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  • 1. Augustsson, Hanna
    et al.
    von Thiele Schwarz, Ulrica
    Stockholm University, Faculty of Social Sciences, Department of Psychology. Karolinska Institutet, Sweden.
    Stenfors-Hayes, Terese
    Hasson, Henna
    Investigating Variations in Implementation Fidelity of an Organizational-Level Occupational Health Intervention2015In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 22, no 3, p. 345-355Article in journal (Refereed)
    Abstract [en]

    The workplace has been suggested as an important arena for health promotion, but little is known about how the organizational setting influences the implementation of interventions. The aims of this study are to evaluate implementation fidelity in an organizational-level occupational health intervention and to investigate possible explanations for variations in fidelity between intervention units. The intervention consisted of an integration of health promotion, occupational health and safety, and a system for continuous improvements (Kaizen) and was conducted in a quasi-experimental design at a Swedish hospital. Implementation fidelity was evaluated with the Conceptual Framework for Implementation Fidelity and implementation factors used to investigate variations in fidelity with the Framework for Evaluating Organizational-level Interventions. A multi-method approach including interviews, Kaizen notes, and questionnaires was applied. Implementation fidelity differed between units even though the intervention was introduced and supported in the same way. Important differences in all elements proposed in the model for evaluating organizational-level interventions, i.e., context, intervention, and mental models, were found to explain the differences in fidelity. Implementation strategies may need to be adapted depending on the local context. Implementation fidelity, as well as pre-intervention implementation elements, is likely to affect the implementation success and needs to be assessed in intervention research. The high variation in fidelity across the units indicates the need for adjustments to the type of designs used to assess the effects of interventions. Thus, rather than using designs that aim to control variation, it may be necessary to use those that aim at exploring and explaining variation, such as adapted study designs.

  • 2. Dekker, Joost
    et al.
    Bai, Bo
    Oldenburg, Brian
    Qiu, Chengxuan
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Zhong, Xuefeng
    Behavioral medicine in China2014In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 21, no 4, p. 571-573Article in journal (Other academic)
  • 3.
    Folkesson, Lisa
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Östberg, V.
    Lindfors, Petra
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Self-esteem and stress as associated with diurnal profiles of salivary alpha-amylase and cortisol in mid-adolescents2014In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 21, no 1 (Suppl.), p. S116-Article in journal (Other academic)
    Abstract [en]

    Salivary cortisol and alpha-amylase (sAA) that reflect hypothalamopituitary-adrenal axis (HPA-axis) activity and sympathetic activity within the autonomic nervous system (ANS) respectively, are biomarkers with pronounced diurnal rhythms. While research on salivary cortisol is increasing, little is known about the diurnal rhythm of salivary alphaamylase, particularly in adolescents. Also, the linkages between individual factors and self-reports of stress as related to HPA-axis activity and autonomic/sympathetic functioning remain to be investigated. This study set out to investigate diurnal rhythms of salivary cortisol and alpha-amylase in 14-16 year-old girls and boys. Moreover, the study investigated whether stress and self-esteem are related to aggregate salivary cortisol and alpha-amylase measures. Besides self-reports in questionnaires, self-administered salivary samples were collected from 47 girls and 23 boys during a school day. Results showed girls had higher levels of morning cortisol than did boys, while there were no differences in morning or diurnal sAA. Additionally, self-esteem and self-reported stress were associated with different measures of cortisol and sAA but for girls only. Taken together, the findings suggest that both self-reported stress and self-esteem are linked to various aspects of sympathetic ANS activity and HPA-axis activity, particularly among mid-adolescent girls.

  • 4.
    Fransson, Emma
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Folkesson, Lisa
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Bergström, Malin
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Östberg, Viveca
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Lindfors, Petra
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Exploring salivary cortisol and recurrent pain in mid-adolescents living in two homes2014In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 21, p. S23-S23Article in journal (Refereed)
    Abstract [en]

