Background: Dementia with Lewy bodies (DLB) includes various core clinical features that result in different phenotypes. In addition, Alzheimer's disease (AD) and cerebrovascular pathologies are common in DLB. All this increases the heterogeneity within DLB and hampers clinical diagnosis. We addressed this heterogeneity by investigating subgroups of patients with similar biological, clinical, and demographic features.

Methods: We studied 107 extensively phenotyped DLB patients from the European DLB consortium. Factorial analysis of mixed data (FAMD) was used to identify dimensions in the data, based on sex, age, years of education, disease duration, Mini-Mental State Examination (MMSE), cerebrospinal fluid (CSF) levels of AD biomarkers, core features of DLB, and regional brain atrophy. Subsequently, hierarchical clustering analysis was used to subgroup individuals based on the FAMD dimensions.

Results: We identified 3 dimensions using FAMD that explained 38% of the variance. Subsequent hierarchical clustering identified 4 clusters. Cluster 1 was characterized by amyloid-beta and cerebrovascular pathologies, medial temporal atrophy, and cognitive fluctuations. Cluster 2 had posterior atrophy and showed the lowest frequency of visual hallucinations and cognitive fluctuations and the worst cognitive performance. Cluster 3 had the highest frequency of tau pathology, showed posterior atrophy, and had a low frequency of parkinsonism. Cluster 4 had virtually normal AD biomarkers, the least regional brain atrophy and cerebrovascular pathology, and the highest MMSE scores.

Conclusions: This study demonstrates that there are subgroups of DLB patients with different biological, clinical, and demographic characteristics. These findings may have implications in the diagnosis and prognosis of DLB, as well as in the treatment response in clinical trials.

Background: This study examines the impact of work-related exposure on the cognitive performance of Faroese deep-sea fishers. Faroese fishing crews work long hours in demanding and noisy environments amidst highly uncertain and challenging weather conditions. These factors, together with compromised patterns of rest and sleep, are known to increase fatigue. Our aim was to study if changes could be measured in fishers’ cognitive performance at the end of the trip when compared with the baseline measure at the beginning.

Materials and methods: Data was collected over 15 months (May 2017 to July 2018) from 157 fishers on 18 fishing trips which involved 202 investigative days on board. Questionnaires and six computerised cognitive tests: Simple Reaction Time, Numeric Working Memory, Corsi Blocks, Rapid Visual Information Processing, Digit Vigilance, and Card Sorting Test were used for data collection at the beginning and end of the trip. Differences between the outcomes on the two test points were analysed with one-way ANOVA comparing the performances at the beginning and end of the voyage, and two-way ANOVA to examine the interactive effect of chronotype and test occasions on the outcomes. Mixed models were used to test for the effects of predictor variables.

Results: Significant declines in cognitive performance were observed from the beginning to the end of the trip, with decreases in visuospatial memory and reaction times, and increases in cognitive lapses. Furthermore, slowing in response times was observed in the second half of the Digit Vigilance test when comparing the halves.

Conclusions: Declines in performance were observed from the start to the end of the trip. Furthermore, fishers performed significantly worse in the second half of some parted tests, and evening types seem less influenced by irregular work hours. These findings call for improving the safety of the vessels and their crew.

Purpose: Faroese fishers have four times more accidents than workers on land. The aim was to understand fishers’ fatigue better and how their work and sleep patterns influenced their sleepiness levels and cognitive performance.

Materials and Methods: A total of 157 Faroese fishers wore wrist-worn actigraphs at sea and one week on land and filled in sleep and sleepiness diaries during the trip. Furthermore, a 3-minute simple reaction time (SRT) test was completed at the beginning and end of the trip. The ship’s movement and noise were also logged. The actiwatch results were analysed with mixed methods repeated measures. The sleepiness registrations and performance on the SRT-test were analysed with paired t-test. The ship movements (Pitch and roll) were divided into approximately three same-sized groups (lowest 1/3, medium 1/3, and highest 1/3) and compared against the Karolinska Sleepiness Scores (KSS ranging from 1– 9) ≥ 7 and physical tiredness (ranging from 1– 9) scores ≥ 7. Chi-square tests were used to determine the significance of these differences. Mean sleepiness scores at sea, and the proportion of sleepiness scores ≥ 7 were calculated, as well as sleepiness scores as a function of the time of day.

