Papers by Gunnar Bergström
Journal of Occupational and Environmental Medicine, 2009
• Review the concept of sickness presenteeism, including previous findings, its associated factor... more • Review the concept of sickness presenteeism, including previous findings, its associated factors and relationship to sickness absenteeism.
Advances in Physiotherapy
International Archives of Occupational and Environmental Health
The primary aim of this prospective study was to investigate whether working despite illness, so ... more The primary aim of this prospective study was to investigate whether working despite illness, so called "sickness presenteeism", has an impact on the future general health of two different working populations during a follow-up period of 3 years. The study was based on two bodies of data collected at a number of Swedish workplaces from 1999 to 2003. The first material comprised 6,901 employees from the public sector and the second 2,862 subjects from the private sector. A comprehensive survey was issued three times: at baseline, after 18 months and after 3 years. Apart from the explanatory variable sickness presenteeism, several potential confounders were considered. The outcome variable was good/excellent versus fair/poor self-reported health. Sickness presenteeism at baseline was consistently found to heighten the risk of fair/poor health at both the 18-month and 3-year follow ups even after adjusting for the detected confounders. To the best of the authors' knowledg...
Work
This study is a prospective multicentre cohort study entitled Work and Health in the Processing a... more This study is a prospective multicentre cohort study entitled Work and Health in the Processing and Engineering Industries, the AHA Study (AHA is the Swedish abbreviation for the study). Four large workplaces in Sweden participated during the years from 2000 to 2003. The present report has two objectives: (1) to present a comprehensive occupational health intervention programme and (2) to evaluate this programme with a focus on lifestyle (smoking and exercise), health related quality of life (HRQoL) and sick leave. Interventions were provided on an individual and group level, including evidence-based methods for four health/focus areas (individual level) and a group intervention based on a survey-feedback methodology. The analyses in this report were exclusively employed at an organizational level. The proportion of smokers decreased at three companies and the course of the HRQoL was advantageous at two of the companies as compared to a gainfully employed reference group. A signific...
Kompetenscenter för företagshälsa, Oct 24, 2014
International Archives of Occupational and Environmental Health, 2014
Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, 2003
To evaluate the responsiveness of the EuroQol (EQ-5D) and Short-Form 36 (SF-36) instruments, i.e.... more To evaluate the responsiveness of the EuroQol (EQ-5D) and Short-Form 36 (SF-36) instruments, i.e. their ability to capture clinically important changes, in elderly patients with a displaced femoral neck fracture. The study was part of a prospective randomised study comparing two different surgical procedures, internal fixation (IF) and total hip replacement (THP). University hospital. A total of 110 patients, mean age 80 years with an acute displaced femoral neck fracture (Garden III and IV). The inclusion criteria were age > or = 70, absence of severe cognitive dysfunction, independent living status and independent walking capability. The patients were randomised to IF or to a THR. Health-related quality of life according to EQ-5D and SF-36. Responsiveness measured by the ability of the EQ-5D and the SF-36 to detect clinically relevant differences in the study population according to an external criterion (EC) for outcome (good or less good clinical outcome). Responsiveness was ...
Scandinavian Journal of Caring Sciences, 2013
Translation and validation of the wound-specific quality of life instrument Cardiff Wound Impact ... more Translation and validation of the wound-specific quality of life instrument Cardiff Wound Impact Schedule in a Swedish population Purpose: To translate and validate the wound-specific health-related quality of life instrument, the Cardiff Wound Impact Schedule (CWIS) in a Swedish population. Methods: The instrument was first translated into Swedish, using the Standard Linguistic Validation Process. The Swedish version of the CWIS was then tested for its psychometric properties in a Swedish context. A total of 117 patients with acute and hard-to-heal wounds were included. The patients were asked to fill in the Swedish version of the CWIS and the generic instrument SF-36 at baseline and after 1 week. Patients with acute wounds were also asked to fill in both instruments after 6 weeks.
Rheumatology (Oxford, England), Jan 27, 2014
The aims of this study were to document adherence to and changes in health-enhancing physical act... more The aims of this study were to document adherence to and changes in health-enhancing physical activity (HEPA) levels and self-reported and assessed functioning and to explore aspects of adherence and response during the first year of an outsourced 2-year HEPA programme in people with RA. Two-hundred and twenty patients participated in this observational cohort study, which included daily physical activity, twice-weekly circuit training and biweekly support group meetings. Self-reported data included current (past week) and maintained (past 6 months) HEPA levels, sociodemographics and disease-related and psychosocial factors. Tests of aerobic capacity and muscle function were performed and anthropometric data were collected. Eighty-eight per cent of the participants completed 1 year assessments. Self-reported current and maintained HEPA increased. General health perception and a number of other self-reported disease-related and psychosocial factors improved, while exercise self-effic...
