| 1. |
- Almroth, Melody
(författare)
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Adolescents’ future academic prospects : predictors and mental health outcomes
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In the context of a changing labor market and increasing demand for higher education, young people may face challenges and uncertainty about their futures. Sweden has also faced many changes to the education system, as well as decreasing trends in youth mental health, especially among girls. These factors may affect how young people perceive their futures, and how they envision their future academic prospects. While academic stress is generally perceived as negative, motivation and goal setting tend to correlate with better achievement and well-being. Academic expectations refer to how far people believe that they will go in school, while academic aspirations refer to how far people want to go in school. Less is known about how these perceived future academic prospects relate to mental health. Additionally, little is known about which modifiable factors may predict future academic prospects. This thesis aims to explore the relationship between future academic prospects and mental health among adolescents and to better understand the contextual and individual factors which predict the formation of adolescents’ future academic prospects. The studies included in this thesis are based on the KUPOL (a Swedish acronym for Knowledge about Young People’s Mental Health and Learning) cohort study. Adolescents (age 13 at baseline) answered questionnaires during three annual waves encompassing measures of their academic expectations, aspirations, and future goals, as well as their mental health, sense of identity, relationships with their parents, and academic achievement. Parents of the adolescents also answered questionnaires encompassing measures of their academic expectations and aspirations for their children as well as sociodemographic characteristics. School-level data were also collected at the schools that the adolescents attended using anonymous questionnaires measuring the pedagogical and social climate of the school given to teachers and 9th grade students. Adolescents future aspirations and goals at baseline were found to be associated with better mental health in terms of both internalizing and externalizing symptoms at one year follow up (study I). This relationship did not appear to differ according to gender. Similarly, parents’ expectations for their adolescent children to attend university, as well as the agreement of parents’ and children’s university expectations were associated with a decreased likelihood of the adolescent experiencing problematic externalizing symptoms (study II), though these associations were not found when considering internalizing symptoms. Furthermore, teacher-rated measures of the overall school climate, as well as the specific domains of academic and disciplinary expectations and support for students were associated with an increased likelihood of the adolescents aspiring to university (study III), but no such relationships were apparent when using the student report of the school climate measures. Finally, adolescents’ academic grades, engagement and parental engagement were associated with adolescents resolving their uncertainty in expectations between 7th and 9th grade, while academic grades, engagement, and parental expectations were associated with adolescents raising their expectations between 7th and 9th grade (study IV). Identity synthesis and mental health, however, were not associated with either of these outcomes. In light of these findings, it is important to find ways to encourage adolescent future prospects at the family and school level with the potential to improve their mental health.
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| 2. |
- Almroth, Melody, et al.
(författare)
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Job control, job demands and job strain and suicidal behaviour among three million workers in Sweden
- 2022
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Ingår i: Occupational and Environmental Medicine. - : BMJ. - 1351-0711 .- 1470-7926. ; 79:10, s. 681-689
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Tidskriftsartikel (refereegranskat)abstract
- Objective To investigate the association between job control, job demands and their combination (job strain) and suicide attempts and deaths among male and female workers in Sweden.Methods Job control and demands were measured separately for men and women using a job exposure matrix, which was linked to around three million individuals based on their occupational title in 2005. Suicide attempts and deaths were measured in the hospital and cause of death registers from 2006 to 2016. HRs were estimated using discrete proportional hazards models with annually updated age as the time axis. Models were adjusted for sociodemographic, family, health, labour market and childhood factors, as well as the time-varying effects of unemployment, sick leave and family factors during follow-up.Results Low job control was associated with an increased risk of suicide attempts and deaths among both men and women while high job demands tended to be associated with a decreased risk. The combination of job control and job demands (job strain) reflected the increased risk of low control jobs and the decreased risk of high demand jobs. Associations were attenuated but still present after adjustments.Conclusions Low job control is related to suicide attempts and deaths, and this is only partially explained by important covariates measured both prebaseline and during follow-up. Attempts to increase job control among workers may be beneficial in preventing suicide.
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| 3. |
- Almroth, Melody, 1989-, et al.
(författare)
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Labour market exit routes in high- and low-educated older workers before and after social insurance and retirement policy reforms in Sweden
- 2024
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Ingår i: Ageing & Society. - 0144-686X .- 1469-1779.
