Objective: To examine the associations between sickness presenteeism (SP) reported as number of days with SP reported as number of times and to evaluate their responsiveness.

Methods: The study population (n = 454) consisted of employed individuals, at risk of long-term sickness absence. Correlation analyses were performed to examine associations between the two SP measures and external constructs such as work performance, general health, and registered sick leave. Both SP constructs were measured several times to examine responsiveness.

Results: The SP measures are moderately correlated. They moderately correlated with work performance and health status measures. SP reported as number of times seems to be more sensitive than number of days in detecting changes after rehabilitation.

Conclusions: Numerical or categorical constructs are valid sources of data on SP. However, categorized SP seems to be more responsive.

Background: There are concerns and diverse experiences related to infertility and childlessness. The lived experience of infertile people from various cultures needs to be explored. Objective: The aim of this qualitative study was to explore Iranian women experiences of their infertility. Materials and Methods: The data comprised interviews about fertility issues in the Persian language with eighteen women, aged 17-45 yr old, who agreed to be interviewed at the Mottahari Infertility Treatment Clinic, affiliated to the Urmia University of Medical Sciences about their fertility problems. They were approached by the researchers at the time of their first visit. The verbatim transcribed interviews were analyzed using deductive conventional content analysis. Results: The experiences of the informants were conceptualized into four major themes: 1) Shock (subthemes: Disbelief and Denial); 2) Reaction (subthemes: Distress, Guilt, Loss of self-esteem and Sexual reluctance); 3) Processing (subthemes: Internal processing, Avoidance, Marriage at risk, External processing, Stigma caused by the family and Stigma caused by the community) and 4) Reorientation (subthemes: Forgetting, Marriage to saving marriage and Sexual consent). Conclusion: Infertility can be a challenging condition. Considering that infertility-related issues affect Iranian women more contextual factors is necessary. So, culturally sensitive and gender specific protocols are suggested to provide suitable and about culturally sensitive and gender-specific protocols is a necessity in order to provide suitable care to infertile women.

The effects of driver sleepiness are often quantified as deteriorated driving performance, increased blink durations and high levels of subjective sleepiness. Driver sleepiness has also been associated with increasing levels of electroencephalogram (EEG) power, especially in the alpha range. The present exploratory study investigated a new measure of driver sleepiness, the EEG fixation-related lambda response. Thirty young male drivers (23.6 +/- 1.7 years old) participated in a driving simulator experiment in which they drove on rural and suburban roads in simulated daylight versus darkness during both the daytime (full sleep) and night-time (sleep deprived). The results show lower lambda responses during night driving and with longer time on task, indicating that sleep deprivation and time on task cause a general decrement in cortical responsiveness to incoming visual stimuli. Levels of subjective sleepiness and line crossings were higher under the same conditions. Furthermore, results of a linear mixed-effects model showed that low lambda responses are associated with high subjective sleepiness and more line crossings. We suggest that the fixation-related lambda response can be used to investigate driving impairment induced by sleep deprivation while driving and that, after further refinement, it may be useful as an objective measure of driver sleepiness.

Objective: This study investigated age-dependent and subtype-related alterations in electroencephalography (EEG) power spectra and current source densities (CSD) in children with attention deficit and hyperactivity disorder (ADHD).

Methods: We performed spectral and cortical source (exact low-resolution electromagnetic tomography, eLORETA) analyses using resting state EEG recordings from 40 children (8-16 years) with combined and inattentive subtypes of ADHD and 41 age-matched healthy controls (HC). Group differences in EEG spectra and CSD were investigated at each scalp location, voxel and cortical region in delta, theta, alpha and beta bands. We also explored associations between topographic changes in EEG power and CSD and age.

Results: Compared to healthy controls, combined ADHD subtype was characterized with significantly increased diffuse theta/beta power ratios (TBR) with a widespread decrease in beta CSD. Inattentive ADHD subtype presented increased TBR in all brain regions except in posterior areas with a global increase in theta source power. In both ADHD and HC, older age groups showed significantly lower delta source power and TBR and higher alpha and beta source power than younger age groups. Compared to HC, ADHD was characterized with increases in theta fronto-central and temporal source power with increasing age.

