Mismatch between actual and preferred extent of telework: cross-sectional and prospective associations with well-being and burnout.

BACKGROUND: This study aimed to determine whether telework mismatch, i.e., lack of fit between actual and preferred extent of telework, is cross-sectionally and prospectively associated with well-being and burnout. METHODS: A questionnaire was sent to employees in a Swedish manufacturing company in November 2020 (baseline) and September 2021 (follow-up). It contained questions about well-being (WHO-5 Well-Being Index) and burnout (Copenhagen Psychosocial Questionnaire III), as well as the preferred extent of telework and extent of telework performed. Telework mismatch was calculated as the difference between the actual and preferred extent of telework. Change in mismatch over time was categorized as 1) less mismatch at follow-up than at baseline, 2) more mismatch at follow-up, and 3) identical levels of mismatch at baseline and follow-up. Multivariate and univariate analyses of variance were used to determine the effects of mismatch and change in mismatch over time on baseline ratings and changes in ratings of well-being and burnout. All analyses were performed with and without adjustment for age, sex, marital status, children, type of employment, commuting time and extent of telework performed. RESULTS: The response rate was 39% at baseline (n = 928, 67% men, mean(SD) age: 45(11) years) and 60% at follow-up (n = 556, 64% men, mean(SD) age: 46(11) years). A cross-sectional association was found between telework mismatch and well-being, showing that employees who teleworked more than they would like reported worse well-being than those who teleworked less than they would like. No statistically significant association was found between telework mismatch and burnout. The ability of telework mismatch at baseline to predict changes in well-being or burnout over 10 months was small and non-significant. No association was found between change in telework mismatch over the 10-month period and corresponding changes in well-being or burnout. CONCLUSION: Our results suggest that telework should be thoughtfully practiced in companies/organizations to avoid negative consequences for employees who already telework more than they prefer. Studies are needed to determine how long-term changes in match between preferred and actual extent of telework is associated with employee well-being, including how the association is modified by the nature of the job and the work environment.

Associations Between Telework Experience and Psychosocial Working Conditions During the COVID-19 Pandemic: A Cross-sectional Analysis Among White-Collar Workers in Sweden.

OBJECTIVES: The aim of the study are to determine to what extent pre-COVID-19 experience of telework was associated with perceived psychosocial working conditions (PWCs; job demands, social support, and influence at work) during the COVID-19 pandemic among white-collar workers in Sweden and to determine to what extent the association depends on demographic factors, organizational tenure, and amount of computer use. METHODS: Cross-sectional questionnaire data from 603 white-collar workers were collected October to December 2020 in an industrial company. RESULTS: In general, telework experience was not significantly associated with PWCs. Women who began teleworking because of COVID-19 reported more job demands than women not teleworking. For those who began teleworking because of COVID-19, managerial support increased with age. CONCLUSIONS: In general, telework experience was not associated with PWCs, but telework due to COVID-19 may have influenced PWCs differently depending on gender and age.

Flexible Work: Opportunity and Challenge (FLOC) for individual, social and economic sustainability. Protocol for a prospective cohort study of non-standard employment and flexible work arrangements in Sweden.

INTRODUCTION: Flexibility in working life, including non-standard employment (NSE) and flexible work arrangements (FWAs), offers the organisation a better ability to adapt to changing conditions while also posing considerable challenges for organisations as well as workers. The aim of the Flexible Work: Opportunity and Challenge (FLOC) study is to investigate associations between NSE and FWA on the one hand, and individual, social and economic sustainability on the other. METHODS AND ANALYSIS: This prospective open cohort study targets approximately 8000 workers 18-65 years old in 8-10 public and private organisations in Sweden. We will use a comprehensive battery of measurement methods addressing financial performance, physical and psychosocial exposures, and physical and mental health, both at the organisational and the individual level. Methods include valid survey questionnaires and register data, and, in subpopulations, technical measurements, interviews and diaries. Main exposures are type of employment and type of work arrangement. Main outcomes are indicators of social and economic sustainability and, at the individual level, health and well-being. Data, collected over 54 months at approximately 18-month intervals, will be analysed using multivariate methods considering main effects as well as potential effect modifiers. The analyses will take into account that respondents are nested in organisations, divisions and/or have specific managers. ETHICS AND DISSEMINATION: FLOC is approved by the Swedish Ethical Review Authority (decision numbers 2019-06220, 2020-06094 and 2021-02725). Data will be published in peer-reviewed journals and presented at international conferences, and researchers will assist the organisations in improving policies and routines for employment and organisation of work.

