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Sökning: WFRF:(Osterberg Kai)

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1.
  • Osterberg, K., et al. (författare)
  • The Lund University Checklist for Incipient Exhaustion: a prospective validation of the onset of sustained stress and exhaustion warnings
  • 2016
  • Ingår i: Bmc Public Health. - : BioMed Central (BMC). - 1471-2458. ; 16
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The need for instruments that can assist in detecting the prodromal stages of stress-related exhaustion has been acknowledged. The aim of the present study was to evaluate whether the Lund University Checklist for Incipient Exhaustion (LUCIE) could accurately and prospectively detect the onset of incipient exhaustion and to what extent work stressor exposure and private burdens were associated with increasing LUCIE scores. Methods: Using surveys, 1355 employees were followed for 11 quarters. Participants with prospectively elevated LUCIE scores were targeted by three algorithms entailing 4 quarters: (1) abrupt onset to a sustained Stress Warning (n = 18), (2) gradual onset to a sustained Stress Warning (n = 42), and (3) sustained Exhaustion Warning (n = 36). The targeted participants' survey reports on changes in work situation and private life during the fulfillment of any algorithm criteria were analyzed, together with the interview data. Participants untargeted by the algorithms constituted a control group (n = 745). Results: Eighty-seven percent of participants fulfilling any LUCIE algorithm criteria (LUCIE indication cases) rated a negative change in their work situation during the 4 quarters, compared to 48 % of controls. Ratings of negative changes in private life were also more common in the LUCIE indication groups than among controls (58 % vs. 29 %), but free-text commentaries revealed that almost half of the ratings in the LUCIE indication groups were due to work-to-family conflicts and health problems caused by excessive workload, assigned more properly to work-related negative changes. When excluding the themes related to work-stress-related private life compromises, negative private life changes in the LUCIE indication groups dropped from 58 to 32 %, while only a negligible drop from 29 to 26 % was observed among controls. In retrospective interviews, 79 % of the LUCIE indication participants confirmed exclusively/predominantly work stressors, while 6 % described a predominance of private life stressors. Conclusions: Negative changes in the work situation were the most prominent change related to a sustained increase in LUCIE scores. The findings seem to confirm that LUCIE is a potentially useful tool for clinical screening of incipient work-related exhaustion.
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2.
  • Fjalldal, Sigridur, et al. (författare)
  • Hypothalamic Involvement Predicts Cognitive Performance and Psychosocial Health in Long-term Survivors of Childhood Craniopharyngioma
  • 2013
  • Ingår i: Journal of Clinical Endocrinology and Metabolism. - : Oxford University Press. - 1945-7197 .- 0021-972X. ; 98:8, s. 3253-3262
  • Tidskriftsartikel (refereegranskat)abstract
    • Context: Hypothalamic damage caused by craniopharyngioma (CP) is associated with poor functional outcome. Objective: To assess cognitive function and quality of life in childhood-onset CP on hormonal replacement, including GH treatment. Design: A cross-sectional study with a median follow-up time of 20 years (1-40). Setting: Patients were recruited from the South Medical Region of Sweden. Participants: The study included 42 patients (20 women) surgically treated for a childhood-onset CP between 1958 and 2000. Patients were aged >= 17 years. Equally many controls, matched for age, sex, residence, and smoking habits, were included. Tumor growth into the third ventricle was found in 25 patients. Main Outcome Measures: All subjects were examined with a battery of cognitive tests and the following questionnaires: Symptom Checklist-90, the Interview Schedule for Social Interaction, and the Social Network concept. Results: The CP patients had lower cognitive performance, reaching statistical significance in 12 of 20 test variables, including executive function and memory. Comparison of patients with tumor growth into the third ventricle to controls revealed a significant lower mean total score (P = .006). A significant negative correlation was recorded between mean z-score of cognitive performance and years since operation (r = -0.407; P = .014). No statistically significant group differences were observed across any of the 9 Symptom Checklist-90 subscales. Conclusions: Adults with childhood-onset CP, on hormone replacement, including GH treatment, have memory defects, disturbed attention, and impaired processing speed. Patients with hypothalamic involvement are more affected. Patients rated their quality of life as good as their matched controls.
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3.
