next step.

    Discussion. A review and analysis of this kind makes it possible for researchers and clini-cians to more easily select the most suitable questionnaire for their purpose based on the content and quality of the questionnaire.

  • 76.
    Zetterberg, Camilla
    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.
    Heiden, Marina
    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.
    Lindberg, Per
    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.
    Nylén, Per
    The Swedish Work Environment Authority, and The Royal Institute of Technology.
    Hemphälä, Hillevi
    Lund University.
    Intra-rater reliability of the Visual Ergonomics Risk Assessment Method (VERAM)2018Conference paper (Refereed)
    Abstract [en]

    Introduction: Visually demanding near work can cause eye discomfort, and eye and neck/shoulder discomfort during, e.g., computer work are associated. Apart from visual demands and dryness a number of environmental factors including design of the work station, lighting, glare, and the quality of the computer screen might exert an impact on eye-related symptoms. To date, there is a lack of valid and reliable instruments assessing factors associated with eye- or visual symptoms. Therefore, a new method to assess visual ergonomics at workplaces was developed in Sweden between 2014 and 2016, the Visual Ergonomics Risk Assessment Method - VERAM. A first version of the method was drafted by the researchers mainly from existing checklists and instruments, and tested in the field by trained visual ergonomists. The method was then revised and used in the field to collect data for validity and reliability analyses. The final version of VERAM includes both a questionnaire for the employee, and an expert evaluation of the employee’s workplace. The questionnaire consists of subjective ratings in six domains: eye discomfort (frequency and intensity), musculoskeletal discomfort (frequency and intensity), ratings of visual symptoms (e.g. blurred and double vision) and ratings of the visual environment (e.g. illumination levels, glare and reflexes from a work object or a computer screen). The expert evaluation consists of both objective measurements and subjective assessments resulting in an overall expert risk assessment (no risk, low risk or high risk) of eight factors: daylight, lighting, illuminance, glare, flicker, work space, work object and work posture.

    Aim: At the IEA conference 2018 the new VERAM method will be presented together with results from intra-rater reliability analyses.

    Results: Intra-rater reliability was evaluated with a re-test interval of minimum two and maximum three weeks. 99 employees were included in the analyses and 32 visual ergonomists performed the corresponding expert evaluations. The Intraclass Correlations (ICC) were between 0.70 and 0.87 for the six subjective domains, and there were no significant systematic differences between the first and second rating for any of the subjective domains (rmANOVA, p > 0.05, α = 0.008). For the eight environmental factors the expert estimated the risk equally during the first and the second assessment in 69-92% of the cases, and, as seen for the subjective domains, there were no significant systematic differences for any of the eight factors (Wilcoxon sign rank test, p > 0.014, α = 0.006). To control for multiple comparisons the Bonferroni method was used.

    Conclusion: The Visual Ergonomics Risk Assessment Method – VERAM showed good intra-rater reliability, both for the subjective questionnaire for the employee, and for the expert evaluation of the employee’s workplace when performed by a trained visual ergonomist.

  • 77.
    Zetterberg, Camilla
    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.
    Heiden, Marina
    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.
    Lindberg, Per
    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.
    Nylén, Per
    Swedish Work Environment Authority, Stockholm, Sweden.
    Hemphälä, Hillevi
    Division of Ergonomics and Aerosol Technology, Design Sciences, Lund University, Lund, Sweden.
    Reliability of a new risk assessment method for visual ergonomics2019In: International Journal of Industrial Ergonomics, ISSN 0169-8141, E-ISSN 1872-8219, Vol. 72, p. 71-79Article in journal (Refereed)
    Abstract [en]

    Introduction

    The Visual Ergonomics Risk Assessment Method (VERAM) is a newly developed and validated method to assess visual ergonomics at workplaces. VERAM consists of a questionnaire and an objective evaluation.

    Objective

    To evaluate reliability of VERAM by assessing test-retest reliability of the questionnaire, and intra- and inter-rater reliability of the objective evaluation.

    Methods

    Forty-eight trained evaluators used VERAM to evaluate visual ergonomics at 174 workstations. The time interval for test-retest and intra-rater evaluations was 2–3 weeks, and the time interval for inter-rater evaluations was 0–2 days. Test-retest reliability was assessed by intraclass correlation (ICC), the standard error of measurement (SEM) and the smallest detectable change (SDC). Intra- and inter-rater reliability were assessed with weighted kappa coefficients and absolute agreement. Systematic changes were analysed with repeated measures analyses of variance and Wilcoxon sign rank test.

    Results

    The ICC of the questionnaire indices ranged from 0.69 to 0.87, while SEM ranged from 7.21 to 10.19 on a scale from 1 to 100, and SDC from 14.42 to 20.37. Intra-rater reliability of objective evaluations ranged from 0.57 to 0.85 (kappa coefficients) and the agreement from 69 to 91%. Inter-rater reliability of objective evaluations ranged from 0.37 to 0.72 (kappa coefficients) and the agreement from 52 to 87%.

    Conclusion

    VERAM is a reliable instrument for assessing risks in visual work environments. However, the reliability might increase further by improving the quality of training for evaluators. Complementary evaluations of VERAM's sensitivity to changes in the visual environment are needed.

    Relevance to industry

    It is advantageous to set up a work environment for maximal visual comfort to avoid negative effects on work postures and movements and thus prevent visual- and musculoskeletal symptoms. This method, VERAM, satisfies the need of a valid and reliable tool for determining risks associated with the visual work environment.

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