| 1. |
- Aasa, Ulrika
(författare)
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Ambulance Work : Relationships between occupational demands, individual characteristics and health-related outcomes
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Although musculoskeletal disorders (MSDs) and other health complaints are an occupational problem for ambulance personnel, there is a lack of knowledge regarding work-related factors associated with MSDs and other health complaints. The overall aim of this thesis was to investigate the relationships between occupational demands, individual characteristics and health-related outcomes among ambulance personnel. A random sample of 234 female and 953 male ambulance personnel participated in a national questionnaire survey on work-related factors, and musculoskeletal and other health complaints. Physical demands was associated with activity limitation due to neck-shoulder and low-back complaints among the female personnel. Among the male personnel, physical demands was associated with low-back complaints and activity limitation due to low-back complaints. Psychological demands was significantly associated with neck-shoulder complaints, sleeping problems, headache and stomach symptoms among both female and male ambulance personnel. Worry about work conditions was associated with musculoskeletal disorders and sleeping problems, headache and stomach symptoms. A local sample of 26 ambulance personnel was followed during a 24-hour work shift and for the next two work-free days. Subjective stress- and energy levels, and cortisol levels were measured at regular intervals, and heart rate was registered continuously by electrocardiogram (ECG). Autonomic reactivity to standardized tests before (pre-work) and at the end of the work shift (post-work) was also investigated. For the whole group, baseline values of heart rate were higher pre-work than post-work, but autonomic reactivity did not differ. Increased reactivity to the mental test, modest deviation in heart rate variability (HRV) pattern during the late night hours at work and higher morning cortisol values during work than during leisure time were observed in personnel with many health complaints, but not among their co-workers without or with few complaints. Ambulance personnel with many health complaints also reported higher psychological demands and tended to be more worried about work conditions. Heart rate (HR), lactate level (LL) and perceived exertion (RPE) were investigated in 17 female and 48 male ambulance personnel during a simulated standardized work task “carry a loaded stretcher”. The ambulance personnel had to carry the loaded stretcher (920 N) up and down three flights of stairs twice. The high physiological strain (HR, LL, RPE) for the male, and near or at maximal strain for the female ambulance personnel, implied the importance to identify what kind of physical capacity is most important for ambulance personnel. Therefore, the explained variance of developed fatigue by tests of cardiorespiratory capacity, muscular strength and endurance, and coordination was investigated. The results showed that VO2max and isometric back endurance were important predictors for development of fatigue when carrying a loaded stretcher. The influence of body size on the relationships between maximal strength and functional performance was investigated in a methodological study. The results confirm that the assessment of physical performance could be confounded by the body weight. Therefore, the models for explaining development of fatigue when carrying the loaded stretcher were adjusted for height and weight. Including height in the models significantly increased the explained variance of accumulated lactate among female, but not among male personnel. Lactate levels were higher among short compared to tall female personnel. Weight had no effect on any of the models. In conclusion, the national survey showed that self-reported physical demands was a risk factor of having MSDs, and that self-reported psychological demands and worry about work were important risk factors of having MSDs and other health complaints. Stress monitoring of ambulance personnel during work and leisure time showed that physiological and subjective stress markers did not show any differences between the 24-hour ambulance work shift and leisure time afterwards. However, ambulance personnel with many health complaints had certain physiological changes during the work shift in comparison with the next two work-free days. The physiological and subjective responses during carrying a loaded stretcher, especially among the female ambulance personnel, showed that female and male ambulance personnel could be exposed to internal exposures at different levels when performing the same work task. A better understanding of the relationships between occupational demands and health-related outcomes require further studies on age- and gender matched groups in long-term perspective studies.
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| 2. |
- Aasa, Ulrika, et al.
(författare)
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Relationships between work-related factors and disorders in the neck-shoulder and low-back region among female and male ambulance personnel.
