Sexual harassment, sexual violence and subsequent depression and anxiety symptoms among Swedish university students: a cohort study.

PURPOSE: To determine the gender-specific impact of recent exposure to different forms of sexual harassment and sexual violence (SHV) on depression and anxiety symptoms three, six, and nine months later. METHODS: We recruited 2229 women and 1274 men studying at Swedish universities and followed them with web-surveys every three months over one year. We estimated mean differences (MDs) of depression and anxiety symptoms between exposed and unexposed at each follow-up, adjusting for prior SHV, prior depression and anxiety symptoms and potential confounders. RESULTS: For women, sexual harassment (wide subjective definition) was associated with higher symptom levels of depression (MD 1.0 [95% CI: 0.3; 1.7]) and anxiety (MD 0.8 [95% CI: 0.3; 1.4]) three months later. Unwanted sexual attention was associated with higher symptom levels of anxiety three (MD 0.5 [95% CI: 0.1; 0.8]) and six months later (MD 0.4 [95% CI: 0.0; 0.7]). Exposure to sex against ones will was associated with higher depression symptoms three (MD 1.7 [95% CI: 0.1;3.4]), and six months later (MD 3.1 [95% CI: 1.0; 5.2]). Trends indicated that associations with subsequent mental health differed between forms of SHV among women, and that most associations were more pronounced in temporal proximity to the exposures. For men, we refrain from interpreting the results since they showed high variability and were not robust to sensitivity analyses using multiple imputation to account for missing outcome data. CONCLUSIONS: Among women, several forms of SHV were associated with higher subsequent depression and anxiety symptoms.

Implementation of the Swedish Guideline for Prevention of Mental ill-health at the Workplace: study protocol of a cluster randomized controlled trial, using multifaceted implementation strategies in schools.

BACKGROUND: Given today's high prevalence of common mental disorders and related sick leave among teachers, an urgent need exists for a more systematic approach to the management of social and organizational risk factors within schools. In 2015, we launched the first Swedish occupational health guideline to support a structured prevention of these risks at the workplace. The existence of guidelines does however not guarantee their usage, as studies show that guidelines are often underused. Knowledge is therefore needed on effective implementation strategies that can facilitate the translation of guidelines into practice. The primary aim of the randomized waiting list-controlled trial described in this study protocol is to compare the effectiveness of a multifaceted implementation strategy versus a single implementation strategy for implementing the Guideline for the prevention of mental ill-health at the workplace within schools. The effectiveness will be compared regarding the extent to which the recommendations are implemented (implementation effectiveness) and with regard to social and organisational risk factors for mental ill-health, absenteeism and presenteeism (intervention effectiveness). METHODS: The trial is conducted among primary schools of two municipalities in Sweden. The single implementation strategy is an educational strategy (an educational meeting). The multifaceted strategy consists of the educational meeting, an implementation team and a series of workshops. The outcome measure of implementation effectiveness is guideline adherence. The primary outcome of intervention effectiveness is exhaustion. Secondary outcomes include demands at work, work organization and job contents, interpersonal relations and leadership, presenteeism, work performance, recovery, work-life balance, work-engagement, self-reported stress, self-perceived health, sickness absence and psychosocial safety climate. Process outcomes as well as barriers and facilitators influencing the implementation process are assessed. Data will be collected at baseline, 6, 12, 18 and 24 months by mixed methods (i.e. survey, focus-group interviews, observation). DISCUSSION: The study described in this protocol will provide valuable knowledge on the effectiveness of implementation strategies for implementing a guideline for the prevention of common mental disorders within schools. We hypothesize that successful implementation will result in reductions in school personnel's perceived social and organizational risk factors, mental ill-health and sick-leave. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT03322839 (trial registration: 09/19/2017).

Prediction of sickness absenteeism, disability pension and sickness presenteeism among employees with back pain.

PURPOSE: The primary aim of this study was to evaluate the predictive ability of the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) concerning long-term sick leave, sickness presenteeism and disability pension during a follow-up period of 2 years. METHODS: The study group consisted of 195 employees visiting the occupational health service (OHS) due to back pain. RESULTS: Using receiver operating characteristic (ROC) curves, the area under the curve (AUC) varied from 0.67 to 0.93, which was from less accurate for sickness presenteeism to highly accurate for the prediction of disability pension. For registered sick leave during 6 months following the baseline the AUC from the ROC analyses was moderately accurate (0.81) and a cut off score of 90 rendered a high sensitivity of 0.89 but a low specificity of 0.46 whereas a cut off score of 105 improves the specificity substantially but at the cost of some sensitivity. The predictive ability appears to decrease with time. Several workplace factors beyond those included in the ÖMPSQ were considered but only social support at the workplace was significantly related to future long-term sick leave besides the total score of the ÖMPSQ. CONCLUSIONS: The results of this study extend and confirm the findings of earlier research on the ÖMPSQ. Assessment of psychosocial risk factors among employees seeking help for back pain at the OHS could be helpful in the prevention of work disabling problems.

