SENSE OF COHERENCE: – sundhedsfremmende eller sygdomsforebyggende?

Sundhed og sygdom beskrives ofte som hver sin pol i et kontinuum, hvor fravær af sygdom udgør et midtpunkt. Sundhedsfremme sigter mod at styrke en bevægelse i retning af den sunde pol og sygdomsforebyggelse sigter mod at forhindre en bevægelse mod den syge pol. I artiklen stilles der spørgsmålstegn ved, om denne opfattelse er adækvat. Specielt fremdrages problemer som den bipolære opfattelse afstedkommer for den empiriske forskning: Sammenblanding af positivt og negativt formulerede items og som følge deraf manglende klarhed i begrebernes dimensionalitet. Problemerne illustreres med udgangspunkt i Antonovskys begreb om Sense of Coherence. Det foreslås, at den bipolære opfattelse erstattes af en multivariat: sundhedstilstanden af sundhedstilstandene.Health and illness are often described as opposite poles in a continuum, where absence of illness constitutes the midpoint. In accordance with this view, health promotion is an effort towards the healthy pole while health protection is an effort trying to hinder a development towards the illness-pole. In the article it is discussed whether this understanding of the relationship is adequate. In particular, consequences of the bipolar understanding for empirical research are pointed out : the mixture of positively and negatively phrased items resulting in unclear dimensionality of the concepts. The problems are illustrated by applying Antonovsky's concept of Sense of Coherence. It is proposed, that the bipolar understanding are replaced by a multidimensional

Structure and Composition of Tree Islands and Krummholz within the Forest-Tundra Ecotone in Central and Eastern Canada

The forest-tundra ecotone is expected to experience some of the initial effects of climate change. At the forefront of this transition zone, we find clonal growth forms of stunted and deformed trees with and without taller erect trees, called tree islands and krummholz, respectively. We sought to assess the potential effects of expansion of these clonal growth forms on tundra plant species at two Canadian locations, one in the Mealy Mountains of Labrador and the other near Churchill, Manitoba. Our objectives were 1) to analyze the structure (height distribution and shape) of these clonal growth forms to determine whether they are expanding; 2) to compare tree cover on the leeward and windward sides of clonal growths and 3) to assess patterns in individual plant species across these growth forms. Cover of trees and other plant species was measured at both locations, while tree stems were mapped near Churchill only. The presence of seedlings and symmetric patterns of tree height suggest that half of the tree islands near Churchill may be expanding. The edges of tree islands and krummholz may harbour safe sites for tundra plant species, as shown by peaks in cover of individual species at these edges. Our results suggest that expansion of tree islands and krummholz would affect the abundance of tundra plant species, which could lead to changes in species composition and biodiversity.On s’attend à ce que l’écotone de la toundra forestière subisse dans une certaine mesure les premiers effets du changement climatique. À l’avant-plan de cette zone de transition se trouvent des formes de croissance clonales d’arbres rabougris et difformes parfois assortis ou non assortis de plus grands arbres dressés, ce que l’on appelle des îlots boisés et des krummholz, respectivement. Nous avons cherché à évaluer les effets potentiels de l’expansion de ces formes de croissance clonales sur les espèces végétales de la toundra à deux emplacements situés au Canada, un aux monts Mealy du Labrador et l’autre près de Churchill, au Manitoba. Nos objectifs étaient les suivants : 1) analyser la structure (répartition des hauteurs et formes) de ces formes de croissance clonales afin de déterminer si elles prennent de l’expansion; 2) comparer la couverture arborescente en aval et en amont des croissances clonales; et 3) évaluer les modèles se dessinant chez les diverses espèces végétales individuelles au sein de ces formes de croissance. Les couvertures arborescentes et d’autres espèces végétales ont été mesurées aux deux endroits, tandis que les tiges d’arbres n’ont été relevées qu’à l’emplacement de Churchill. La présence de semis et de modèles symétriques en ce qui a trait à la hauteur des arbres suggère que la moitié des îlots boisés près de Churchill pourraient être en expansion. Le bord des îlots boisés et des krummholz pourrait constituer des lieux sûrs pour les espèces végétales de la toundra, comme l’indiquent les crêtes caractérisant la couverture des espèces individuelles situées en bordure. Nos résultats laissent entendre que l’expansion des îlots boisés et des krummholz aurait des incidences sur l’abondance des espèces végétales de la toundra, ce qui pourrait entraîner des changements sur le plan de la composition et de la biodiversité des espèces

