A nurse-led lifestyle intervention for adult persons with attention-deficit/hyperactivity disorder (ADHD) in Sweden.

Introduction: Attention-deficit/hyperactivity disorder (ADHD) is associated with lifestyle-related diseases. Therefore, a nurse-led lifestyle intervention including interpersonal relationships, health education and cognitive support was developed to facilitate healthier lifestyle habits.Aim: The aim was to develop a lifestyle intervention and investigate its impact on mental and physical healthMethod: The 52-week intervention included 35 adults with ADHD. In a pre- and post-test design, symptoms of ADHD were measured with the Adult ADHD Self-Report Scale, quality of life was measured with the Adult ADHD Quality of Life scale and mental health was measured with the Hospital Anxiety and Depression scale. Lifestyle habits and dimensions of health were measured by the Lifestyle-Performance-Health Questionnaire and physical fitness was measured by the VO2 Max Test and calculations of waist circumference and body mass index. Result: Post-tests for a group of 25 persons showed positive changes following the intervention regarding weekly physical activity, quality of life and general and mental health. Lifestyle habit support was found to be important. The impact of the intervention should be confirmed in a long-term study with a control group.Conclusion: This intervention may be beneficial and may be implemented in a primary healthcare setting or in other open care units.

Mortality differences between self-employed and paid employees: a 5-year follow-up study of the working population in Sweden.

OBJECTIVES: Analyse mortality differences between self-employed and paid employees with a focus on industrial sector, educational level and gender using Swedish register data. METHODS: A cohort of the total working population (4 776 135 individuals; 7.2% self-employed; 18-100 years of age at baseline 2003) in Sweden with a 5-year follow-up (2004-2008) for all-cause and cause-specific mortality (57 743 deaths). Self-employed individuals were categorised as sole proprietors or limited liability company (LLC) owners according to their enterprise's legal form. Cox proportional hazards models were applied to compare mortality rates between sole proprietors, LLC owners and paid employees, adjusted for sociodemographic confounders. RESULTS: Mortality from cardiovascular diseases was 16% lower and from suicide 26% lower among LLC owners than among paid employees, adjusted for confounders. Within the industrial category, all-cause mortality was 13-15% lower among sole proprietors and LLC owners compared with employees in manufacturing and mining (MM) as well as personal and cultural services (PCS), and 11-20% higher in sole proprietors in trade, transport and communication and the welfare industry (W). A significant three-way interaction indicated 17-23% lower all-cause mortality among male LLC owners in MM and female sole proprietors in PCS, and 50% higher mortality in female sole proprietors in W than in employees in the same industries. CONCLUSIONS: Mortality differences between self-employed individuals and paid employees vary by the legal form of self-employment, across industries, and by gender. Differences in work environment exposures and working conditions, varying market competition across industries and gender segregation in the labour market are potential mechanisms underlying these findings.

Self-employed persons in Sweden - mortality differentials by industrial sector and enterprise legal form: a five-year follow-up study.

OBJECTIVES: This study investigated mortality differentials between self-employed persons in Sweden, considering industrial sector, enterprise characteristics and socio-demographic factors. METHODS: Data on 321,274 self-employed persons were obtained from population registers in Sweden. Cox proportional hazards models were used to compare all-cause and cause-specific mortality rate ratios by industrial sector and enterprise legal form, adjusted for confounders. RESULTS: All-cause mortality was 10-32% higher in self-employed persons in Manufacturing and Mining, Trade and Communication, and Not Specified and Other sectors than in Agriculture, Forestry, and Fishing. Mortality from cardiovascular disease was 23% higher in Trade and Communication, and from neoplasms 17-51% higher in Manufacturing and Mining, Not Specified, and Other. Mortality from suicide was 45-60% lower in Personal and Cultural Services, and in Not Specified. Mortality was 8-16% higher in sole proprietorship than limited partnership. CONCLUSIONS: Further research of working conditions is warranted, considering industry and enterprise legal form.

Working from home, work/life conflict and mental wellbeing in Europe during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic has pushed many employees away from their offices into their homes. During the first wave of the COVID-19 pandemic, in early spring 2020, most countries recommended or required that employees work remotely from home to reduce the spread of infection at workplaces and during travel to and from these workplaces. OBJECTIVE: The main aim of this study was to investigate the relationships between working from home, work/life conflict and mental wellbeing in Europe during the pandemic. METHODS: The study was based on a large-scale, online survey that was conducted during the COVID-19 pandemic three times, in 2020, 2021 and 2022, in 27 EU countries, and included 53 214 respondents that were employed at the time of the study. RESULTS: The results showed that working from home, work-to-life conflict and life-to-work conflict has increased and that mental wellbeing has decreased during the pandemic. Our regression analyses showed that the number of hours worked from home was negatively associated with work-to-life conflict and positively associated with life-to-work conflict. These results indicate that working from home can have both positive and negative consequences for employees' work/life conflict. The regression results showed that hours worked from home, work-to-life conflict and life-to-work conflict were negatively associated with mental wellbeing. CONCLUSION: It is important to consider different work situations for different working life groupings when implementing work-from-home measures. Organizations must consider how work is supervised and help managers understand how to support employees to achieve work-life balance when working remotely.