    Introduction: Every year, around 50.000 children in Sweden experience a separation between their parents. Joint physical custody (JPC), where the child alternates homes between the parents for about equal amount of time, has become a common living arrangement after parental separation. Children living in two homes can benefit from everyday contact with both parents and access to both parents’ financial resources. However, children can also experience stress from constantly moving and from exposure to any parental conflict. Yet, research on JPC and stress-related biological functioning is limited. The aimof this study was to investigate how living arrangements (intact family/JPC) relate toHPA-axis activity and recurrent pain in mid-adolescents. Methods: Mid-adolescents (106 girls and 51 boys) provided demographic details, self-reports of recurrent pain (headache, stomachache, neck/shoulder and back pain) and salivary samples. Salivary cortisol samples were collected: 1) immediately at awakening, 2) +30 minutes, 3) +60 minutes, and 4) at 8 p.m. Results: Hierarchical regressions showed that living arrangements did not predict morning cortisol levels, the diurnal cortisol rhythm nor recurrent pain. However, sex was significantly associated with both morning cortisol and recurrent pain. Conclusion: Living arrangements were not linked to HPA-axis activity or recurrent pain in this group of well-functioning mid-adolescents. Although this is the first study investigating how living arrangements relate to HPA-axis functioning, which means that additional research is needed, the findings suggest that these mid-adolescents have adapted to their living arrangements and that other factors seem more pertinent for HPA-functioning and subjective health complaints.

  • 5. Gustafsson, Klas
    et al.
    Aronsson, Gunnar
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Marklund, Staffan
    Wikman, Anders
    Hagman, Maud
    Floderus, Birgitta
    Social integration, Socioeconomic Conditions and Type of ill Health Preceding Disability Pension in Young Women: a Swedish Population Based Study2014In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 21, no 1, p. 77-87Article in journal (Refereed)
    Abstract [en]

    Background: Disability pension has increased in recent decades and is seen as a public health and socioeconomic problem in Western Europe. In the Nordic countries, the increase has been particularly steep among young women.

    Purpose: The aim was to analyze the influence of low social integration, socioeconomic risk conditions and different measures of self-reported ill health on the risk of receiving disability pension in young women.

    Method: The study comprised all Swedish women born in 1960 to 1979, who had been interviewed in any of the annual Swedish Surveys of Living Conditions (1990–2002). The assumed predictors were related to disability pension by Cox proportional hazard regression. The mean number of years of follow-up for the 10,936 women was 7 years (SD 3.8), and the study base was restricted to the ages 16 to 43 years of age.

    Results: An increased risk of receiving a disability pension was found among lone women, those who had sparse contacts with others, job-seeking women, homemakers, as well as women with low education, and poor private financial situations. A tenfold increase in the risk of receiving a disability pension was found among women reporting a long-standing illness and poor self-rated health, compared to women without a long-standing illness and good self-rated health. Psychiatric diagnoses and symptoms/unspecified illness were the strongest predictors of disability pension, particularly before 30 years of age.

    Conclusion: The study suggests that weak social relations and weak connections to working life contribute to increase the risk of disability pension in young women, also after control for socioeconomic conditions and self-reported ill health. Self-rated health was the strongest predictor, followed by long-standing illness and not having a job (job seekers and homemakers).

  • 6.
    Härter Griep, Rosane
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Oswaldo Cruz Foundation, Brazil.
    Toivanen, Susanna
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    van Diepen, Cornelia
    Guimarães, Johanna M. N.
    Camelo, Lidyane V.
    Lopes Juvanhol, Leidjaira
    Aquino, Estela M.
    Chor, Dóra
    Work–family conflict and self-rated health: the role of gender and educational level. Baseline data from the Brazilian longitudinal study of adult health (ELSA-Brasil)2016In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 23, no 3, p. 372-382Article in journal (Refereed)
    Abstract [en]

    Purpose

    This study examined gender differences in the association between work–family conflict and self-rated health and evaluated the effect of educational attainment.

    Method

    We used baseline data from ELSA-Brasil, a cohort study of civil servants from six Brazilian state capitals. Our samples included 12,017 active workers aged 34–72 years. Work–family conflict was measured by four indicators measuring effects of work on family, effects of family in work and lack of time for leisure and personal care.

