| 1. |
- Virtanen, Marianna, et al.
(författare)
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Long working hours and alcohol use : systematic review and meta-analysis of published studies and unpublished individual participant data.
- 2015
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Ingår i: BMJ (Clinical research ed.). - : BMJ. - 1756-1833 .- 0959-8138. ; 350, s. Art. no. g7772-
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To quantify the association between long working hours and alcohol use.DESIGN: Systematic review and meta-analysis of published studies and unpublished individual participant data.DATA SOURCES: A systematic search of PubMed and Embase databases in April 2014 for published studies, supplemented with manual searches. Unpublished individual participant data were obtained from 27 additional studies.REVIEW METHODS: The search strategy was designed to retrieve cross sectional and prospective studies of the association between long working hours and alcohol use. Summary estimates were obtained with random effects meta-analysis. Sources of heterogeneity were examined with meta-regression.RESULTS: Cross sectional analysis was based on 61 studies representing 333 693 participants from 14 countries. Prospective analysis was based on 20 studies representing 100 602 participants from nine countries. The pooled maximum adjusted odds ratio for the association between long working hours and alcohol use was 1.11 (95% confidence interval 1.05 to 1.18) in the cross sectional analysis of published and unpublished data. Odds ratio of new onset risky alcohol use was 1.12 (1.04 to 1.20) in the analysis of prospective published and unpublished data. In the 18 studies with individual participant data it was possible to assess the European Union Working Time Directive, which recommends an upper limit of 48 hours a week. Odds ratios of new onset risky alcohol use for those working 49-54 hours and ≥55 hours a week were 1.13 (1.02 to 1.26; adjusted difference in incidence 0.8 percentage points) and 1.12 (1.01 to 1.25; adjusted difference in incidence 0.7 percentage points), respectively, compared with working standard 35-40 hours (incidence of new onset risky alcohol use 6.2%). There was no difference in these associations between men and women or by age or socioeconomic groups, geographical regions, sample type (population based v occupational cohort), prevalence of risky alcohol use in the cohort, or sample attrition rate.CONCLUSIONS: Individuals whose working hours exceed standard recommendations are more likely to increase their alcohol use to levels that pose a health risk.
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| 2. |
- Heikkilä, Katriina, et al.
(författare)
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Job strain and COPD exacerbations: an individual-participant meta-analysis
- 2014
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Ingår i: European Respiratory Journal. - : European Respiratory Society (ERS). - 0903-1936 .- 1399-3003. ; 44:1, s. 247-251
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Tidskriftsartikel (refereegranskat)abstract
- To the Editor:Chronic obstructive pulmonary disease (COPD) is a major cause of mortality and disability worldwide (1). The clinical course of COPD is characterised by exacerbations, which can be minor and manageable at home or in primary care, or severe, leading to hospitalisation or even death. Known causes of exacerbations include tobacco smoke, air pollution, dusts and fumes, and respiratory infections (1, 2). One less well understood risk factor is stress, which could plausibly lead to COPD exacerbations as it can trigger inflammation (3, 4) and is associated with increased smoking (5), which are both implicated in COPD pathology (2). Work is an important source of stress in the age groups in which COPD is typically diagnosed (1, 6). However, we are not aware of previous investigations of work-related stress and the risk of COPD exacerbations.In this study, we examined the associations between job strain (the most widely studied conceptualisation of work-related stress) and severe COPD exacerbations using individual-level data from 10 prospective cohort studies from the Individual Participant Data Meta-analysis in Working Populations (IPD-Work) Consortium (7). Job strain is defined as a combination of high demands (excessive amounts of work) and low control (having little influence on what tasks to.
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| 3. |
- Westerlund, Hugo, et al.