Conclusions: Our results confirm that TBR can be used as a neurophysiological biomarker to differentiate ADHD from healthy children at both the source and sensor levels.

Significance: Our findings emphasize the importance of performing the source imaging analysis in order to better characterize age-related changes in resting-state EEG activity in ADHD and controls.

Purpose: Insomnia has adverse effects on people with epilepsy. We aimed to test a novel cognitive behavioral therapy for insomnia (CBT-I) app-based intervention on insomnia symptoms and social psychological factors in people with epilepsy and to examine the possible mechanisms among the factors.

Methods: Participants were recruited from neurology clinics in Iran and comprised individuals diagnosed with epilepsy and having moderate to severe insomnia. A two-arm randomized controlled trial design was used, consisting of a treatment group (CBT-I; n = 160) and control group (patient education; n = 160). Primary outcomes were self-reported sleep quality, insomnia severity, and sleep hygiene behavior and objective sleep characteristics measured by actigraphy. Secondary outcomes were attitude, perceived behavioral control, intention, action planning, coping planning, behavioral automaticity, self-monitoring, anxiety, depression, and quality of life (QoL). All outcomes were measured at baseline, and at one, three, and six months postintervention, except objective sleep, which was assessed at baseline, and one and six months postintervention. Data were analyzed using linear mixed models.

Results: Current findings showed that sleep quality, insomnia severity, sleep hygiene behavior, and sleep onset latency were significantly improved in the CBT-I group compared with the patient education group at all measurement points. Also, the CBT-I group had significantly improved anxiety, depression, and QoL compared with the patient education group. Mediation analyses showed that attitude, intention, coping planning, self-monitoring, and behavioral automaticity significantly mediated the effect of the intervention on sleep outcomes.

Conclusion: Results support the use of the CBT-I app to improve sleep outcomes among people with epilepsy.

Objectives Evidence shows that work-time control (WTC) affects health but underlying mechanisms are still unclear. Work-life interference (WLI) might be a step on the causal pathway. The present study examined whether WLI mediates effects on mental and physical health and contrasted these to other causal pathways.

Methods Four biennial waves from the Swedish Longitudinal Occupational Survey of Health (SLOSH, N=26 804) were used. Cross-lagged analyses were conducted to estimate if WLI mediated effects from WTC (differentiating between control over daily hours and time off) to subsequent depressive and musculoskeletal symptoms. Other causal directions (reversed mediation, direct and reversed direct effects) and robustness of mediation (by including covariates) were examined.

Results WLI partially mediated the relationship of WTC (control over daily hours/time off) with both health outcomes. Indirect effect estimates were small for depressive symptoms (-0.053 for control over time off and -0.018 for control over daily hours) and very small for musculoskeletal symptoms (-0.007 and -0.003, respectively). While other causal directions were generally weaker than causal mediational pathways, they played a larger role for musculoskeletal compared to depressive symptoms. Estimates relating to control over time off were in general larger than for control over daily hours.

Conclusions Our results suggest that WLI mediates part of the effect from WTC to mental/musculoskeletal symptoms, but small estimates suggest that (i) WTC plays a small but consistent role in effects on health and (ii) particularly regarding musculoskeletal disorders, other causal directions and mediators need to be further examined.

Objectives: Work-time control is associated with lower sickness absence rates, but it remains unclear whether this association differs by type of diagnosis and sub-dimension of work-time control (control over daily hours and control over time off) and whether certain vulnerable groups benefit more from higher levels of work-time control.

Methods: Survey data from the Finnish 10-town study in 2004 were used to examine if baseline levels of work-time control were associated with register data on diagnose-specific sickness absence for 7 consecutive years (n = 22 599). Cox proportional hazard models were conducted, adjusted for age, sex, education, occupational status, shift work including nights, and physical/mental workload.