    Results

    Women experienced more frequent work–family conflict, but in both genders, increased work–family conflict directly correlated with poorer self-rated health. Women’s educational level interacted with three work–family conflict indicators. For time-based effects of work on family, highly educated women had higher odds of suboptimal self-rated health (OR = 1.54; 95 % CI = 1.19–1.99) than less educated women (OR = 1.14; 95 % CI = 0.92–1.42). For strain-based effects of work on family, women with higher and lower education levels had OR = 1.91 (95 % CI 1.48–2.47) and OR = 1.40 (95 % CI 1.12–1.75), respectively. For lack of time for leisure and personal care, women with higher and lower education levels had OR = 2.60 (95 % CI = 1.95–3.47) and OR = 1.11 (95 % CI = 0.90–1.38), respectively.

    Conclusion

    Women’s education level affects the relationship between work–family conflict and self-rated health. The results may contribute to prevention activities.

  • 7.
    Leineweber, Constanze
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Radboud University, The Netherlands.
    Lindfors, Petra
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Change in Work-Time Control and Work-Home Interference Among Swedish Working Men and Women: Findings from the SLOSH Cohort Study2016In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 23, no 6, p. 670-678Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The aim is to study the influence of change in work-time control (WTC) on work-home interference (WHI) while adjusting for other work-related factors, demographics, changes at work and WHI at baseline among women and men. An additional aim was to explore sex differences in the relation between change in WTC and WHI.

    METHODS: The study included working participants of the Swedish Longitudinal Occupational Survey of Health (SLOSH) study of the third (2010) and fourth (2012) waves (n = 5440). Based on a seven-item index, four groups of WTC were formed: stable high (40 %), stable low (42 %), increasing (9 %), or decreasing (9 %) WTC over the 2 years. WHI was measured by four items and individuals were categorised in whether suffering or not suffering of WHI. Sex-stratified logistic regression analyses with 95 % confidence intervals (CI) were used to estimate the odds of experiencing WHI by change in WTC.

    RESULTS: Controlling for demographics and work-related factors, women with stable low (OR = 1.46; 95 % CI 1.14-1.88) and women and men with decreasing WTC (women OR = 1.99; 95 % CI 1.38-2.85; men OR = 1.80; 95 % CI 1.18-2.73) had higher odds of WHI than those with a stable high WTC. Additionally, adjusting for changes at work and WHI at baseline did not alter the results substantially. Interaction analysis did not reveal any significant sex difference in the relation between WTC and WHI.

    CONCLUSIONS: For both women and men decreased and for women only, low control over working hours resulted in WHI also after adjusting for work-related factors and demographics.

  • 8.
    Liang, Yajun
    et al.
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI). Jining Medical University, People's Republic of China .
    Yan, Zhongrui
    Cai, Chuanzhu
    Jiang, Hui
    Song, Aiqin
    Qiu, Chengxuan
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Association Between Lipid Profile and Depressive Symptoms Among Chinese Older People: Mediation by Cardiovascular Diseases?2014In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 21, no 4, p. 590-596Article in journal (Refereed)
    Abstract [en]

    The potential mediating effect of cardiovascular diseases (CVDs) (e.g., ischemic heart disease and stroke) on the association between abnormal serum lipids and late-life depressive symptoms has not been investigated. We aimed to examine the associations between serum lipids and elevated depressive symptoms among older Chinese people and to determine the extent to which CVDs mediate their associations. This cross-sectional study included 1,529 participants (age a parts per thousand yen60 years, 59.2 % women) in the Confucius Hometown Aging Project. In June 2010-July 2011, data were collected through an interview, clinical examinations, and laboratory tests. Abnormal serum lipids were defined according to international criteria and use of hypolipidemic drugs. Presence of elevated depressive symptoms was defined as the 15-item Geriatric Depression Scale score a parts per thousand yen5. Data were analyzed with logistic and mediation models controlling for potential confounders. The prevalence of depressive symptoms was 20.3 %. Depressive symptomatology was significantly associated with high total cholesterol, high triglycerides, low high-density lipoprotein cholesterol (HDL-C), high low-density lipoprotein cholesterol (LDL-C), and dyslipidemia (p < 0.05). The mediating effects on the associations of serum lipids with depressive symptoms were statistically significant for ischemic heart disease and stroke with the proportion of mediating effects over the total effects ranging 4.7-7.0 % and 7.3-12.1 %, respectively. Elevated depressive symptoms are associated with lipid profile characterized by high cholesterol, high triglycerides, low HDL-C, high LDL-C, and dyslipidemia; the associations are partially mediated by ischemic heart disease and stroke. These findings imply that unfavorable lipid profile may be involved in late-life depressive symptoms independent of atherosclerotic disorders.

