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| 2. |
- Berglind, Daniel, et al.
(författare)
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An eHealth program versus a standard care supervised health program and associated health outcomes in individuals with mobility disability : study protocol for a randomized controlled trial.
- 2018
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Ingår i: Trials. - : Springer Science and Business Media LLC. - 1745-6215. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Young adults with mobility disability (MD) are less likely to engage in regular physical activity (PA) compared with their able-bodied peers and inactive adults with a MD are more likely to report one or more chronic diseases compared to those who are physically active. Despite the vast amount of research published in the field of PA interventions over the past decades, little attention has been focused on interventions aiming to increase PA among individuals with MD. Thus, we propose to compare the effects of an eHealth program compared to a usual care supervised health program on levels of PA and other health behaviors.METHODS: The current intervention will use a randomized controlled trial (RCT) design with two treatment groups (an eHealth program and a usual care supervised health program) in young adults with newly acquired MD. In total, 110 young adults (aged 18-40 years) with a MD, acquired within the past 3 years, will be recruited to participate in a 12-week intervention. The primary study outcome is accelerometer-measured time spent in moderate to vigorous PA. Secondary outcomes includes health-related quality of life, depression, stress, fitness, body composition, diet, musculoskeletal pain, motivation to exercise and work ability.DISCUSSION: There is a lack of RCTs investigating effective ways to increase levels of PA in young adults with MD. Increased levels of PA among this physically inactive population have the potential to substantially improve health-related outcomes, possibly more so than in the general population. The trial will put strong emphasis on optimizing exercise adherence and investigating feasibility in the two treatment programs. The Ethical Review Board (EPN) at Karolinska Institutet has approved the study (2017/1206-31/1).TRIAL REGISTRATION: International Standard Randomised Controlled Trial Number (ISRCTN), reference number ISRCTN22387524 . Prospectively registered February 4, 2018.
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| 3. |
- Efverström, Anna, et al.
(författare)
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Anti-doping and legitimacy : an international survey of elite athletes’ perceptions
- 2016
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Ingår i: International Journal of Sport Policy. - : Informa UK Limited. - 1940-6940 .- 1940-6959. ; , s. 491-514
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Tidskriftsartikel (refereegranskat)abstract
- Anti-doping work is a comprehensive enterprise that entails control and governance of elite athletes’ everyday lives. However, in policy-making regarding doping and anti-doping in elite sports, the athletes’ perspective has not been considered adequately. Focusing on elite athletes’ perceptions of anti-doping as both principle and praxis, the study aimed to analyse how these perceptions can be understood from a legitimacy perspective. A survey study involving 261 elite athletes from 51 different countries and four international sports federations was conducted. The results showed that the athletes did not question the legitimacy of the rules, but had concerns about the legitimacy of the way the rules and principles are enforced in practice, specifically with regard to matters of privacy, lack of efficiency and equal conditions as well as athletes’ involvement in the anti-doping work. The article describes how athletes’ perceptions of the legitimacy of anti-doping work constitute the basis for their willingness to follow regulations as well as a precondition for the work’s functionality and stability. In light of this finding, the article calls for the empowerment of athletes in anti-doping work.
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| 4. |
- Efverström, Anna, et al.
(författare)
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Contexts and conditions for a level playing field : Elite athletes’ perspectives on anti-doping in practice
- 2016
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Ingår i: Performance Enhancement & Health. - : Elsevier BV. - 2211-2669. ; 5:2, s. 77-85
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Tidskriftsartikel (refereegranskat)abstract
- The implementation of global anti-doping regulations was intended to provide a level playing field for all athletes entering sports competitions. However, studies have shown that the worldwide harmonization of rules has not been entirely efficacious. For instance, great variation has been found in how anti-doping organizations implement anti-doping regulations, and it has also been shown that athletes distrust the equivalence of the worldwide rules as regards their effects. The purpose of the present article is to examine how elite athletes from different contexts experience anti-doping procedures and to analyse the legitimacy of anti-doping practice. In order to capture a variety of voices and perspectives, 13 elite athletes from five different continents and three international sports federations were interviewed. The analysis shows that when global anti-doping policy is implemented in different contexts and under different conditions, inequities and structural injustices emerge concerning infrastructure, knowledge and support at the individual athlete level. These consequences may have implications for the legitimacy of anti-doping work, because the existence of procedural justice may be called into questioned. We therefore suggest that anti-doping policy-making should be based on taking into account these different conditions and being aware of the perspectives that underpin regulations intended to be applied global.
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| 5. |
- Efverström, Anna, 1965-, et al.
