| 1. |
- Bergström, Gunnar, et al.
(författare)
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Preventing sickness absenteeism among employees with common mental disorders or stress-related symptoms at work : Design of a cluster randomized controlled trial of a problem-solving based intervention versus care-as-usual conducted at the Occupational Health Services
- 2017
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Ingår i: BMC Public Health. - : BioMed Central. - 1471-2458. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Common mental disorders (CMDs) are among the leading causes of sick leave in Sweden and other OECD countries. They result in suffering for the individual and considerable financial costs for the employer and for society at large. The occupational health service (OHS) can offer interventions in which both the individual and the work situation are taken into account. The aim of this paper is to describe the design of a study evaluating the effectiveness of an intervention given at the OHS to employees with CMDs or stress-related symptoms at work. In addition, intervention fidelity and its relation to the outcome will be assessed in a process analysis.Methods: The study is designed as a cluster randomized trial in which the participating OHS consultants are randomized into either delivering the intervention or performing care as usual. Employees with CMDs or stress-related symptoms at work are recruited consecutively by the OHS consultants. The intervention aims to improve the match between the employee and the job situation. Interviews are held individually with the employee and the nearest supervisor, after which a joint meeting with both the employee and the supervisor takes place. A participatory approach is applied by which the supervisor and the employee are guided by the OHS consultant and encouraged to actively take part in problem solving concerning the work situation. Outcomes will be assessed at baseline and at six and 12 months. A long-term follow-up at 3 years will also be performed. The primary outcome is registered sickness absence during a 1-year period after study inclusion. Secondary outcomes are mental health and work ability. The intervention's cost effectiveness, compared to treatment as usual, both for society and for the employer will be evaluated. A process evaluation by both the OHS consultants and the employee will be carried out.Discussion: The study includes analyses of the effectiveness of the intervention (clinical and economic) as well as an analysis of its implementation at the participating OHSs. Possible methodological challenges such as selection bias and risk of contamination between OHS consultants delivering the experimental condition and consultants giving usual care are discussed.
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| 2. |
- Hosie, S., et al.
(författare)
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Gastrointestinal dysfunction in patients and mice expressing the autism-associated R451C mutation in neuroligin-3
- 2019
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Ingår i: Autism Research. - : Wiley. - 1939-3792 .- 1939-3806. ; 12:7, s. 1043-1056
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Tidskriftsartikel (refereegranskat)abstract
- Gastrointestinal (GI) problems constitute an important comorbidity in many patients with autism. Multiple mutations in the neuroligin family of synaptic adhesion molecules are implicated in autism, however whether they are expressed and impact GI function via changes in the enteric nervous system is unknown. We report the GI symptoms of two brothers with autism and an R451C mutation in Nlgn3 encoding the synaptic adhesion protein, neuroligin-3. We confirm the presence of an array of synaptic genes in the murine GI tract and investigate the impact of impaired synaptic protein expression in mice carrying the human neuroligin-3 R451C missense mutation (NL3(R451C)). Assessing in vivo gut dysfunction, we report faster small intestinal transit in NL3(R451C) compared to wild-type mice. Using an ex vivo colonic motility assay, we show increased sensitivity to GABA(A) receptor modulation in NL3(R451C) mice, a well-established Central Nervous System (CNS) feature associated with this mutation. We further show increased numbers of small intestine myenteric neurons in NL3(R451C) mice. Although we observed altered sensitivity to GABA(A) receptor modulators in the colon, there was no change in colonic neuronal numbers including the number of GABA-immunoreactive myenteric neurons. We further identified altered fecal microbial communities in NL3(R451C) mice. These results suggest that the R451C mutation affects small intestinal and colonic function and alter neuronal numbers in the small intestine as well as impact fecal microbes. Our findings identify a novel GI phenotype associated with the R451C mutation and highlight NL3(R451C) mice as a useful preclinical model of GI dysfunction in autism. Autism Res 2019, 12: 1043-1056. (c) 2019 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary People with autism commonly experience gastrointestinal problems, however the cause is unknown. We report gut symptoms in patients with the autism-associated R451C mutation encoding the neuroligin-3 protein. We show that many of the genes implicated in autism are expressed in mouse gut. The neuroligin-3 R451C mutation alters the enteric nervous system, causes gastrointestinal dysfunction, and disrupts gut microbe populations in mice. Gut dysfunction in autism could be due to mutations that affect neuronal communication.