Results: While at sea, fishers had more split sleep, slept less, and had lower sleep efficiency than onshore. Sleepiness was higher at the end of the trip, and cognitive decline was found. The number of major lapses was higher at the end of the trip, but with no significant difference between the median reaction times.

Conclusion: The crew on-board the freezer longliner, who worked 8– 8 shifts, slept the most, had the longest continuous sleep periods, the highest sleep efficiency, the lowest sleepiness levels, and the highest noise exposure during their time off.

Hours of service regulations govern the working hours of commercial motor vehicle drivers, but these regulations may become more flexible as highly automated vehicles have the potential to afford periods of in-cab rest or even sleep while the vehicle is moving. A prerequisite is robust continuous monitoring of when the driver is resting (to account for reduced time on task) or sleeping (to account for the reduced physiological drive to sleep). The overall aims of this paper are to raise a discussion of whether it is possible to obtain successful rest during automated driving, and to present initial work on a hypothetical data driven algorithm aimed to estimate if it is possible to gain driving time after resting under fully automated driving. The presented algorithm consists of four central components, a heart rate-based relaxation detection algorithm, a camera-based sleep detection algorithm, a fatigue modelling component taking time awake, time of day and time on task into account, and a component that estimates gained driving time. Real-time assessment of driver fitness is complicated, especially when it comes to the recuperative value of in-cab sleep and rest, as it depends on sleep quality, time of day, homeostatic sleep pressure and on the activities that are carried out while resting. The monotony that characterizes for long-haul truck driving is clearly interrupted for a while, but the long-term consequences of extended driving times, including user acceptance of the key stakeholders, requires further research.

The COVID-19 pandemic crippled many parts of society as it spread throughout the world beginning in early 2020. Overnight, whole societies were forced to change their way of life, because of social distancing and lockdowns. For therapists, the pandemic meant that in-person sessions were no longer possible and many switched to different forms of synchronous remote communication by telephone, online audio or video link. The aim of this study was to explore psychodynamic therapists’ experiences over time of forced transitions to telepsychotherapy. Five therapists were interviewed at the beginning of the pandemic and at a one-year follow-up. The data were analysed by applying thematic analysis with a phenomenological approach. Initially, the therapists struggled with technical and safety issues. The loss of the therapy room and of access to non-verbal nuances contributed to impaired contact with the patients and more superficial conversations. The therapists experienced that the very nature of psychodynamic psychotherapy was affected, even if telepsychotherapy could give some new opportunities. One year later many of the difficulties remained, but the therapists developed better coping strategies and were back to the therapy focus. One implication of this study is that telepsychotherapy needs to be integrated into psychotherapy training and supervision.

Background: Polypharmacy, the use of multiple medications by one individual, may be associated with adverse health outcomes including poor cognition. However, it remains unclear whether a longitudinal relationship exists.

Objectives: To investigate the association between polypharmacy and 3-year cognitive ability in older adults.

Methods: A longitudinal cohort study of older adults 65 years and older, residing in the community, who participated in waves 12 (2012), 13 (2013) and 16 (2016) of the Household Income and Labour Dynamics (HILDA) Survey was conducted. Polypharmacy was defined as the regular use of 5 or more prescription medications. Cognitive ability was assessed using backwards digit span test (BDS), 25-item version of the National Adult Reading Test (NART-25) and symbol-digit modalities test (SDM). Linear regression was used to test the longitudinal association between polypharmacy and cognitive test scores at 3 years. All analyses were adjusted for age, sex, education, comorbidities, socioeconomic and lifestyle factors, and baseline cognitive test scores.

