| 1. |
- Bendtsen, Preben, et al.
(författare)
-
Implementing referral to an electronic alcohol brief advice website in primary healthcare: results from the ODHIN implementation trial
- 2016
-
Ingår i: BMJ Open. - : BMJ PUBLISHING GROUP. - 2044-6055. ; 6:6
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives The objective of the present study was to explore whether the possibility of offering facilitated access to an alcohol electronic brief intervention (eBI) instead of delivering brief face-to-face advice increased the proportion of consulting adults who were screened and given brief advice. Design The study was a 12-week implementation study. Sixty primary healthcare units (PHCUs) in 5 jurisdictions (Catalonia, England, the Netherlands, Poland and Sweden) were asked to screen adults who attended the PHCU for risky drinking. Setting A total of 120 primary healthcare centres from 5 jurisdictions in Europe. Participants 746 individual providers (general practitioners, nurses or other professionals) participated in the study. Primary outcome Change in the proportion of patients screened and referred to eBI comparing a baseline 4-week preimplementation period with a 12-week implementation period. Results The possibility of referring patients to the eBI was not found to be associated with any increase in the proportion of patients screened. However, it was associated with an increase in the proportion of screen-positive patients receiving brief advice from 70% to 80% for the screen-positive sample as a whole (pamp;lt;0.05), mainly driven by a significant increase in brief intervention rates in England from 87% to 96% (pamp;lt;0.01). The study indicated that staff displayed a low level of engagement in this new technology. Staff continued to offer face-to-face advice to a larger proportion of patients (54%) than referral to eBI (38%). In addition, low engagement was seen among the referred patients; on average, 18% of the patients logged on to the website with a mean log-on rate across the different countries between 0.58% and 36.95%. Conclusions Referral to eBI takes nearly as much time as brief oral advice and might require more introduction and training before staff are comfortable with referring to eBI.
|
|
| 2. |
- Bendtsen, Preben, et al.
(författare)
-
Online Alcohol Assessment and Feedback for Hazardous and Harmful Drinkers: Findings From the AMADEUS-2 Randomized Controlled Trial of Routine Practice in Swedish Universities
- 2015
-
Ingår i: Journal of Medical Internet Research. - : Journal of Medical Internet Research / JMIR Publications. - 1438-8871. ; 17:7, s. e170-
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Previous research on the effectiveness of online alcohol interventions for college students has shown mixed results. Small benefits have been found in some studies and because online interventions are inexpensive and possible to implement on a large scale, there is a need for further study. Objective: This study evaluated the effectiveness of national provision of a brief online alcohol intervention for students in Sweden. Methods: Risky drinkers at 9 colleges and universities in Sweden were invited by mail and identified using a single screening question. These students (N=1605) gave consent and were randomized into a 2-arm parallel group randomized controlled trial consisting of immediate or delayed access to a fully automated online assessment and intervention with personalized feedback. Results: After 2 months, there was no strong evidence of effectiveness with no statistically significant differences in the planned analyses, although there were some indication of possible benefit in sensitivity analyses suggesting an intervention effect of a 10% reduction (95% CI -30% to 10%) in total weekly alcohol consumption. Also, differences in effect sizes between universities were seen with participants from a major university (n=365) reducing their weekly alcohol consumption by 14% (95% CI -23% to -4%). However, lower recruitment than planned and differential attrition in the intervention and control group (49% vs 68%) complicated interpretation of the outcome data. Conclusions: Any effects of current national provision are likely to be small and further research and development work is
|
|
| 3. |
- Bendtsen, Preben, et al.
(författare)
-
Professional's Attitudes Do Not Influence Screening and Brief Interventions Rates for Hazardous and Harmful Drinkers: Results from ODHIN Study
- 2015
-
Ingår i: Alcohol and Alcoholism. - : Oxford University Press (OUP). - 0735-0414 .- 1464-3502. ; 50:4, s. 430-437
-
Tidskriftsartikel (refereegranskat)abstract
- To determine the relation between existing levels of alcohol screening and brief intervention rates in five European jurisdictions and role security and therapeutic commitment by the participating primary healthcare professionals. Health care professionals consisting of, 409 GPs, 282 nurses and 55 other staff including psychologists, social workers and nurse aids from 120 primary health care centres participated in a cross-sectional 4-week survey. The participants registered all screening and brief intervention activities as part of their normal routine. The participants also completed the Shortened Alcohol and Alcohol Problems Perception Questionnaire (SAAPPQ), which measure role security and therapeutic commitment. The only significant but small relationship was found between role security and screening rate in a multilevel logistic regression analysis adjusted for occupation of the provider, number of eligible patients and the random effects of jurisdictions and primary health care units (PHCU). No significant relationship was found between role security and brief intervention rate nor between therapeutic commitment and screening rate/brief intervention rate. The proportion of patients screened varied across jurisdictions between 2 and 10%. The findings show that the studied factors (role security and therapeutic commitment) are not of great importance for alcohol screening and BI rates. Given the fact that screening and brief intervention implementation rate has not changed much in the last decade in spite of increased policy emphasis, training initiatives and more research being published, this raises a question about what else is needed to enhance implementation.
|
|
| 4. |
- Ekberg, Kerstin, 1948-, et al.