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| 3. |
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| 4. |
- Bergström, Gunnar, Professor, et al.
(författare)
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Reliability and factor structure of the Multidimensional Pain Inventory--Swedish Language Version (MPI-S).
- 1998
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Ingår i: Pain. - : LWW. - 0304-3959 .- 1872-6623. ; 75:1, s. 101-10
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Tidskriftsartikel (refereegranskat)abstract
- The psychological assessment of chronic pain is often accomplished using questionnaires such as the (West Haven-Yale) Multidimensional Pain Inventory ((WHY)MPI) which is constructed to capture the multidimensionality of chronic pain. The (WHY)MPI theoretically originates from behavioural and cognitive behavioural theories of pain. It is divided into three parts and measures psychosocial and behavioural consequences of pain. This questionnaire has displayed satisfactory psychometric properties and translations of the original English version into German and Dutch have been demonstrated to be reliable and valid. The aim of this study was to test the reliability and factor structure of a Swedish translation of the (WHY)MPI, the MPI-S, and also to test the generalisability of the factor structure found for the (WHY)MPI. We performed analyses of internal consistency using Cronbach's alpha, and carried out a confirmatory factor analysis (CFA) employing LISREL-8 on a population of 682 patients suffering from chronic musculoskeletal pain. Test-retest analysis was accomplished on a sub-sample of 54 individuals taken from the aforementioned population. For sections 1 and 2 of the MPI-S the overall reliability and stability were good, and after the exclusion of four items, the factor structure was similar to other versions of the MPI. For section 3, despite removal of five questions, the proposed factor structure could not be replicated. This part of the inventory is designed to measure the extent of different types of activities, and our results suggest that this section may only be used for assessing general activity level. We conclude that, with a few adjustments, the analyses yielded satisfactory results for sections 1 and 2 of the MPI-S regarding its factor structure, reliability and generalisability. For section 3 the hypothesised factor structure could not be confirmed.
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| 5. |
- Glendor, Ulf, et al.
(författare)
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Direct and indirect time spent on care of dental trauma : a 2-year prospective study of children and adolescents
- 2000
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Ingår i: Endodontics and dental traumatology. - : Wiley. - 0109-2502 .- 1600-4469 .- 1600-9657. ; 16:1, s. 16-23
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to account for the total time spent by professional care-givers (direct time) and by patients and companions engaged as support and help (indirect time) to treat and otherwise attend to children and adolescents with dental trauma to primary and permanent teeth. The study was based on a random sample of 192 children and adolescents with dental traumas reported to an insurance company and prospectively followed up by telephone interviews over a period of 2 years after the trauma episode. On average, direct time represented 16% of total time for all visits for dental trauma to permanent teeth and 11% for trauma to primary teeth. The most extensive type of indirect time was transport time, which took up 30% of the total time spent on injuries to permanent teeth and 36% for injuries to primary teeth. Multiple regression analysis of the impact of dental and demographic injury variables on the time variables showed that complicated trauma was associated with extended time, direct as well as indirect, for permanent and primary teeth injuries. Our estimate of the average relative increase in total time spent by patients and companions in cases of complicated injury to permanent teeth was 117% (95% confidence interval [CI], 52-211) for patients and 112% (95% CI, 42-217) for companions. For transport time a strong predictor was access to a dental clinic near the place of residence. Lack of access could extend the average transport time by 180% (95% CI, 80-335) for patients and 163% (95% CI, 67-317) for their companions in cases of injuries to primary teeth.