A systematic review of the research on telework and organizational economic performance indicators.

Introduction: A systematic review is conducted in the study to investigate the relationship between telework and organizational economic performance indicators such as self-reported employee performance, organizational performance, actual employee turnover rates, or intentions. Methods: The databases Scopus, Business Source Premier, and Web of Science were used to conduct a literature search. Original articles published from 2000 and up to May 2021 were selected. Studies were screened for inclusion independently by review pairs and data were extracted. The Mixed Methods Appraisal Tool (MMAT) was used to evaluate the quality of the studies included. Results: Forty-three studies were included with some addressing multiple outcomes. Self-reported performance was higher for teleworking employees compared to those working in the ordinary workplace. The extent of the change in performance was dependent on individual characteristics and the extent of the teleworking practice in the organization. Telework was also associated with increased organizational performance, particularly in homogenous samples with unique work tasks. When telework is voluntary, it appears that both actual employee turnover rates and intentions to leave the organization are lower. Discussion: Further research with high-quality prospective designs is necessary to properly understand the contribution of telework to organizational economic performance indicators.

Experiences of job demand and control: A study of first line managers in for-profit psychiatric and addiction care.

BACKGROUND: The complex position of a first line manager is characterized by heavy workload and contradictory demands. Little is known about how first line managers experience demand and control in their work. OBJECTIVES: The aim of this study was to explore experiences of demand and control among first line managers within psychiatric and addiction care. METHOD: In the present study, interviews with ten managers in for-profit psychiatric and addiction care in Sweden were analyzed with a phenomenographic approach. RESULTS: The managers experiences of demand and control implied varied and extensive responsibilities for a wide range of professions; regulation by organizational, economic, and political frameworks; creating balance in their work; and handling the emergence and consequences of acute crisis. These experiences of demand and control involved high and contradictory demands together with coexisting high and low levels of control. Many of their work characteristics could be described in terms of both demand and control. CONSLUSION: The first line managers experiences of demand and control are more complex than implied by the job demand control theory. Our results suggest that the organizational position and branch should be considered when identifying health hazards in the work environment of first line managers.

Working from home during the COVID-19 outbreak in Sweden: effects on 24-h time-use in office workers.

BACKGROUND: The COVID-19 pandemic has triggered national recommendations encouraging people to work from home (WFH), but the possible impact of WFH on physical behaviors is unknown. This study aimed to determine the extent to which the 24-h allocation of time to different physical behaviors changes between days working at the office (WAO) and days WFH in office workers during the pandemic. METHODS: Data were collected on 27 office workers with full-time employment at a Swedish municipal division during the COVID-19 outbreak in May-July 2020. A thigh-worn accelerometer (Axivity) was used to assess physical behavior (sedentary, stand, move) during seven consecutive days. A diary was used to identify periods of work, leisure and sleep. 24-h compositions of sedentary, standing and moving behaviors during work and non-work time were examined using Compositional data analysis (CoDA), and differences between days WAO and days WFH were determined using repeated measures ANOVA. RESULTS: Days WFH were associated with more time spent sleeping relative to awake, and the effect size was large (F = 7.4; p = 0.01; ηp2 = 0.22). The increase (34 min) in sleep time during WFH occurred at the expense of a reduction in work and leisure time by 26 min and 7 min, respectively. Sedentary, standing and moving behaviors did not change markedly during days WFH compared to days WAO. CONCLUSION: Days working from home during the COVID-19 pandemic in Sweden were associated with longer duration of sleep than days working at the office. This behavioral change may be beneficial to health.

