Swedish Survey Research Articles

Is refugee experience in childhood a risk for poorer health in adulthood?-A Swedish national survey study.

Studies on experiences of migration in childhood and subsequent health in adulthood report conflicting results. While there is limited research on the long-term health outcomes of refugee children as they transition into adulthood, it is often observed that refugee children experience adverse health conditions upon their arrival in the host country. We examined whether adults with a childhood refugee experience were more likely to have poorer mental health, general health, and risk-behaviours compared to non-refugee migrants and Swedish-born peers We included a nationally representative sample of 18-64-year-olds who answered the Swedish National Public Health survey in 2018 or 2020. Using official register data, we categorized individuals as: 1) refugees in childhood (<age 18 years); 2) migrants in childhood; or 3) Swedish-born. Associations between childhood status (refugee, migrant, or Swedish-born) and all outcomes in adulthood were analyzed using logistic regression. The final model was adjusted for age, sexual- and gender-minority (SGM) identity, and stratified by sex. We also analysed the above and all outcomes stratified by age (18-25, 26-64), adjusted for sex and SGM-identity. We found that a childhood refugee experience was not associated with worse self-rated general or mental health, or more risk behaviours in adulthood, compared to non-refugee migrants or Swedish-born individuals. Additionally, adults with a childhood refugee experience had lower odds of at-risk alcohol use and substance use than Swedish-born peers. In general, a childhood refugee experience was not associated with worse self-rated health or risk behaviours in adulthood when considering age and sexual- and gender-minority status.

Errors, Omissions, and Offenses in the Health Record of Mental Health Care Patients: Results from a Nationwide Survey in Sweden.

Previous research reports that patients with mental health conditions experience benefits, for example, increased empowerment and validation, from reading their patient-accessible electronic health records (PAEHRs). In mental health care (MHC), PAEHRs remain controversial, as health care professionals are concerned that patients may feel worried or offended by the content of the notes. Moreover, existing research has focused on specific mental health diagnoses, excluding the larger PAEHR userbase with experience in MHC. The objective of this study is to establish if and how the experiences of patients with and those without MHC differ in using their PAEHRs by (1) comparing patient characteristics and differences in using the national patient portal between the 2 groups and (2) establishing group differences in the prevalence of negative experiences, for example, rates of errors, omissions, and offenses between the 2 groups. Our analysis was performed on data from an online patient survey distributed through the Swedish national patient portal as part of our international research project, NORDeHEALTH. The respondents were patient users of the national patient portal 1177, aged 15 years or older, and categorized either as those with MHC experience or with any other health care experience (nonmental health care [non-MHC]). Patient characteristics such as gender, age, education, employment, and health status were gathered. Portal use characteristics included frequency of access, encouragement to read the record, and instances of positive and negative experiences. Negative experiences were further explored through rates of error, omission, and offense. The data were summarized through descriptive statistics. Group differences were analyzed through Pearson chi-square. Of the total sample (N=12,334), MHC respondents (n=3131) experienced errors (1586/3131, 50.65%, and non-MHC 3311/9203, 35.98%), omissions (1089/3131, 34.78%, and non-MHC 2427/9203, 26.37%) and offenses (1183/3131, 37.78%, and non-MHC 1616/9203, 17.56%) in the electronic health record at a higher rate than non-MHC respondents (n=9203). Respondents reported that the identified error (MHC 795/3131, 50.13%, and non-MHC 1366/9203, 41.26%) and omission (MHC 622/3131, 57.12%, and non-MHC 1329/9203, 54.76%) were "very important," but most did nothing to correct them (MHC 792/3131, 41.29%, and non-MHC 1838/9203, 42.17%). Most of the respondents identified as women in both groups. About 1 in 2 MHC patients identified an error in the record, and about 1 in 3 identified an omission, both at a much higher rate than in the non-MHC group. Patients with MHC also felt offended by the content of the notes more commonly (1 in 3 vs 1 in 6). These findings validate some of the worries expressed by health care professionals about providing patients with MHC with PAEHRs and highlight challenges with the documentation quality in the records.