Results: A total of 2141 participants (mean age 72.9 years, 54.4% female) were included in the study sample. Polypharmacy was present in 27.3%. After adjusting for potential confounders, polypharmacy was negatively associated with cognitive ability at 3 years: BDS: −0.067 (95% CI = −0.353 to −0.051), NART-25: −0.071 (95% CI = −1.428 to −0.294), SDM: −0.073 (95% CI = −2.960 to −0.696).

Conclusion: Polypharmacy was associated with poorer cognitive ability at 3 years, even after adjusting for comorbidities and other confounders. Future research should consider the long-term impact of polypharmacy on cognitive ability, and identify strategies to optimise medication use and cognition in older adults.

Practice effects (PEs) defined as an improvement of performance in cognition due to repeated assessments between sessions are well known in unimpaired individuals, while less is known about impaired cognition and particularly in latent brain disease as autosomal-dominant Alzheimer's disease. The purpose was to evaluate the general (across tests/domains) and domain-specific PE calculated as the annual rate of change (ARC) in relation to years to the estimated disease onset (YECO) and in four groups of AD: asymptomatic mutation carriers (aAD, n = 19), prodromal, i.e., symptomatic mutation carriers, criteria for AD diagnosis not fulfilled (pAD, n = 4) and mutation carriers diagnosed with AD (dAD, n = 6) as well as mutation non-carriers from the AD families serving as a healthy comparison group (HC, n = 35). Cognition was assessed at baseline and follow-up about 3 years later by 12 tests covering six domains. The aAD and HC groups were comparable at baseline in demographic characteristics (age, gender, and education), when they were in their early forties, while the pAD and dAD groups were older and cognitively impaired. The results on mean ARC for the four groups were significantly different, small, positive, and age-insensitive in the HC group, while ARC was negative and declined with time/disease advancement in AD. The differences between HC and aAD groups in mean ARC and domain-specific ARC were not significant, indicating a subtle PE in aAD in the early preclinical stage of AD. In the symptomatic stages of AD, there was no PE probably due to cognitive disease-related progression. PEs were the largest in the verbal domain in both the HC and aAD groups, indicating a relationship with cognitive vulnerability. The group-related difference in mean ARC was predominant in timekeeping tests. To conclude, the practice effect in over 3 years was suggested to be linked to procedural learning and memory.

Stress and mental ill-health carry considerable costs for both individuals and organizations. Although interventions targeting compassion and self-compassion have been shown to reduce stress and benefit mental health, related research in organizational settings is limited. We investigated the effects of a 6-week psychological intervention utilizing compassion training on stress, mental health, and self-compassion. Forty-nine employees of two organizations were randomly assigned to either the intervention (n = 25) or a physical exercise control condition (n = 24). Multilevel growth models showed that stress (p = 0.04) and mental ill-health (p = 0.02) decreased over 3 months in both groups (pre-intervention to follow-up: Cohen’s d = −0.46 and d = 0.33, respectively), while self-compassion only increased in the intervention group (p = 0.03, between group d = 0.53). There were no significant effects on life satisfaction in any of the groups (p > 0.53). The findings show promising results regarding the ability of compassion training within organizations to decrease stress and mental ill-health and increase self-compassion. 

Objective: The present study investigates if symptoms of COVID-19 contagion in different social contexts (cohabitants, family, acquaintances, and others) are associated with university students' own self-reported symptoms of COVID-19 contagion, mental health, and study capacity. This was investigated by a cross-sectional survey administrated in Sweden during the first wave of the COVID-19 pandemic, at the time when universities were locked down to limit viral spread and contagion.

Results: Mild to moderate symptoms of COVID-19 in cohabitants and family members were associated with student’s self-reported symptoms of contagion, while no associations could be seen in relation to mental health and study capacity. Symptoms of COVID-19 contagion in acquaintances and others were not associated with students’ self-reported symptoms, nor with their mental health and study capacity.

To conclude, during the initial lockdown of universities students’ self-reported symptoms of contagion were mainly associated with cohabitants and family members, while symptoms of contagion in different social contexts were not associated with mental health and study capacity. Findings suggest that lockdown of universities may have contributed to limiting infection pathways, while still allowing students to focus on their studies despite significant contagion among others known to the student.