HANDLEKOMPETENCE SOM BEGREB I SUNDHEDSPÆDAGOGIK OG -FORSKNING

Kompetence er blevet et af nøgleordene i psykologisk, pædagogisk og socialpsykologisk forskning, praksis og formidling. Blandt faglige eksperter såvel som i dagligdagens tænkning gives der udtryk for, at enhver på en eller anden måde er »kompetent«, »kan noget«, »vil noget«, »har« en måske uspecifik form for »intelligens«, som ikke lige behøver at være sammenfaldende med den gængse, der kan måles ved en intelligensprøve. Begrebet om kompetence byder på en rummelighed, der må bydes velkommen i et fagligt videnskabeligt univers med en tilbøjelighed til sort/hvid tænkning og klare kategoriseringer. Men med kompetencebegrebet signaleres der også: Over for hvad, hvilke er vore endpoints, med hvilke ressourcer til rådighed? »Kompetent« er der ingen, der bare er, de er det altid i forhold til noget uden for dem selv. Dette har et praksisniveau og også et lokalt niveau, som vi skal være opmærksomme på

Workplace Social Capital in the Development and Implementation of a Senior Policy

Senior policies have been introduced by many Danish companies with the intention of retaining senior employees, but implementation can be challenging and may create tension at the workplace.This study aims to explore how social capital at the workplace may support or counteract the development and implementation of senior policies. A qualitative case study approach was used to collect and analyze interview data from managers, union- and H&S representatives, and senior employees at eightheen workplaces.The analysis reveals that successful development and implementation of a senior policy rely on legitimacy, transparency, and involvement of relevant parties in the process, as well as a good fit between the policy and the companies’ structure for collaboration. Workplace social capital is discussed as a supporting factor for senior employee retention, and a reciprocal positive relationship between implementing senior policies and procedures and the social capital of the workplace is suggested

Youth Health and Safety Groups: Process Evaluation from an Intervention in Danish Supermarkets

Young workers employed in temporary positions constitute a vast part of the employees in the Danish retail sector. The aim of the present study was to evaluate the implementation of an intervention to establish H&S groups for young workers in Danish supermarkets. The intervention aimed to include and involve the young workers in the management of their work environment and work conditions, and simultaneously to strengthen the organization’s ability to include them in the H&S management. The study was designed as a multiple case study. Twelve youth H&S groups were established and ran for 2 months within 10 supermarkets. Results based on qualitative data suggest that H&S groups for young workers have potential for increasing inclusion and involvement in the work environment among the young workers and for being beneficial for the supermarkets. However, the implementation requires continuous support from the management and H&S representatives

Employer Strategies for Preventing Mental Health Related Work Disability: A Scoping Review

This study examined Nordic research on psychosocial work environment and disability management, specifically employer strategies for preventing work disability in common mental disorders (CMDs). A scoping review was performed to identify strategies across several research databases, alongside contact with content experts, hand-searching of non-indexed journals, and internet searches. Identification and selection of relevant studies, charting of data, and collating and summarizing of results was done using a six-step framework for conducting scoping reviews. Several key elements and knowledge gaps were identified in current prevention approaches and workplace initiatives across the included studies. We propose a program theory for workplace prevention of CMD-related work disability. The program theory may help specify employer strategies, and bridge activities with stakeholders outside the workplace

Shift work and use of psychotropic medicine:A follow-up study with register linkage

OBJECTIVE: This study aimed to investigate a prospective association between shift work and use of psychotropic medicine. METHODS: Survey data from random samples of the general working population of Denmark (N=19 259) were linked to data from national registers. Poisson regression was used for analyses of prospective associations between shift work and redeemed prescriptions of psychotropic medicine. Prevalent cases were excluded at baseline. In secondary analyses, we tested differential effects on subsets of psychotropic medicine and, cross-sectionally, we studied correspondence between estimates based on psychotropic medicine and self-reported mental health. According to the protocol we interpret results from the secondary analyses following the principles for nested hypothesis testing, if the primary analyses reject the null-hypothesis, and otherwise we regard it as hypothesis generating exploratory analyses. RESULTS: In the primary analysis, the rate ratio for incidence of psychotropic medicine among shift workers was 1.09 (95% confidence interval 0.99–1.21). Results from the secondary analyses suggested increased incidence of use of hypnotics, sedatives and antidepressants and decreased incidence of use of anxiolytics. Cross-sectional analysis suggested increased risk for use of psychotropic medicine (all kinds), but not for poor self-rated mental health. CONCLUSIONS: Results did not support that working in shifts to the extent that is currently practiced in Denmark is associated with an increased incidence of overall psychotropic medicine use. Future studies should test, whether there is a differential incidence for different drugs among shift workers as suggested by the secondary analyses and how psychotropic medicine use and mental health are related