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Tidskriftsartikel (refereegranskat)abstract
- Few previous studies have investigated how socioeconomic differences in labour market exit have changed after restrictions in social insurance policies. The aim of this register-based study is to investigate how early labour market exit pathways among older men and women with different levels of education changed after major restrictive social insurance and retirement policy reforms in Sweden. Cohort 1 (pre-reform) consisted of individuals who were 60 or 61 years old in 2005 (N = 186,145) and Cohort 2 (post-reform) consisted of individuals who were 60 or 61 years old in 2012 (N = 176,216). Educational differences in four labour market exit pathways were investigated using Cox proportional hazards regression; the exit pathways were disability pension, early old-age pension with and without income respectively, and no income for two consecutive years. As expected, exits through disability pension were rarer in Cohort 2. Lower education was also more strongly associated with disability pension in Cohort 2. Parallel to this, lower education showed a stronger association with both early old-age pension types in Cohort 2. Additionally, a tendency towards a relatively higher likelihood of earning no income was seen among the less educated. Increases in inequalities tended to be greater for women. Our results indicate that educational inequalities in labour market exit have grown significantly after restrictions in social insurance and changes in retirement policies, which can have negative financial repercussions for those already in a vulnerable position. These results indicate that careful analyses of effects on disparities are needed before making major changes in welfare systems.
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| 4. |
- Almroth, Melody, et al.
(författare)
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Psychosocial workplace factors and alcohol-related morbidity : a prospective study of 3 million Swedish workers
- 2022
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Ingår i: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 32:3, s. 366-371
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Tidskriftsartikel (refereegranskat)abstract
- Background: Psychosocial workplace factors may be associated with alcohol-related morbidity, but previous studies have had limited opportunities to take non-occupational explanatory factors into account. The aim of this study is to investigate associations between job control, job demands and their combination (job strain) and diagnosed alcohol-related morbidity while accounting for several potentially confounding factors measured across the life-course, including education. Methods: Job control, job demands and job strain were measured using the Swedish job exposure matrix measuring psychosocial workload on the occupational level linked to over 3 million individuals based on their occupational titles in 2005 and followed up until 2016. Cox regression models were built to estimate associations with alcohol-related diagnoses recorded in patient registers. Results: Low job control was associated with an increased risk of alcohol-related morbidity, while high job demands tended to be associated with a decreased risk. Passive and high-strain jobs among men and passive jobs among women were also associated with an increased risk of alcohol diagnoses. However, all associations were found to be weakened in models adjusted for other factors measured prospectively over the life-course, especially in models that included level of education. Conclusion: The associations between low job control and high job demands, and the risk of alcohol-related morbidity reflect underlying socioeconomic differences to some extent. Lower job control, however, remained associated with a higher risk of alcohol-related morbidity.
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| 5. |
- Almroth, Melody, 1989-, et al.
(författare)
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The role of working conditions in educational differences in all-cause and ischemic heart disease mortality among Swedish men
- 2024
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Ingår i: Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 50:4, s. 300-309
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Tidskriftsartikel (refereegranskat)abstract
- Objectives This study aims to investigate the extent to which low job control and heavy physical workload in middle age explain educational differences in all-cause and ischemic heart disease (IHD) mortality while accounting for important confounding factors.Methods The study is based on a register-linked cohort of men who were conscripted into the Swedish military at around the age of 18 in 1969/1970 and were alive and registered in Sweden in 2005 (N=46 565). Cox proportional hazards regression models were built to estimate educational differences in all-cause and IHD mortality and the extent to which this was explained by physical workload and job control around age 55 by calculating the reduction in hazard ratio (HR) after adjustments. Indicators of health, health behavior, and other factors measured during conscription were accounted for.Results We found a clear educational gradient for all-cause and IHD mortality (HR 2.07 and 2.47, respectively, for the lowest compared to the highest education level). A substantial part was explained by the differential distribution of the confounding factors. However, work-related factors, especially high physical workload, also played important explanatory roles.Conclusion Even after accounting for earlier life factors, low job control and especially high physical workload seem to be important mechanistic factors in explaining educational inequalities in all-cause and IHD mortality. It is therefore important to find ways to reduce physical workload and increase job control in order to decrease inequalities in mortality.
