Previous radiotherapy improves treatment responses and causes a trend toward longer time to progression among patients with immune checkpoint inhibitor-related adverse events.

BACKGROUND: Immune-related adverse events (irAEs) are frequently encountered by patients during immune checkpoint inhibitor (ICI) treatment and are associated with better treatment outcomes. The sequencing of radiotherapy (RT) and ICIs is widely used in current clinical practice, but its effect on survival has remained unclear. METHODS: In a real-world multicenter study including 521 patients who received ICI treatment for metastatic or locally advanced cancer, RT schedules and timing, irAEs, time to progression, overall survival, and treatment responses were retrospectively reviewed. RESULTS: Patients who received previous RT and developed irAE (RT +/AE +) had the best overall response rate (ORR 44.0%). The ORR was 40.1% in the RT -/AE + group, 26.7% in the RT -/AE - group and 18.3% in the RT + /AE - group (p < 0.001). There was a significantly longer time to progression (TTP) in the RT + /AE + group compared to the RT -/AE - and RT + /AE - groups (log rank p = 0.001 and p < 0.001, respectively), but the trend toward longer TTP in the RT + /AE + group did not reach statistical significance in pairwise comparison to that in the RT -/AE + group. Preceding RT timing and intent had no statistically significant effect on TTP. In a multivariate model, ECOG = 0 and occurrence of irAEs remained independent positive prognostic factors for TTP (HR 0.737; 95% CI 0.582-0.935; p = 0.012, and HR 0.620; 95% CI 0.499-0.769; p < 0.001, respectively). CONCLUSIONS: Better ORR and a trend toward longer TTP were demonstrated for patients with RT preceding ICI treatment and development of irAEs, which suggests that RT may boost the therapeutic effect of immunotherapy in patients with metastatic cancers.

Autonomy and health-related quality of life in adolescents.

BACKGROUND: Autonomy is recognized as important for individual well-being and constitutes one dimension in the KIDSCREEN-instrument measuring health related quality of life (HRQoL) in children and adolescents. However, the autonomy questions in KIDSCREEN are restricted to opportunities to influence leisure time activities, which is a form of autonomy as volition. Yet, there are other aspects of autonomy that might be related to adolescent's HRQoL. The aims of the present study were first to investigate the psychometric properties of a scale measuring autonomy in adolescence from a control perspective (AAC) including its relation to the autonomy dimension in KIDSCREEN, and second; to investigate AACs ability to predict each of the 10 dimensions constituting KIDSCREEN. METHODS: Students (n = 154) aged 15-16 years who were recruited from schools located in both low (two schools) and high (two schools) socioeconomic status (SES) areas in Sweden participated in a cross-sectional study. The adolescents answered a questionnaire including a new 6-item scale measuring perceived autonomy and HRQoL assessed by the KIDSCREEN-52 instrument. A factor analyses was computed to investigate the relation between the items in the AAC scale and the autonomy items in the KIDSCREEN instrument. Hierarchical regression analyses were computed to investigate if the AAC scale predicted HRQoL in any of the 10 dimensions in KIDSCREEN after controlling for gender, SES and the original autonomy scale included in KIDSCREEN. RESULTS: The factor analysis showed that all the items from the autonomy scale loaded in one factor and that all the items from the AAC scale loaded in another dimension. The hierarchical regression models showed that the AAC scale uniquely predicted HRQoL in all dimensions of the KIDSCREEN instrument after controlling for gender, SES and the original autonomy scale included in KIDSCREEN-52. A high level of perceived autonomy was associated with a high level of HRQoL for both scales. CONCLUSION: A new scale for measuring autonomy from a control perspective has been presented and shown to differ from autonomy as volition. Both forms of autonomy are positively related to HRQoL in adolescence 15-16 years old.

Are return to work beliefs, psychological well-being and perceived health related to return-to-work intentions among women on long-term sick leave for common mental disorders? A cross-sectional study based on the theory of planned behaviour.