A comparative study of governmental financial support and resilience of self-employed people in Sweden and Canada during the COVID-19 pandemic.

Globally, self-employed people were among the hardest hit by the repercussions of the COVID-19 pandemic and faced hardships such as financial decline, restrictions, and business closures. A plethora of financial support measures were rolled out worldwide to support them, but there is a lack of research looking at the effect of the policy measures on self-employed people. To understand how different governmental financial support measures enhanced the resilience of the self-employed and improved their ability to manage the pandemic, we conducted a mixed-method study using policy analysis and semi-structured interviews. The documents described policies addressing governmental financial support in Sweden and Canada during the pandemic, and the interviews were conducted with Swedish and Canadian self-employed people to explore how they experienced the support measures in relation to their resilience. The key results were that self-employed people in both countries who were unable to telework were less resilient during the pandemic due to financial problems, restrictions, and lockdowns. The interviews revealed that many self-employed people in hard-hit industries were dissatisfied with the support measures and found them to be unfairly distributed. In addition, the self-employed people experiencing difficulties running their businesses reported reduced well-being, negatively affecting their business survival.

Life Satisfaction among Self-Employed People in Different Welfare Regimes during the COVID-19 Pandemic: Significance of Household Finances and Concerns about Work.

Most studies have shown that self-employed people have higher levels of life satisfaction than employed people due to high levels of job satisfaction, work flexibility, and job control. However, during the COVID-19 pandemic, many self-employed people experienced economic strain and worried about the situation of their employees and survival of the company. The aim of this study was to examine the level of life satisfaction among self-employed people during the COVID-19 pandemic in different welfare regimes. Analyses were mainly based on Eurofound's "Living, Working and COVID-19" online survey. Fieldwork took place between April and June 2020 in 27 EU countries. The results showed that there was a significantly lower level of life satisfaction among self-employed people than employed people during the pandemic. This was in contrast to analyses from approximately one year before the pandemic, which showed that life satisfaction was higher among self-employed people. The main reasons for this lower level of life satisfaction among the self-employed during the pandemic were worse household financial situation and more worries about their job. Analyses of life satisfaction among the self-employed in different welfare regimes indicated that self-employed people in the Nordic welfare state regime largely kept their relatively high level of life satisfaction during the pandemic, but this was not the case for self-employed people in other welfare regimes.

Making things work-In spite of a pandemic small scale enterprise managers' approach to business changes and health issues.

BACKGROUND: Covid-19 is one of the worst crises in modern working life with a direct negative impact on many enterprises and organizations. The aim of this study is to explore what managers in Small Scale Enterprises (SSEs) changed in their business during the Covid-19 pandemic, particularly addressing health issues. METHODS: A longitudinal qualitative research methodology was used, interviewing 16 managers of SSEs in the Norwegian and Swedish manufacturing and service sector both before (round 1) and during the pandemic (round 2). In this approach, time is designed into the research process, making change a key focus for analysis. RESULTS: The analysis resulted in two main themes, resilience and demanding occupational health and safety conditions, and five sub-themes. Results show how managers in SSEs changed their business during the Covid-19 pandemic and the impact of these changes. Although, the enterprises were heavily affected in the beginning of the pandemic, several managers found new solutions for their businesses to maintain and reach new customers. They applied a socially responsible management which addressed different health issues. CONCLUSION: Crises like the Covid-19 pandemic will have future impact on SSEs making it important to understand how managers in such enterprises address business and health issues. This knowledge may have practical implications for supporting managers in SSEs in how to perform a socially responsible management and maintain occupational health and safety measures. The managerial implications from this research are that they need to be flexible, reorientable and, at the same time, be loyal to the core business. This study shows the importance of doing longitudinal studies about business and health issues among mangers in SSEs.

Correction: The disappointment of financial support measures during the COVID-19 pandemic among small business managers' in Sweden.

[This corrects the article DOI: 10.1007/s43546-022-00347-7.].

Food Insecurity and Associated Factors among Households in Maputo City.