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| 6. |
- Badarin, Kathryn, et al.
(författare)
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Combined exposure to heavy physical workload and low job control and the risk of disability pension : A cohort study of employed men and women in Sweden
- 2023
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Ingår i: International Archives of Occupational and Environmental Health. - 0340-0131 .- 1432-1246. ; 96:7, s. 973-984
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Tidskriftsartikel (refereegranskat)abstract
- Objective To investigate the separate and combined effects of overall heavy physical workload (PWL) and low decision authority on all-cause disability pension (DP) or musculoskeletal DP.Methods This study uses a sample of 1,804,242 Swedish workers aged 44–63 at the 2009 baseline. Job Exposure Matrices (JEMs) estimated exposure to PWL and decision authority. Mean JEM values were linked to occupational codes, then split into tertiles and combined. DP cases were taken from register data from 2010 to 2019. Cox regression models estimated sex-specific Hazard Ratios (HR) with 95% confidence intervals (95% CI). The Synergy Index (SI) estimated interaction effects.Results Heavy physical workload and low decision authority were associated with an increased risk of DP. Workers with combined exposure to heavy PWL and low decision authority often had greater risks of all-cause DP or musculoskeletal DP than when adding the effects of the single exposures. The results for the SI were above 1 for all-cause DP (men: SI 1.35 95%CI 1.18–1.55, women: SI 1.19 95%CI 1.05–1.35) and musculoskeletal disorder DP (men: SI 1.35 95%CI 1.08–1.69, women: 1.13 95%CI 0.85–1.49). After adjustment, the estimates for SI remained above 1 but were not statistically significant.Conclusion Heavy physical workload and low decision authority were separately associated with DP. The combination of heavy PWL and low decision authority was often associated with higher risks of DP than would be expected from adding the effects of the single exposures. Increasing decision authority among workers with heavy PWL could help reduce the risk of DP.
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| 7. |
- Berglund, Karin, et al.
(författare)
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The impact of cardiorespiratory fitness and physical workload on disability pension–a cohort study of Swedish men
- 2024
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Ingår i: International Archives of Occupational and Environmental Health. - 0340-0131 .- 1432-1246. ; 97:1, s. 45-55
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Tidskriftsartikel (refereegranskat)abstract
- Objective Understanding the impact of physical capacity in combination with high physical workload could be beneficial for the prevention of health-related exits from work. Therefore, the aim of this study was to investigate the separate and combined effects of low cardiorespiratory fitness and high physical workload on disability pension (DP) due to any cause, musculoskeletal disorders (MSD), and cardiovascular diseases (CVD).Methods A total of 279 353 men born between 1951 and 1961 were followed regarding DP between 2006 and 2020, ages 45–64. Cardiorespiratory fitness was assessed during military conscription, using an ergometer bicycle test. Physical workload was based on a job-exposure matrix (JEM) linked to occupational title in 2005. Cox regression models estimated separate and combined associations with DP.Results Low cardiorespiratory fitness and high physical workload were associated with increased risk of DP. For all cause DP, the fully adjusted hazard ratio and 95% confidence interval for those with low cardiorespiratory fitness was 1.38 (1.32–1.46) and for those with high physical workload 1.48 (1.39–1.57). For all cause and MSD DP, but not for CVD DP, the combination of low cardiorespiratory fitness and high physical workload resulted in higher risks than when adding the effect of the single exposures.Conclusion Both low cardiorespiratory fitness in youth and later exposure to high physical workload were associated with an increased risk of DP, where workers with the combination of both low cardiorespiratory fitness and a high physical workload had the highest risks (all-cause and MSD DP).
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| 8. |
- Chowdhury, Mohammad Rocky Khan, et al.