Results: During follow-up, 2,818 individuals were on sick leave (>= 10 days) due to musculoskeletal disorders and 1724 due to mental disorders. Employees with high (HR = 0.80, 95% CI 0.74-0.87; HR = 0.76, 95% CI 0.70-0.82, respectively) and moderate (HR = 0.83, 95% CI 0.77-0.90; HR = 0.85, 95% CI 0.79-0.91, respectively) levels of control over daily hours/control over time off had a decreased risk of sickness absence due to musculoskeletal disorders. Sub-group analyses revealed that especially workers who were older benefitted the most from higher levels of work-time control. Neither sub-dimension of work-time control was related to sickness absence due to mental disorders.

Conclusions: Over a 7-year period of follow-up, high and moderate levels of work-time control were related to lower rates of sickness absence due to musculoskeletal disorders, but not due to mental disorders.

BACKGROUND & AIMS: There is debate over the optimal method for colonoscopic surveillance of patients with inflammatory bowel diseases. Guidelines recommend chromoendoscopy, but the value of chromoendoscopy in high-definition colonoscopy has not been proven. Furthermore, the value of random biopsies is controversial. METHODS: We performed a prospective study of 305 patients with ulcerative colitis or Crohn's colitis referred for surveillance colonoscopy at a university hospital in Sweden, from March 2011 through April 2016. Patients randomly assigned to a group that received high-definition chromoendoscopy with indigo carmine (HD-CE; n=152), collection of 32 random biopsies, and targeted biopsies or polypectomies or to a group that received high-definition white light endoscopy (HD-WLE; n=153), collection of 32 random biopsies, and targeted biopsies or polypectomies. The primary endpoint was number of patients with dysplastic lesions. RESULTS: Dysplastic lesions were detected in 17 patients with HD-CE and 7 patients with HD-WLE (P=.032). Dysplasias in random biopsies (n=9760) were detected in 9 patients: 6 (3.9%) in the HD-CE group and 3 (2.0%) in the HD-WLE group (P=.72). Of the 9 patients with dysplasia, 3 patients (33%) had primary sclerosing cholangitis-only 18% of patients (54/305) included in the study had primary sclerosing cholangitis. The number of dysplastic lesions per 10 min of withdrawal time was 0.066 with HD-CE and 0.027 with HD-WLE (P=.056). CONCLUSIONS: In a randomized trial, we found HD-CE with collection of random biopsies to be superior to HD-WLE with random biopsies for detection of dysplasia per colonoscopy. These results support the use of chromoendoscopy for surveillance of patients with inflammatory bowel diseases. ClinicalTrials.gov no: NCT01505842.

Ocular issues are common, burdensome, and under-researched among residents of aged care services. This study aims to investigate the prevalence of dry eyes or use of ocular lubricants among residents, and the possible association with systemic medications known or suspected to cause dry eyes. A cross-sectional study of 383 residents of six aged care services in South Australia was conducted. Data were extracted from participants' medical histories, medication charts, and validated assessments. The main exposure was systemic medications known to cause, contribute to, or aggravate dry eyes. The primary outcome was documented dry eyes or regular administration of ocular lubricants. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between systemic medications and dry eyes/use of ocular lubricants. Dry eyes were documented for 53 (13.8%) residents and 98 (25.6%) residents were administered ocular lubricants. Overall, 116 (30.3%) residents had documented dry eyes/used ocular lubricants. Of these, half (n= 58) were taking a medication known to cause, contribute to, or aggravate dry eyes. Taking one or more medications listed as known to cause dry eyes was associated with having dry eyes/use of ocular lubricants (OR 1.83, 95% CI 1.15-2.94). In sub-analyses, no individual medication was associated with dry eyes/use of ocular lubricants. Dry eyes and use of ocular lubricants are common in residential aged care. Our hypothesis generating findings suggest the need for further research into the clinical significance of systemic medications as a possible cause of dry eyes.