(författare)
-
Arbetsgivares kostnader, åtgärder och anpassningar för sjuknärvarande och sjukfrånvarande medarbetare : samband med återgång i arbete och produktion
- 2017
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Studien syftade till att undersöka vilka åtgärder arbetsgivare gör för sjukskrivna medarbetare och vilka kostnader arbetsgivare och samhället har i samband med sjuknärvaro och sjukfrånvaro.Totalt 3000 sjukskrivna personer i AFA Försäkrings register med diagnoserna psykiska besvär eller besvär i rörelseorganen fick ett informationsbrev och förfrågan om samtycke till att forskarna skulle få skicka en enkät till deras arbetsledare; 393 sjukskrivna gav samtycke. En webbenkät skickades till dessa arbetsledare. Totalt 198 arbetsledare (50 %) till sjukskrivna personer besvarade enkäten.Resultaten visar att arbetsgivare genomför en rad olika åtgärder och anpassningar när en medarbetare blir sjukskriven. Analyserna visade att dessa åtgärder och anpassningar i viss mån beror på vem den sjukskrivne medarbetaren är. Åtgärder och anpassningar var vanligare för sjukskrivna med psykiska diagnoser, för högutbildade och för sjukskrivna i högkvalificerade yrken. Kvinnor fick i högre grad anpassningar och åtgärder såsom ändrade arbetsuppgifter och psykosocialt stöd jämfört med män.Demografiska faktorer visade sig ha mindre betydelse för om den sjukskrivne återgick i arbete eller ej. Multipla logistiska regressionsanalyser visade att åtgärder och anpassningar på arbetsplatsen hade signifikanta samband med en ökad chans för återgång i arbete. Resultaten visade också att för sjukskrivna medarbetare vars arbetsledare hade tagit många kontakter med andra aktörer, som HR-avdelningen, företagshälsan och/eller Försäkringskassan var sannolikheten lägre att den sjukskrivne medarbetaren återgick i arbete. Arbetsledare tog fler kontakter, om den sjukskrivne medarbetaren hade en psykisk diagnos.Sjuknärvaro och produktionsförlust före, under och efter sjukskrivningen skattades av arbetsledarna. Sammanlagt beräknades produktionsförlusterna till cirka SEK 100 000 per sjukskrivningsfall. Härutöver lägger arbetsgivare tid på att ta kontakter, genomföra åtgärder och anpassningar och organisera om arbetet. Arbetsledare hade mycket oklar eller saknade helt uppfattning om vad tid, åtgärder och anpassningar kostar, varför detta inte har kunnat analyseras närmare. De beräknade genomsnittliga kostnaderna till följd av produktivitetsförluster är således en underskattning av de faktiska kostnaderna för arbetsgivare.Studien visar att arbetsledares kunskap om vad sjuknärvaro och sjukfrånvaro kostar för verksamheten och för samhället är begränsad. En ökad kostnadsmedvetenhet skulle kunna stimulera till att större resurser läggs på att implementera policys för hälsofrämjande åtgärder och att utbilda arbetsledare i att hantera frågor om hälsa och arbetsförmåga på arbetsplatsen.
|
|
| 5. |
- Fagerlind Ståhl, Anna-Carin, et al.
(författare)
-
Associations between organisation of work, work conditions, work-relatedf low and performance: a multilevel analysis
- 2015
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this study is to investigate how organisation of work in terms of sociotechnical characteristics and use of tools inspired by lean production, and psychosocial conditions at the workplace, are associated with work-related flow and performance.A questionnaire including questions concerning work organisation, psychosocial work conditions, work-related flow and self-rated performance was sent to employees in ten Swedish organisations; 4442 people (56%) responded. Multilevel logistic regression analyses were used in order to investigate organisation of work and work conditions in relation to work-related flow and performance. In addition, the association between work-related flow and performance was investigated.Our results show that a high degree of lean tool use in combination with a low degree of sociotechnical characteristics was negatively associated with work-related flow but positively associated with performance. When decision latitude, social capital, and innovative learning climate were included in the model, the association was no longer significant in relation to work-related flow, but remained and was strengthen in relation to performance. Work-related flow had a positive association with performance.The conclusion is that work-related flow and work conditions that enable individual and collective skill use are important for increased performance. When lean tools are used to a high degree, good decision latitude, social capital and innovative learning climate buffer negative effects on health, and increase performance.
|
|
| 6. |
- Fagerlind Ståhl, Anna-Carin, et al.