Reduced use of phosphorus and water in sequential dark fermentation and anaerobic digestion of wheat straw and the application of ensiled steam-pretreated lucerne as a macronutrient provider in anaerobic digestion.

BACKGROUND: Current EU directives demand increased use of renewable fuels in the transportation sector but restrict governmental support for production of biofuels produced from crops. The use of intercropped lucerne and wheat may comply with the directives. In the current study, the combination of ensiled lucerne (Medicago sativa L.) and wheat straw as substrate for hydrogen and methane production was investigated. Steam-pretreated and enzymatically hydrolysed wheat straw [WSH, 76% of total chemical oxygen demand (COD)] and ensiled lucerne (LH, 24% of total COD) were used for sequential hydrogen production through dark fermentation and methane production through anaerobic digestion and directly for anaerobic digestion. Synthetic co-cultures of extreme thermophilic Caldicellulosiruptor species adapted to elevated osmolalities were used for dark fermentation. RESULTS: Based on 6 tested steam pretreatment conditions, 5 min at 200 °C was chosen for the ensiled lucerne. The same conditions as applied for wheat straw (10 min at 200 °C with 1% acetic acid) would give similar sugar yields. Volumetric hydrogen productivities of 6.7 and 4.3 mmol/L/h and hydrogen yields of 1.9 and 1.8 mol/mol hexose were observed using WSH and the combination of WSH and LH, respectively, which were relatively low compared to those of the wild-type strains. The combinations of WSH plus LH and the effluent from dark fermentation of WSH plus LH were efficiently converted to methane in anaerobic digestion with COD removal of 85-89% at organic loading rates of COD 5.4 and 8.5 g/L/day, respectively, in UASB reactors. The nutrients in the combined hydrolysates could support this conversion. CONCLUSIONS: This study demonstrates the possibility of reducing the water addition to WSH by 26% and the phosphorus addition by 80% in dark fermentation with Caldicellulosiruptor species, compared to previous reports. WSH and combined WSH and LH were well tolerated by osmotolerant co-cultures. The yield was not significantly different when using defined media or hydrolysates with the same concentrations of sugars. However, the sugar concentration was negatively correlated with the hydrogen yield when comparing the results to previous reports. Hydrolysates and effluents from dark fermentation can be efficiently converted to methane. Lucerne can serve as macronutrient provider in anaerobic digestion. Intercropping with wheat is promising.

The association between subordinate perception of task and relation oriented leadership behaviors and sense of coherence among a sample of Swedish white-collar workers.

BACKGROUND: Evidence suggests that leadership behaviors and sense of coherence (SOC) influences subordinate health. However, this has not been investigated in any detail. OBJECTIVES: To study the association between leadership behaviors and SOC. It was hypothesized that both task and relation oriented leadership behaviors would be positively associated with SOC, whereas a laissez-faire leadership would be negatively associated with SOC. METHODS: This is a cross-sectional quantitative study of managers and subordinates in a large governmental organization. The study used two common and empirically tested leadership styles: task oriented leadership and relation oriented leadership. In a logistic regression analysis, the association between types of leadership behavior and SOC were analyzed while controlling for age, gender, income, type of employment and organizational tenure. RESULTS: Neither task oriented or relation oriented leadership behavior were significantly associated with SOC. CONCLUSIONS: The result indicates that the type of leadership behavior exercised is not directly associated with subordinate's SOC. In future studies the importance of subordinate leadership preferences should be acknowledged. More research is needed to reach an understanding as to the nature of and the potential of this mechanism.

Economically viable components from Jerusalem artichoke (Helianthus tuberosus L.) in a biorefinery concept.