The internet and modern information technology have influenced society and also the practice of clinical psychology. In this chapter, we describe how internet-delivered psychological assessment and treatment procedures work and provide an updated review of the evidence. Therapist-supported internet interventions, mainly derived from cognitive behavior therapy treatment protocols, have been developed and tested in a large number of controlled trials and also for a range of psychiatric and somatic problems and conditions. There are clear indications that internet interventions can be as effective as seeing a therapist face-to-face, that long-term effects can be obtained, and that it has been possible to transfer internet interventions to more regular service provision (e.g., effectiveness trials).

The current study investigated longitudinal associations between parent-rated temperament, observed exuberance and accelerometer activity level at 18-months and symptoms of ASD and ADHD at 36-months in a sample of 54 children at elevated likelihood for ASD. For the specific parent-rated temperament scales, most observed significant associations appeared to be specific for either ASD or ADHD symptoms. Indeed, by controlling for overlapping symptoms a different pattern of associations emerged. These results illustrate how temperamental measures may signal risk for later ASD versus ADHD symptomatology in infants at elevated likelihood for ASD. In addition, they indicate the potential of adopting a broader view on neurodevelopmental disorders by investigating not only ASD traits, but also co-occurring disorders such as ADHD in samples of elevated likelihood for ASD.

Background: Answering calls for an interactionist approach that would help clarify the complexity of organizational socialization, this study applied a person-centered analytic approach aiming to examine the role of proximal socialization outcome profiles for distal outcomes. Organizational socialization concerns the learning and adjustment process enabling newcomers to adapt to an organizational role. Proximal outcomes (or adjustment indicators) are assumed to reflect how well individuals adjust on their way to become organizational insiders, while distal outcomes reflect the ultimate organizational socialization outcomes. Thus, proximal outcomes precede distal outcomes, mediating effects of various organizational and individual socialization factors (known as antecedents) that foster the socialization process.

Method: In this study, a person-centered analytic approach was used to examine the role of proximal socialization outcome profiles for distal outcomes. Data from new police officers in Sweden (N = 430), from three time points (T0 = Application process [spring 2008], T1 = Near end of field training [end of 2010], and T2 = Near end of first work year [end of 2011]), were analyzed. First, latent profile analysis (LPA) was performed to identify proximal outcomes profiles. Then, the identified profiles were validated by a complementary analysis, which examined differences in antecedents and distal socialization outcomes among officers with different profiles.

Results: Among the new police officers, three proximal outcome profiles were identified – a vulnerable (35%), a troublesome (11%), and a successful (54%) – with profiles exhibiting distinct patterns in the proximal outcome indicators role conflict, task mastery, and social integration. Complementary analysis showed subgroup differences in some antecedents (e.g., personality and psychosocial working conditions) and distal outcomes (e.g., organizational commitment, job satisfaction, and work-related anxiety), thus emphasizing the role of personality and psychosocial working conditions in organizational socialization.

Implications: The study showed that proximal socialization outcome indicators may form profiles that characterize subgroups of newcomers following different socialization paths. Depicting how the socialization process may differ among subgroups is a significant theoretical contribution that adds nuance to traditional stage models. Findings also emphasize that both psychosocial working conditions and personality are important antecedents, which support viewing organizational socialization as an interactive process including both the individual and the environment. Accordingly, the study suggests the person-centered approach as promising for gaining new insights regarding organizational socialization processes. Further, this study indicates that the socialization process was successful for most new police officers. Still, for a fairly large proportion (i.e., the Vulnerable and Troublesome groups), the proximal outcome profiles indicated a less favourable adjustment. The differences in proximal outcome profiles suggest that the Troublesome and the Vulnerable groups struggled with somewhat different adjustment challenges, which may yield organizational challenges. From an applied perspective, the findings suggest that targeting the challenges and needs that characterize different groups of newcomers may help organizations to tailor actions facilitating learning and adjustment among newcomers. Moreover, to facilitate newcomers’ socialization, organizations may also benefit from monitoring newcomers’ experiences of their working climate as well as their personality.