  • Jönsson, Peter, et al. (författare)
  • Cardiovascular and cortisol reactivity and habituation to a virtual reality version of the Trier Social Stress Test : a pilot study
  • 2010
  • Ingår i: Psychoneuroendocrinology. - : Elsevier. - 0306-4530 .- 1873-3360. ; 35:9, s. 1397-1403
  • Tidskriftsartikel (refereegranskat)abstract
    • The Trier Social Stress Test (TSST) is a widely used protocol to induce stress in laboratory settings. Briefly, in the TSST, the test participant is asked to hold a speech and to do an arithmetic task in front of an audience. In the present pilot study, we examined endocrine and autonomic reactivity and habituation to repeated stress provocations using a virtual reality (VR) version of TSST. The VR system was a CAVE™ system with three rear projected walls (4 m×3 m), and one floor projection. The system also included a head tracking system and passive stereoscopy. The virtual audience consisted of one woman, and two men. Ten healthy men, mean age 28.3 years (24-38 years), were confronted with the test twice (1 week between sessions), during which salivary cortisol, heart rate (HR), high frequency heart rate variability (HF-HRV, parasympathetic activity), and T-wave amplitude (TWA, suggested to be related to sympathetic influence on myocardial performance) were assessed. Cortisol secretion showed a marked increase (88% vs. baseline) during the first stress provocation, but habituated in the second session. The magnitude of HR and TWA reactivity during stress provocation was approximately the same at both sessions, implying a stable increase in sympathetic activity. Heart rate showed a maximum increase of 40% at the first session, and 32% at the second. TWA showed a maximum decrease of 42% at the first session, and 39% at the second. The results resemble those obtained in prior studies using the real-life TSST. If these results can be replicated with larger samples, VR technology may be used as a simple and standardized tool for social stress induction in experimental settings.
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4.
  • Karlson, Björn, et al. (författare)
  • Long-term stability of return to work after a workplace-oriented intervention for patients on sick leave for burnout
  • 2014
  • Ingår i: BMC Public Health. - : BioMed Central (BMC). - 1471-2458 .- 1471-2458. ; 14
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND:The period from the mid-1990s to the mid-2000s saw a rapid increase in long-term sick leave in Sweden, primarily due to mental illness and often related to job burnout. This led to an urge for effective treatment programs that could prevent the often long sick leaves. In 2010 we presented a newly developed work-place intervention method, showing that 89% of the intervention group had returned to work at a 1.5 year follow-up, compared to 73% of the control group. The main aim of this study was to assess the long-term stability of these promising results.METHODS:Sick leave registry data from the Regional Social Insurance Office were analyzed for an additional year (50 weeks) beyond the original 1.5 year period (80 weeks). Data from 68 matched pairs of intervention participants (IP) and controls were available. The proportions of participants being on full-time sick leave versus having returned to work to any extent were computed for every 10th week. Generalized estimating equations were used with GROUP (IP versus controls) as between-subjects factor, WEEKS and AGE as covariates, and return-to-work (RTW) as dependent variable. Significant differences (Wald χ2 with α ≤ .05) was followed up with polynomial contrasts. Individual relapses to higher degrees of sick leave (e.g. from 50% to 100%) and whether partial RTW led to later full-time RTW, were also analyzed.RESULTS:The omnibus test over all 130 weeks showed a GROUP*WEEKS interaction effect (p = .02), indicating differential group developments in RTW, though similarly high at week 130 in both groups with 82.4% of the IP and 77.9% of the controls having RTW (p = .22; χ2-test). A significant interaction with age led to separate analyses of the younger and older subgroups, indicating a stable pattern of superior RTW only among younger IP (week 130: 88.6% vs. 69.7%, p = .054; χ2-test). There was no group difference in relapses into increased degree of sick leave. Part-time sick leave did not predict a later stable full-time RTW.CONCLUSIONS:The previously reported improvement in RTW with the newly developed workplace-oriented intervention showed a long-term stability only among younger participants.
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5.
  • Karlson, Björn, et al. (författare)
  • Return to work after work after a workplace-oriented intervention for patients on sick-leave for burnout - a prospective controlled study
  • 2010
  • Ingår i: BMC Public Health. - : BioMed Central (BMC). - 1471-2458. ; 10
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: In the present study the effect of a workplace-oriented intervention for persons on long-term sick leave for clinical burnout, aimed at facilitating return to work (RTW) by job-person match through patient-supervisor communication, was evaluated. We hypothesised that the intervention group would show a more successful RTW than a control group. Methods: In a prospective controlled study, subjects were identified by the regional social insurance office 2-6 months after the first day on sick leave. The intervention group (n = 74) was compared to a control group who had declined participation, being matched by length of sick leave (n = 74). The RTW was followed up, using sick-listing register data, until 1.5 years after the time of intervention. Results: There was a linear increase of RTW in the intervention group during the 1.5-year follow-up period, and 89% of subjects had returned to work to some extent at the end of the follow-up period. The increase in RTW in the control group came to a halt after six months, and only 73% had returned to work to some extent at the end of the 1.5-year follow-up. Conclusions: We conclude that the present study demonstrated an improvement of long-term RTW after a workplace-oriented intervention for patients on long-term sick leave due to burnout. Trial registration: Current Controlled Trials NCT01039168.