Food insecurity (FI) is a global concern and is one of the main causes of malnutrition in low- and middle-income countries. In Mozambique, the burden of FI and how various factors contribute to FI is not well known. This study aimed to investigate the prevalence of FI and its associated factors in southern Mozambique. Data from 1842 household heads in Maputo City were analyzed in a cross-sectional design. Food insecurity was measured using a modified version of the US Department of Agriculture Household Food Security scale, and its association with socio-demographic factors was assessed through multiple regressions. Altogether, 79% of the households were food insecure; of these, 16.6% had mild FI, 28.1% moderate and 34.4% severe FI. The study revealed that low-income households, those with less educated heads, and those engaged in informal work were significantly more prone to FI. Likewise, dietary diversity and the number of meals were also significant predictors of FI. These findings suggest the need for decent work and job creation, which calls for joint efforts from government, the private sector, and international institutions. Furthermore, these key drivers should be considered in the development of public health policies and programs designed to alleviate household FI and malnutrition in Mozambique.

Perceptions of Health and Wellbeing Among Employees in a Work Integration Social Enterprise in Sweden.

Background: Work Integration Social Enterprises (WISEs) constitute an important vehicle for providing employment opportunities for disadvantaged groups. Objective: The goal of this qualitative case study is to explore perceptions of health and wellbeing among employees working in a WISE located in the Gävleborg region, in east central Sweden. Methods: Data were gathered using 16 in-depth, semi-structured interviews with the social enterprise employees. Results: Findings were categorized into three main categories: the importance of financial independence and societal benefits; team spirit and a sense of belonging; and improved quality of life and wellbeing. Conclusion: The participants perceived that working in the WISE gave them a feeling of freedom and increased their self-esteem because of the possibility to earn an income. Also, they were satisfied with their job (e.g., with regard to work quality and flexibility) and believed that their work contributed to society. Moreover, through working in a WISE, the participants felt a sense of belonging and togetherness through interaction with co-workers and managers, and an improved quality of life for themselves and their families.

Changing the Office Design to Activity-Based Flexible Offices: A Longitudinal Study of How Managers' Leadership Behaviours Are Perceived.

This longitudinal study examines the impact of office type on employees' perception of managers' leadership behaviours, which is an unexplored area. The expanding research related to activity-based flexible offices (AFOs) has mainly focused on employees' working conditions and health outcomes, not on the changes in leadership behaviours when moving from traditional offices to AFOs. Office workers (n = 261) from five office sites within a large Swedish government agency were included in a controlled study of a natural intervention. At four sites, traditional offices were replaced by AFOs, while workers at one site with no relocation acted as the control. The same employees rated different leadership behaviours in a web-based questionnaire at baseline and at one follow-up. The analyses showed that relocations from cell and open-plan offices to AFOs were clearly related to a decrease in the perception of relation-oriented leadership behaviours. However, coming from open-plan offices to AFOs also decreased the perception of the other leadership dimensions. As expected, the control group was stable over time in their perceptions. This emphasises the need for organisations to provide managers with prerequisites so they can keep up with behaviours that support employees' performance and health when office designs and ways of working are changed.

Socio-Ecological Factors and Well-Being among Self-Employed in Europe during the COVID-19 Pandemic.

BACKGROUND: The self-employed are at increased risk of negative well-being outcomes when facing adversity such as the COVID-19 pandemic. Studies that examine socio-ecological factors that may protect their well-being are warranted. METHODS: Data were drawn from a cross-sectional survey of European self-employed people (n = 1665). The WHO-5 Well-being Index was used to examine the impact on well-being of factors at four socio-ecological levels. Independent sample t-tests, Pearson correlations and linear regression were applied to analyse differences between groups of self-employed and interactions between variables using SPSS. RESULTS: Well-being and the socio-ecological factors of resilience, social support, useful work and finding the rules clear were positively correlated with well-being. For self-employed who reported that it was challenging to run their business during the pandemic, social support and finding rules clear were of significantly greater importance to their well-being. CONCLUSIONS: The findings highlight that the socio-ecological factors of resilience, social support, doing useful work and finding the rules clear affect well-being. The results also indicate that it is vital to consider factors at multiple socio-ecological levels to improve the well-being of the self-employed during adversity.

Small business managers and Covid-19-The role of a sense of coherence and general resistance resources in coping with stressors.