Comparison between Swedish EORTC QLQ-C30 general population norm data published in 2000 and 2019

Background Normative health-related quality of life (HRQoL) data from the general population are regularly used to facilitate the interpretation of HRQoL as reported by cancer patients participating in cancer clinical trials, especially when conducting long-term follow-up studies after treatment. The aim of the present study is to compare two Swedish normative data sets, published in 2000 and 2019 respectively, and explore whether HRQoL as reported by the Swedish general population has changed over time. Material and Methods ‘Sample 2000’ was comprised of normative data from the Swedish general population who responded to the EORTC QLQ-C30 in a Swedish mail survey in 1999 (n = 3069). ‘Sample 2019’ consisted of data from the Swedish general population collected as part of a European norm data study using online panels, published in 2019 (n = 1027). Data were analyzed stratified by sex and age (40–49; 50–59; 60–69; 70–79 years). Results For most of the subscales and single items, no age group differences between the two samples were found, with the exception of the oldest age group (70–79 years), where Sample 2019 generally showed better HRQoL as compared to Sample 2000. Lower (worse) levels of Global quality of life and higher (worse) levels of Dyspnoea were found in Sample 2019 for most age groups. Conclusion There were no differences found between the samples for most EORTC QLQ-C30 subscales and single items, with the exception of the oldest age group of both sexes in Sample 2019 who reported better HRQoL on many variables. When deciding which normative dataset to use, the mode of data collection and age group have to be considered.

CN40 Time to identify CAM-users during oncology treatment: The results of a regional survey in Sweden

CN40 Time to identify CAM-users during oncology treatment: The results of a regional survey in Sweden

Recent Secular Trends of Body Mass Index in Individuals With Bipolar Disorders and in the General Population.

The aims of this study were to investigate secular trends and distribution of body mass index (BMI) among individuals with bipolar disorders and the general population between 2008 and 2019. Data were from the Swedish National Quality Register for Bipolar Disorder, where 24,423 adults with bipolar disorders were identified, and from the national Swedish Living Conditions Surveys, where 77,485 adults from the general population were identified. Quantile regression was used to compare the 15th, 50th, and 85th percentiles of BMI across age and study years. The study sample included 22,127 individuals with bipolar disorders (mean age, 48 years; 63% women) and 71,894 individuals from the general population (mean age, 52 years; 51% women). BMI percentiles were higher among individuals with bipolar disorders. At the 50th percentile, the BMI group differences were 1.1 (95% CI=0.8-1.14) for men and 1.8 (95% CI=1.5-2.1) for women. The gap was widest at the 85th BMI percentile: men, 2.3 (95% CI=1.8-2.8); women, 4.1 (95% CI=3.7-4.6). BMI increased over time in both study groups, but more in the group with bipolar disorders. The changes per decade in mean BMI were 0.4 (95% CI=0.3-0.5) among men in the general population, 1.1 (95% CI=0.7-1.4) among men with bipolar disorders, 0.6 (95% CI=0.5-0.7) among women in the general population, and 1.4 (95% CI=1.1-1.7) among women with bipolar disorders. Women with bipolar disorders had the highest prevalence and the greatest rate of increase of obesity. In 2019, the obesity prevalence was 33% among women and 29% among men with bipolar disorders, compared with 13% and 15%, respectively, among women and men in the general population. Adults with bipolar disorders had a higher BMI and a higher prevalence of obesity than the general population, indicating a higher cardiometabolic risk. Annually, BMI increased more in the group with bipolar disorders than in the general population, particularly among women and among those with high BMI.

The Road to Retirement: A Life Course Perspective on Labor Market Trajectories and Retirement Behaviors

Abstract While a prolonged working life has been mainly feasible for people with the most advantageous working careers, knowledge about the barriers for those with vulnerable occupational paths is still scarce. This study explores the conditions for prolonged working life from a perspective on labor market trajectories. Drawing from a gendered life course perspective and that (dis)advantageous tends to accumulate over time, we investigate the opportunity structure for the most disadvantaged workers and which characteristics of labor market trajectories can explain the decision to work longer. To this end, a Swedish longitudinal survey and register data from the Panel Survey of Ageing and the Elderly (PSAE) were used, following people across a substantial part of their working life. With sequence analysis, we identified 5 trajectories that represent typical labor market trajectories from mid-life until retirement age. Our findings showed that labor market precarity in mid-life remained a key characteristic until the expected retirement age, showing both early signs of early labor market exit and a precarity trap into a prolonged working life. These findings emphasize the need to identify at-risk groups early in their careers and that mid-life interventions are needed to prevent involuntary labor market exits and to ensure a sustainable working life. In particular, the need to protect older workers with turbulent or precarious labor market trajectories against labor market risks and retirement schemes that could inadvertently contribute to increased social and economic inequality in later life.