Answering calls for an interactionist approach that would help clarify complex relationships among organizational socialization variables, this study applied a person-centered analytic approach aiming to examine the role of proximal socialization outcome profiles for distal outcomes. This approach is novel to organizational socialization research, contrasting the variable-centered approach dominating the field. Data from new police officers in Sweden (N = 430) were analyzed using latent profile analysis (LPA). Three proximal outcome profiles – a vulnerable (n = 151), a troublesome (n = 47), and a successful (n = 232) – were identified, with distinct patterns in the proximal outcome indicators role conflict, task mastery, and social integration. Complementary analysis showed subgroup differences in some antecedents and distal outcomes, which emphasized the role of personality and psychosocial working conditions. Thus, the findings show that proximal socialization outcome indicators may yield profiles characteristic of subgroups of newcomers who follow different socialization paths. Importantly, the findings show that a person-centered approach can add nuance to the understanding of how socialization processes differ among newcomers. While these results are promising, their generalizability to other professions and organizations remains to be investigated, which calls for continued person-centered research of organizational socialization processes. 

BACKGROUND: Approximately 30% of Swedish urban bus drivers report having been exposed to threats or violence. As 50% of drivers have voiced concerns about the occurrences, threats and violence also represent contributing factors to driver stress and fatigue. OBJECTIVE: The aim of this study was to explore bus drivers' experience of threats and violence; how threats and violence manifests and how the problem is handled by drivers. Gaining understanding of the circumstances is important to reduce the number of threats and violent incidents to provide healthy and attractive working conditions for drivers. METHODS: This study is based on in-depth interviews with 12 urban bus drivers in the City of Malmö in Sweden. RESULTS: Urban bus drivers experience threats daily from passengers, although physical violence occurs less often. The most common situations resulting in threats involve asking passengers to show valid tickets, denying child carriages onboard and running late to a bus stop. The drivers have not received clear guidelines as to strategic handling of the invalid ticket situation. CONCLUSIONS: Recommendations include a clear policy and consensus with regard to handling invalid tickets, providing drivers with guidelines for appropriate procedures for passengers refusing to pay, improving reporting routines and establishing a strategy for the Public Transportation provider and operator to follow with regard to reports, in-vehicle surveillance cameras including informing passengers that they are being video recorded as well as harmonizing the location of alarm buttons on buses. 

I beskrivningar av arbetslivet talas det ofta om det nya men inte sällan är det nygamla frågor som uppenbarar sig i en ny kontext. Det finns en kontinuitet till tidigare förhållanden som är värd att uppmärksamma inte minst i fråga om makt, sociala relationer och mänskliga behov. Digitala infrastrukturer genomsyrar nu arbetslivet och dessa kan ses som en ny produktionsform i relation till tidigare agrara och industriella former. I kapitlet undersöks och jämförs anställningsvillkor och anställningssystem i dessa tre produktionsformer. Gemensamt är grundkonflikten mellan den enskilda individens behov av kontroll, trygghet, mening och förutsägbarheti livet och företags och organisationers intresse av snabbar anpassningar till omvärldsförändringar. Konflikten formar konstruktionenav anställnings- och anknytningsformer både i kvalitativ och i kvantitativ mening. Kapitlet har i grunden ett psykologiskt perspektiv med fokus på arbetsvillkor och hälsa i två grupper av anställda -inlåsta och utlåsta - med stor diskrepans mellan sin aktuella och sin önskvärda arbets- och livssitutation

During the first wave of the COVID-19 pandemic in early spring 2020, most countries, including Sweden, chose to recommend or require employees for whom doing so was possible to work remotely from home in order to reduce the spread of infection at workplaces, and during commutes to and from workplaces. Working remotely differs in many respects from working at theemployer’s premises. The overall objective of this three-part review has been to compile and increase research-based knowledge of remote work from home.

This review encompasses research literature in three areas:

• work environment and health
• work–life balance
• productivity.