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| 6. |
- Modigh, C M, et al.
(författare)
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Time to pregnancy among partners of men exposed to di(2-ethylhexyl)phthalate
- 2002
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Ingår i: Scandinavian Journal of Work, Environment and Health. - 0355-3140. ; 28:6, s. 418-428
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Tidskriftsartikel (refereegranskat)abstract
- Objectives This study assessed paternal occupational exposure to di(2-ethylhexyl)phthalate (DEHP) in association with reduced fertility. Methods Men working in three plants with DEHP exposure were studied retrospectively. Male and female employees and their partners were invited to participate if they had reported a pregnancy or an attempt to achieve a pregnancy. Postal questionnaires and telephone interviews were used to collect additional data from the men and women, respectively. Information on time to pregnancy was eligible for 326 pregnancies fathered by 193 men. Male exposure to DEHP during every month of their time to pregnancy was classified into one of three exposure categories. The exposure ranged from <0.1 to 2.1 mg/ml(3). The fathers of only four pregnancies had DEHP exposure of >0.5 mg/m(3) during the time to pregnancy. The pregnancies of employed women with unexposed partners or pregnancies of employed men unexposed during the time to pregnancy formed the reference group. Results The fecundability ratio for time to pregnancy was 1.07 [95% confidence interval (95% Cl) 0.84-1.351 for those with low exposure and 0.97 (95% CI 0.70-1.33) for the highly exposed after adjustment for the father's age, mother's age, and length of recall. When the analyses were restricted to first pregnancy, the fecundability ratio was 1.13 (95% Cl 0.83-1.56) for low exposure and 1.02 (95% Cl 0.66-1.59) for high exposure. Conclusions Time to pregnancy is not prolonged among couples with paternal exposure to DEHP at a mean exposure level of <0.5 mg/ml.
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| 7. |
- Matilla-Santander, Nuria, et al.
(författare)
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Trajectories of precarious employment and the risk of myocardial infarction and stroke among middle-aged workers in Sweden : A register-based cohort study
- 2022
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Ingår i: The Lancet Regional Health. - : Elsevier BV. - 2666-7762. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- Background The aim is to identify trajectories of precarious employment (PE) over time in Sweden to examine associations of these with the subsequent risk of myocardial infarction (MI) and stroke.Methods This is a nation-wide register-based cohort study of 1,583,957 individuals aged 40 to 61 years old residing in Sweden between 2003-2007. Trajectories of PE as a multidimensional construct and single PE components (contractual employment relationship, temporariness, income levels, multiple job holding, probability of coverage by collective agreements) were identified for 2003-2007 by means of group-based model trajectories. Risk Ratios (RR) for MI and stroke according to PE trajectories were calculated by means of generalized linear models with binomial family.Findings Adjusted estimates showed that constant PE and borderline PE trajectories increased the risk of MI (RR: 1.08, CI95%:1.05-1.11 and RR:1.13, CI95%: 1.07-1.20 respectively) and stroke (RR:1.14, CI95%: 1.10-1.18 and HR:1.24, CI95%: 1.16-1.33 respectively) among men. A higher risk of stroke in men was found for the following unidimensional trajectories: former agency employees (RR:1.32, CI95%:1.04-1.68); moving from high to a low probability of having collective agreements (RR: 1.10, CI95%:1.01-1.20). Having constant low or very low income was associated to an increased risk of MI and Stroke for both men and women.Interpretation The study findings provide evidence that PE increases the risk of stroke and possibly MI. It highlights the importance of being covered by collective bargaining agreements, being directly employed and having sufficient income levels over time.
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| 8. |
- Ahlborg, Gunnar, 1948, et al.