(författare)
-
Lean production tools and decision latitude enable conditions for innovative learning in organizations : a multilevel analysis
- 2015
-
Ingår i: Applied Ergonomics. - : Elsevier. - 0003-6870 .- 1872-9126. ; 47, s. 285-291
-
Tidskriftsartikel (refereegranskat)abstract
- The effect of lean production on conditions for learning is debated. This study aimed to investigate how tools inspired by lean production (standardization, resource reduction, visual monitoring, housekeeping, value flow analysis) were associated with an innovative learning climate and with collective dispersion of ideas in organizations, and whether decision latitude contributed to these associations. A questionnaire was sent out to employees in public, private, production and service organizations (n = 4442). Multilevel linear regression analyses were used. Use of lean tools and decision latitude were positively associated with an innovative learning climate and collective dispersion of ideas. A low degree of decision latitude was a modifier in the association to collective dispersion of ideas. Lean tools can enable shared understanding and collective spreading of ideas, needed for the development of work processes, especially when decision latitude is low. Value flow analysis played a pivotal role in the associations.
|
|
| 7. |
- Fagerlind Ståhl, Anna-Carin, et al.
(författare)
-
The effect of lean tool use and work conditions on employee health : a longitudinal multilevel study
- 2015
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: Although lean production is an increasingly common approach to increase the efficiency of organisations, its effect on employee health is not clear. This longitudinal study investigates the effect of lean tool use and work conditions on work-related flow. Flow is a measure of health that reflects the experience of intrinsic motivation, absorption and work enjoyment.Methods: A questionnaire was sent to employees in seven organisations on two occasions with an interval of two years (n =1722). Multilevel linear regression analyses were used in order to investigate the association between the use of lean tools (i.e. standardisation, value stream mapping, visual monitoring, housekeeping and resource reduction), decision latitude, social capital, and innovative learning climate at baseline, and work-related flow at follow-up.Results: In multivariate analyses, adjusted for flow at baseline, use of lean tools was positively associated with work-related flow at follow-up. When the tools were investigated separately, only value stream mapping remained significant after adjustment for work conditions and flow at baseline. Social capital and decision latitude were positively associated with flow at follow-up. Flow at baseline and follow-up were strongly associated.Conclusions: The extent to which lean tool use has an effect on employee health depends on which tools are used. Work conditions that support learning, such as decision latitude and social capital, are associated with a longitudinal increase in the experience of work-related flow, and are important for gaining health-promoting benefits from the use of lean tools.
|
|
| 8. |
|
|
| 9. |
- Jood, Katarina, 1966, et al.
(författare)
-
The psychosocial work environment is associated with risk of stroke at working age
- 2017
-
Ingår i: Scandinavian Journal of Work Environment & Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 43:4, s. 367-374
-
Tidskriftsartikel (refereegranskat)abstract
- Objective The aim of this study was to explore the relation between the risk of first-ever stroke at working age and psychological work environmental factors. Methods A consecutive multicenter matched 1:2 case control study of acute stroke cases (N=198, age 30-65 years) who had been working full-time at the time of their stroke and 396 sex- and age-matched controls. Stroke cases and controls answered questionnaires on their psychosocial situation during the previous 12 months. The psychosocial work environment was assessed using three different measures: the job control demand model, the effort reward imbalance (ERI) score, and exposures to conflict at work. Results Among 198 stroke cases and 396 controls, job strain [odds ratio (OR) 1.30, 95% confidence interval (95% CI) 1.05-1.62], ERI (OR 1.28, 95% CI 1.01-1.62), and conflict at work (OR 1.75, 95% CI 1.07-2.88) were independent risk factors of stroke in multivariable regression models. Conclusions Adverse psychosocial working conditions during the past 12 months were more frequently observed among stroke cases. Since these factors are presumably modifiable, interventional studies targeting job strain and emotional work environment are warranted.
|
|
| 10. |
- Karlsson, Jon, 1984-, et al.
(författare)
-
Tracing modern environmental conditions to their roots in early mining, metallurgy, and settlement in Gladhammar, southeast Sweden : Vegetation and pollution history outside the traditional Bergslagen mining region
- 2015
-
Ingår i: The Holocene. - : Sage Publications. - 0959-6836 .- 1477-0911. ; 25:6, s. 944-955
-
Tidskriftsartikel (refereegranskat)abstract
- We present results from a multidisciplinary project using lake sediment as a natural archive in combination with archaeology to investigate the earliest history of the Gladhammar mining area, southeastern Sweden. The aim was to identify and trace human impacts on the landscape, specifically in connection with settlement and metal production. Sediment records from two lakes linked to different processes in metal production were analyzed; Tjursbosjon down-slope of the mining area and Hyttegol situated downstream of an excavated blast furnace, 1.8km from the mines. The sediment analyses included multi-element geochemistry (WD-XRF), stable lead isotopes, pollen, and charcoal. Although historical documents record activities beginning in AD 1526, the archaeological study found indications that mining and metal production likely predated this period. The known historical period is well reflected in the sediment records, such as a 500-fold increase in copper, stream erosion, loss of forest cover and an expansion in agriculture. More importantly, already in the 12th-13th centuries, there was a 2- to 10-fold increase in lead, copper, and charcoal particles and evidence of erosion linked to the establishment of a blast furnace. Lead isotopes reveal a change from natural conditions to an input of lead from regional ores as early as the 9th-10th centuries. Settlement in the form of agriculture can be seen from 2000 BP. This sediment evidence of early mining or metallurgy during the 9th-15th centuries is supported by a few radiocarbon dates from the excavated mining fields, which on their own were considered as vague or improbable outliers by archaeologists.
|
|