(författare)
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Different socities, different conditions : Lessons from anti-doping in elite-sport on a global level
- 2017
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Ingår i: Doping in sport, doping in society - Lessons, themes and connections. - : Aarhus University, Department of Public Health. ; , s. 7-8
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Konferensbidrag (refereegranskat)abstract
- Justice and fairness in sport is fundamental for its legitimate existence. On a global level, the creation of the World Anti-Doping Agency and the regulatory framework World Anti-Doping Code was formed largely as a consequence of the need for a coordination of the work against performance enhancing drugs in sports. Today, the anti-doping system often means application of rules and "best practice" developed in the cultural West for the cultural rest. Research on anti-doping policy or practice not only tends to be based on deductive models, these models may also assumingly be culturally biased. Moreover, we have relatively little knowledge of the practical conditions for individual athletes concerning implementation of the rules in different contexts around the world. This presentation, however, adds to the existing research with new empirical findings from interview data on diverging conditions for elite athletes in different social, cultural and geographical contexts. Through exploring how 13 elite athletes from five continents and three different sports federations perceived the anti-doping programme, we were able to show that global anti-doping policy was implemented in different contexts under different conditions. These differences included infrastructure, knowledge and support. How participation in anti-doping procedures on an everyday basis is endorsed may thus vary around the world.By examining our interview data on the athletes’ perceptions and experiences in relation to theories of procedural justice, we were able to analyse the legitimacy of anti-doping in practice. These findings suggest that inequities and structural injustice emerge on an individual level because of the varying contexts and conditions. In turn, the consequences may have implications for the legitimacy of the anti-doping work. In order to understand implementation processes of regulations, we propose that anti-doping policy-making pay attention to differences that may exist on an individual and practical level. Perspectives that underpin regulations applied globally should in other words be sensitive to varying contexts and conditions.
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| 7. |
- Helgadóttir, Björg, et al.
(författare)
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The association between part-time and temporary employment and sickness absence : A prospective Swedish twin study
- 2019
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Ingår i: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 29:1, s. 147-153
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Tidskriftsartikel (refereegranskat)abstract
- Background: Sickness absence (SA) is becoming a major economic problem in many countries. Our aim was to investigate whether type of employment, including temporary employment or part-time employment, is associated with SA while controlling for familial factors (genetic and shared environment). Differences between men and women and across employment sectors were explored.Methods: This is a prospective twin study based on 21 105 twins born in Sweden 1959–85. The participants completed a survey in 2005 with follow-up of SA (≥15 days), using register data, until end of 2013. The data were analyzed with logistic regression, with results presented as odds ratios (OR) with 95% confidence intervals (CI).Results: Temporary employment involved higher odds of SA (OR=1.21 95% CI=1.04–1.40) compared to full-time employment. Both part-time workers (OR=0.84 95% CI=0.74–0.95) and the self-employed (OR=0.77 95%CI=0.62–0.94) had lower odds of SA. Stratifying by sex showed lower odds for part-timers (OR=0.82 95% CI=0.73–0.94) and self-employed women (OR=0.65 95% CI=0.47–0.90), but higher odds for men in temporary employment (OR=1.33 95% CI=1.03–1.72). Temporary employees in county councils (OR=1.73 95% CI=1.01–2.99) and municipalities (OR=1.41 95% CI=1.02–1.96) had higher odds while part-timers employed in the private sector had lower odds (OR=0.77 95% CI=0.64–0.93). Familial factors did not confound the association between employment type and SA.Conclusions: Employment type is associated with SA, with temporary employment involving a higher risk compared to permanent full-time employment while both part-time employment and self-employment involved a lower risk. The associations vary between women and men and across sectors.
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| 8. |
- Helgadóttir, Björg, et al.
(författare)
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The role of occupational class on the association between sickness absence and disability pension : A Swedish register-based twin study
- 2019
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Ingår i: Scandinavian Journal of Work, Environment and Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 45:6, s. 622-630
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Tidskriftsartikel (refereegranskat)abstract
- Objectives The aim of this study was to examine the association between long-term sickness absence (LTSA) due to mental disorders and musculoskeletal disorders and all-cause disability pension (DP) among blue- and white-collar workers. A secondary objective was to examine the influence of familial factors on the associations. Methods This was a prospective twin cohort study of 42 984 individuals (21-64 years at baseline), 3017 of whom had a new LTSA spell (>14 days) due to mental or musculoskeletal disorders in 2005-2006. Average follow-up time was 5.4 years. Survey data on occupational class and register data on LTSA and DP were used. Cox proportional hazards regression was applied to calculate hazards ratios (HR) with 95% confidence intervals (CI). Results During follow-up, 989 participants went on disability. LTSA due to mental disorders and musculoskeletal disorders led to similar HR for DP among both white- and blue-collar workers when compared to white-collar workers not on LTSA (reference group). LTSA >= 6 months due to musculoskeletal disorders was associated with a higher risk of DP for white-collar (HR 31.50, 95% CI 20.45-48.52) than blue-collar (HR 17.64, 95% CI 13.08-23.78) workers when compared to the reference group. HR were lower in the discordant twin pair models for LTSA due to mental disorders than in the whole cohort. Conclusions White-collar workers on LTSA due to musculoskeletal disorders are especially vulnerable to all-cause DP. This pattern was not present for LTSA due to mental disorders. Familial factors seem to influence the association between LTSA due to mental disorders and all-cause DP.