  • 9.
    Lindfors, Petra
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Folkesson, Lisa
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Östberg, Viveca
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Linking self-reported stress to aggregate cortisol measures and recurrent pain in midadolescent girls and boys2014In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 21, no S1, p. S179-S180, article id P605Article in journal (Refereed)
    Abstract [en]

    Introduction: Previous research has developed an 11-item self-report measure assessing activation and pressure stress among adolescents. However, the biological correlates of this measure are unclear. Considering this, the present study investigated how perceived stress relates to aggregate cortisol measures and recurrent pain in mid-adolescent girls and boys. Methods: Mid-adolescents (119 girls and 56 boys) provided self-ratings of activation and pressure stress and recurrent pain (headache, stomachache, neck/shoulder and back pain) in questionnaires. Additionally, adolescents sampled saliva during an ordinary school day: 1) immediately at awakening, 2) 30 minutes after waking up, 3) 60minutes after waking up, and 4) at 8 p.m. Aggregate cortisol measures including ground and increase measures of the area under the curve and a diurnal slope measure were computed. Hierarchical regression analyseswere performed for girls and boys respectively. Results: Activation and pressure were significantly associated with recurrent pain in girls but not in boys. However, there were no significant associations between self-ratings of stress and salivary cortisol, neither for girls nor for boys. Conclusion:While self-rated activation and pressure stress were related to recurrent pain in girls, but not in boys, neither activation nor pressure was linked to any of the aggregate cortisol measures. The differences between subjective and objective measures perhaps relate to these measures reflecting distinct and unrelated aspects of functioning. However, the findings may also result from the participants being mid-adolescents whose bodily systems are flexible and still unaffected by daily activation and pressure stress.

  • 10.
    Lundberg, Ulf
    Stockholm University, Faculty of Social Sciences, Department of Psychology. Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Sleep and musculoskeletal pain2008In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 15, no 4, p. 253-253Article in journal (Refereed)
    Abstract [en]

    The article focuses on sleep disorders as a risk factor for musculoskeletal pain. It is reported that sleep disorders at baseline predict development of chronic musculoskeletal pain in initially healthy working female and male one year later. Job strain was also predictive of musculoskeletal pain in female. The hypothalamo-pituitary adrenal axis is activated by sleep disturbance which results in elevated cortisol levels.

  • 11.
    Magnusson Hanson, Linda L.
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Chungkham, Holendro Singh
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Indian Statistical Institute, India.
    Vahtera, J.
    Rod, N. H.
    Alexandersson, K.
    Goldberg, M.
    Stenholm, S.
    Platts, Loretta G.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Zins, M.
    Head, J.
    Loss of healthy life years between ages 50-75 years attributed to job strain: analyses of 64,533 individuals from four prospective European cohort studies2016In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 23, p. S64-S64Article in journal (Other academic)
    Abstract [en]

    Introduction: Poor working conditions potentially limit quality of life and the possibilities for individuals to remain in paid employment because of poor health. However, no studies so far have investigated how psychosocial working conditions might impact on how long older workers can expect to stay healthy. This study examines whether job strain in older workers is associated with healthy life expectancy (HLE).

    Methods: We used repeated measures data for 64,533 individuals from four cohort studies: Whitehall II (UK), Finnish Public Sector Study (Finland), GAZEL (France), and Swedish Longitudinal Occupational Survey of Health (Sweden). Job strain at baseline and two different measures of HLE were computed based on self-rated health and chronic health conditions. Multistate life table models were used to estimate partial life expectancy (LE) and HLE from ages 50 to 75 by job strain, cohort, occupational position and sex.

    Results: Job strain was consistently related to shorter HLE, but not total LE. Particularly men in lower occupational positions with job strain had shorter HLE. The HLE in good self-rated health was 2–3 years shorter in this group. The corresponding HLE based on chronic disease was almost 2 years shorter although the relation was less pronounced for GAZEL. Women with job strain in lower occupational positions also lived 1–2 fewer years in good health.

    Conclusions: The results indicate that job strain affects how long people remain healthy, and that interventions to prevent high job strain in older workers might enable people to work for longer in good health.