(författare)
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Social Adversity in Adolescence Increases the Physiological Vulnerability to Job Strain in Adulthood : A Prospective Population-Based Study
- 2012
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 7:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: It has been argued that the association between job strain and health could be confounded by early life exposures, and studies have shown early adversity to increase individual vulnerability to later stress. We therefore investigated if early life exposure to adversity increases the individual's physiological vulnerability job strain in adulthood. Methodology/Principal Findings: In a population-based cohort (343 women and 330 men, 83% of the eligible participants), we examined the association between on the one hand exposure to adversity in adolescence, measured at age 16, and job strain measured at age 43, and on the other hand allostatic load at age 43. Adversity was operationalised as an index comprising residential mobility and crowding, parental loss, parental unemployment, and parental physical and mental illness (including substance abuse). Allostatic load summarised body fat, blood pressure, inflammatory markers, glucose, blood lipids, and cortisol regulation. There was an interaction between adversity in adolescence and job strain (B = 0.09, 95% CI 0.02 to 0.16 after adjustment for socioeconomic status), particularly psychological demands, indicating that job strain was associated with increased allostatic load only among participants with adversity in adolescence. Job strain was associated with lower allostatic load in men (beta = -0.20, 95% CI -0.35 to -0.06). Conclusions/Significance: Exposure to adversity in adolescence was associated with increased levels of biological stress among those reporting job strain in mid-life, indicating increased vulnerability to environmental stressors.
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| 4. |
- Andreeva, Elena, et al.
(författare)
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Risk of psychological ill health and methods of organisational downsizing : a cross-sectional survey in four European countries
- 2017
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Background: The manner in which organizational downsizing is implemented can make a substantial difference as to whether the exposed workers will suffer from psychological ill health. Surprisingly, little research has directly investigated this issue. We examined the likelihood of psychological ill health associated with strategic and reactive downsizing. Methods: A cross-sectional survey included 1456 respondents from France, Sweden, Hungary and the United Kingdom: 681 employees in stable workplaces (reference group) and 775 workers from downsized companies. Reactive downsizing was exemplified by the exposures to compulsory redundancies of medium to large scale resulting in job loss or surviving a layoff while staying employed in downsized organizations. The workforce exposed to strategic downsizing was represented by surplus employees who were internally redeployed and supported through their career change process within a policy context of no compulsory redundancy. Symptoms of anxiety, depression and emotional exhaustion were assessed in telephone interviews with brief subscales from Hospital Anxiety Scale (HADS-A), Hopkins Symptom Checklist (SCL-CD6) and Maslach Burnout Inventory (MBI-GS). Data were analyzed using logistic regression. Results: We observed no increased risk of psychological ill health in the case of strategic downsizing. The number of significant associations with psychological ill health was the largest for the large-scale reactive downsizing: surviving a layoff was consistently associated with all three outcome measures; returning to work after the job loss experience was related to anxiety and depression, while persons still unemployed at interview had elevated odds of anxiety. After reactive medium-scale downsizing, unemployment at interview was the only exposure associated with anxiety and depression. Conclusions: The manner in which organizational downsizing is implemented can be important for the psychological wellbeing of workers. If downsizing is unavoidable, it should be achieved strategically. Greater attention is needed to employment and health policies supporting the workers after reactive downsizing.
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| 5. |
- Aronsson, Gunnar, et al.
(författare)
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A systematic review including meta-analysis of work environment and burnout symptoms
- 2017
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Ingår i: Bmc Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 17:264
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Forskningsöversikt (refereegranskat)abstract
- Background: Practitioners and decision makers in the medical and insurance systems need knowledge on the relationship between work exposures and burnout. Many burnout studies -original as well as reviews-restricted their analyses to emotional exhaustion or did not report results on cynicism, personal accomplishment or global burnout. To meet this need we carried out this review and meta-analyses with the aim to provide systematically graded evidence for associations between working conditions and near-future development of burnout symptoms. Methods: A wide range of work exposure factors was screened. Inclusion criteria were: 1) Study performed in Europe, North America, Australia and New Zealand 1990-2013. 2) Prospective or comparable case control design. 3) Assessments of exposure (work) and outcome at baseline and at least once again during follow up 1-5 years later. Twenty-five articles met the predefined relevance and quality criteria. The GRADE-system with its 4-grade evidence scale was used. Results: Most of the 25 studies focused emotional exhaustion, fewer cynicism and still fewer personal accomplishment. Moderately strong evidence (grade 3) was concluded for the association between job control and reduced emotional exhaustion and between low workplace support and increased emotional exhaustion. Limited evidence (grade 2) was found for the associations between workplace justice, demands, high work load, low reward, low supervisor support, low co-worker support, job insecurity and change in emotional exhaustion. Cynicism was associated with most of these work factors. Reduced personal accomplishment was only associated with low reward. There were few prospective studies with sufficient quality on adverse chemical, biological and physical factors and burnout. Conclusion: While high levels of job support and workplace justice were protective for emotional exhaustion, high demands, low job control, high work load, low reward and job insecurity increased the risk for developing exhaustion. Our approach with a wide range of work exposure factors analysed in relation to the separate dimensions of burnout expanded the knowledge of associations, evidence as well as research needs. The potential of organizational interventions is illustrated by the findings that burnout symptoms are strongly influenced by structural factors such as job demands, support and the possibility to exert control.
