Mats Eklöf

Effects of experimentally induced mental and physical stress on motor unit recruitment in the trapezius muscle

Mental stress may induce muscle tension and it is thought to contribute to the development of musculoskeletal disorders. Prolonged activity of a muscles motor units (the smallest functional units) having low activation thresholds, may cause metabolic disturbances, degenerative processes and pain. The present experiment was aimed at investigating if the same motor units are activated by mental stress as by physical demands. Seventeen participants were exposed to mental stress tests (mental arithmetic, Stroop color word) and physical demands (standardized reference contraction, force ramp contraction) in the laboratory. In addition, they were exposed to the cold pressor test. Bipolar intramuscular electromyographic (EMG) activity was measured in the trapezius muscle, which covers the upper part of the back, the neck and the shoulder, and an automatic classification programme was used to separate the contributions of the individual motor units in the compex EMG signal. Overall muscle activity was measured by bipolar surface EMG and heart rate was recorded as an indicator of stress. The mental stress induced significant increases in muscle activity ( p < .05) and in heart rate ( p < .05). In 12 out of 14 participants, one or more motor units were found to be active in mentally as well as in physically induced muscle contraction. The results indicate that mentally induced stress may contribute to keeping low threshold motor units active, even in the absence of physical demands. Considering the health risks of prolonged motor unit activity, it was concluded that lack of mental rest is an important risk factor for the development of muscular pain.

Prevalence of perceived stress, symptoms of depression and sleep disturbances in relation to information and communication technology (ICT) use among young adults - an explorative prospective study

The aim of this study was to prospectively investigate whether high quantity of information and communication technology (ICT) use is a risk factor for developing psychological symptoms among young ICT users. A cohort of college students responded to a questionnaire at baseline and at 1-year follow-up (n=1127). Exposure variables, such as different types of ICT use, and effect variables, such as perceived stress, symptoms of depression and sleep disturbances, were assessed. Prevalence ratios were computed, based on symptom-free subjects at baseline and prevalence of symptoms at follow-up. For women, high combined use of computer and mobile phone at baseline was associated with increased risk of reporting prolonged stress and symptoms of depression at follow-up, and number of short message service (SMS) messages per day was associated with prolonged stress. Also online chatting was associated with prolonged stress, and e-mailing and online chatting were associated with symptoms of depression, while Internet surfing increased the risk of developing sleep disturbances. For men, number of mobile phone calls and SMS messages per day were associated with sleep disturbances. SMS use was also associated with symptoms of depression. The findings suggest that ICT may have an impact on psychological health, although causal mechanisms are unclear.

Pushing Oneself Too Hard : Performance-Based Self-Esteem as a Predictor of Sickness Presenteeism Among Young Adult Women and Men-A Cohort Study

Objective: To examine whether young adults with highly performance-based self-esteem (PBSE) were present at work/studies when ill more frequently than were others. Methods: By using data from a Swedish cohort of young adults aged 20 to 25 years (n = 5582 at baseline), we examined the association between PBSE and sickness presenteeism (SP) >5 times/yr (retrospectively at 1-year follow-up). Results: PBSE was a predictor of SP even when adjusting for general health, psychological demands, physical demands, economic problems, and main occupation. A synergy effect was also observed between PBSE and environmental and personal factors in relation to SP. The effect of PBSE on SP was four times higher among individuals with poor health, compared to individuals with good health. Conclusions: These results provide support for the role of personality characteristics as a predictor of frequent SP.

Perception and control of occupational injury risks in fishery--a pilot study

The frequency of occupational accidents in fishery is high in most fishery nations. Implementation of safety measures has, however, been limited. The purpose of the present cross-sectional study was to explore Swedish fishermens attitudes towards occupational risks and accident control. Information was acquired through a questionnaire distributed to a convenience sample of 92 fishermen. Indices were built, containing variables relevant to perceived risk levels in connection with work, perceived manageability of risks, activity in safety work, technical knowledge and individual attitudes towards risks. The results did not support earlier findings of low risk awareness and risk acceptance among fishermen. Perceived manageability of risks but not perceived risk level, accident experience or risk acceptance, were significantly associated with activity in safety work. The results suggest that safety work might benefit from efforts to develop fishermens understanding of how the development of hazardous situations can be prevented or managed. The results do not support strategies for accident control in fishery based solely on increasing risk awareness.

Conceptions of Diabetes and Diabetes Care in Young People With Minority Backgrounds

Adolescents with type 1 diabetes (T1DM) need stable self-care routines for good metabolic control to minimize future cardiovascular health complications. These routines are demanding, and might be particularly challenging in underprivileged groups. The aim of this study was to gain in-depth knowledge on the experience of adolescents with T1DM and a non-Swedish background regarding factors that might influence their ability to take care of themselves; in particular, factors that might influence diabetes management routines, their social situation, and the support they receive from caregivers. We interviewed 12 adolescents with T1DM and minority backgrounds. The results indicated resources and constraints in the adolescents’ social context and in the health care organization. The adolescents developed conceptions that helped to explain and excuse their self-care failures, and their successes. These findings highlight the importance of integrating T1DM as part of the individual’s personal prerequisites. We discuss implications for the organization of diabetes care for adolescents.