  • 12.
    Mellner, Christin
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Krantz, Gunilla
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Lundberg, Ulf
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Symptom reporting and self-rated health among women in mid-life: the role of work characteristics and family responsibilities2006In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 13, no 1, p. 1-7Article in journal (Refereed)
    Abstract [en]

    This study investigated how socioeconomic factors and psychosocial conditions are related to self-reported health among 43-year-old women representing the general Swedish population (N = 569). Odds ratios and multiple logistic regression analyses were used for associations and effect modification, adjusted for symptom reporting in adolescence. Poor self-reported health was predicted by low income, financial worries, and job strain, as well as combined exposure to a high level of unpaid household work and job strain (double burden). In conclusion, poor psychosocial conditions related to working life, as well as to the combined impact of paid and unpaid work were revealed to be risk factors for poor self-reported health among middle-aged women. These results highlight the need for improving women's work conditions, as well as designing family policies that promote a better sharing of unpaid household tasks and responsibilities between spouses.

  • 13.
    Odéen, Magnus
    et al.
    Uni Res, Uni Hlth, Bergen, Norway.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Eriksen, Hege R
    Univ Bergen, Fac Psychol, Dept Hlth Promot & Dev, Bergen,.
    Ursin, Holger
    Uni Res, Uni Hlth, Bergen, Norway.
    Expectancies, Socioeconomic Status, and Self-Rated Health: Use of the Simplified TOMCATS Questionnaire2013In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 20, no 2, p. 242-251Article in journal (Refereed)
    Abstract [en]

    Background: Coping has traditionally been measured with inventories containing many items meant to identify specific coping strategies. An alternative is to develop a shorter inventory that focusses on coping expectancies which may determine the extent to which an individual attempts to cope actively.

    Purpose: This paper explores the usefulness and validity of a simplified seven-item questionnaire (Theoretically Originated Measure of the Cognitive Activation Theory of Stress, TOMCATS) for response outcome expectancies defined either as positive ("coping"), negative ("hopelessness"), or none ("helplessness"). The definitions are based on the Cognitive Activation Theory of Stress (CATS; Ursin and Eriksen, Psychoneuroendocrinology, 29(5):567-92, 2004). The questionnaire was tested in two different samples. First, the questionnaire was compared with a traditional test of coping and then tested for validity in relation to socioeconomic differences in self-reported health.

    Methods: The first study was a comparison of the brief TOMCATS with a short version of the Utrecht Coping List (UCL; Eriksen et al., Scand J Psychol, 38(3):175-82, 1997). Both questionnaires were tested in a population of 1,704 Norwegian municipality workers. The second study was a cross-sectional analysis of TOMCATS, subjective and objective socioeconomic status, and health in a representative sample of the Swedish working population in 2003-2005 (N = 11,441).

    Results: In the first study, the coping item in the TOMCATS questionnaire showed an expected significant positive correlation with the UCL factors of instrumental mastery-oriented coping and negative correlations with passive and depressive scores. There were also the expected correlations for the helplessness and hopelessness scores, but there was no clear distinction between helplessness and hopelessness in the way they correlated with the UCL. In the second study, the coping item in TOMCATS and the three-item helplessness scores showed clear and monotonous gradients over a subjective socioeconomic status (SES) ladder. Positive response outcome expectancy ("coping") was related to high subjective SES and no expectancy ("helplessness") to low subjective SES. In a model including age and sex, TOMCATS scores explained more variance (r (2) = 0.16) in self-reported health than both subjective (r (2) = 0.08) and objective SES (r (2) = 0.02).

    Conclusion: The brief TOMCATS questionnaire showed acceptable and significant correlations with a traditional coping questionnaire and is sensitive enough to register systematic differences in response outcome expectancies across the socioeconomic ladder. The results furthermore confirm that psychological and learning factors contribute to the socioeconomic gradient in health.