Work-related stress is considered one of the biggest health and safety challenges among the member states of the European Union. A critical factor is recovery between periods of stress. The primary purpose of this study was to investigate whether a brief behaviorally oriented stress-recovery management intervention delivered in an individual setting could reduce stress symptoms among individuals with high levels of perceived stress. A single-subject experimental design with multiple baselines across three individuals was used. The results indicate, with at least moderate experimental control, a temporal relation between the start of the intervention and beneficial changes from baseline in continuous self-recordings of stress symptoms. The changes were maintained at 1-year and 5-year follow-up assessments. Also, self-reporting inventories measuring perceived stress, worry, anxiety, depression, burnout, type A behavior, unwinding and recuperation from work stress, and insomnia showed overall changes in beneficial directions at post-assessment, as well as the two follow-up assessments. The results indicate that a behaviorally oriented stress-recovery management intervention delivered in an individual setting can reduce stress symptoms in individuals with high levels of perceived stress. However, for firm conclusions to be drawn, further research is needed.

Continuous and prolonged exposure to stressors or unsuccessfully dealing with such exposure has been suggested as precursors for burnout. Current research indicates that such stress problems could be conceptualized as deficiencies in recovery between periods of stress. The purpose of this study was to evaluate the efficacy of a behaviorally oriented stress recovery management intervention for people experiencing high levels of stress. A total of 73 individuals with experiences of stress symptoms and high levels of perceived stress (>= 25 on the Perceived Stress Scale) were randomly allocated to either a 10-week intervention group or a waiting-list control group. Participants were assessed at preintervention, postintervention, and 3-month follow-up. The Perceived Stress Scale, questions about tension, and the Shirom-Melamed Burnout Questionnaire were used as primary outcome measures. and the Hospital Anxiety and Depression Scale was used as a secondary outcome measure. Data were analyzed following the intention-to-treat principle. The analysis demonstrated statistically significant improvements for all measures at posttreatment and at follow-up. The between-groups effect sizes were high at posttreatment and moderate-to-high at follow-up. Intervention focused on stress recovery behavior seems to be an effective way of reducing perceived stress, tension, burnout symptoms, anxiety, and depression in people with stress symptoms and high levels of perceived stress in everyday life. The tested intervention warrants further research. Other stress recovery behavior interventions need to be tested to draw conclusions on the efficacy of stress recovery behavior interventions in general regarding stress and burnout.

Sickness behavior including malaise, fatigue and increased pain sensitivity is thought to be adaptive and facilitate recovery from disease. However, it may also reduce functioning and health if symptoms persists, which is why validated instruments for its assessment are needed. We evaluated the English translation of the Sickness Questionnaire (SicknessQ) in an Australian population of 156 participants with high level of persistent musculoskeletal pain and/or gastrointestinal symptoms without an organic explanation. The SicknessQ total score had an adequate model fit and no other models were found to fit data better. The SicknessQ correlated most strongly with fatigue, stress, anxiety and depression, which explained 62% of the variance in SicknessQ, but not with physical functioning. The mean score (8.9; 95 %CI: 8.0–9.8) was in between those previously reported in a general population sample and in primary care patients. In conclusion, the evaluation of the English version of the SicknessQ in an Australian sample with significant, chronic unexplained medical symptoms supports the use of the English version of the total SicknessQ score as an overall measure of sickness behavior.

Samtidigt som det pågår en inre specialisering i de ”gamla” disciplinerna fysiologi, psykologi och sociologi uppstår nya vetenskaper som syftar till att integrera och tillämpa de gamla disciplinernas fynd och kunskapsmassa. Arbetsvetenskapen etablerar sig på 1970-talet när det inom andra envetenskapliga discipliner utvecklats kunskapsmassor som kan sammanföras och få synergieffekter av både praktisk och teoretisk art. Jag ser Arbetsvetenskap som en sådan nödvändig skapelse som tillvaratar enskilda discipliners forskningsrön och för samman dem till praktikrelevant kunskap för tillämpning i ett mångfacetterat arbetsliv med mycket olika verksamheter, organisationsmodeller och arbetsvillkor. Det är med sådana glasögon jag börjar läsa boken Arbetsvetenskap – en introduktion.

Inom arbetslivsforskningen har tillitsforskning inte haft samma expansiva utveckling som inom samhällsvetenskap. Kapitlet riktar fokus på tillitsbegreppet, konsekvenser av tillit och förhållanden som skapar eller raserar tillit.  