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| 9. |
- Qvarfordt, Anna, 1965-
(författare)
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Anti-doping – a legitimate effort? : Elite athletes' perspectives on policy and practice
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The global anti-doping enterprise in sport is a comprehensive system in which the athlete is at the centre of regulation, scrutiny and control. There is limited knowledge about the implications of this extensive control system for athletes and about how athletes perceive the system; little is known about possible consequences of these implications and perceptions for the legitimacy of the system. The overall aim of this thesis is to analyse the legitimacy of global anti-doping policy and practice from the perspectives of international elite athletes.Four articles are included in this compilation thesis. The first illustrates, based on a discourse analytical approach, how claims for legitimacy of the anti-doping system are produced in policy documents aimed at athletes. The second explores the perceptions and legitimacy of anti-doping policy and practice through a survey aimed at elite athletes in different sports and from different regions of the world. The third article examines, through an interview study, how athletes in different contexts experience the practice of anti-doping and what consequences this may have for the system's legitimacy. The interview study was also the basis for the fourth article, focusing on the athletes' experiences and perceptions of their opportunities for compliance and how this is related to their view of the system's legitimacy. Using the four articles as a basis, the analysis of legitimacy within the anti-doping system is expanded in the thesis through an overarching analytical framework inspired by David Beetham.The results show that the legitimacy of the policy documents is based on essentially authoritative, but also rational, arguments for justifying the anti-doping enterprise. Elite athletes are generally in favour of anti-doping policy and the principle that doping should be prohibited. However, when the rules are implemented into practice, problems to do with lack of procedural justice arise which may have an impact on the system's legitimacy. Procedures in the system are perceived as having a negative effect on sportspersons' private life, and as ineffective and unequally implemented across the world; also, athletes have little influence over decision-making processes. Anti-doping practice is moreover perceived to cause structural inequalities due to inequality in access to technology, education and knowledge as well as supportive systems. Most athletes wish to comply with the rules, but many struggle with lack of control and have limited scope for taking responsibility regarding compliance with the doping rules. Even when athletes are dutiful and perform acts that confer legitimacy to the rules and the authorities, some experiences and perceptions could endanger the legitimacy of antidoping, as seen in the overall legitimacy analysis of the thesis. Athletes' perceptions of inequality, ineffectiveness and lack of leeway can be interpreted as a lack of rule conformity to the anti-doping authority. There also appears to be a lack of shared normative beliefs between sportspersons and the anti-doping authorities, as many athletes feel that their opinions are not taken into account. Decision-making processes that do not pay attention to the perceptions of those involved can result in a discrepancy between the rules and the norms.The international anti-doping system is a major international enterprise with comprehensive rules that need to be applied equally around the world, and that also need to be legitimated in different countries where athletes have different conditions to comply with the regulations. In this thesis, I have shown that these different conditions have consequences for the ability to comply with the rules and also for the application of the regulations. The far-reaching rules mean that procedures within the system are experienced as causing a number of negative consequences. I have shown that this poses a risk to the legitimacy of the system if these problems are not addressed.
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| 10. |
- Svedberg, Pia, et al.
(författare)
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Time pressure and sleep problems due to thoughts about work as risk factors for future sickness absence
- 2018
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Ingår i: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 91:8, s. 1051-1059
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: This study investigated whether time pressure or sleep problems due to thoughts about work are associated with future sickness absence (SA) among women and men employed in different sectors, also when adjusting for confounders including familial factors (genetics and shared environment).METHODS: The study sample included 16,127 twin individuals (52% women), aged 19-47 years who in 2005 participated in an online survey including questions regarding time pressure, sleep, work and health. Register data on SA (> 14 days) were obtained from the National Social Insurance Agency and individuals were followed from date of survey response until 12/31/2013. Associations between time pressure, sleep problems due to thoughts about work and future SA were investigated using logistic regression analyses to assess odds ratios (OR) with 95% confidence intervals (CI).RESULTS: In total 5723 (35%) individuals had an incident SA spell during follow-up. Sleep problems due to thoughts about work were associated with SA in the fully adjusted model (OR 1.22, CI 1.10-1.36). Stratified by sector, the highest estimate was found for state employees (OR 1.54, CI 1.11-2.13). Familial factors did not seem to influence the associations. We found no statistically significant associations between time pressure and SA. No sex differences were found.CONCLUSIONS: Results indicated that sleep problems due to thoughts about work is a risk factor for future SA. This follows previous research showing that sleep length and sleep disturbances, regardless of reason, are associated with SA. But, experiences of work-related time pressure seem to have no effect on SA.
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