- 2005
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Ingår i: Journal of Occupational Health. - : Wiley. - 1341-9145 .- 1348-9585. ; 47:6, s. 481-9
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Tidskriftsartikel (refereegranskat)abstract
- This cross-sectional study on a random sample of 1,500 ambulance personnel investigated the relationships between self-reported work-related physical and psychosocial factors, worry about work conditions, and musculoskeletal disorders among female and male ambulance personnel. Three different outcomes, complaints, activity limitation, and sick leave, for the neck-shoulder and low-back region, respectively, were chosen. Among the female personnel, physical demands was significantly associated with activity limitation in the neck-shoulder (OR 4.13) and low-back region (OR 2.17), and psychological demands with neck-shoulder (OR 2.37) and low-back (OR 2.28) complaints. Among the male personnel, physical demands was significantly associated with low-back complaints (OR 1.41) and activity limitation (OR 1.62). Psychological demands and lack of social support were significantly associated with neck-shoulder complaints (OR 1.86 and OR 1.58, respectively) and activity limitation (OR 3.46 and OR 1.71) as well as activity limitation due to low-back complaints (OR 2.22 and OR 1.63). Worry about work conditions was independently associated with activity limitation due to low-back complaints among the female (OR 5.28), and to both neck-shoulder and low-back complaints (OR 1.79 and OR 2.04, respectively) and activity limitation (OR 2.32 and OR 1.95) among the male personnel. In conclusion, the association patterns between physical and psychological demands and MSDs suggest opportunities for intervention.
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| 3. |
- Aasa, Ulrika, et al.
(författare)
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Stress monitoring of ambulance personnel during work and leisure time
- 2006
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Ingår i: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 80:1, s. 51-59
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of the present study was to assess physiological and subjective stress markers during a 24-h ambulance work shift and during the next two work-free days, and relate these parameters to self-reported health complaints. Methods: Twenty-six ambulance personnel were followed during a 24-h work shift and during the next two work-free days with electrocardiogram, cortisol assessments and diary notes. The ambulance personnel also performed tests of autonomic reactivity before and at the end of the work shift. The subjects were categorized into two groups according to their number of health complaints. Results: In general, stress markers did not show differences between the work shift and leisure time. However, a modest deviation in heart rate variability pattern and higher morning cortisol values during work in comparison with work-free days were observed in personnel with many health complaints. Conclusions: Subjective and physiological characteristics of ambulance personnel did not indicate distinctive stress during the 24-h work shift. Relationships between frequent health complaints and specific work-related factors require further prospective studies.
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| 4. |
- Aasa, Ulrika, et al.
(författare)
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The effects of a 1-year physical exercise programme on development of fatigue during a simulated ambulance work task.
- 2008
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Ingår i: Ergonomics. - : Informa UK Limited. - 0014-0139 .- 1366-5847. ; 51:8, s. 1179-94
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to evaluate the effects of individually prescribed physical exercise programmes on development of fatigue during the carrying of a loaded stretcher up and down the stairs. Nineteen ambulance personnel performed the training for 1 year. Testing occurred before and after 1 year of the training. Both the training group (n = 19) and the control group (n = 15) were assessed for physical capacity and lactate concentration in blood and ratings of perceived exertion during carrying a stretcher on the stairs. When comparisons were made between those who had been training three times/week for 1 year and the control group, lactate concentration was significantly decreased. In conclusion, markers of fatigue during stretcher carrying can be reduced by the use of individually prescribed physical exercise programmes.
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| 5. |
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| 6. |
- Barnekow-Bergkvist, Margareta, et al.