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| 6. |
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| 7. |
- Bojner Horwitz, Eva, 1965-
(författare)
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Dance/Movement Therapy in Fibromyalgia Patients : Aspects and Consequences of Verbal, Visual and Hormonal Analyses
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis presents hormonal, emotional, physical and visual status changes in female fibromyalgia (FMS) patients after treatment with the Creative Art therapy; dance/movement therapy, compared to controls. FMS is a syndrome of chronic pain involving musculoskeletal aches, stiffness and pain where perturbations in the stress-axis and high scores on somatic anxiety and muscular tension also have been found. The study comprises thirty-six female FMS patients divided in treatment- and control group. Serum concentrations of the hormones prolactin, dehydroepiandrosterone sulphate (DHEA-S), cortisol and neuropeptide Y (NPY) in plasma and cortisol in saliva were analysed. Different verbal self-rating scales concerning well-being, pain, personality and life events among other things have been used. Assessments of the condition of the FMS patients affected by video-viewing were evaluated together with interviews about the self-perception phenomenon of video viewing (a phenomenological hermeneutic method). The results of the study show that six months of dance/movement therapy appears sufficient to improve both psychological and physical function, as indicated by the visual analyses. The video interpretation technique (VIT) and self-figure drawings captured treatment effects that were not evident from verbal scales or reflected in hormone levels. The biological markers probably need a longer treatment period to activate the HPA axis and its inter-related hormones and peptides. The use of different assessment techniques most likely has affected the treatment outcome. Difficulties perceiving information through verbal/cognitive modalities as well as alexithymia are factors discussed. The VIT may be useful for early identification of maladaptive movement patterns and as a mirror of facial and bodily expressions of emotions. In conclusion, this study indicates that both the dance/movement therapy and the VIT have had great influence on the FMS patient’s well-being, self-perception and perception of pain.
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| 8. |
- Bojner Horwitz, Eva, et al.
(författare)
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Dance/movement therapy in fibromyalgia patients : Changes in self-figure drawings and their relation to verbal self-rating scales
- 2006
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Ingår i: The arts in psychotherapy. - : Elsevier BV. - 0197-4556 .- 1873-5878. ; 33:1, s. 11-25
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Tidskriftsartikel (refereegranskat)abstract
- This study evaluates if verbally oriented scales are as effective as the visual instruments of self-figure drawing and video interpretation in detecting treatment responses after 6 months of dance/movement therapy in fibromyalgia patients.The self-figure drawing and video interpretation technique captured treatment effects that were not seen on verbal scales. In the self-figure drawings, significant differences were seen in the variables “amount of body details” and “amount of paper use in percent” between the treatment group and controls after dance/movement therapy. The treatment group showed a significant increase in the “amount of body details” and “amount of paper use in percent” compared to controls. Specific parts of the verbally oriented ratings in CPRS, “bodily discomfort” and “compulsive act,” were positively correlated to “number of different colours.” The variable “pain and ache” in the CPRS indicated a negative correlation to the “amount of paper use in percent,” i.e. the more pain, the less paper used.The use of different assessment techniques may affect the treatment outcome and verbal instrumentation may not be the most appropriate in this patient group. Difficulties perceiving information through verbal/cognitive modalities as well as alexithymia are factors that are discussed.
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