Early inequalities in excellent health and performance among young adult women and men in Sweden

BACKGROUND Although health inequality between young adult women and men has been strikingly evident in symptoms of ill health, we found no studies examining these inequalities with a focus on positive health and performance. OBJECTIVE The aim of the present study was to examine possible inequalities between young adult women and men in a combined assessment of positive health and health-related performance. METHODS Women and men aged 18 to 25 years studying medicine or computer science at 6 colleges/universities in 5 cities in Sweden were recruited for this study. All respondents answered a Web-based questionnaire regarding health, health-related performance, information and communication technology exposure, mood, and individual factors. A combined assessment of excellent health and health-related performance (EHHP) was defined and tested. Prevalence ratios (PRs) with 95% CIs of EHHP were calculated separately for female and male respondents. To assess potential determinants of EHHP, differences in the relationships between EHHP and the explanatory factors were compared for both sexes. RESULTS In a study group of young adult students consisting of 1046 women and 1312 men, women were less likely than men to have EHHP (PR 0.90 [95% CI, 0.83-0.98]). This inequality was even stronger within each course of study (medicine or computer science). Health-related factors showed similar patterns of relationship to EHHP for women and men; however, the strength of these relationships differed between the sexes. Logical relationships were observed between EHHP and almost all of the symptoms as well as between EHHP, the mood index, and health-related behavior. CONCLUSIONS The well-known inequality in symptoms of ill health between young adult women and men was prevalent even in a combined assessment of positive health and health-related performance. That this inequality was prevalent in a relatively homogeneous sample of young adults indicates the importance of gender-based psychological and psychosocial factors beyond the more well-known structural gender-differentiating factors of vertical and horizontal segregation and disproportional responsibilities for domestic work. It may therefore be essential to emphasize these gender-based psychological and psychosocial factors when designing future studies and health promotion programs.

Health care to empower self-care in adolescents with type 1 diabetes mellitus and an immigrant minority background:

Background: The pediatric diabetes team aims to support health, quality of life, and normal growth and development among adolescents with type 1 diabetes mellitus. Adolescents with an immigrant background have been found less successful in self-care. Previous research indicated that adolescents who had integrated the disease as a part of their self-image reasoned differently about their self-care to those who had not. Objective: The aim of this study was to identify elements in the patient–pediatrician consultations that might influence such integration of the disease among adolescents with type 1 diabetes mellitus. Methods: A total of 12 pediatrician–adolescent consultations were video-recorded and analyzed. The adolescents all had an immigrant background. Results: Integration of the disease appeared enabled when responsibility was shared; when hope, autonomy, and emotions were confirmed; and when the pediatrician asked probing questions. Letting objective data dominate the adolescent’s experiences, using risk as a motivator, neutralizing emotions in relation to having diabetes, and confirming forgetfulness, may instead inhibit disease integration. Conclusion: An extended person-centered approach with focus on the adolescent’s experiences of everyday life with a chronic disease and less attention on physical parameters in the pediatrician–adolescent consultations may increase integration of the disease.

The relationship between patient safety climate and occupational safety climate in healthcare – A multi-level investigation

INTRODUCTION Patient safety climate/culture is attracting increasing research interest, but there is little research on its relation with organizational climates regarding other target domains. The aim of this study was to investigate the relationship between patient safety climate and occupational safety climate in healthcare. METHOD The climates were assessed using two questionnaires: Hospital Survey on Patient Safety Culture and Nordic Occupational Safety Climate Questionnaire. The final sample consisted of 1154 nurses, 886 assistant nurses, and 324 physicians, organized in 150 work units, within hospitals (117units), primary healthcare (5units) and elderly care (28units) in western Sweden, which represented 56% of the original sample contacted. RESULTS Within each type of safety climate, two global dimensions were confirmed in a higher order factor analysis; one with an external focus relative the own unit, and one with an internal focus. Two methods were used to estimate the covariation between the global climate dimensions, in order to minimize the influence of bias from common method variance. First multilevel analysis was used for partitioning variances and covariances in a within unit part (individual level) and a between unit part (unit level). Second, a split sample technique was used to calculate unit level correlations based on aggregated observations from different respondents. Both methods showed associations similar in strength between the patient safety climate and the occupational safety climate domains. CONCLUSIONS The results indicated that patient safety climate and occupational safety climate are strongly positively related at the unit level, and that the same organizational processes may be important for the development of both types of organizational climate. PRACTICAL APPLICATIONS Safety improvement interventions should not be separated in different organizational processes, but be planned so that both patient safety and staff safety are considered concomitantly.

Dissociation of dysfunctional breathing and odour intolerance among adults in a general-population study.

Background:  Many patients present with a mixture of respiratory problems such as shortness of breath, heavy breathing, coughing and odour intolerance. If these patients are diagnosed as asthma, it might sometimes be a false diagnosis. Concepts such as sensory hyperreactivity, hyperventilation, asthma‐like symptoms, odour intolerance and dysfunctional breathing are used to refer to these patients. Non‐respiratory symptoms such as headache, fatigue and bloating are sometimes also part of the clinical picture. Our aim was to use factor analysis to increase our understanding of breathing‐related symptoms in a general‐population frame.

Improving communication among healthcare workers: a controlled study

Purpose – This paper aims to test the effects on aspects of workplace communication relevant to teamwork, and social support, in hospital units, of a dialog training (DT) intervention based on knowledge of key quality aspects related to interpersonal work-related communication among healthcare workers. Design/methodology/approach – A cluster randomized controlled study conducted among approximately 300 Swedish healthcare workers employed at ten hospital units. Workplace communication was measured in the form of participative safety, trust/openness, and social support. Effects were tested at three-month and six-month follow-ups. Repeated measurements were made. Findings – The results indicated that DT had a positive influence on participative safety and social support from managers. A positive tendency was observed for trust/openness. Originality/value – Developing and practicing good staff communication in hospital units is an important area for interventions designed to improve job performance and health.