BMC Health Services Research, 2015
Background: Nationwide implementation of guaranteed access to evidence-based rehabilitation was e... more Background: Nationwide implementation of guaranteed access to evidence-based rehabilitation was established in Sweden in 2009, through an Act of the Swedish Government. The rehabilitation guarantee's primary goal was to increase the rate of return-to-work, reduce and prevent long-term absenteeism after diagnoses related to back pain and common mental health problems. This study aims to develop knowledge about factors influencing large-scale implementation of complex and extensive interventions in healthcare settings.
Disability and Rehabilitation, 2014
Purpose: To explore and describe health professionals' experience of working with return to work ... more Purpose: To explore and describe health professionals' experience of working with return to work (RTW) in multimodal rehabilitation for people with non-specific back pain. Method: An interview study using qualitative content analysis. Fifteen participants were interviewed, all were working with multimodal rehabilitation for people with non-specific back pain in eight different rehabilitation units. Results: The participants experienced RTW as a long-term process reaching beyond the time frames of the multimodal rehabilitation (MMR). Their attitudes and, their patients' condition, impacted on their work which focused on psychological and physical well-being as well as participation in everyday life. They often created an action plan for the RTW process, however the responsibility for its realisation was transferred to other actors. The participants described limited interventions in connection with patients' workplaces. Conclusions: Recommended support in the RTW process in MMR comprises the provision of continuous supervision of vocational issues for the health care professionals, the development of guidelines and a checklist for how to work in close collaboration with patients' workplaces and employers, the provision of long-term follow-up in relation to the patients' work, and the development of proper interventions in order to promote transitions between all the different actors involved.
Twin Research and Human Genetics, 2014
Background: This study aims to assess whether the associations between burnout and sick leave due... more Background: This study aims to assess whether the associations between burnout and sick leave due to stress-related mental disorders, other mental disorders, and somatic conditions are influenced by familial (genetic and shared environmental) factors. Methods: In this prospective cohort study, 23,611 Swedish twins born between 1959 and 1985, who answered a web-based questionnaire, including the Pines Burnout Measure 2004-2006, were included. Registry data on sick leave spells from the response date until December 31, 2010 were obtained from the Swedish Social Insurance Agency. Logistic regression analysis was performed to assess odds ratios with 95% confidence intervals for the association between burnout and sick leave for the whole sample, while conditional logistic regression of the same-sex discordant twin pairs was used to estimate the association between burnout and sick leave, adjusting for familial confounding. The Bivariate Cholesky models were used to assess whether the covariation between burnout and sick leave was explained by common genetic and/or shared environmental factors. Results: Burnout was a risk factor for sick leave due to stress-related and other mental disorders, and these associations were explained by familial factors. The phenotypic correlation between burnout and sick leave due to somatic conditions was 0.07 and the association was not influenced by familial factors. The phenotypic correlations between burnout and sick leave due to stress-related (0.26) and other mental disorders (0.30) were completely explained by common genetic factors. Conclusions: The association between burnout and sick leave due to stress-related and other mental disorders seems to be a reflection of a shared genetic liability.
OBJECTIVES: To investigate the prospective value of the transitional and dynamic patterns of pain... more OBJECTIVES: To investigate the prospective value of the transitional and dynamic patterns of pain disability over time on sick leave in chronic recurrent back/neck pain cases. METHODS: The material used was based on a longitudinal study with three repeated measurements. The graded Chronic Pain Scale was used to assess levels of pain disability. The relationship between the transitional patterns of the pain disability score (ten defined states of decrease, increase or no change, between two time points) and sick leave was analyzed for 909 chronic/recurrent cases in three different models using logistic regression. RESULTS: Those with high level of pain disability have a more transitional pattern and their pain level changed during the time period studied. When adjusting for age, gender, education and previous sick leave, the final model indicated that the current level of pain disability was a risk factor in taking sick leave. The likelihood of sick leave was highest in the transition of pain into the highest levels of disability, independent of past disability level of pain. Earlier sick leave remained as an important predictor of sick leave. CONCLUSIONS: From a clinical and prognostic perspective the probability of sick leave will be different and can be predicted based on previous sick leave but not from former history of pain disability level or its transitional pattern.