Rape Victims' Perceptions of Quality of Encounters With the Swedish Police.

This study focused on raped women's perceptions of their encounters with Swedish police, with a specific focus on quality of encounters, trust, questions asked during police interviews, and perceptions of justice. One hundred and six rape victims, 74 of whom had reported to the police, answered a web-based questionnaire. Results show that where officers explained their line of questioning the perceived intrusiveness of the questioning was lower, as was the level of perceived victim-blaming. Higher quality police encounters were associated with higher trust in the legal system and in police work, and with higher levels of received justice. Findings highlight the importance of trauma-informed policing as a response to sexual assault and provide insights which might help inform policy and practice developments, both in Sweden and more generally.

The effectiveness of implementing the Guideline for the Prevention of Mental Ill-health Problems at the Workplace on health-outcomes, organizational and social risk factors: a cluster-randomized controlled trial in Swedish schools.

OBJECTIVES: This study aimed to compare the effectiveness of the multifaceted implementation strategy (multifaceted group) versus a discrete implementation strategy (discrete group) for implementing the Swedish Guideline for the Prevention of Mental Ill-health Problems at the Workplace on the primary intervention outcome - exhaustion - and secondary outcomes of stress, health, recovery, psychosocial safety climate, and social and organizational risk factors. Another aim was to examine whether the primary and secondary outcomes differed on the basis of guideline adherence levels, irrespective of the group. METHODS: A cluster-randomized waiting-list controlled trial with 6- and 12-months follow-up was conducted among 19 Swedish public schools. Primary and secondary outcomes as well as guideline adherence were assessed by self-reported questionnaire. Linear mixed modeling was used to compare differences in outcomes between the groups from baseline to 6 and 12 months, and in relation to different adherence levels. RESULTS: The trial comprised 698 employees (83.1%) participated. There were no differences between groups in the primary and secondary outcomes at 6 months, while at 12 months differences were observed for some outcomes to the advantage of the discrete group. Better guideline adherence was associated with improvements in exhaustion at 12 months and the secondary outcomes of psychosocial safety climate, work organization and job content, interpersonal relations and leadership, and recovery over 6 and 12 months. CONCLUSION: The multifaceted implementation strategy was no more effective than the discrete strategy in improving health outcomes or organizational and social work environment. However, higher adherence to the guideline was associated with larger improvements in health outcomes and organizational and social work environment, irrespective of the implementation strategy used.

Do Attitudes towards Work or Work Motivation Affect Productivity Loss among Academic Employees?

Work motivation and job attitudes are important for productivity levels among academic employees. In situations where employees perceive problems, for example, health-related and work environment-related problems, the ability to perform at work could be affected, which may result in fewer publications, reduced quality and less research funding. Few studies, however, have paid attention to productivity loss among academic employees in order to understand how, or if, the perceived loss is affected by the reported problems, either alone or in combination with work motivation and job attitudes. To evaluate whether attitudes towards work-measured as job satisfaction, organisational commitment and work motivation-are associated with productivity loss in the workplace, a cross-sectional study was conducted. This type of design is required as performance is highly variable and is affected by changes in health and work status. This study includes employees who reported either health-related problems, work environment problems or a combination of both (n = 1475). Linear regression analyses were used to answer the hypotheses. Higher levels of motivation, job satisfaction and organisational commitment were associated with lower levels of productivity loss among employees who experienced either health-related or work environment problems. High work motivation and high commitment were significantly associated with lower levels of productivity loss among employees who experienced a combination of problems. In summary, productivity loss among academic employees is not only affected by health-related problems or problems in the work environment but also by work motivation, job satisfaction and organisational commitment; i.e., these factors seem to buffer, or moderate, the reduction in performance levels for this group of employees.

Effectiveness of a multifaceted implementation strategy for improving adherence to the guideline for prevention of mental ill-health among school personnel in Sweden: a cluster randomized trial.