Dairy cow longevity and farm economic performance: Evidence from Swedish dairy farms

The longevity of dairy cows is mainly determined by farmers' subjective culling decisions and can be linked to the environmental impact of dairy production and to the social acceptance of the industry. Still, the economic impacts of dairy cow longevity are not well understood. The aim of this study was therefore to examine how herd average dairy cow longevity is related to the farm economic outcome. We used 3 indicators of economic outcome: technical efficiency, profitability and average milk yield per cow. We used 2 indicators of dairy cow longevity: average herd length of life and average herd length of productive life. The study was based on a unique and detailed data set from Swedish dairy agriculture, where herd management data from the national dairy herd recording scheme were combined with farm level economic variables, the Swedish farm accountancy survey, for a total of 1,959 observations over the time period 2010 - 2018. The regression results highlight that both measures of average herd dairy cow longevity have an overall positive and statistically significant association with farm level economic performance. These associations had an inverted U-shape which implies that the association is first positive and then declines. Descriptive statistics indicate that the point where the maximum economic performance is attained varied across the economic indicators. Our results are relevant for individual dairy farmers and their advisors who are interested in understanding how herd average longevity relates to economic performance on the farms. Our results are also important from a greater sustainability perspective: linking them to previous knowledge about the positive environmental and social sustainability benefits from keeping cows longer, highlights there may be dairy cow longevity-associated tradeoffs between those benefits and the farm economic outcomes.

Are Personality Traits Related to Politicians’ Positions on Immigration?

ABSTRACT The political debates spurred on by rapidly growing immigrant populations in many countries have resulted in an extensive, and growing, scholarship that seeks to explain citizens’ attitudes toward immigration. Yet, there is surprisingly an absence of research regarding the factors that correlate with political elites’ positions on immigration. This study therefore seeks to address an important scholarly gap by exploring the factors that help to explain politicians’ positions on immigration. Specifically, this study is inspired by the growing research into personality that underlines psychological traits as being important determinants for a wide variety of citizens’ sociopolitical attitudes, including attitudes towards immigration. Using data from the 2010 Swedish Candidate Survey, our findings highlight that candidates’ personality traits are related to their immigration attitudes. Specifically, extraversion and openness are shown to have positive relationships with attitudes towards immigrants. Furthermore, while the political context of the candidates can moderate some of the relationships between personality and attitudes toward immigration, our results show that personality traits are associated with immigration attitudes independent of political considerations.

Psychosocial and organisational work factors as predictors of sickness absence among professionally active adults with common mental disorders

BackgroundThe incidence of sickness absence (SA) due to common mental disorders (CMDs) has increased in recent decades. It is hence important to elucidate how individuals with CMDs can maintain work. The aim was to analyse the relationship between psychosocial and organisational workplace factors and a spell of > 14 days of SA among persons with CMDs.MethodsIncluded were respondents of the Swedish Work Environment Survey (SWES) 1993–2013, diagnosed with a CMD up to five years before the interview in the SWES (n = 3,795). Relative Risk (RR) regression models with 95% Confidence Intervals (CIs) analysed associations between psychosocial-, and organisational workplace factors and a subsequent spell of SA > 14 days.ResultsLow control over work (RR:1.16; CI:1.01–1.35), job strain (RR:1.25; CI:1.04–1.49), no flexible working hours (RR:1.25; CI:1.08–1.45) or no possibility to work from home (RR:1.37; CI:1.13–1.66) were significantly related to an increased risk of SA. Persons diagnosed with depression experiencing job strain had the highest increased risk of SA (RR:1.55; CI: 1.07–2.25).ConclusionsA sustainable work-life among working individuals with CMDs can be provided by reducing job strain, and if possible, by increasing flexibility regarding workplace and working hours. This may prevent spells of SA, and hereby increase productivity.