BACKGROUND: Long-term sick leave due to common mental disorders (CMDs) is a great burden in society today, especially among women. A strong intention to return to work (RTW) as well as symptom relief may facilitate RTW in this group. However, there is a lack of knowledge regarding what constitutes a strong intention. The Theory of Planned Behaviour is well-suited to identifying underlying beliefs about intentions to perform a behaviour. By including psychological well-being and perceived health, a more comprehensive picture of determinants of RTW intention might be achieved. Thus, the aim of the present study was to identify associations between RTW beliefs, psychological well-being, perceived health and RTW intentions among women on long-term sick leave due to CMDs, and to do so based on the Theory of Planned Behaviour. METHODS: The study was cross-sectional. Between October 2019 and January 2020, 282 women on long-term sick leave (> 2 months) due to CMDs were included in the study. The questionnaires for data collection were: "RTW Beliefs Questionnaire", the "General Health Questionnaire -12" and the "EuroQol Visual Analogue Scale". Standard multiple regression analysis was performed both with and without adjustment for potential confounders. RESULTS: The results showed that a more positive attitude towards RTW, stronger social pressure to RTW, higher perceived control over RTW and higher psychological well-being were associated with stronger RTW intention. The adjusted analysis eliminated the importance of psychological well-being for RTW intention, but showed that women who reported that their employer had taken actions to facilitate their RTW had stronger RTW intention. CONCLUSION: The RTW beliefs, derived from the Theory of Planned Behaviour, were all important for a strong RTW intention, while psychological well-being and perceived health showed weaker associations. Furthermore, having an employer that take actions for facilitating RTW was associated with stronger RTW intentions. Though some caution is warranted regarding the representativeness of the sample, the results do improve our understanding of some important determinants of RTW intention among women on long-term sick leave for CMDs.

Beliefs About Return to Work Among Women During/After Long-Term Sick Leave for Common Mental Disorders: A Qualitative Study Based on the Theory of Planned Behaviour.

PURPOSE: Long-term sick leave due to common mental disorders (CMDs) is an increasing problem, especially among women. To help these women return to work (RTW) sustainably, we need to know more about their own beliefs about RTW. One applicable theory is the theory of planned behaviour (TPB). Thus, the present study aimed to describe, based on the TPB, women's beliefs about RTW during or after long-term sick leave for a CMD. METHODS: A qualitative approach was used. Twenty women were included during a long-term sick leave period due to a CMD. A deductive content analysis was conducted using predetermined factors from the TPB: behavioural beliefs (advantages-disadvantages of RTW), normative beliefs (supporters and non-supporters of RTW), and control beliefs (facilitators of-barriers to RTW). RESULTS: The women believed that RTW would give them meaning and balance in life, but also that it would be challenging to maintain balance after RTW. They believed they had several supporters of RTW, but that the support was sometimes perceived as stressful rather than encouraging. Furthermore, individual adaptation and high demands were the most mentioned facilitator and barrier, respectively. Workplace conditions and personal strategies were thought to be important aspects. CONCLUSIONS: By using the TPB, the present study was able to offer new findings on women's beliefs about RTW after long-term sick leave for a CMD. Based on the findings, we suggest that various RTW stakeholders should focus on striving to provide the tasks and work pace women need so they can maintain their professional competence and sense of meaning.

Associations between scores of psychosomatic health symptoms and health-related quality of life in children and adolescents.

BACKGROUND: The aims of the present study are to investigate whether there are differences in health-related quality of life (HRQoL) between girls and boys in two different age groups, to study how much of children's variance in HRQoL can be explained by common psychosomatic health symptoms, and to examine whether the same set of psychosomatic symptoms can explain differences in HRQoL, both between girls and boys and between older and younger school children. METHODS: A cross-sectional study was conducted of 253 children, 99 of ages 11-12 years (n=51 girls, n=48 boys) and 154 of ages 15-16 years (n=82 girls, n=72 boys), in Swedish schools. The KIDSCREEN-52 instrument, which covers 10 dimensions of HRQoL and additional questions about psychosomatic health symptoms, were used. Analyses of variance were conducted to investigate differences between the genders and age groups, and in interaction effects on the KIDSCREEN-52 dimensions. Regression analyses were used to investigate the impacts of psychosomatic symptoms on gender and age group differences in HRQoL. RESULTS: Boys rated themselves higher than girls on the KIDSCREEN dimensions: physical and psychological well-being, moods and emotions, self-perception, and autonomy. Main effects of age group were found for physical well-being, psychological well-being, moods and emotions, self-perception, autonomy, and school environment, where younger children rated their HRQoL more highly than those aged 15-16 years. Girls rated their moods and emotions dramatically lower than boys in the older age group, but the ratings of emotional status were more similar between genders at younger ages. Psychosomatic symptoms explained between 27% and 50% of the variance in the children's HRQoL. Sleeping difficulties were a common problem for both girls and boys. Depression and concentration difficulties were particularly associated with HRQoL among girls whereas stomach aches were associated with HRQoL among boys. CONCLUSIONS: Girls and adolescents experience poorer HRQoL than boys and younger children, but having psychosomatic symptoms seem to explain a substantial part of the variation. Strategies to promote health among school children, in particular to alleviate sleep problems among all children, depression and concentration difficulties among girls, and stomach aches among boys, are of great importance.