In the analyses, we have therefore focused in particular on similarities and differences in the conditions for men and women regarding paid work at home. Additional aims were to investigate and draw conclusions about remote work from home during the period before and during the pandemic, respectively.

The first part is a review of research reviews of remote work before the pandemic (published 2005–2021), while the second part is a review of original studies of remote work from home during the pandemic (2020– 2021). Part three comments on and summarises the material presented in parts one and two. The main purpose of the division into before and after is that remote work before the pandemic was primarily voluntary and planned, while remote work from home during the pandemic was unexpected, with minimal planning, and more or less forced.

The review has been limited to remote work from home conducted by employees through an internet connection.

The ability to adapt utterances to the world knowledge of one’s addressee is undeniably ubiquitous in human social cognition, but its development and association with other cognitive mechanisms during adolescence have not been studied. In an online production task, we measured the ability of children entering adolescence (ages 11–12, M= 11.8, 𝑁=29,17girlsN=29, 17 girls) and adolescents (ages 15–16, M = 15.9, 𝑁=29,17girlsN=29, 17 girls) to tailor referential expressions in accordance with the inferred world knowledge of their addressee—an ability we refer to as world knowledge-based audience design (AD). A post-test survey showed that both age groups held similar assumptions about the addressees’ knowledge of referents, but the younger age group did not consistently adapt their utterances in accordance with these assumptions during online production, resulting in a significantly improved AD behaviour across age groups. We also investigated the reliance of AD on executive functions (EF). Executive functioning (as reflected by performance on the Wisconsin card sorting task) increased significantly with age, but did not explain the age-related increase in AD performance. We thus provide evidence in support of an adolescent development of world knowledge-based AD over and above development of EF.

En praktisk och lättillgänglig bok om ett av våra största orosmoment och hälsoproblem idag, nämligen sömnen. John Axelsson, välkänd sömnforskare och professor, vill bidra till att minska vår oro kring sömnen men också ge handfasta verktyg kring hur man kan tänka och hantera perioder med lite sömn.

Här finns råd för småbarnsföräldern, skolbarn, tonåringen eller dig som har en neuropsykiatrisk diagnos. Boken baseras på såväl John Axelssons egen forskning som andra sömnforskares. Den går på ett pedagogiskt sätt igenom olika aspekter av sömn, så att du kan fatta bättre beslut kring din egen sömn. Till exempel hur du kan beta av en sömnskuld eller få förståelse för hur du kan hjälpa din hjärna att fungera bättre i vardagen. Dygnsrytmer, sömnmyter och spännande rön om drömmar tas förstås också upp.

Objective: To elaborate on possible cognitive sequelae related to COVID-19, associated cerebrovascular injuries as well as the general consequences from intensive care. COVID-19 is known to have several, serious CNS-related consequences, but neuropsychological studies of severe COVID-19 are still rare.

Methods: M., a 45-year-old man, who survived a severe COVID-19 disease course including Acute Respiratory Distress Syndrome (ARDS), cerebral microbleeds, and 35 days of mechanical ventilation, is described. We elaborate on M’s recovery and rehabilitation process from onset to the 8-month follow-up. The cognitive functions were evaluated with a comprehensive screening battery at 4 weeks after extubation and at the 8-month follow-up.

Results: Following extubation, M. was delirious, reported visual hallucinations, and had severe sleeping difficulties. At about 3 months after COVID-19 onset, M. showed mild to moderate deficits on tests measuring processing speed, working memory, and attention. At assessments at 8 months, M. performed better, with results above average on tests measuring learning, memory, word fluency, and visuospatial functions. Minor deficits were still found regarding logical reasoning, attention, executive functioning, and processing speed. There were no lingering psychiatric symptoms. While M. had returned to a part-time job, he was not able to resume previous work-tasks.

Conclusion: This case-study demonstrates possible cognitive deficits after severe COVID-19 and emphasizes the need of a neuropsychological follow-up, with tests sensitive to minor deficits. The main findings of this report provide some support that the long-term prognosis for cognition in severe COVID-19 may be hopeful.