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6.
  • Persson, Roger, et al. (författare)
  • Seasonal Variation in Human Salivary Cortisol Concentration
  • 2008
  • Ingår i: Chronobiology International. - : Taylor & Francis. - 0742-0528 .- 1525-6073. ; 25:6, s. 923-937
  • Tidskriftsartikel (refereegranskat)abstract
    • Measurement of cortisol concentration can contribute important information about an individual's ability to adjust to various environmental demands of both physical and psychosocial origin. However, one uncertainty that affects the possibilities of correctly interpreting and designing field studies is the lack of observations of the impact of seasonal changes on cortisol excretion. For this reason, the month-to-month changes in diurnal cortisol concentration, the awakening cortisol response (ACR), maximum morning concentration, and fall during the day were studied in a group of 24 healthy men and women 32 to 61 yrs of age engaged in active work. On one workday for 12 consecutive months, participants collected saliva at four time points for determination of cortisol: at awakening, +30min, +8h, and at 21:00h. Data were analyzed by a repeated measures design with month (12 levels) and time-of-day (4 levels) as categorical predictors. Cortisol concentrations were analyzed on a log scale. The diurnal pattern of cortisol was similar across months (interaction between month and time of day: p0.4). The main effects of month and time-of-day were statistically significant (p0.001). Highest concentrations were observed in February, March, and April, and lowest concentrations were observed in July and August. There were no statistically significant effects in any of the other measures, or between men and women. In conclusion, a seasonal variation in salivary cortisol concentrations was detected in an occupationally active population. Thus, seasonal variation needs to be taken into account when designing and evaluating field studies and interventions and when making comparisons across studies.
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7.
  • Carter, N, et al. (författare)
  • EUROQUEST - A questionnaire for solvent related symptoms: Factor structure, item analysis and predictive validity
  • 2002
  • Ingår i: NeuroToxicology. - : Elsevier. - 1872-9711 .- 0161-813X. ; 23:6, s. 711-717
  • Tidskriftsartikel (refereegranskat)abstract
    • The study evaluates the factor structure and predictive validity of the symptom questionnaire EUROQUEST (EQ) that had been developed with the goal of simplifying the evaluation of health effects associated with long-term solvent exposure. The EQ was added to the normal evaluation procedures for 118 male patients with suspected solvent-induced toxic encephalopathy (TE) referred to seven Swedish clinics of occupational medicine during an 18-month period. EQ was also completed by 239 males from a random sample of 400 Swedish males aged 25-64 years selected from the general population and a sample of 559 occupationally active male spray painters aged 25-64 years. Factor and item analyses of EQ responses were performed. Ordinary least square regression analysis was used to evaluate sensitivity and correlation to evaluate the specificity of EQ and the separate components. Questions concerning memory and concentration symptoms alone showed better sensitivity than the other five EQ dimensions singly or combined for the entire EQ and for a subset of questions approximating Q16, a widely used organic solvent symptom screening questionnaire. However, the diagnosis of TE required information in addition to exposure and responses to EQ and Q16-like questions. The results indicate that the subset of EQ questions concerning memory and concentration might replace the more cumbersome EQ and less sensitive Q16 in screening for TE, although none of the screening instruments alone replaces current clinical diagnostic procedures. (C) 2002 Elsevier Science Inc. All rights reserved.
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8.