Biorefinery applications are receiving growing interest due to climatic and waste disposal issues and lack of petroleum resources. Jerusalem artichoke (Helianthus tuberosus L.) is suitable for biorefinery applications due to high biomass production and limited cultivation requirements. This paper focuses on the potential of Jerusalem artichoke as a biorefinery crop and the most viable products in such a case. The carbohydrates in the tubers were found to have potential for production of platform chemicals, e.g., succinic acid. However, economic analysis showed that production of platform chemicals as a single product was too expensive to be competitive with petrochemically produced sugars. Therefore, production of several products from the same crop is a must. Additional products are protein based ones from tubers and leaves and biogas from residues, although both are of low value and amount. High bioactive activity was found in the young leaves of the crop, and the sesquiterpene lactones are of specific interest, as other compounds from this group have shown inhibitory effects on several human diseases. Thus, future focus should be on understanding the usefulness of small molecules, to develop methods for their extraction and purification and to further develop sustainable and viable methods for the production of platform chemicals.

Ammonia sanitization of blackwater for safe use as fertilizer.

Source-separated blackwater from low-flush toilets contains plant-available nutrients and can be used as a fertilizer. The aim of the study was to evaluate the impact on pathogen inactivation when treating blackwater with urea and/or lime. Blackwater was spiked with Salmonella typhimurium, Escherichia coli O157, Enterococcus faecalis, and Ascaris suum eggs, and treated with urea and/or lime in concentrations up to 0.1% w/w. The bottles were kept in a storage facility (manure slurry tank) for 102 days while monitoring the pathogen concentrations. The treatment time needed to meet the requirement for Salmonella and E. coli reduction could be reduced at least six-fold. The enterococci were more persistent, and only the highest treatment doses had a significantly higher inactivation than the controls. The Ascaris egg viability was only reduced by around 50%, so higher urea/lime doses and/or longer treatment times are required to fulfill the treatment requirements of 3 log10 reductions of parasite eggs.

Ethanol production from industrial hemp: effect of combined dilute acid/steam pretreatment and economic aspects.

In the present study, combined steam (140-180°C) and dilute-acid pre-hydrolysis (0.0-2.0%) were applied to industrial hemp (Cannabis sativa L.), as pretreatment for lignocellulosic bioethanol production. The influence of the pretreatment conditions and cultivation type on the hydrolysis and ethanol yields was also evaluated. Pretreatment with 1% sulfuric acid at 180°C resulted in the highest glucose yield (73-74%) and ethanol yield of 75-79% (0.38-0.40 g-ethanol/g-glucose). Taking into account the costs of biomass processing, from field to ethanol facility storage, the field-dried hemp pretreated at the optimal conditions showed positive economic results. The type of hemp cultivation (organic or conventional) did not influence significantly the effectiveness of the pretreatment as well as subsequent enzymatic hydrolysis and ethanol fermentation.

Area of ischemia assessed by physicians and software packages from myocardial perfusion scintigrams.

BACKGROUND: The European Society of Cardiology recommends that patients with >10% area of ischemia should receive revascularization. We investigated inter-observer variability for the extent of ischemic defects reported by different physicians and by different software tools, and if inter-observer variability was reduced when the physicians were provided with a computerized suggestion of the defects. METHODS: Twenty-five myocardial perfusion single photon emission computed tomography (SPECT) patients who were regarded as ischemic according to the final report were included. Eleven physicians in nuclear medicine delineated the extent of the ischemic defects. After at least two weeks, they delineated the defects again, and were this time provided a suggestion of the defect delineation by EXINI HeartTM (EXINI). Summed difference scores and ischemic extent values were obtained from four software programs. RESULTS: The median extent values obtained from the 11 physicians varied between 8% and 34%, and between 9% and 16% for the software programs. For all 25 patients, mean extent obtained from EXINI was 17.0% (± standard deviation (SD) 14.6%). Mean extent for physicians was 22.6% (± 15.6%) for the first delineation and 19.1% (± 14.9%) for the evaluation where they were provided computerized suggestion. Intra-class correlation (ICC) increased from 0.56 (95% confidence interval (CI) 0.41-0.72) to 0.81 (95% CI 0.71-0.90) between the first and the second delineation, and SD between physicians were 7.8 (first) and 5.9 (second delineation). CONCLUSIONS: There was large variability in the estimated ischemic defect size obtained both from different physicians and from different software packages. When the physicians were provided with a suggested delineation, the inter-observer variability decreased significantly.