  • 14.
    Olsson, Gabriella
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    School stratification and risk behaviours among students in Stockholm2012In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 19, no suppl 1, p. 285-286Article in journal (Refereed)
  • 15.
    Olsson, Gabriella
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Hemström, Örjan
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Identifying factors associated with good and ill health. Not just opposite sides of the same coin2009In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 16, no 4, p. 323-330Article in journal (Refereed)
    Abstract [en]

    Background  Work-related health research has traditionally focused on identifying risks rather than determinants of good health. Our knowledge of variation in ill health is thus greater than our understanding of such variations in good health. Purpose  In this study, the associations between work-environment exposures and good health are examined. We are especially interested in contrasting our indices of ill health with a narrow measure of good health. Moreover, the salutary effect of sense of coherence (SOC) is explored, focusing particularly on its moderating role. Method  Data stem from the panel of Swedish level of living surveys for 1991 and 2000. The analysis is based on a sample of 2,334 employed men and women. Logistic regressions are used. Results  Assessed work-environment factors are to a large extent related, in a mirrored way, to good health and ill health. The models' fit are, however, generally better for the latter. Our findings also indicate that SOC has a protective role for individuals exposed to work risks such as stress and high physical demands. Conclusion  To improve our understanding of what promotes good health, research needs to focus on salutary factors. One such salutary factor explored in this paper is sense of coherence.

  • 16.
    Riva, Roberto
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Psychobiological responses in women with regional or widespread musculoskeletal pain conditions2012In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 19, no Issue 1 Supplement, p. 120-121Article in journal (Other academic)
    Abstract [en]

    Musculoskeletal disorders (MSDs) are very common. Regional chronic shoulder and neck pain (SNP) and widespread chronic pain due to fibromyalgia syndrome (FMS) are examples of MSDs characterized by altered physiology of the autonomic nervous system (ANS) and the hypothalamic-pituitary-adrenal (HPA) axis. The aims of the present study is to compare the cortisol awakening response (CAR) in SNP women, FMS patients and healthy controls, and to compare salivary cortisol levels, urinary catecholamine levels (adrenaline, noradrenaline, and dopamine), and cardiovascular responses in FMS patients and healthy controls. Self-ratings of sleep, anxiety, perceived stress, and pain were also investigated. CAR tended to be higher in SNP women than in healthy controls, whereas it was significantly higher than in FMS patients. Moreover, CAR was significantly lower in FMS patients than in healthy controls. Cortisol levels were lower in FMS patients than in healthy controls during the rest of the day as well. In addition, adrenaline and dopamine (but not noradrenaline) levels were significantly lower in FMS patients than in healthy controls. Resting heart rate was significantly higher in FMS patients than in healthy controls, but no differences emerged during stress provocation or unconstrained daily activities. Finally, SNP women and FMS patients reported more pain and health complaints than did healthy controls, but SNP women were less affected. Potential confounders (e.g., age, obesity, smoking habit, employment fraction, sleeping problems, and physical exercise) had no effects on the findings. Taken together, the findings show altered ANS and HPA axis regulation in FMS patients. Specifically, the hyperactive HPA axis found in SNP women (i.e., higher cortisol levels) might constitute a preliminary stage of a hypoactive HPA axis in FMS patients (i.e., lower cortisol levels). In view of this, an altered regulation of the HPA axis in the progression from regional to widespread MSDs may follow a temporal development.

  • 17.
    Riva, Roberto
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Mork, Paul Jarle
    Norwegian University of Science and Technology, Human Movement Science Programme.
    Westgaard, Rolf Harald
    Norwegian University of Science and Technology, Department of Industrial Economics and Technology.
    Rø, Magne
    Norwegian University of Science and Technology, Department of Neuroscience.
    Lundberg, Ulf
    Stockholm University, Faculty of Social Sciences, Department of Psychology. Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Fibromyalgia syndrome is associated with hypocortisolism2010In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 17, no 3, p. 223-233Article in journal (Refereed)
    Abstract [en]

    Background: Fibromyalgia syndrome (FMS) is a disease of unknown pathogenesis characterized by chronic musculoskeletal pain. FMS has been also associated with altered endocrinological responses, but findings are inconsistent.

    Purpose: The aim of the present study was to investigate free salivary cortisol levels in FMS patients compared with healthy controls with a particular focus on the Cortisol Awakening Response (CAR). The saliva samples were collected in a controlled hospital-hotel setting, in which the participants’ compliance was high and a number of potential confounders were analyzed.