Lange og skæve arbejdstider — kan øget indflydelse bedre balancen?

arbejdstidens tilrettelæggelse er et af de forhold i arbejdslivet, som har størst indfl ydelse på privatlivet. Artiklen undersøger, hvilken rolle arbejdstidens længde og placering samt graden af indflydelse på placeringen af arbejdstiden spiller for oplevelsen af balance mellem arbejde og privatliv. Desuden undersøges, hvordan oplevelsen af balance mellem arbejde og privatliv ser ud i forskellige familie-typer og for ansatte i stillinger med potentielt grænseløst arbejde sammenlignet med ansatte i andre stillinger. Artiklen konkluderer, at øget indflydelse på placeringen af arbejdstiden har en positiv, men ret begrænset virkning, og ikke ser ud til at kunne mindske de negative konsekvenser af lange og uregelmæssige arbejdstider. Hvis balancen mellem arbejde og privatliv for alvor skal bedres, er det derfor nødvendigt at mindske arbejdstiden for de mest belastede grupper og at reducere arbejdet på 'skæve' tidspunkter mest muligt

Multi-method investigation of normative integration in a novel inter-sectoral collaboration between mental health care services and public sick leave insurance organizations in Denmark

Introduction: Inter-sectoral integration is increasingly warranted between the health care sector and other welfare-sectors. However, lack of normative integration (shared mission, values. and culture) among stakeholders is considered an important barrier. An integrated vocational rehabilitation intervention was established in a novel collaboration between public mental health care and sick leave insurance organizations in Denmark. The purpose of this study is to describe how normative integration was developed between the professionals in the inter-sectoral teams delivering the intervention.Theory and Methods: Gittells’ theory of relational coordination (RC) was used to design the interventions’ integration-activities. The theoretical sub-concepts from RC shared knowledge, shared goals and respect were considered aspects of normative integration and constituted the main analytical framework for this study. A mixed methods approach was used to examine the professionals’ perceptions of and experiences with mutual respect, shared goals, and shared knowledge across sectoral borders. This was investigated abductively through 30 semi-structured interviews with professionals and supervisors, 12 participant observations of inter-sectoral meetings, document analysis of 12 inter-sectoral plans, and the validated RC questionnaire. Contextual factors influencing normative integration was investigated inductively through the same data. Data collection began one year after intervention initiation.Results: Synthesizing data showed that mutual respect was established through trust and shared experiences between individual workers from the two sectors. Development of shared goals mainly took place through a growing focus on the predefined purpose of the intervention ‘fast return to work’, though this was initially difficult to internalize for health care professionals. Inter-sectoral meetings with both professionals and the service user on sick leave were assessed to have great potential as a forum for the creation of shared knowledge about the service users. Few inter-sectoral working relationships with co-located full-time professionals supported the development of normative integration.Discussions: This study found that the shared experiences between individual professionals from two sectors were key to the creation of normative integration in the inter-sectoral team. Organization of integrated teams with very few inter-sectoral relationships might be difficult to implement and could compromise intra-professional specialization. However, we argue that team-size and full-time commitment of employees should be considered important factors in novel team-based inter-sectoral collaboration.Conclusions: Normative integration in the intervention was developed through professional’s adaption of intervention goals, increasingly better use of intersectoral meetings and respect build on shared experiences and trust. Few inter-sectoral relationships, full-time employees and co-location were valued important for integration by the professionals.Lessons learned: Few inter-sectoral relationships and shared experiences were facilitators of normative integration across sectors.Limitations: Following initial data collection, the organization of professionals was changed, and analysis showed that there was considerable potential for further development of normative integration thereafter. The long-term perspective was subsequently only investigated through follow-up interviews with supervisors 2.5 years after intervention initiation.Suggestions for future research: We suggest the development of respect, shared goals, and shared knowledge in newly established inter-sectoral integration should be investigated with a long-term longitudinal design

Workplace Social Capital in the Development and Implementation of a Senior Policy

Senior policies have been introduced by many Danish companies with the intention of retaining senior employees, but implementation can be challenging and may create tension at the workplace.This study aims to explore how social capital at the workplace may support or counteract the development and implementation of senior policies. A qualitative case study approach was used to collect and analyze interview data from managers, union- and H&S representatives, and senior employees at eightheen workplaces.The analysis reveals that successful development and implementation of a senior policy rely on legitimacy, transparency, and involvement of relevant parties in the process, as well as a good fit between the policy and the companies’ structure for collaboration. Workplace social capital is discussed as a supporting factor for senior employee retention, and a reciprocal positive relationship between implementing senior policies and procedures and the social capital of the workplace is suggested