Spine, 2000
A prospective cohort study including patients with nonspecific spinal pain was performed. To inve... more A prospective cohort study including patients with nonspecific spinal pain was performed. To investigate whether the use of expert judgment in routine practice can provide a basis for reliable decision making concerning the need for intervention in patients with spinal pain and their ability to benefit from treatment. A wide range of instruments and techniques are used to assess and treat patients with spinal pain. Many instruments are used without being clinimetrically tested. A questionnaire concerning the patients' need of treatment and their potential to assimilate it was sent to experts in the health care arena: physicians, physical therapists, social insurance officers. The experts included were those connected with patients participating in a larger outcome study. Two cohorts of patients (sample 1, n = 217; sample 2, n = 257) were followed for 6 and 12 months, during which time the patients' health and work status were mapped. No acceptable agreement was found between any of the experts' ratings of patients' needs and potential for rehabilitation. Logistic regression showed that the experts' judgments were based almost solely on the age of the patient. The prediction analyses showed that the most consistent predictor of the patients' status at the 6-month follow-up assessment was the patients' own belief in the existence of effective treatments and their perceived ability for learning to cope with the condition. Expert judgment as exercised in routine practice cannot be used as basis for reliable decision making concerning the need of the patient with spinal pain for intervention and the patient's ability to benefit from treatment.
Analytical Biochemistry, 2014
In this study, we compared affinity data from surface plasmon resonance (SPR) and weak affinity c... more In this study, we compared affinity data from surface plasmon resonance (SPR) and weak affinity chromatography (WAC), two established techniques for determination of weak affinity (mM-μM) small molecule-protein interactions. In the current comparison, thrombin was used as target protein. In WAC the affinity constant (KD) was determined from retention times, and in SPR it was determined by Langmuir isotherm fitting of steady-state responses. Results indicate a strong correlation between the two methods (R(2)=0.995, P<0.0001).
Biosensors and Bioelectronics, 2015
Ligands for identifying protein aggregates are of great interest as such deposits are the patholo... more Ligands for identifying protein aggregates are of great interest as such deposits are the pathological hallmark of a wide range of severe diseases including Alzheimer's and Parkinson's disease. Here we report the synthesis of an azide functionalized fluorescent pentameric oligothiophene that can be utilized as a ligand for multimodal detection of disease-associated protein aggregates. The azide functionalization allows for attachment of the ligand to a surface by conventional click chemistry without disturbing selective interaction with protein aggregates and the oligothiophene-aggregate interaction can be detected by fluorescence or surface plasmon resonance. In addition, a methodology where the oligothiophene ligand is employed as a capturing molecule selective for aggregated proteins in combination with an antibody detecting a distinct peptide/protein is also presented. We foresee that this methodology will offer the possibility to create a variety of multiplex sensing systems for sensitive and selective detection of protein aggregates, the pathological hallmarks of several neurodegenerative diseases.
Acta Chemica Scandinavica, 1991
The Spine Journal, 2013
BACKGROUND CONTEXT: Because low back pain (LBP) is a fluctuating condition, the diversity in the ... more BACKGROUND CONTEXT: Because low back pain (LBP) is a fluctuating condition, the diversity in the prediction literature may be due to when the outcome is measured. PURPOSE: The objective of this study was to investigate the prediction of LBP using an outcome measured at several time points. STUDY DESIGN/SETTING: A multicenter clinical observational study in Sweden. PATIENT SAMPLE: Data were collected on 244 subjects with nonspecific LBP. The mean age of the subjects was 44 years, the mean pain score at inclusion was 4.4/10, and 51% of the sample had experienced LBP for more than 30 days the previous year. OUTCOME MEASURES: The outcome used in this study was the ''number of days with bothersome pain'' collected with weekly text messages for 6 months. METHODS: In subjects with nonspecific LBP, weekly data were available for secondary analyses. A few baseline variables were chosen to investigate prediction at different time points: pain intensity, the presence of leg pain, duration of LBP the previous year, and self-rated health at baseline. Age and gender acted as additional covariates. RESULTS: In the multilevel models, the predictive variables interacted with time. Thus, the risk of experiencing a day with bothersome LBP varied over time. In the logistic regression analyses, the predictive variable's previous duration showed a consistent predictive ability for all the time points. However, the variables pain intensity, leg pain, and self-rated health showed inconsistent predictive patterns. CONCLUSIONS: An outcome based on frequently measured data described the variability in the prediction of future LBP over time. Prediction depended on when the outcome was measured. These results may explain the diversity of the results of the predictor studies in the literature. Ó
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Papers by Gunnar Bergström