(författare)
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Tobacco smoke exposure and pregnancy outcome among working women. A prospective study at prenatal care centers in Orebro County, Sweden
- 1991
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Ingår i: Am J Epidemiol. - 0002-9262. ; 133:4, s. 338-47
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Tidskriftsartikel (refereegranskat)abstract
- Among 4,687 women undergoing prenatal care in Orebro County, Sweden, from October 1980 to June 1983, 678 nonsmokers reported passive exposure to tobacco smoke. Of these women, 267 had been passively exposed at work, and the risk ratio (RR) for intrauterine death (spontaneous abortion or stillbirth) among these pregnancies was increased to 1.53 (95% confidence interval (CI) 0.98-2.38) compared with pregnancies of unexposed working women. This could not be explained by age, previous spontaneous abortion, educational level, planning of pregnancy, or alcohol use. The effect was confined to first-trimester fetal loss (adjusted RR = 2.16, 95% CI 1.23-3.81), while active smoking was associated with intrauterine death after the first trimester. Passive exposure in the workplace was weakly associated with preterm birth (less than 37 weeks) but not with low birth weight (less than 2,500 g) among full-term livebirths. Active smoking clearly increased the risk of both of these outcomes. However, passive exposure in the home only did not seem to affect pregnancy outcome. The lack of quantitative exposure data points to the need for more research before passive exposure to tobacco smoke can be regarded as an established hazard to fetal development and survival.
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| 9. |
- Axelsson, Gösta, 1950, et al.
(författare)
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Shift work, nitrous oxide exposure, and spontaneous abortion among Swedish midwives
- 1996
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Ingår i: Occupational and Environmental Medicine. - 1351-0711. ; 53:6, s. 374-8
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To study the relation between irregular work hours, nitrous oxide (N2O) exposure, and the risk of spontaneous abortion. METHODS: All 3985 female members of the Swedish Midwives Association in 1989, born in 1940 or later, received a questionnaire on exposure before and during all of their pregnancies. Questions on work conditions covered occupation, extent of employment, workplace, work schedules, use of anaesthetics, and work load. The association between exposure variables and spontaneous abortion was analysed by logistic regression models. RESULTS: Night work and three shift schedules among midwives showed increased odds ratios (ORs) (95% confidence intervals (95% CI)) 1.63 (0.95-2.81) and 1.49 (0.86-2.59), respectively. The ORs of late spontaneous abortions (after the 12th week of pregnancy) was increased for night work 3.33 (1.13-9.87). Use of N2O (> 50% of the deliveries) was not associated with increased risk of spontaneous abortion OR 0.95 (0.62-1.47). Frequent or permanent shortage of staff was related to an increased risk of spontaneous abortions before the 13th week of pregnancy. CONCLUSIONS: The results support the hypothesis that night work and high work load increase the risk of spontaneous abortion.
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| 10. |
- Matilla-Santander, N., et al.
(författare)
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COVID-19 and Precarious Employment : Consequences of the Evolving Crisis
- 2021
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Ingår i: International Journal of Health Services. - : Sage Publications. - 0020-7314 .- 1541-4469. ; 5:2, s. 226-228
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Tidskriftsartikel (refereegranskat)abstract
- The world of work is facing an ongoing pandemic and an economic downturn with severe effects worldwide. Workers trapped in precarious employment (PE), both formal and informal, are among those most affected by the COVID-19 pandemic. Here we call attention to at least 5 critical ways that the consequences of the crisis among workers in PE will be felt globally: (a) PE will increase, (b) workers in PE will become more precarious, (c) workers in PE will face unemployment without being officially laid off, (d) workers in PE will be exposed to serious stressors and dramatic life changes that may lead to a rise in diseases of despair, and (e) PE might be a factor in deterring the control of or in generating new COVID-19 outbreaks. We conclude that what we really need is a new social contract, where the work of all workers is recognized and protected with adequate job contracts, employment security, and social protection in a new economy, both during and after the COVID-19 crisis.
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