(författare)
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Relationships between physical activity and physical capacity in adolescent females and bone mass in adulthood
- 2006
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Ingår i: Scandinavian Journal of Medicine and Science in Sports. - : Wiley. - 0905-7188 .- 1600-0838. ; 16:6, s. 447-455
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Tidskriftsartikel (refereegranskat)abstract
- This study investigates whether physical activity and physical performance in adolescence are positively related to adult bone mineral density (BMD). In 1974, physical activity, endurance, and muscular strength were measured in 204 randomly selected female students, age 16.1 +/- 0.3 year (range 15-17 years). Twenty years later, 36 of the women volunteered to undergo a measurement of their BMD. Women who were members in a sports club in adolescence had significantly higher adult BMD (mean differences of 5% to 17% depending on site) compared with subjects who were not engaged in a sports club. Furthermore, women with persistent weight-bearing activity in adulthood had significantly higher BMD compared with women who had stopped being active or had never been active. The differences ranged between 5% and 19% with the highest difference found in trochanter BMD. Stepwise regression analyses showed that membership in a sports club at baseline was a significant independent predictor of BMD in the total body, lumbar spine, legs, trochanter, and femoral neck, explaining 17-26% of the variation in BMD. Change in body weight was a strong independent predictor of BMD of the total body and arms, explaining 8% of the variation in both sites. In addition, running performance at baseline was an independent predictor of total body BMD, whereas the two-hand lift performance significantly predicted BMD of the total body, legs and trochanter. The hanging leg-lift and handgrip were both significant predictors of arm BMD. In conclusion, membership in a sports club and site-specific physical performance in adolescence together with the change in body weight were significantly associated with adult BMD in premenopausal women
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| 7. |
- Bergfors, M, et al.
(författare)
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Short-term effects of repetitive arm work and dynamic exercise on glucose metabolism and insulin sensitivity.
- 2005
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Ingår i: Acta Physiologica Scandinavica. - 0001-6772 .- 1365-201X. ; 183:4, s. 345-356
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To detennine whether repetitive ann work, with a large component of static muscle contraction alters glucose metabolism and insulin sensitivity. Methad: Euglycemic clamps (2h) were started in ten healthy individuals 15 minutes after 37 minute periods of: 1) repetitive ann work in a simulated occupational setting; 2) dynamic concentric exercise on a cycle ergometer at 60% OfVO2 max and 3) a resting regime as a control. During the experimental periods, blood samples were collected, blood pressure was measured repeatedly and electrocardiogram (ECG) wasrecorded continuously. During the clamps, euglycemia was maintained at 5 mmo1/l and insulin was infused at 56 mU/m2/min for 120 min. Results: The insulin-mediated glucose disposal rate (M-value) for the steady state period (60- 120 min) of the clamp, tended to be lower following ann work than for both cycling and resting regimes. When dividing the steady state period into 20-minute intervals, the insulin sensitivity index, (ISI) was significantly lower for ann work compared with the resting control situation between 60-80 minutes (p=0.04) and 80-100 minutes (p=0.01) respectively. Catecholamines increased significantly for ann work and cycling compared with resting regime. .Data from heart rate variability (HRV) me asurements indicated significant sympathetic activation during repetitive ann work test. Canelusian: The results indicate that repetitive ann work might acutely promote insulin resistance, whereas no such effect on insulin resistance was produced by dynamic concentric exercise.
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| 8. |
- Björklund, Erika, 1972-
(författare)
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Constituting the Healthy Employee? : Governing gendered subjects in workplace health promotion
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- With a post-structural approach and an analytical focus on processes of governmentality and biopower, this study is concerned with how discourses of health are contextualized in educational practice and interaction between educators and participants in workplace health promotion (WHP) interventions. Of concern are issues of the discursive production, regulation and representation of power, knowledge and subjects as gendered beings in workplace health promotion interventions. The methods for generating data are participant observation, interviews and gathering of documentation pertaining to four different workplace health promotion interventions. Based on these data, the thesis offers an analysis of the health discourses drawn on in the interventions and the technologies of power and of the self by which the participants are governed and invited to govern themselves in the name of health. It also asks what practices and positions that thus come to be made available or not to the participants. Two health discourses are identified: the biomedical discourse and the wellness discourse. Both discourses are drawn on in all four studied interventions, the biomedical discourse being the dominating discourse drawn on. The biomedical discourse is informed by scientific ‘facts’ and statistics and is underpinned by a notion of risk. The wellness discourse is informed by an understanding of health as a subjective embodied experience and is underpinned by a notion of pleasure. Drawing on these discourses, the responsibility for health is placed with the participants and the healthy participant/employee is constituted as a rationally motivated risk-avoider and disciplined pleasure seeker who is both willing and able to actively make ‘good’ choices regarding their lifestyle. Furthermore, and informed by essentialist and heteronormative ideas about gender, the ideal healthy person is modelled on a male norm, representing women as the deviant Other.