BACKGROUND: There is limited research on prevention of mental ill-health of school personnel and the systematic management of school work environments. The aim of this study was to assess the effectiveness of implementing the guideline recommendations for the prevention of mental ill-health in schools, in particular, whether there was a difference in adherence to guideline recommendations between a multifaceted (group 1) and single implementation strategy (group 2) from baseline to 6 and to 12 months. METHOD: We conducted a cluster-randomized controlled trial with a 6- and 12-month follow-up. Data was collected from nearly 700 participants in 19 Swedish schools. Participants were school personnel working under the management of a school principal. The single implementation strategy consisted of one educational meeting, while the multifaceted implementation strategy comprised an educational meeting, an ongoing training in the form of workshops, implementation teams and Plan-Do-Study-Act cycles. Adherence was measured with a self-reported questionnaire. Generalized Linear Mixed Models were used to assess the difference between groups in adherence to the guideline between baseline, 6-, and 12-months follow-up. RESULTS: There were no statistically significant differences between the groups in improvements in adherence to the guideline between baseline, 6-, and 12-months follow-up. However, among those schools that did not undergo any organizational changes during the 12 months of the study significant differences between groups were observed at 12 months for one of the indicators. CONCLUSIONS: The multifaceted strategy was no more effective than the single strategy in improving guideline adherence. There are some limitations to the study, such as the measurement of the implementation outcome measure of adherence. The outcome measure was developed in a systematic manner by the research team, assessing specific target behaviors relevant to the guideline recommendations, however not psychometrically tested, which warrants a careful interpretation of the results. TRIAL REGISTRATION: ClinicalTrials.gov, 150571 . Registered 12 September 2017.

A randomized controlled trial in schools aimed at exploring mechanisms of change of a multifaceted implementation strategy for promoting mental health at the workplace.

BACKGROUND: This study will explore implementation mechanisms through which a single implementation strategy and a multifaceted implementation strategy operate to affect the implementation outcome, which is fidelity to the Guideline For The Prevention of Mental Ill Health within schools. The guideline gives recommendations on how workplaces can prevent mental ill health among their personnel by managing social and organizational risks factors in the work environment. Schools are chosen as the setting for the study due to the high prevalence of mental ill health among teachers and other personnel working in schools. The study builds on our previous research, in which we compared the effectiveness of the two strategies on fidelity to the guideline. Small improvements in guideline adherence were observed for the majority of the indicators in the multifaceted strategy group. This study will focus on exploring the underlying mechanisms of change through which the implementation strategies may operate to affect the implementation outcome. METHODS: We will conduct a cluster-randomized-controlled trial among public schools (n=55 schools) in Sweden. Schools are randomized (1:1 ratio) to receive a multifaceted strategy (implementation teams, educational meeting, ongoing training, Plan-Do-Study-Act cycles) or a single strategy (implementation teams, educational meeting). The implementation outcome is fidelity to the guideline. Hypothesized mediators originate from the COM-B model. A mixed-method design will be employed, entailing a qualitative study of implementation process embedded within the cluster-randomized controlled trail examining implementation mechanisms. The methods will be used in a complementary manner to get a full understanding of the implementation mechanisms. DISCUSSION: This implementation study will provide valuable knowledge on how implementation strategies work (or fail) to affect implementation outcomes. The knowledge gained will aid the selection of effective implementation strategies that fit specific determinants, which is a priority for the field. Despite recent initiatives to advance the understanding of implementation mechanisms, studies testing these mechanisms are still uncommon. TRIAL REGISTRATION: ClinicalTrials.org dr.nr 2020-01214.

Observed peptide pI and retention time shifts as a result of post-translational modifications in multidimensional separations using narrow-range IPG-IEF.