Den psykologiska kärnan i tillit är att människor och ting är pålitliga. Därigenom blir socialt liv mera förutsägbart, osäkerhet och komplexitet reduceras, upplevelsen av risker, stress och kaos minskar. Tillit stabiliserar människors identitetsupplevelse och tillit styrker människors förmåga att vara aktörer i sina egna liv – den som känner tillit vågar göra det han eller hon vill, önskar och drömmer om. Genom tillit skapas och bibehålls sociala relationer och handlingar kan genomföras som annars skulle vara omöjliga utan stora transaktionskostnader. Om tilliten minskar eller försvinner minskar också människors vilja att ta risker. I forskning med inriktning mot arbete och hälsa finns ett fokus på kontroll i meningen anställdas inflytande i sitt arbete. Balans mellan kontroll och krav dämpar stress och förebygger ohälsa. Kontroll är begreppsligt en nära släkting till tillit. Gemensamt är att osäkerhet reduceras, vilket minskar stress och gör det lättare att fatta beslut och handla. 

Tillit till andra människor spelar en avgörande roll för samarbete. Den som litar på att de andra – arbetskamrater och ledning – kommer att försöka uppfylla viktiga förpliktelser kommer också att öka sin egen uppslutning kring dessa förpliktelser. Ökade kunskaper om sambandet mellan tillit och kollektivt handlande skulle kunna förebygga ofruktbara konflikter och främja effektivt handlande och hälsa.

Hur kommer det sig att arbetet medför status, goda arbetsvillkor och hälsa för vissa, medan det innebär vanmakt, underordning och sjukdom för andra? Denna uråldriga och till synes naiva fråga pockar allt ihärdigare på ett svar i en tid där den sociala ojämlikheten ökar. Den som är det minsta intresserad av arbetsliv och hälsa och som läser de kapitel som nu följer kommer att bli inspirerad, kanske provocerad och troligen väldigt imponerad av svensk arbetslivsforskning. Flera av Sveriges mest framträdande arbetslivsforskare medverkar i boken.

Extensive staff turnover within the statutory social services is a serious problem in Sweden and in other European countries. This study examines which work conditions predict social workers’ willingness to stay in their organisation. A web-based questionnaire was used to gather data. The participating social workers responded to two questionnaires over a one-year period. To identify the social workers who wanted to stay and also remained in the organisation, the group ‘Stayers’ (n = 1,368) consisted of social workers who reported low intentions to quit at T1. The group ‘Leavers’ (n = 1,182) were social workers who had actually resigned at T2. The data were analysed using univariate and multivariate logistic regression analyses. The multivariate analysis shows that the work conditions that predicted staying in the organisation were low degrees of conflicting demands and quantitative demands, high degrees of openness and human resource orientation in the organisation and a high degree of perceived service quality. The results are discussed in relation to public management and managerial responsibility to create sustainable work conditions that facilitate the provision of good social services for citizens.

STUDY OBJECTIVES: To determine how sleepiness and sleep deprivation drive the motivation to engage in different behaviors.

METHODS: We studied the sleepiness of 123 participants who had been randomized to sleep deprivation or normal sleep, and their willingness to engage in a range of everyday behaviors.

RESULTS: Self-reported sleepiness was a strong predictor of the motivation to engage in sleep-preparatory behaviors such as shutting one's eyes (OR=2.78, 95%CI: 2.19-3.52 for each step up on the Karolinska Sleepiness Scale) and resting (OR=3.20, CI: 2.46-4.16). Sleepiness was also related to the desire to be cared for by a loved one (OR=1.49, CI: 1.22-1.82), and preparedness to utilize monetary and energy resources to get to sleep. Conversely, increased sleepiness was associated with a decreased motivation for social and physical activities (e.g., be with friends OR=0.71, CI: 0.61-0.82; exercise OR=0.65, CI: 0.56-0.76). Sleep deprivation had similar effects as sleepiness on these behaviors. Neither sleepiness nor sleep deprivation had strong associations with hunger, thirst, or food preferences.