(författare)
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Prevalence and factors associated with severe undernutrition among under-5 children in Bangladesh, Pakistan, and Nepal: a comparative study using multilevel analysis
- 2023
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Ingår i: Scientific Reports. - : Springer Nature. - 2045-2322. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- Despite economic growth and poverty reduction, under-5 child undernutrition is still rampant in South Asian countries. This study explored the prevalence and risk factors of severe undernutrition among under-5 children in Bangladesh, Pakistan, and Nepal for comparison using the Composite Index of Severe Anthropometric Failure. We utilised information on under-5 children from recent Demographic Health Surveys. We used multilevel logistic regression models for data analysis. The prevalence of severe undernutrition among under-5 children was around 11.5%, 19.8%, and 12.6% in Bangladesh, Pakistan, and Nepal, respectively. Children from the lowest socioeconomic quintile, and children born with low birth weight were key factors associated with severe undernutrition in these countries. The factors, parental education, maternal nutritional status, antenatal and postnatal care, and birth order were not homogeneous in explaining the determinants of child severe undernutrition across the countries. Our results suggest that the poorest households, and low birth weight of children have significant effects on severe undernutrition among under-5 children in these countries, which should be considered to formulate an evidence-based strategy to reduce severe undernutrition in South Asia.
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| 9. |
- d'Errico, Angelo, et al.
(författare)
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Long-term sick leave for back pain, exposure to physical workload and psychosocial factors at work, and risk of disability and early-age retirement among aged Swedish workers
- 2022
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Ingår i: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 95:7, s. 1521-1535
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Tidskriftsartikel (refereegranskat)abstract
- Purpose To assess the risk of disability and early-age retirement associated with previous long-term sickness absence for back pain (back-pain SA), exposure to high physical workload, low job control, high demands and high strain, and to evaluate effect modification by work factors on the relationship between back-pain SA and premature retirement.Methods All employed Swedish residents born 1946–1955 (n = 835,956) were followed up from 2010 to 2016 for disability (DP) and early-age pension (EAP). Associations of premature retirement with exposure to work factors and back-pain SA in the 3 years before follow-up were estimated through proportional hazards models. Retirement, back-pain SA and covariates were assessed through administrative sources, and exposure to work factors through a job-exposure matrix.Results In both genders, back-pain SA was associated with DP (> 1 episode: HR 3.23 among men; HR 3.12 among women) and EAP (> 1 episode: HR 1.24 among men; HR 1.18 among women). Higher physical workload and lower job control were also associated with an increased DP risk in both genders, whereas higher job demands showed a decreased risk. For EAP, associations with work factors were weak and inconsistent across genders. No effect modification by work factors was found, except for a negative effect modification by job strain on DP risk among women, i.e. a reduced effect of back-pain SA with increasing exposure.Conclusion Back-pain SA was a significant predictor of both DP and EAP, while work factors were consistently associated only with DP. Our results indicate that the joint effect of back-pain SA and work factors on DP is additive and does not support effect modification by work factors.
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| 10. |
- Falkstedt, Daniel, et al.
(författare)
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Disability pensions related to heavy physical workload : a cohort study of middle-aged and older workers in Sweden
- 2021
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Ingår i: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 94, s. 1851-1861
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Tidskriftsartikel (refereegranskat)abstract
- Objectives The aim of the study was to examine the associations between heavy physical workload among middle-aged and older workers and disability pension due to any diagnosis, as well as musculoskeletal, psychiatric, cardiovascular or respiratory diagnoses. The population-based design made it possible to examine dose-response and potential gender differences in the associations. Methods About 1.8 million men and women aged 44-63 years and registered as living in Sweden in 2005 were followed regarding disability pension during 2006-2016, until ages 55-65 years. Mean values of physical workload and job control, estimated through gender-specific job-exposure matrices (JEMs), were assigned to individuals through their occupational titles in 2005. Exposure values were ranked separately for women and men and divided into quintiles. Associations were analyzed with Cox proportional-hazards regression. Results The analyses showed robust, dose-response associations between physical workload and disability pension with a musculoskeletal diagnosis in both genders: the adjusted hazard ratio and 95% confidence interval for those with the heaviest exposure was 2.58 (2.37-2.81) in women and 3.34 (2.83-3.94) in men. Dose-response associations were also seen in relation to disability pension with a cardiovascular or a respiratory diagnosis, though the hazard ratios were smaller. Physical workload was not associated with disability pension with a psychiatric diagnosis after adjustment for job control. Conclusion This study of the entire Swedish population of middle-aged and older workers suggests that higher degrees of physical workload may increase the risk of disability pension overall, and specifically with musculoskeletal, cardiovascular or respiratory diagnosis, in both women and men.
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