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| 9. |
- Björklund, Martin, et al.
(författare)
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Acute muscle stretching and shoulder position sense
- 2006
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Ingår i: Journal of athletic training. - 1062-6050 .- 1938-162X. ; 41:3, s. 270-274
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Tidskriftsartikel (refereegranskat)abstract
- Context: Stretching is common among athletes as a potential method for injury prevention. Stretching-induced changes in the muscle spindle properties are a suggested mechanism, which may imply reduced proprioception after stretching; however, little is known of this association. Objective: To evaluate whether acute stretching of the shoulder muscles affects position sense. Design: A crossover design with subjects randomized to 3 groups. Setting: A university human research laboratory. Patients or Other Participants: Nine male (age = 24 +/- 3 years) and 9 female (age = 21 +/- 2 years) healthy volunteers. Intervention(s): Stretching of shoulder (1) agonists or (2) antagonists or (3) nonstretching control. Main Outcome Measure(s): We determined position sense acuity of the right shoulder before and after the interventions by having subjects attempt to reproduce arm positions of 15 degrees and 30 degrees (shoulder adduction) while starting at 45 degrees to the sagittal plane. The outcome variables were response variability (variable error) and overall accuracy (absolute error). Results: The relative change in variable error (ie, variable error after/variable error before) was not significantly different between the interventions ( P = .38). Similarly, no change in absolute error was found ( P = .76). Furthermore, no differences were noted regarding test sequence or the interaction of intervention x sequence for either variable error ( P = .73 and .53, respectively) or absolute error ( P = .71 and .67, respectively). Conclusions: We found no effect on shoulder position sense after an acute bout of stretching of either agonist or antagonist shoulder muscles.
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| 10. |
- Björklund, Martin, et al.
(författare)
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The assessment of symptoms and functional limitations in low back pain patients : validity and reliability of a new questionnaire
- 2007
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Ingår i: European spine journal. - : Springer Science and Business Media LLC. - 0940-6719 .- 1432-0932. ; 16:11, s. 1799-1811
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Tidskriftsartikel (refereegranskat)abstract
- Many of the existing low back pain (LBP) questionnaires of function and symptoms have a content of different domains of disability presented as a single sum score, making it difficult to derive changes within a specific domain. The present study describes the development of a clinically derived back-specific questionnaire incorporating both a functional limitation and a symptom scale, with a further subdivision of the symptom scale in separate indices for severity and temporal aspects. The aims of the study were to assess the overall reliability and validity of the new questionnaire, named the Profile Fitness Mapping questionnaire (PFM). A total of 193 chronic LBP patients answered the PFM together with five validated criterion questionnaires. For the internal consistency of the questionnaires, the three indices of the PFM had the highest Cronbach's alpha (0.90-0.95) and all items had item-total correlations above 0.2. The correlation coefficients between the PFM and the back-specific criterion questionnaires ranged between 0.61 and 0.83, indicating good concurrent criterion validity. The best discriminative ability between patients with different pain severities was demonstrated by the functional limitation scale of the PFM. Well centered score distribution with no patient's score at the floor or the ceiling level indicates that the PFM has the potential to detect the improvement or worsening of symptoms and functional limitations in chronic LBP patients. Classification according to the International Classification of Functioning, Disability and health (ICF) of WHO revealed a high degree of homogeneous item content of the symptom scale to the domain of impairments, and of the functional limitation scale to the domain of activity limitations. The present study suggests that the PFM has a high internal consistency and is a valid indicator of symptoms and functional limitations of LBP patients. It offers the combination of a composite total score and the possibility of evaluations within specific domains of disability. Complementary evaluation of test-retest reliability and responsiveness to change is warranted.
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