BACKGROUND: The response of small business managers to an external event such as the pandemic can have a profound effect on the work environment, health and well-being for themselves and their employees. Previous research on small business managers during the pandemic has mainly focused on traditional pathogenic effects, and there is a lack of studies looking at the issue from a salutogenic health promotion perspective. The aim of this study is to explore whether a sense of coherence and general resistance resources were experienced by small business managers in Sweden and Norway during the Covid-19 pandemic. METHODS: A qualitative design was applied through exploratory interviews with 16 managers of small businesses in Sweden and Norway. A content analysis of the interviews was conducted using the sense of coherence concept by Aaron Antonovsky, with the three main components of comprehensibility, meaningfulness and manageability acting as a conceptual framework for the analysis process. RESULTS: Within the three main sense-of-coherence categories, six general resistance resources were identified as being important for the managers to handle uncertainty during the pandemic. These were understanding rules and regulations, social support, optimism, proactivity, problem-solving and flexibility and cooperation. CONCLUSIONS: The small business managers handled the pandemic in a way that worked well in their contexts, and the pandemic generally did not have a negative effect on their businesses or themselves. A salutogenic approach, through which the managers focused on identifying and using resources, was an important factor for managing stressors and adversity during the pandemic. Hence, the concept of salutogenesis may be used as an intervention to foster better health in small businesses, both at a personal and organisational level in order to handle future challenges effectively.

Food Insecurity and Health Outcomes Other than Malnutrition in Southern Africa: A Descriptive Systematic Review.

Food insecurity (FI) is one of the major causes of malnutrition and is associated with a range of negative health outcomes in low and middle-income countries. The burden of FI in southern Africa is unknown, although FI continues to be a major public health problem across sub-Saharan Africa as a whole. Therefore, this review sought to identify empirical studies that related FI to health outcomes among adults in southern Africa. Altogether, 14 publications using diverse measures of FI were reviewed. The majority of the studies measured FI using modified versions of the United States Department of Agriculture Household Food Security Survey Module. A wide range in prevalence and severity of FI was reported (18-91%), depending on the measurement tool and population under investigation. Furthermore, FI was mostly associated with hypertension, diabetes, anxiety, depression and increased risk of human immunodeficiency virus (HIV) acquisition. Based on the findings, future research is needed, especially in countries with as yet no empirical studies on the subject, to identify and standardize measures of FI suitable for the southern African context and to inform public health policies and appropriate interventions aiming to alleviate FI and potentially improve health outcomes in the region.

Managers of micro-sized enterprises and Covid-19: impact on business operations, work-life balance and well-being.

The aim of this study is to identify how managers of micro-sized enterprises experience the impact of the Covid-19 pandemic on their business operations, work-life balance and well-being. Further, the study aims to make comparisons between managers of micro-sized businesses and managers of small-sized businesses. This mixed-method study is based on qualitative interviews with ten managers of micro-sized enterprises and a questionnaire answered by 95 managers of micro-sized and small-sized enterprises in regions in the north of Sweden. Managers of micro-sized enterprises reported significantly worse scores for mental well-being, job satisfaction and life satisfaction in comparison with managers of small-sized enterprises. Three themes emerged from the qualitative analysis: Changed leadership role, Impact on private life and Impact on well-being. In the interviews, the managers of micro-sized enterprises reported that the pandemic had increased their workload and forced them to mobilise strategies for enterprise survival. This study indicates that managers of micro-sized enterprises had changed their leadership role and increased their workload and number of work tasks, including supporting the employees, developing strategies for business survival and applying for governmental support. However, the managers demonstrated creativity in finding new solutions for their enterprises.

Sickness Presenteeism Among the Swedish Self-Employed During the Covid-19 Pandemic.

The present study analyzed the impact of business operations, work and family circumstances, and well-being on the risk of sickness presenteeism for Swedish self-employed workers during the Covid-19 pandemic. It is of great importance to investigate the impact of the pandemic on the self-employed and their enterprises because they are seen as key drivers of economic growth and constitute an expanding group in many countries. Data were obtained from 845 self-employed workers by a web-based survey including questions about background information, work and family circumstances, well-being, sickness presenteeism, and questions about the pandemic. Results were that around 40% of the self-employed introduced new products, processes, and marketing methods, and just over 50% attempted to get new customers during the pandemic. Nearly half of the self-employed people reported that they lost contracts, and 22% judged the risk of bankruptcy to be quite or highly likely. Regression analyses showed that the more the self-employed reported impact on business indicators, increased work hours, a higher level of work-family conflict, and a lower level of mental well-being, the higher the risk of sickness presenteeism. The most common reasons given by the participants for sickness presenteeism during the pandemic were "nobody else can carry out my responsibilities," "I can't afford to take sick leave" and "I enjoy my work." Conclusions are that a critical event such as the pandemic probably adds to an already high workload for the self-employed. Impact on business operations such as developing new products/services and marketing, risk of bankruptcy and increased work hours seems to be important factors for explaining sickness presenteeism among the self-employed. Theoretical contributions from the study suggest that critical events such as the Covid-19 pandemic should be considered as an important environmental factor when studying sickness presenteeism among self-employed.