Modified peptides constitute a sub-population among the tryptic peptides analyzed in LC-MS based shotgun proteomics experiments. For larger proteomes including the human proteome, the tryptic peptide pool is very large, which necessitates some form of sample fractionation. By carefully choosing the sample fractionation and separation methods applied as shown here for the combination of narrow-range immobilized pH gradient isoelectric focusing (IPG-IEF) and nanoUPLC-MS, significantly increased information content can be achieved. Relatively low standard deviations were obtained for such multidimensional separations in terms of peptide pI (<0.05 pI units) and retention time (<0.3 min for a 350 min gradient) for a selection of highly complex proteomics samples. Using narrow-range IPG-IEF, experimental and predicted pI were in relative good agreement. However, based on our data, retention time prediction algorithms need further improvements in accuracy to match state-of-the-art reversed-phase chromatography performance. General trends of peptide pI shifts induced by common modifications including deamidations and N-terminal modifications are described. Deamidations of glutamine and asparagines shift peptide pI by approximately 1.5 pI units, making the peptides more acidic. Additionally, a novel pI shift (+~0.4 pI units) was found associated with dethiomethyl Met modifications. Further, the effects of these modifications as well as methionine oxidation were investigated in terms of experimentally observed retention time shifts in the chromatographic separation step. Clearly, post-translational modification-induced influences on peptide pI and retention time can be accurately and reproducibly measured using narrow-range IPG-IEF and high-performance nanoLC-MS. Even at modest mass accuracy (±50 ppm), the inclusion of peptide pI (±0.2 pI units) and/or retention time (±20 min) criteria are highly informative for human proteome analyses. The applications of using this information to identify post-translationally modified peptides and improve data analysis workflows are discussed.

Process Evaluation of a Participative Organizational Intervention as a Stress Preventive Intervention for Employees in Swedish Primary Health Care.

This study is a process evaluation of a trial examining the effects of an organizational intervention (Productivity Measurement and Enhancement System or ProMES) on employee stress. The aims were to explore the implementation process and fidelity to the intervention guidelines, examine the influence of contextual factors (hindrances and facilitators) and explore participants' experience of working with ProMES. We used the UK Medical Research Council (MRC) guidance to guide the process evaluation. The recruitment, reach and dose delivered were satisfactory and participation high. The employees felt ProMES clarified priorities, gave control and increased participation in decision-making. However, difficulty in obtaining statistical productivity data from the central administration office (a central feature of the intervention) hindered full implementation and regular feedback meetings. Staffing shortages interfered with the implementation process, while having seven design teams and one consultant prevented all occupational groups from working simultaneously. A detailed examination of access to necessary organizational data should be undertaken before implementing ProMES. We recommend a better introduction for new employees, more work on design and packaging and giving employees more training in how to use the software program. The study contributes to our understanding of process evaluations in research into organizational stress management interventions.

A Resourceful Work Environment Moderates the Relationship between Presenteeism and Health. A Study Using Repeated Measures in the Swedish Working Population.

The objective of this study was to investigate if the psychosocial work environment moderates the proposed negative impact of presenteeism on future general health. We expect that the negative impact of presenteeism on general health is weaker if the psychosocial work environment is resourceful, and more pronounced if the environment is stressful. Data were derived from the 2008-2018 biennial waves of the Swedish Longitudinal Occupational Survey of Health (SLOSH). The final analytic sample consisted of n = 15,779 individuals. We applied repeated measures regression analyses through generalized estimating equations (GEE). Results from the autoregressive GEE models showed statistically significant interaction terms between presenteeism and all four investigated moderators, i.e., job demands, job control, job support and job strain. The results indicate that the psychosocial work environment moderates the negative association between presenteeism and general health and illustrates a buffering effect of the psychosocial work environment. A possible explanation for these results may be that psychosocially resourceful work environments give room for adjustments in the work situation and facilitate recovery. The results also indicate that by investing the psychosocial work environment employers may be able to promote worker health as well as prevent reduced job performance due to presenteeism.

Experience of Stress Assessed by Text Messages and Its Association with Objective Workload-A Longitudinal Study.

Exploring stress trajectories in detail and over a long time may give valuable information in terms of both understanding and practice. We followed a group of primary health care employees in a randomized controlled trial. The objective was to describe their experience of stress, explore the intra-individual variability and examine the association between the experience of stress and the objective workload. Weekly text messages with a single item stress question were distributed in two time series: 12 weeks at the beginning of the trial and 26 weeks after the 6-month follow up. Aggregated objective data about workload were collected from their administration office and related to stress levels. There was a seasonal variation, with higher stress during the fall than in spring and summer. The analysis comparing high and low stress subgroups showed that the stress trajectory of a high-stress subgroup was different from that of a low-stress subgroup. Individuals with high exhaustion scores had higher odds of belonging to a subgroup of individuals with high intra-individual variability in stress experience. The objective workload was measured in two ways and was strongly associated with the stress experience. We found that the lower the productivity, the higher the feeling of stress.

Promoting Evidence-Based Practice for Improved Occupational Safety and Health at Workplaces in Sweden. Report on a Practice-Based Research Network Approach.