Computer-aided diagnosis system outperforms scoring analysis in myocardial perfusion imaging.

BACKGROUND: The aim of this myocardial perfusion imaging (MPI) study was to compare the diagnostic performance of two computer-aided diagnosis (CAD) systems, EXINI Heart(TM) (EXINI), and PERFEX(TM) (PERFEX) Emory Cardiac Toolbox (ECT), and the summed stress score (SSS) values from both software packages. METHODS: We studied 1,052 consecutive patients who underwent 2-day stress/rest (99m)Tc-sestamibi MPI studies. The reference standard classifications for the MPI studies were obtained from three experienced physicians who separately classified all cases regarding the presence or absence of ischemia and/or infarction. Automatic processing was carried out using EXINI and PERFEX to obtain CAD results and SSS values based on the 17-segment model. RESULTS: The three experts' classifications showed ischemia in 257 patients and abnormal studies, i.e., either ischemia or infarction or both, in 318 patients. Accuracy was significantly higher in EXINI than in PERFEX, regarding both the detection of ischemia (87.4 vs 77.6%; P < 0.0001) and the detection of abnormal studies (91.6 vs 67.9%; P < 0.0001). EXINI's CAD system showed a higher specificity than its SSS values (86.8 vs 73.6%; P < 0.0001) at the same level of sensitivity. CONCLUSIONS: EXINI demonstrated greater diagnostic accuracy for detection of ischemia and abnormal studies than did PERFEX. EXINI CAD also outperformed its SSS analysis.

Bioconversion of industrial hemp to ethanol and methane: the benefits of steam pretreatment and co-production.

Several scenarios for ethanol production, methane production (by anaerobic digestion) and co-production of these, using autumn harvested hemp as substrate, were investigated and compared in terms of gross energy output. Steam pretreatment improved the methane production rate compared with mechanical grinding. The methane yield of steam pretreated stems was similar both with and without pre-hydrolysis with cellulolytic enzymes. Co-production of ethanol and methane from steam pretreated stems gave a high yield of transportation fuel, 11.1-11.7 MJ/kg processed stem dry matter (DM); more than twice that of ethanol production alone from hexoses, 4.4-5.1 MJ/kg processed stem DM. Co-production from the whole hemp plant would give 2600-3000 L ethanol and 2800-2900 m(3) methane, in total 171-180 GJ per 10,000 m(2) of agricultural land, based on a biomass yield of 16 Mg DM. Of this, the yeast and enzymes from ethanol production were estimated to contribute 700 m(3) (27 GJ) of methane.

Diagnostic evaluation of three cardiac software packages using a consecutive group of patients.

PURPOSE: The aim of this study was to compare the diagnostic performance of the three software packages 4DMSPECT (4DM), Emory Cardiac Toolbox (ECTb), and Cedars Quantitative Perfusion SPECT (QPS) for quantification of myocardial perfusion scintigram (MPS) using a large group of consecutive patients. METHODS: We studied 1,052 consecutive patients who underwent 2-day stress/rest 99mTc-sestamibi MPS studies. The reference/gold-standard classifications for the MPS studies were obtained from three physicians, with more than 25 years each of experience in nuclear cardiology, who re-evaluated all MPS images. Automatic processing was carried out using 4DM, ECTb, and QPS software packages. Total stress defect extent (TDE) and summed stress score (SSS) based on a 17-segment model were obtained from the software packages. Receiver-operating characteristic (ROC) analysis was performed. RESULTS: A total of 734 patients were classified as normal and the remaining 318 were classified as having infarction and/or ischemia. The performance of the software packages calculated as the area under the SSS ROC curve were 0.87 for 4DM, 0.80 for QPS, and 0.76 for ECTb (QPS vs. ECTb p = 0.03; other differences p < 0.0001). The area under the TDE ROC curve were 0.87 for 4DM, 0.82 for QPS, and 0.76 for ECTb (QPS vs. ECTb p = 0.0005; other differences p < 0.0001). CONCLUSION: There are considerable differences in performance between the three software packages with 4DM showing the best performance and ECTb the worst. These differences in performance should be taken in consideration when software packages are used in clinical routine or in clinical studies.