Development and psychometric evaluation of a theory-based questionnaire measuring women's return-to-work beliefs after long-term sick leave for common mental disorders.

BACKGROUND: Common mental disorders (CMDs) are currently a major cause of long-term sick leave, with women being most affected. OBJECTIVE: Using the Theory of Planned Behaviour (TPB), we aimed to describe the development and psychometric evaluation of a new questionnaire to measure women's beliefs about return to work (RTW) after long-term sick leave for CMDs. METHODS: Data were collected in central Sweden from women on long-term sick leave (2- 24 months) for CMDs. The questionnaire was developed by conducting an elicitation study with 20 women and included both direct and indirect measures. Subsequently, 282 women participated in a psychometric evaluation and 35 of them in a test-retest procedure. Psychometric properties were evaluated by determining reliability (internal consistency [Cronbach's alpha] and test-retest stability [intraclass correlation coefficient]), construct validity (exploratory factor analysis) and content validity. RESULTS: The development resulted in 60 questionnaire items. Content validity assessment showed that the women overall found it easy to complete the questionnaire. Reliability analyses showed satisfactory results for both direct and indirect measures, with a few exceptions. Factor analyses of the indirect scales showed that items were generally in line with the TPB, but that items related to life as a whole/personal life and items related to work were separated into two different factors. CONCLUSION: The questionnaire, called the RTW Beliefs Questionnaire, showed promising results and can among women with CMDs be considered useful, especially the scales for direct measures. This questionnaire gives opportunity to identify new potential predictors for RTW.

Predictors of return to work and psychological well-being among women during/after long-term sick leave due to common mental disorders - a prospective cohort study based on the theory of planned behaviour.

Common mental disorders are associated with long-term sick leave, especially among women. There is a lack of theory-based research regarding the impact of personal factors on return to work and psychological well-being. Therefore, the aim of this study was to examine whether return-to-work beliefs and perceived health were predictors of return to work and psychological well-being among women during or after long-term sick leave for common mental disorders, based on the Theory of Planned Behaviour. This was a prospective cohort study with a 1-year follow-up. At baseline, women (n = 282) had been on full- or part-time sick leave for common mental disorders for 2-24 months. Data were collected in October 2019-January 2020 and October 2020-January 2021 in Sweden. The Social Insurance Agency identified the women at baseline. The Return-To-Work Beliefs Questionnaire, EuroQol Visual Analogue Scale and General Health Questionnaire-12 were used. Multiple logistic and linear regression analyses were conducted. The women were divided into two groups: full-time sick leave or part-time sick leave at baseline. The results showed that stronger return-to-work intention significantly predicted return to work among women on full-time sick leave at baseline. No significant predictors of return to work were found among women on part-time sick leave at baseline. Psychological well-being was predicted by stronger social pressure to return to work (full-time group) and a more positive attitude toward returning to work and better perceived health (part-time group). We concluded that the Theory of Planned Behaviour can be useful for understanding return to work among women on full-time sick leave, and what underlies psychological well-being in both groups. However, return to work and psychological well-being were predicted by different factors, indicating that a multifactorial approach should be used in supporting women to return to work after long-term sick leave for common mental disorders.

Psychophysiological Reactivity, Postures and Movements among Academic Staff: A Comparison between Teleworking Days and Office Days.

The aim of this study was to determine if psychophysiological activity, postures and movements differ during telework (i.e., work performed at home) and work performed at the conventional office. We performed twenty-four-hour pulse recordings and accelerometry measurements on 23 academic teaching and research staff during five consecutive workdays, with at least one day of telework. Additionally, we conducted salivary sampling during one day of telework, and one day of office work. Heart rate and heart rate variability indices, postural exposure and cortisol concentration were analyzed using repeated measures analysis of variance with Workplace and Time (i.e., before, during and after workhours) as within-subject effects. We found a significant interaction effect of Workplace and Time in heart rate variability indices and in the number of transitions between seated and standing postures. This shows more parasympathetic activity among academic teleworkers during telework than office work, which may indicate more relaxation during telework. They had an overall sedentary behavior at both workplaces but switched between sitting and standing more often during telework, which may be beneficial for their health.

Short Is Beautiful: Dimensionality and Measurement Invariance in Two Length of the Basic Psychological Need Satisfaction at Work Scale.