Longitudinal trajectories of sickness absence among young adults with a history of depression and anxiety symptoms in Sweden

BackgroundDepression and anxiety are associated with increased risk of sickness absence (SA), yet the developmental patterns of SA remain unclear. We aimed to identify trajectories of SA in young adults with depression and/or anxiety, accounting for sociodemographic and occupational factors. MethodsLongitudinal study of 1445 twin individuals with elevated depressive/anxiety symptoms in late adolescence or young adulthood (age range: 19–30), assessed in Swedish surveys completed in 2005. Through linkage to nationwide registries, individuals were prospectively followed from 2006 to 2018. The outcome included consecutive annual days of SA, which were analyzed using group-based trajectory modeling. Multinomial logistic regression estimating odds ratios (OR) with 95 % confidence intervals (CI) was used to examine associations of age, sex, and educational level with the resulting SA trajectories. ResultsFour distinct SA trajectories were identified in the total sample: ‘high-increasing’ (6 %), ‘low-increasing’ (12 %), ‘high-decreasing’ (13 %), and ‘low-constant’ (69 %). Increasing age was associated with higher odds of belonging to the low-increasing trajectory (OR = 1.07, 95 % CI = 1.02–1.12). Women had higher odds of belonging to the low-increasing trajectory (OR = 1.67, 95 % CI = 1.10–2.53), compared with men. Higher education was associated with lower odds of belonging to high-increasing (OR = 0.34, 95 % CI = 0.22–0.54) and high-decreasing (OR = 0.59, 95 % CI = 0.43–0.81) trajectories, compared with lower education. Few differences were observed in analyses stratified by occupational sector. LimitationsInformation on potential confounders (e.g., psychiatric comorbidity, work-environment factors) was not available. ConclusionsAmong young adults with prior depression/anxiety, close to every fifth showed rising SA trajectories over time. This calls for targeted strategies to improve public mental health already at young ages.

Association of workplace violence and bullying with later suicide risk: a multicohort study and meta-analysis of published data

Workplace offensive behaviours, such as violence and bullying, have been linked to psychological symptoms, but their potential impact on suicide risk remains unclear. We aimed to assess the association of workplace violence and bullying with the risk of death by suicide and suicide attempt in multiple cohort studies. In this multicohort study, we used individual-participant data from three prospective studies: the Finnish Public Sector study, the Swedish Work Environment Survey, and the Work Environment and Health in Denmark study. Workplace violence and bullying were self-reported at baseline. Participants were followed up for suicide attempt and death using linkage to national health records. We additionally searched the literature for published prospective studies and pooled our effect estimates with those from published studies. During 1 803 496 person-years at risk, we recorded 1103 suicide attempts or deaths in participants with data on workplace violence (n=205 048); the corresponding numbers for participants with data on workplace bullying (n=191 783) were 1144 suicide attempts or deaths in 1 960 796 person-years, which included data from one identified published study. Workplace violence was associated with an increased risk of suicide after basic adjustment for age, sex, educational level, and family situation (hazard ratio 1·34 [95% CI 1·15-1·56]) and full adjustment (additional adjustment for job demands, job control, and baseline health problems, 1·25 [1·08-1·47]). Where data on frequency were available, a stronger association was observed among people with frequent exposure to violence (1·75 [1·27-2·42]) than occasional violence (1·27 [1·04-1·56]). Workplace bullying was also associated with an increased suicide risk (1·32 [1·09-1·59]), but the association was attenuated after adjustment for baseline mental health problems (1·16 [0·96-1·41]). Observational data from three Nordic countries suggest that workplace violence is associated with an increased suicide risk, highlighting the importance of effective prevention of violent behaviours at workplaces. Swedish Research Council for Health, Working Life and Welfare, Academy of Finland, Finnish Work Environment Fund, and Danish Working Environment Research Fund.

Gender-based harassment in Swedish workplaces and alcohol-related morbidity and mortality: A prospective cohort study.