To control with health: from statistics to strategy.

The main purpose of this study is to develop and test a generic model for workplace health management in organizations. Four private and four public organizations in northern Sweden were selected for the study. A model for health control was developed on the basis of a literature review and dialogues with the stakeholders in the workplaces. The model was then implemented at the workplaces during a two-year period. Interviews with leaders and co-workers were conducted on two occasions and were analyzed using content analysis and the constant comparison method. By using a grounded theory approach, three main categories were found: health closure and other health and working environment indicators, monetary accounting of health related indicators and changes in leadership behaviour and organizational practices. An important result was that the model influenced leadership values more than leadership and organizational methodologies. From the results a model for workplace health management is proposed, incorporating the planning, control, and improvement structures. The purpose of the model is to take health aspects into consideration when deciding organizational structure (work demands, control and social support). The model controls health by using health-related indicators with high frequency measuring whereas workplace health promotion is done in a structured way with a reflective model.

Sickness Presenteeism among the Self-employed and Employed in Northwestern Europe-The Importance of Time Demands.

BACKGROUND: European policymakers encourage individuals to become self-employed because it is a way to promote innovation and job creation. It can be assumed that health and well-being among the self-employed and managers in small-scale enterprises are particularly crucial in this enterprise group because the smallness of the enterprise makes its members vulnerable. Earlier studies have indicated that the self-employed have a high working pace and work for long and irregular hours, indicating that it can be difficult to stay at home because of sickness. The purpose of this study is to investigate the occurrence of sickness presenteeism among the self-employed in relation to the organizationally employed and to analyze whether any differences can be explained by higher work demands among the self-employed. METHODS: The study is based on the fifth European survey on working conditions (2010) and includes the northwestern European countries in the survey. The questions cover a wide range of topics designed to meet the European Union's political needs. The main variables in this study are sickness presenteeism and several indicators of time demands. RESULTS: The results show that the self-employed report a higher level of sickness presenteeism than the employed: 52.4 versus 43.6%. All indicators of time demands are significantly related to the risk for sickness presenteeism, also when controlling for background characteristics. CONCLUSION: The results confirm that the level of sickness presenteeism is higher among the self-employed and that high time demands are a major explanation to this.

Workplace health interventions in small enterprises: a Swedish longitudinal study.

This article has a two-fold approach. First, it investigates relationships between work organizational factors, and health and performance outcomes. Second, it compares two change strategy approaches in workplace health interventions by studying changes of these factors and outcomes. The sample consisted of ten Swedish small enterprises including 102 individuals, who answered a before and after questionnaire about organizational factors and outcomes. The leaders were interviewed and answered a questionnaire about performed workplace health interventions. Statistical methods used were reliability tests, correlation analyses and t-tests. Results indicate rather strong links between indicators of respectful leadership, creative work and team spirit, and the outcome indicators self-assessed health and judged workplace adaptability in association with customer satisfaction. The results concerning changes of determinants and outcomes (after workplace health interventions) showed significant differences between enterprises using a broad change strategy and those using an expert/problem-based strategy with the former having more favourable results. The leader interview results also point at obstacles concerning workplace change processes as lack of resources, insufficient competence and influence of external factors. The study results suggest that work organizational factors and integrated models for workplace health intervention are of importance for health and performance outcomes in small enterprises.

Cooperation Between Occupational Health Services and Small-Scale Enterprises in Norway and Sweden: A Provider Perspective.

Although small-scale enterprises (SSEs) dominate the private enterprise sector, knowledge about support for these organizations from occupational health services (OHSs) is insufficient. The aim of this research was to study OHS services provided and staff cooperation with SSEs in Norway and Sweden. In total, 87 Norwegian and 51 Swedish OHS providers answered a survey on their experiences providing requested services from and cooperation with SSEs. Based on survey questions and constructed indices, providers in the two countries were compared using independent sample t tests and non-parametric tests. Open-ended questions were analyzed using qualitative content analysis. The results showed that SSEs, particularly in industrial, construction, and trade sectors, commonly contract for Norwegian and Swedish OHSs, and these contracts have increased in the last 12 months. Norwegian providers state that SSEs request broader organizationally- based services; their Swedish counterparts request more individual-based health-related services. Improvements concerning specific strategies for OHS collaboration with SSEs may be needed.