Increased plasma concentrations of N-terminal pro-B-type natriuretic peptide in patients with mild primary hyperparathyroidism.

OBJECTIVE: Primary hyperparathyroidism (PHPT) is associated with heart disease. The aims of the present study were to evaluate how cardiac function and secretion of N-terminal pro-B-type natriuretic peptide (NT-proBNP) correlate in patients with mild PHPT, and how the plasma level of NT-proBNP is influenced by cure of the parathyroid disease. DESIGN AND PATIENTS: Forty-two patients with PHPT without symptoms of heart disease were examined before and 1 year after curative parathyroidectomy. MEASUREMENTS: Plasma or serum concentrations of NT-proBNP, calcium, PTH, creatinine, oestradiol, testosterone and SHBG were measured. Cardiac function was evaluated by equilibrium radionuclide angiography (ERNA). RESULTS: At baseline, NT-proBNP levels correlated negatively with systolic function [left ventricular ejection fraction (LVEF), P < 0.001]. Twelve per cent of the patients had NT-proBNP levels above normal reference values preoperatively. One year postoperatively, the corresponding proportion was 21%. The mean plasma concentration of NT-proBNP increased after parathyroidectomy (P < 0.01) in parallel with a dip in diastolic function (peak filling rate, P < 0.05) and a falling trend in systolic function (LVEF, P = 0.08). The postoperative percentage changes in circulating NT-proBNP and total oestradiol correlated positively (P < 0.05). CONCLUSIONS: Patients with mild PHPT and normal renal function may have high levels of circulating NT-proBNP despite the absence of symptomatic heart disease. Cure of the parathyroid disease is followed by a further increase in NT-proBNP secretion in parallel with ERNA measures, indicating subclinical changes in heart function. These results are in line with data indicating an association between PHPT and increased risk of premature death.

Cardiac dysfunction in mild primary hyperparathyroidism assessed by radionuclide angiography and echocardiography before and after parathyroidectomy.

BACKGROUND: Primary hyperparathyroidism (PHPT) is associated with increased cardiovascular morbidity for reasons that are incompletely understood. The present study was undertaken to evaluate the effects of parathyroidectomy on cardiac function especially in patients with mild PHPT. METHODS; Fifty patients with mild PHPT (serum calcium, 2.55 to 2.95 mmol/L) were randomized to parathyroidectomy either directly (group A) or after 1 year of observation (group B). Equilibrium radionuclide angiography (ERNA) at rest and at exercise was performed in addition to echocardiography on all patients at inclusion in the study and 1 and 2 years later. RESULTS: Left ventricular mass index was larger (P <.05) in group B compared with group A after 2 years and showed significant correlation to the serum concentration of parathyroid hormone (but not serum calcium) after 1 year. ERNA showed transient subclinical changes in both systolic and diastolic function parameters after parathyroidectomy (decrease of left ventricular ejection fraction and peak filling rate, with return to preoperative levels within 1 year). CONCLUSIONS: Combined evaluation by ERNA and echocardiography has shown previously unknown aspects of parathyroid/myocardial interaction, which is consistent with an inotropic influence exerted by parathyroid hormone, and is in favor of early surgical treatment for PHPT irrespective of serum calcium levels.