Despite the rapid growth in research and R&D expenditures, the translation of research into practice is limited. One approach to increase the translation and utilization of research is practice based research networks. With the aim of strengthening evidence-based practice (EBP) within occupational health services in Sweden (OH-Services), a practice-based research network (PBRN-OSH) was developed. The PBRN-OSH includes researchers and representatives from end-users. This paper reports on the development, outputs and lessons learned in the PBRN-OSH. The PBRN-OSH resulted in several practice-based research projects as well as different measures to ensure EBP in OSH such as the governmentally sanctioned national guidelines for the OH-services. Moreover, results show that the competence in EBP increased among practitioners at the OH-services. Conducting research in a PBRN is more resource demanding; however, this does not imply that it is less cost effective. To succeed in increasing the utility of research findings via PBRN, resources must be invested into an infrastructure that supports collaboration in the PBRN, including costs for a variety of means of dissemination. Further, translation activities need to be included in academic career paths and reward systems if a major improvement in the impact and return of investments from research is to be expected.

Associations Between Job-Strain, Physical Activity, Health Status, and Sleep Quality Among Swedish Municipality Workers.

OBJECTIVE: To examine the associations between work-stress and physical activity (PA) with sleep quality while controlling for covariates, including social support. METHODS: A cross-sectional study among employees of a municipality (n = 2765). Data from respondents (n = 1973) with good/poor sleep quality were included. Prevalence ratios (PR) were estimated using modified Poisson regression analyses. RESULTS: A significant interaction was observed between job-strain and self-reported health in the explanation of sleep quality. Consequently, interaction (job strain × self-rated health) adjusted PRs were calculated. The PRs for high job strain were 1.986 (95% CI 1.58 to 2.49) and 1.220 (95% CI 1.04 to 1.44) compared with the reference groups. CONCLUSIONS: Findings show that high job strain and low PA levels are associated with poor sleep quality, and that self-rated health plays an important moderating role in the association between job strain and sleep quality.

Workplace Bullying as Experienced by Managers and How They Cope: A Qualitative Study of Swedish Managers.

Background: The aim of the study was to describe factors that contribute to the occurrence of workplace bullying, that enable it to continue and the coping strategies managers use when they are bullied. METHODS: A qualitative study design was applied. Twenty-two managers from the private and public sectors were interviewed. Data were analyzed by means of content analysis. RESULTS: Several factors could be linked to the bullying: being new in the managerial position; lack of clarity about roles and expectations; taking over a work group with ongoing conflicts; reorganizations. The bullying usually lasted for quite some time. Factors that allowed the bullying to continue were passive bystanders and the bullies receiving support from higher management. The managers in this study adopted a variety of problem-focused and emotion-focused coping strategies. However, in the end most chose to leave the organization. Only four remained in their managerial position at the time of the interview. CONCLUSIONS: The study concludes that bullying can occur in all types of organization. To prevent it we need to look primarily at organizational factors. Social support is also crucial for managers' ability to cope successfully with bullying.

Health and Work Environment among Female and Male Swedish Elementary School Teachers-A Cross-Sectional Study.

BACKGROUND AND OBJECTIVES: Changes in teachers' work situation in Sweden since the 1990s may have contributed to an increase in common mental disorders (CMDs) and burnout. However, there is a lack of research in this field. The aim was to describe how Swedish elementary school teachers experience their health, organizational and social work environment, and the psychosocial safety climate at the workplace, and especially differences and similarities between female and male teachers. MATERIALS AND METHODS: Data were collected with the COPSOQ, OLBI, UWES and PSC-12 from 478 elementary teachers, 81.0% of them women, from twenty schools. The response rate was 96.4%. RESULTS: Teachers reported relatively good general health but experienced high stress, high work pace and emotional demands, low influence at work and a poor psychosocial safety climate. These factors were especially prominent among female teachers. Both women and men experienced good development possibilities and high work engagement. CONCLUSIONS: The results of this study can help us to develop a more sustainable work environment for female and male teachers. A more sustainable work environment might attract more people to the profession and incentivize existing teachers to remain in the profession.

Exhaustion and Impaired Work Performance in the Workplace: Associations With Presenteeism and Absenteeism.