The study investigated experiences of different types of work-related gender-based harassment (GBH), specifically sexual and gender harassment, as risk factors for alcohol-related morbidity and mortality (ARMM). Information about experiences of (i) sexual harassment (SH-I) and (ii) gender harassment (GH-I) from inside the organization and (iii) sexual harassment from a person external to the organization (SH-E) were obtained from the Swedish Work Environment Survey 1995-2013, a biannual cross-sectional survey, administered to a representative sample of the Swedish working population. The survey responses from 86 033 individuals were connected to multiple registers containing information about alcohol-related diagnoses, treatment, or cause of death. Cox proportional hazard models were fitted to assess hazard ratios (HR) of incident ARMM during a mean follow-up of eight (SH-I and GH-I) and ten (SH-E) years. A higher prospective risk estimate of ARMM was found among participants who reported experiences of SH-E [HR 2.01, 95% confidence interval (CI) 1.61-2.52], GH-I (HR 1.33, CI 1.03-1.70), or SH-I (HR 2.37, CI 1.42-3.00). Additional analyses, distinguishing one-time from reoccurring harassment experiences, indicated a dose-response relationship for all three harassment types. Gender did not modify the associations. Under the assumption of causality, 9.3% (95% CI 5.4-13.1) of the risk of ARMM among Swedish women and 2.1% (95% CI 0.6-3.6) among Swedish men would be attributable to any of the three types of GBH included in this study. Experiences of GBH in the work context may be a highly relevant factor in the etiology of ARMM.

Patient reported experiences of Swedish patients being investigated for cancer during the Covid-19 pandemic

BackgroundPatient reported experiences in individuals being investigated for cancer have been recorded in a nationwide survey in Sweden, providing an opportunity to assess the impact of the Covid-19-pandemic.Material and MethodsQuestionnaires from 45920 patients were analyzed to assess the experience of being investigated for cancer. Data from before the Covid-19-pandemic (2018–2019) was compared to data acquired during the pandemic (2020–2021), using chi-square and Wilcoxon rank sum tests. Both, patients who were cleared from suspicion of cancer and those who were diagnosed with cancer were included.ResultsFewer patients in total visited health services during the pandemic. However, patients that did seek help did so to a similar extent during as prior to the pandemic. Patient waiting time was perceived to be shorter during the pandemic and judged as neither too long nor too short by most patients. The emotional support to patients improved during the pandemic, whereas the support to next of kin declined. A majority of patients received the results from the investigation in a meeting with the physician. Although there was a preference for receiving results in a meeting with the physician, the pandemic has brought an increasing interest in receiving results by phone.ConclusionSwedish cancer healthcare has shown resilience during the Covid-19-pandemic, maintaining high patient satisfaction while working under conditions of extraordinary pressure. Patients became more open to alternatives to physical “in person” health care visits which could lead to more digital visits in the future. However, support to significant others demands special attention.

Green sleep: Immediate residential greenspace and access to larger green areas are associated with better sleep quality, in a longitudinal population-based cohort

ObjectiveSleep is pivotal to health, wellbeing and functioning in daily life, but sleep difficulties are common and may be affected by modifiable qualities in the residential surrounding environment, in terms of greenspace. However, population-based studies on individual-level greenspace and sleep are limited. The objective of the current study was thus to investigate prospective associations between fine-grained individual-level residential greenspace and sleep, and moderating effects of life style (physical activity, work status) and sex, in a nationwide population-based Swedish cohort. MethodsParticipants of the Swedish Longitudinal Occupational Survey of Health (SLOSH)—a population-based sample of adults in Sweden—were studied during 2014–2018 (19,375 individuals; 43,062 observations). Residential greenspace land cover, and coherent green area size, were assessed via high resolution geographic information systems, at 50, 100, 300, 500 and 1000 m buffers around residences. Prospective greenspace and sleep associations were assessed via multilevel general linear models, adjusting for demographic, socioeconomic (individual and neighborhood), life style and urban factors. ResultsHigher greenspace availability in the immediate residential surroundings (50 m and 100 m buffer zones) was associated with less sleep difficulties, even after adjustment for confounders. Greenspace effects were generally greater among non-working individuals. Among the physically active, and among non-working, greenspace and green area size further away from home (300, 500 and 1000 m, i.e. dependent on mobility) were also associated with less sleep difficulties. ConclusionsResidential greenspace in the immediate residential surroundings is associated with significantly less sleep difficulties. Greenspace further away from home was associated with better sleep especially among the physically active, and non-working individuals. The results highlight the importance of greenspace in the immediate residential-surrounding environment for sleep, and the need to integrate health and environmental policies, urban planning and greening.