  • Follin, Cecilia, et al. (författare)
  • Impaired brain metabolism and neurocognitive function in childhood leukemia survivors despite complete hormone supplementation in adulthood
  • 2016
  • Ingår i: Psychoneuroendocrinology. - : Elsevier. - 0306-4530 .- 1873-3360. ; 73, s. 157-165
  • Tidskriftsartikel (refereegranskat)abstract
    • Cranial radiotherapy is a known risk factor for neurocognitive impairment in survivors of childhood acute lymphoblastic leukemia (ALL). Understanding the nature of cognitive dysfunction during adulthood in ALL survivors is important as it has an impact on major life situations. Thirty-eight (21 women) ALL survivors were investigated 34 years after diagnosis. Median-age was 38 (27–46) years. All were treated with a CRT dose of 24 Gy and 11 years (3–13) of complete hormone supplementation. Comparisons were made to 29 matched controls. Assessments of magnetic resonance spectroscopy (white and grey matter metabolic alterations), brain volume and neuropsychological tests were performed. ALL survivors demonstrate a generally lower performance in neuropsychological tests. ALL survivors scored lower than controls in vocabulary (p < 0.001), memory (p < 0.001), learning capacity (p < 0.001), spatial ability (p < 0.001), executive functions and attention (p < 0.001) 34 years after ALL treatment. Compared to controls ALL survivors had reduced white matter (WM) (492 vs 536 cm3, p < 0.001) and grey matter (GM) volumes (525 vs 555 cm3, p = 0.001). ALL survivors had lower levels of WM N-acetyl aspartate/creatin (NAA/Cr) (1.48 vs 1.63, p = 0.004), WM NAA + NAAG (N-acetylaspartylglutamate)/Cr (1.61 vs 1.85, p < 0.001) and lower levels of GM NAA/Cr (1.18 vs 1.30, p = 0.001) and GM NAA + NAAG/Cr (1.28 vs 1.34, p = 0.01) compared to controls. ALL survivors had higher levels in WM MI (Myoinositol)/NAA (0.65 vs 0.56, p = 0.01) concentrations compared to controls. There was a significantly negative correlation of years since ALL diagnosis to WM NAA + NAAG/Cr (r = −0.4, p = 0.04) in ALL survivors. The present study shows impaired brain metabolism detected by MRS, reduced brain volumes and neurocognitive impairment in childhood ALL survivors treated with cranial radiotherapy and chemotherapy, despite complete hormone substitution. We also report an impairment of metabolites correlated to time since treatment and a progressive impairment in sustained attention, suggesting an accelerated aging in the irradiated brain. Following these survivors many decades, or throughout life, after treatment with cranial radiotherapy and chemotherapy is highly warranted for a broader understanding of long-term outcome in this patient group.
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9.
  • Karlson, Björn, et al. (författare)
  • Return to work after a workplace-oriented intervention for patients on sick-leave for burnout : a prospective controlled study
  • 2010
  • Ingår i: BMC Public Health. - 1471-2458 .- 1471-2458. ; 10
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: In the present study the effect of a workplace-oriented intervention for persons on long-term sick leave for clinical burnout, aimed at facilitating return to work (RTW) by job-person match through patient-supervisor communication, was evaluated. We hypothesised that the intervention group would show a more successful RTW than a control group.METHODS: In a prospective controlled study, subjects were identified by the regional social insurance office 2-6 months after the first day on sick leave. The intervention group (n = 74) was compared to a control group who had declined participation, being matched by length of sick leave (n = 74). The RTW was followed up, using sick-listing register data, until 1.5 years after the time of intervention.RESULTS: There was a linear increase of RTW in the intervention group during the 1.5-year follow-up period, and 89% of subjects had returned to work to some extent at the end of the follow-up period. The increase in RTW in the control group came to a halt after six months, and only 73% had returned to work to some extent at the end of the 1.5-year follow-up.CONCLUSIONS: We conclude that the present study demonstrated an improvement of long-term RTW after a workplace-oriented intervention for patients on long-term sick leave due to burnout.TRIAL REGISTRATION: Current Controlled Trials NCT01039168.
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10.
  • Persson, Roger, et al. (författare)
  • Effects of the implementation of an 84-hour workweek on neurobehavioral test performance and cortisol responsiveness during testing.
  • 2003
  • Ingår i: Scandinavian Journal of Work, Environment and Health. - : Finnish Institute of Occupational Health. - 0355-3140. ; 29:4, s. 261-269
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: This study examined whether long workhours in combination with an extended workweek (12 hours/7 days), as requested by the workers, impaired attention and cognitive performance and whether the degree of hypothalamic-pituitary-adrenal (HPA) activation was related to the response to the performance tasks. METHODS: A group of 41 male construction workers between 21 and 60 (mean 39) years of age who worked 84 hours a week, with alternate weeks off, was compared with a group of 23 male construction workers between 24 and 65 (mean 43) years of age who had a traditional 40-hour work schedule. Neurobehavioral test performance, self-ratings of fatigue and sleepiness, and salivary cortisol levels were evaluated in a counterbalanced repeated-measures design. RESULTS: The 84-hour group did not show any signs of reduced test performance or elevated fatigue and sleepiness. The 84-hour group had faster reaction times on day 7 than on days 1 and 5. Although the expected activation of the HPA axis was only found in the total study sample when workdays 1 and 5 were collapsed, the HPA activation can be considered normal. CONCLUSIONS: The results suggest that an 84-hour work regimen in response to requests from workers does not induce more performance deficits than an ordinary 40-hour workweek. An extended work schedule of 84 hours cannot in the short-term be considered to affect basic mental capabilities negatively.
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