CONCLUSIONS: Our findings indicate that sleepiness is a dynamic motivational drive that promotes sleep-preparatory behaviors and competes with other drives and desired outcomes. Consequently, sleepiness may be a central mechanism by which impaired alertness, e.g., due to insufficient sleep, contributes to poor quality of life and adverse health. We propose that sleepiness helps organize behaviors toward the specific goal of assuring sufficient sleep, in competition with other needs and incentives. A theoretical framework on sleepiness and its behavioral consequences are likely to improve our understanding of several disease mechanisms.

Background: Research has established a strong relationship between education and later life outcomes, where the connection between different school problems and delinquency have been widely acknowledged. These studies have often sampled male juvenile offenders exhibiting extensive and/or persistent delinquency. Less is known about the educational attainment of female juvenile offenders, especially those who display limited delinquency. In a previous study (Azad and Ginner Hau in Child Youth Serv Rev 95:384–396, 2018), the characteristics of this particular group of offenders were explored where the results showed limited self-reported delinquency but elevated school problems.

Objective: The present aim was to conduct a follow-up study of the same sample of female adolescents, in order to study their educational attainment during adolescence and the rate of recidivism within 24 months after being sentenced through registry data.

Method: The sample consisted of adolescent females (N = 144) who were convicted of a crime and sentenced to youth service between 2007 and 2012 in Stockholm, Sweden.

Results: The results showed that the majority of the females did not reoffend within 2 years after being sentenced. They did, however, display high educational deficits. Their grade point average at the end of both compulsory education and upper secondary school was much lower than that of young females in general, and the majority had either dropped out, never begun or received zero in all subjects at the end of upper secondary school.

Conclusions: The low school results indicate a need to support young delinquent females’ educational attainment in order to improve their overall life chances.

The nature of work and the contexts in which firms operate have changed significantly in the many decades since the study of psychological contracts (PCs) at work began in earnest. These changes have altered the contours of the traditional employer-employee relationship and are key motivators of this Special Issue. We seek to chart new directions for PC research over the next decade by widening the theoretical and methodological lenses used to explore PC processes. In the introductory editorial we briefly outline the PC construct, overview the collected papers, and discuss the next exciting wave of PC research (exploring PC dynamics, PC counterparties, and the PC context) inspired by this collection.

Background: Improved neonatal care has resulted in increased survival rates among infants born after only 22 gestational weeks, but extremely preterm children still have an increased risk of neurodevelopmental delays, learning disabilities and reduced cognitive capacity, particularly executive function deficits. Parent-child interaction and parental mental health are associated with infant development, regardless of preterm birth. There is a need for further early interventions directed towards extremely preterm (EPT) children as well as their parents. The purpose of this paper is to describe the Stockholm Preterm Interaction-Based Intervention (SPIBI), the arrangements of the SPIBI trial and the chosen outcome measurements.

Methods: The SPIBI is a randomized clinical trial that includes EPT infants and their parents upon discharge from four neonatal units in Stockholm, Sweden. Inclusion criteria are EPT infants soon to be discharged from a neonatal intensive care unit (NICU), with parents speaking Swedish or English. Both groups receive three initial visits at the neonatal unit before discharge during the recruitment process, with a strengths-based and development-supportive approach. The intervention group receives ten home visits and two telephone calls during the first year from a trained interventionist from a multi-professional team. The SPIBI intervention is a strengths-based early intervention programme focusing on parental sensitivity to infant cues, enhancing positive parent-child interaction, improving self-regulating skills and supporting the infant’s next small developmental step through a scaffolding process and parent-infant co-regulation. The control group receives standard follow-up and care plus extended assessment. The outcomes of interest are parent-child interaction, child development, parental mental health and preschool teacher evaluation of child participation, with assessments at 3, 12, 24 and 36 months corrected age (CA). The primary outcome is emotional availability at 12 months CA.

Discussion: If the SPIBI shows positive results, it could be considered for clinical implementation for child-support, ethical and health-economic purposes. Regardless of the outcome, the trial will provide valuable information about extremely preterm children and their parents during infancy and toddlerhood after regional hospital care in Sweden.

Trial registration: The study was registered in ClinicalTrials.gov in October 2018 (NCT03714633).