    Method: Twenty-nine chronic female FMS patients and 29 age-matched healthy female controls were recruited. Salivary cortisol samples were investigated eight times: in the afternoon when participants arrived at the hospital, after stress provocation (to be reported separately), in the evening, before they went to sleep, upon awakening, 30 and 60 minutes later, and during the afternoon of the second day. Questionnaires measuring pain levels, sleeping problems, perceived stress and personality were administered to the participants. Other psychophysiological measurements were used to assess sleep quality and heart rate.

    Results: Patients with FMS had significantly lower cortisol levels during the day, most pronounced in the morning (CAR). The potential confounders analyzed did not influence the results. As expected, FMS patients reported more pain, stress, sleeping problems, anxiety and depression.

    Conclusions: The results lend support to the hypothesis of a dysfunction in the Hypothalamus-Pituitary-Adrenal axis in FMS patients, with generally lower cortisol values, most pronounced upon awakening (CAR).

  • 18. Svedberg, Pia
    et al.
    Mather, Lisa
    Bergström, Gunnar
    Lindfors, Petra
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Blom, Victoria
    Stockholm University, Faculty of Social Sciences, Department of Psychology. Karolinska Institutet, Sweden; The Swedish School of Sport and Health Sciences, Sweden.
    Work-Home Interference, Perceived Total Workload, and the Risk of Future Sickness Absence Due to Stress-Related Mental Diagnoses Among Women and Men: A Prospective Twin Study2018In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 25, no 1, p. 103-111Article in journal (Refereed)
    Abstract [en]

    Work-home interference has been proposed as an important explanation for sickness absence (SA). Previous studies show mixed results, have not accounted for familial factors (genetics and shared everyday environment), or investigated diagnosis specific SA. The aim was to study whether work-home interference and perceived total workload predict SA due to stress-related mental diagnoses, or SA due to other mental diagnoses, among women and men, when adjusting for various confounders and familial factors. This study included 11,916 twins, 19-47 years (49% women). Data on work-to-home and home-to-work conflicts, perceived total workload, and relevant confounders were derived from a 2005 survey, and national register data on SA spells until 2013 were obtained. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Discordant twin pair design was applied to adjust for familial factors. Each one unit increase in work-to-home and home-to-work conflicts, and perceived total workload was associated with higher odds for SA due to stress-related mental diagnoses and to SA due to other mental diagnoses among women, when adjusting for sociodemographic factors (ORs 1.15-1.31). Including health or familial factors, no associations remained. For men, each one unit increase in work-to-home conflicts was associated with higher odds for SA due to stress-related diagnoses (ORs 1.23-1.35), independently of confounders. Work-to-home conflict was independently associated with future SA due to stress-related diagnoses among men only. Health- and work-related factors seem to be important confounders when researching work-home interference, perceived total workload, and SA. Not including such confounders involves risking drawing incorrect conclusions. Further studies are needed to confirm sex differences and whether genetic factors are important for the associations studied.

  • 19.
    Toivanen, Susanna
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Income differences in cardiovascular disease prevalence: the contribution of job control and physical work demands2004In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 11(Suppl), p. 73-74Article in journal (Refereed)
  • 20. Van Laethem, Michelle
    et al.
    Beckers, Debby G. J.
    Geurts, Sabine A. E.
    Garefelt, Johanna
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Magnusson Hanson, Linda
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Perseverative Cognition as an Explanatory Mechanism in the Relation Between Job Demands and Sleep Quality2018In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 25, no 2, p. 231-242Article in journal (Refereed)
    Abstract [en]

    Purpose The aim of this longitudinal three-wave study was to examine (i) reciprocal associations among job demands, work-related perseverative cognition (PC), and sleep quality; (ii) PC as a mediator in-between job demands and sleep quality; and (iii) continuous high job demands in relation to sleep quality and work-related PC over time.

    Method A representative sample of the Swedish working population was approached in 2010, 2012, and 2014, and 2316 respondents were included in this longitudinal full-panel survey study. Structural equation modelling was performed to analyse the temporal relations between job demands, work-related PC, and sleep quality. Additionally, a subsample (N = 1149) consisting of individuals who reported the same level of exposure to job demands during all three waves (i.e. stable high, stable moderate, or stable low job demands) was examined in relation to PC and sleep quality over time.