Organizational injustice and sickness absence: The moderating role of locked-in status

Organizational injustice is known to negatively affect employees’ health and to increase the risk for sickness absence. The negative health effects are also known to be more pronounced in uncontrollable, strain increasing, situations at the workplace. This study tests whether locked-in status, i.e., being stuck in a non-preferred workplace, modifies the associations between injustice perceptions and frequent (≥2 times/yr) and long (≥ 8 days/yr) sickness absence. The sample contained 2631 permanent employees from the Swedish Longitudinal Occupational Survey of Health in 2018 and 2020. Multigroup structural equation modelling was used to compare the proposed relationships between employees who are locked-in in their workplace and employees who are not. We found a positive association between higher overall organizational injustice and long sickness absence two years later, with the association being stronger for the locked-in group. Also, higher injustice was associated with more frequent sickness absence, but only for those not being locked-in.Employees being locked-in seem to have higher risk of long-term sickness absence which might indicate more serious health problems. Employees not being locked-in more often take short sickness absence, which could indicate a coping behaviour to handle high strain. This study adds knowledge to the role of locked-in status as a moderator in the much-studied relationship between organizational justice and health as well as to the multiple reasons underlying sickness absence.

Workplace Psychosocial Resources and Risk of Sleep Disturbances Among Employees

Workplace psychosocial resources naturally tend to cluster in some work teams. To inform work-related sleep health promotion interventions, it is important to determine the associations between clustering of workplace resources and sleep disturbances when some resources are high while others are low and to mimic an actual intervention using observational data. To examine whether clustering of and changes in workplace psychosocial resources are associated with sleep disturbances among workers. This population-based cohort study used data from the Swedish Longitudinal Occupational Survey of Health (2012-2018), the Work Environment and Health in Denmark study (2012-2018), and the Finnish Public Sector Study (2008-2014), collected biennially. Statistical analysis was conducted from November 2020 to June 2022. Questionnaires were distributed measuring leadership quality and procedural justice (ie, vertical resources) as well as collaboration culture and coworker support (ie, horizontal resources). Resources were divided into clusters of general low, intermediate vertical and low horizontal, low vertical and high horizontal, intermediate vertical and high horizontal, and general high. Odds ratios (ORs) and 95% CIs were reported from logistic regression models for the associations between the clustering of resources and concurrent and long-term sleep disturbances. Sleep disturbances were measured by self-administered questionnaires. The study identified 114 971 participants with 219 982 participant-observations (151 021 [69%] women; mean [SD] age, 48 [10] years). Compared with participants with general low resources, other groups showed a lower prevalence of sleep disturbances, with the lowest observed in the general high group concurrently (OR, 0.38; 95% CI, 0.37-0.40) and longitudinally after 6 years (OR, 0.52; 95% CI, 0.48-0.57). Approximately half of the participants (27 167 participants [53%]) experienced changes in resource clusters within 2 years. Improvements in vertical or horizontal dimensions were associated with reduced odds of persistent sleep disturbances, and the lowest odds of sleep disturbances was found in the group with improvements in both vertical and horizontal dimensions (OR, 0.53; 95% CI, 0.46-0.62). A corresponding dose-response association with sleep disturbances was observed for decline in resources (eg, decline in both dimensions: OR, 1.74; 95% CI, 1.54-1.97). In this cohort study of workplace psychosocial resources and sleep disturbances, clustering of favorable resources was associated with a lower risk of sleep disturbances.

Animal welfare efforts and farm economic outcomes: Evidence from Swedish beef production

AbstractWe estimate the relationship between farm animal welfare (FAW) efforts taken by beef farmers and the economic performance of beef farms by using farm accounting data from the Swedish Farm Economic Survey matched with survey data on farm management practices. To this end, we perform a two-step analysis. First, an item response theory (IRT) model estimates the latent FAW effort on farms. FAW effort likely depends on a host of complementary FAW-improving strategies, and the IRT model combines the considered strategies into a unidimensional scale. We take this to represent on-farm FAW effort. Second, we use instrumental variable regressions to estimate the relationship between FAW effort and multiple measures of farm economic performance. We find that higher FAW effort scores have no effect on margins and costs. However, higher FAW effort scores are associated with lower farm sales. Findings suggest that policies (such as targeted label for high FAW) that increase farm revenue as well as incentivize the uptake of FAW-improvement practices may be able to compensate farmers for their FAW effort.