OBJECTIVE: The aim of this study was to investigate the association between presenteeism and absenteeism during the previous year and the current levels of exhaustion and impaired work performance in a Swedish university setting. METHODS: In a study of 3525 employees, an ordinal logistic regression and general linear model was used to examine the association between presenteeism and absenteeism during the previous year and the current exhaustion and impaired work performance, respectively. RESULTS: Presenteeism, but not absenteeism, during the previous year independently increased the risk of having moderate or severe exhaustion. Presenteeism, absenteeism, and exhaustion remained positively associated with impaired work performance when health status and other confounders had been adjusted for. CONCLUSIONS: Presenteeism, but not absenteeism, was associated with exhaustion. Both presenteeism and absenteeism were the salient correlates of impaired work performance.

Diseases and causes of death among alpacas in Sweden: a retrospective study.

BACKGROUND: Due to increasing popularity in Sweden during the last decade, alpacas are frequently encountered by practising veterinarians and pathologists. Knowledge regarding their health and diseases under Swedish conditions is, however, limited. OBJECTIVES: To improve knowledge about the health of alpacas in Sweden by collecting information on diseases and health status. DESIGN: A retrospective study was made of 93 necropsies conducted on alpacas in Sweden during the period 2001-2013. SETTING: Data were obtained from the two major veterinary pathology centres in Sweden. The alpacas were hobby or farm animals and they were submitted by veterinarians in local practices or at a national animal healthcare organisation. RESULTS: The digestive system was most frequently affected (29 per cent), with parasitic gastroenteritis (17 per cent) and hepatic disease being especially prevalent (15 per cent fascioliasis and 7 per cent hepatitis). Cardiovascular conditions (9 per cent), systemic diseases (7 per cent) and perinatal deaths were also common, including abortions (10 per cent) and fatal septicaemia (4 per cent). Wasting/emaciation was a frequent finding (26 per cent). Other diagnoses included dermatitis (8 per cent), diseases of the central nervous system (8 per cent), traumatic injuries (7 per cent), neoplasia (5 per cent), pneumonia (5 per cent) and nephritis (3 per cent). CONCLUSIONS: This study identified areas of concern regarding diagnostic and pathological procedures, for which specific measures have been recommended. One particular cause for concern was the number of deaths from emaciation in weanling alpacas during late winter or early spring. For adult alpacas, infectious and non-infectious causes of death were approximately equally frequent. Many of the diseases were considered clinically acute but pathology often showed them to be chronic conditions that had eventually deteriorated and presented as acute cases in the late stages. This study revealed similarities in the health/disease status reported in other European countries and in North America. The results can be used by alpaca keepers and veterinary practitioners to improve management, diagnosis and treatment of alpacas.

Proteomic analysis of phospholipidosis in citalopram treated U937 cells--support for the cholesterol biosynthesis hypothesis.

Excessive accumulation of phospholipids leads to phospholipidosis (PL), which disrupts cellular functions, in extreme cases leading to acute or chronic disease. Citalopram and many other cationic amphiphilic drugs (CADs) have been shown to cause PL both in vitro and in vivo. Recent toxicogenomic studies suggest four hypothetical mechanisms for PL (lysosomal enzyme transport decrease, lysosomal phospholipase activity decrease, phospholipids biosynthesis increase or cholesterol biosynthesis increase). However, the post-genomic steps remain largely unknown and proteomic analyses hold significant promise for defining mechanisms of PL induction. In this study U937 monoblastoid cells were exposed to citalopram hydrobromide for 24 h (0, 20, 100 or 200 microM as citalopram free base) and then harvested for whole cell proteomic analysis using 2-D gel electrophoresis, or transmission electron microscopy (TEM). Protein spots that were significantly altered versus controls were analysed by MALDI-TOF mass spectrometry. Up-regulated proteins were Glyoxalase-I (Glo 1) and 3-Hydroxy-3-methylglutaryl-Coenzyme A synthase 1 (HMGCS1) in cells with PL shown by TEM (favouring the cholesterol biosynthesis increase hypothesis for citalopram induced PL). Other altered proteins were catalase (up-regulated), beta-actin (up-regulated) and 14-3-3 protein (down-regulated). The function of several of the successfully identified proteins indicates a potential perturbed lipid metabolism.

A comprehensive workplace intervention and its outcome with regard to lifestyle, health and sick leave: the AHA study.

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 significant decrease in sick leave was revealed at one company, whereas a break in an ascending sick-leave trend appeared at a second company as compared to their respective corporate groups. This comprehensive workplace intervention programme appears to have had positive effects on smoking habits, HRQoL and sick leave.