Self-determination theory proposes that all humans have three intrinsic psychological needs: the needs for Autonomy, Competence, and Relatedness. These needs take different forms in different areas of life. The present study examines the psychometric properties of a Swedish version of the Basic Psychological Need Satisfaction at Work (BPNS-W) scale. The fit of 10-factor structures previously suggested for related versions of the scale were compared. Cross-sectional data from 1,200 participants were examined in a confirmatory factor analysis framework. Both the original 21-item version and a reduced 12-item version of the BPNS-W were examined. The General Health Questionnaire was used for validation. The results supported a three-factor solution with correlated error variances for the reversed items. Invariance testing of the long and short scales gave best support to the short scale, for which partial scalar invariance was achieved. The external validity of the short scale was supported by a hierarchical regression analysis in which each need made a unique contribution in predicting psychological well-being. In conclusion, the results corroborate a three-factor structure of BPNS-W. Although not perfect the short scale should, it is argued, be preferred over the long version. Directions for the future development of the scale are discussed.

Can people with disabilities gain from education? Similarities and differences between occupational attainment among persons with and without disabilities.

BACKGROUND: More knowledge is needed of occupational attainment of persons with disabilities, i.e., the relationship between their educational level and their profession, and factors of importance for this relationship. OBJECTIVE: To compare occupational attainment among persons with and without a disability. METHOD: 3396 informants with disabilities and 19,004 non-disabled informants participated (control group) in a survey study by Statistics Sweden.The informants with disabilities were divided into six groups. RESULTS: Occupational attainment did not differ between the disability groups, neither between persons with and without a disability. Follow-up analysis showed that men with disabilities with primary or secondary school had an occupation above their educational level to a significantly larger extent than women with disabilities. This pattern was even clearer in comparison with the control group. Persons without disabilities, with secondary or higher education, were more successful in the labor market than persons with disabilities. Occupational attainment increased with age in both groups. CONCLUSIONS: Young women with disabilities who only have primary or secondary education run a higher risk of having a job that is below their educational level than men at the same educational level. This indicates discriminating mechanisms in the society related to gender and ability.

Structural equation models of memory performance across noise conditions and age groups.

Competing models of declarative memory were tested with structural equation models to analyze whether a second-order latent variable structure for episodic and semantic memory was invariant across age groups and across noise exposure conditions. Data were taken from three previous experimental noise studies that were performed with the same design, procedure, and dependent measures, and with participants from four age groups (13-14, 18-20, 35-45, and 55-65 years). Two noise conditions, road traffic noise and meaningful irrelevant speech, were compared to a quiet control group. The structural models put to the test were taken from Nyberg et al. (2003), which employed several memory tests that were the same as ours and studied age-groups that partly overlapped with our groups. In addition we also varied noise exposure conditions. Our analyses replicated and supported the second-order semantic-episodic memory models in Nyberg et al. (2003). The latent variable structures were invariant across age groups, with the exception of our youngest group, which by itself showed a less clear latent structure. The obtained structures were also invariant across noise exposure conditions. We also noted that our text memory items, which did not have a counterpart in the study by Nyberg et al. (2003), tend to form a separate latent variable loading on episodic memory.

The effects of noise and gender on children's episodic and semantic memory.

The main objectives in the present study were to examine meaningful irrelevant speech and road traffic noise effects on episodic and semantic memory, and to evaluate whether gender differences in memory performance interact with noise. A total of 96 subjects, aged 13-14 years (n = 16 boys and 16 girls in each of three groups), were randomly assigned to a silent or two noise conditions. Noise effects found were restricted to impairments from meaningful irrelevant speech on recognition and cued recall of a text in episodic memory and of word comprehension in semantic memory. The obtained noise effect suggests that the meaning of the speech were processed semantically by the pupils, which reduced their ability to comprehend a text that also involved processing of meaning. Meaningful irrelevant speech was also assumed to cause a poorer access to the knowledge base in semantic memory. Girls outperformed boys in episodic and semantic memory materials, but these differences did not interact with noise.

The effects of road traffic noise and meaningful irrelevant speech on different memory systems.

To explore why noise has reliable effects on delayed recall in a certain text-reading task, this episodic memory task was employed with other memory tests in a study of road traffic noise and meaningful but irrelevant speech. Context-dependent memory was tested and self-reports of affect were taken. Participants were 96 high school students. The results showed that both road traffic noise and meaningful irrelevant speech impaired recall of the text. Retrieval in noise from semantic memory was also impaired. Attention was impaired by both noise sources, but attention did not mediate the noise effects on episodic memory. Recognition was not affected by noise. Context-dependent memory was not shown. The lack of mediation by attention, and road traffic noise being as harmful as meaningful irrelevant speech, are discussed in relation to where in the input/storing/output sequence noise has its effect and what the distinctive feature of the disturbing noise is.