Job loss and job instability during the COVID-19 pandemic and the risk of depression and anxiety among Swedish employees

The COVID-19 pandemic led to permanent and temporary job losses but the mental health consequences of different types of employment transitions are not well-understood. In particular, knowledge is scarce concerning furloughs, which was a common job protection strategy in many high- and upper middle-income countries during this crisis. This study focuses on how different types of job instability and job loss during the pandemic influences depression and anxiety in the context of Sweden.A subset of participants from the Swedish Longitudinal Occupational Survey of Health were contacted in February 2021 and again in February 2022. A total of 1558 individuals participated in either or both waves and worked before the pandemic. We examined whether i) workplace downsizing, ii) furlough, or iii) unemployment/job loss were associated with depression and anxiety over this one-year period during the pandemic. Logistic regression models with cluster-robust standard errors were estimated, adjusting for sociodemographic factors and prior mental health problems. Effect modification by sex and prior mental health problems was also examined.In comparison to stable employment, being furloughed was unrelated to mental health, while experiencing workplace downsizing during the pandemic was associated with an increased risk of anxiety (adjusted Odds Ratio (OR) = 2.09, 95% Confidence interval (CI) = 1.08–4.05). Job loss/unemployment increased the risk of depression (OR = 1.91, 95% CI = 1.02–3.57) compared to being stably employed, but the risk estimate crossed unity when considering prior mental health status. No effect modification by sex or by prior mental health problems was found.This study found that while job loss and downsizing during the COVID-19 pandemic were associated with depression and anxiety, respectively, being furloughed was not. These findings thus suggest that job retention schemes in the form of short-time work allowances, as implemented in Sweden during the COVID-19 pandemic, may prevent mental health problems among employees during economic crises.

The Uneven Costs of Connection: Mapping Deep Mediatization Under COVID-19

The COVID-19 pandemic caused what we might think of as a “natural experiment in deep mediatization” as people were more or less forced to alter their lives from one day to the other. This report presents the results from a representative Swedish survey conducted in 2021 that mapped how the COVID-19 pandemic affected people’s usage of media and digital tools. The analysis deploys factor analysis to construct five types of mediatization that took place during the pandemic and then investigates the impact of demographic factors on each type. The study shows that the costs of connection played out differently in different segments of the Swedish population. Notably, while young women were affected in a more negative way than others by digital entanglement, older people with low education suffered from a sense of alienation vis-à-vis new technology. While these types of costs represent two different forms of fractured autonomy, the analysis also shows that younger men with higher education to a greater extent maintained a sense of “elective connectivity” during the COVID-19 pandemic.

Impact of Virtual Disaster Collaboration Exercises on Disaster Leadership at Hospitals in Saudi Arabia

Introduction:This study measured the impact of virtual three-level collaboration (3LC) exercises on participants’ perceived levels of collaboration, learning, and utility (CLU) at hospitals in the southern region of Saudi Arabia. Our 3LC exercise is a tabletop training tool used to facilitate disaster education and document CLU. This model enables the practitioner to acquire new knowledge and promotes active learning.Method:An English version of the CLU scale, the validated Swedish survey tool, was applied to 100 health-care managers or leaders in various positions at both the operational and tactical levels after conducting the 3LC exercises.Results:The results show that most participants strongly agreed that the exercises focused on collaboration (r2 = 0.767) and that they had acquired new knowledge during the exercises. There was a statistically significant association between participation in the collaboration exercises and perceived learning (r2 = 0.793), as well as between perceived learning and utility (r2 = 0.811).Conclusion:This study confirms the feasibility of three level collaboration exercises conducted virtually. Our work also demonstrates that learning depends on collaboration practices and that collaboration exercises before crises can help to build qualities that people can apply in daily life. Collaboration elements exercised in this study contributed to perceived learning. There was a strong covariation between participation in the participants’ collaboration exercises and perceived learning and utility. The virtual three-level collaboration exercises were well received by the participants and achieved an acceptable collaboration, learning, and utility score. Although exercises were conducted virtually, they were well received by the participants and achieved a value M = 4.4 CLU score, which opens up new dimensions in collaboration simulation exercises, at least from an organizational perspective, in a world with an increasing number of disasters and public health emergencies.