    Results Analyses showed that job demands, PC, and poor sleep quality were positively and reciprocally related. Work-related PC mediated the normal and reversed, direct across-wave relations between job demands and sleep quality. Individuals with continuous high job demands reported significantly lower sleep quality and higher work-related PC, compared to individuals with continuous moderate/low job demands.

    Conclusion This study substantiated reciprocal relations between job demands, work-related PC, and sleep quality and supported work-related PC as an underlying mechanism of the reciprocal job demands-sleep relationship. Moreover, this study showed that chronically high job demands are a risk factor for low sleep quality.

  • 21.
    Welmer, Anna-Karin
    et al.
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Liang, Yajun
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI). Jining Medical University, People's Republic of China.
    Angleman, Sara
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Santoni, Giola
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Yan, Zhongrui
    Cai, Chuanzhu
    Qiu, Chengxuan
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Vascular Risk Factor Burden, Atherosclerosis, and Functional Dependence in Old Age: A Population-Based Study2014In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 21, no 4, p. 597-604Article in journal (Refereed)
    Abstract [en]

    Vascular risk factors such as hypertension and obesity have been associated with physical limitations among older adults. The purpose of this study is to examine whether individual and aggregated vascular risk factors (VRFs) are associated with functional dependence and to what extent carotid atherosclerosis (CAS) or peripheral artery disease (PAD) may mediate the possible associations of aggregated VRFs with functional dependence. This cross-sectional study included 1,451 community-living participants aged a parts per thousand yen60 years in the Confucius Hometown Aging Project of China. Data on demographic features, hypertension, high total cholesterol, obesity, smoking, physical inactivity, diabetes, CAS, PAD, and cardiovascular diseases (CVDs) were collected through an interview, a clinical examination, and laboratory tests. Functional dependence was defined as being dependent in at least one activity in the personal or instrumental activities of daily living. Data were analyzed using multiple logistic models controlling for potential confounders. We used the mediation model to explore the potential mediating effect of CAS and PAD on the associations of aggregated VRFs with functional dependence. Of the 1,451 participants, 222 (15.3 %) had functional dependence. The likelihood of functional dependence increased linearly with increasing number of VRFs (hypertension, high total cholesterol, abdominal obesity, and physical inactivity) (p for trend < 0.002). Mediation analysis showed that controlling for demographics and CVDs up to 11 % of the total association of functional dependence with clustering VRFs was mediated by CAS and PAD. Aggregation of multiple VRFs is associated with an increased likelihood of functional dependence among Chinese older adults; the association is partially mediated by carotid and peripheral artery atherosclerosis independently of CVDs.

  • 22. Yang, Zhi-Yin
    et al.
    Yang, Zhen
    Zhu, Lifang
    Qiu, Chengxuan
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Human Behaviors Determine Health: Strategic Thoughts on the Prevention of Chronic Non-communicable Diseases in China2011In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 18, no 4, p. 295-301Article in journal (Refereed)
    Abstract [en]

    In the last three decades, people's living standards have significantly increased along with the rapid growth of the national economy of China. However, the prevalence of unhealthy behaviors and unfavorable lifestyles (e.g., smoking, excessive use of alcohol, physical inactivity, and unhealthy diets) also steadily increased, which may contribute to the growing epidemic of chronic non-communicable diseases (CNCDs) such as diabetes, coronary heart disease, stroke, and cancers. To briefly summarize the major studies from China concerning epidemic and burden of CNCDs and unhealthy lifestyles, and propose intervention strategies toward unhealthy lifestyles and behaviors aiming for effective control of the growing epidemic of CNCDs in China. We first review the major national studies addressing the epidemic and burden of CNCDs and unhealthy behaviors in China. Then, we aim to develop the preventive strategies against the increasing epidemic of CNCDs by focusing on the intervention campaign toward health unfavorable behaviors and lifestyles. CNCDs have posed major challenges to public health and the ongoing reform of health care system in China. Unhealthy lifestyles and behaviors (e.g., smoking, excessive alcohol consumpsion, physical inactivity, and imbalanced diets) are responsible for the growing epidemic of CNCDs. Adherence to healthy behaviors and lifestyles is critical for maintaining physical and mental health. Active implementation of the population-wide intervention program of health education and promotion by targeting unhealthy behaviors and lifestyles may help to constrain the growing epidemic of CNCDs in China.

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