Utrymningsförsök i Götatunneln

An evacuation experiment was performed in the Göta tunnel on November 22, 2006 in Göteborg, Sweden. In total twenty-nine participants who were not informed about the experimental conditions evacuated as they were forced to stop in the tunnel due to a simulated car accident where a fire had started. After two and a half minute after the first car stopped an evacuation alarm started but at that time several of the participants had already initiated their evacuation. Green flashing lights were found to be significant for some of the participant’s decision to evacuate and choose an evacuation route. Results also suggest that people were influenced by others during evacuation, i.e., that social influence was important. Social influence was important both for the decision to evacuate and the choice of exit

The internationalization of work : Psychophysiological predictors of adjustment to foreign assignment

Developments during the last decade have resulted in an increased globalization of both personal and financial resources. This thesis is based on a longitudinal, prospective study, following a group of employees and their families (n=131, expatriate group) before (pre-assignment), during (expatriation) and after (repatriation) a work-related assignment abroad. Concurrently, a home-based, non- moving group was followed (n=81). Psychosocial and physiological parameters were assessed on a regular basis. The aims of the thesis were 1) to study psychological, social, physiological and immunological reactions during the relocation process; 2) to identify biophysiological predictors of healthy adjustment to foreign work assignment and; 3) to increase knowledge of individual modifiers of psychophysiologic reactions to strains an stressors. Psychophysiological reactions, such as increased serum levels of prolactin were associated with relocating abroad and partly modified by individual characteristics, such as internal locus of control, high self-esteem, active coping ability and sense of coherence. The first year of the assignment seems to be the most critical period abroad. Negative changes in the psychosocial work environment predicted a large part of the decrease in work adjustment - measured as decreased work satisfaction - during the first year. These findings were also reflected in physiological stress indicators. Job promotion was not related to work satisfaction. Contrary to our expectations, employees reported more decreased well-being after the first six months abroad than their spouses. This might indicate that employees, not the spouses, are the most vulnerable link, in mediating decreased mental well-being in families during the first period abroad. The repatriation phase affected employees' mental health more negatively than expatriation. Psychophysiological indicators of distress, such as cortisol, significantly increased. Results in paper V suggest that unidentified factors associated with foreign relocations increase the risk of sensitization in predisposed children. Stress might be one such factor. In one paper we evaluate the interplay between a real-life stressor (relocation) and possible effects on subjective rated health. Sleep quality suggests a link between stress, vital exhaustion, and subjective health. Changes in subjective health seem closely related to changes in sleep quality and decreased mental energy. Psychophysiological reactions to relocation were primarily individual, as were the consequences for mental well-being and health. Therefore, solutions need to be targeted to individual needs. Results in the thesis emphasize the importance of multinational organizations looking more closely at these individual characteristics before sending employees abroad. They should also be more involved in supporting employees to more effectively manage stressors characteristic of the first year of foreign work. The results suggest that company resources should be concentrated on expatriate employees who exhibit a reduced capacity to handle stress situations. Companies could design policies that ensure the mental and psychological well-being of employees during both the expatriation and repatriation phases of foreign assignments. Such policies would ultimately benefit the individual, employee, family, company and the end user: the customer

Rehabilitation coordinator intervention versus control in psychiatric specialist care for return to work and reduced sick leave : study protocol of a randomised controlled trial

Background Mental disorders are the most common reason for sick leave in Sweden. Knowledge about effective methods to help these individuals to return to work (RTW)/entry into work or studies is limited. Rehabilitation coordinators (RC's) have been introduced within healthcare with the purpose to promote cooperation, streamline the sick leave and rehabilitation process, and facilitate RTW for sick-listed patients. The function of RC's has shown positive results by reducing sick leave within primary healthcare. However, the function has not been evaluated in terms of specialist psychiatry. This paper describes the design of a study to evaluate effects of a RC intervention on sick leave and RTW/entry in work or studies in patients with moderate to severe affective and/or moderate to severe anxiety disorders within specialist psychiatric care. Methods A randomised controlled trial (RCT) comparing an intervention group receiving support from a RC with a control group receiving treatment as usual (TAU). The target group is patients on sick leave, treated for affective and/or anxiety disorder, aged 25-64, with or without employment. Discussion This study gives the possibility to evaluate a RC intervention for individuals with mental disorders. If the study has promising vocational outcomes, it may be of importance for the participants in many ways, e.g. increase participation in society, provide economic benefits and improve health and wellbeing. This would be valuable for the individual as well as for the society

Effectiveness of two vocational rehabilitation programmes in women with long-term sick leave due to pain syndrome or mental illness : 1-year follow-up of a randomized controlled trial

Objective: Mental illness and chronic pain are common reasons for long-term sick leave, typically more so for women. This study investigated the effects on return to work of 2 vocational rehabilitation programmes. Methods: In this randomized controlled study, 308 women were allocated to treatment with acceptance and commitment therapy, to multidisciplinary assessment and individualized rehabilitation interventions, or to a control group. Return-to-work at 12 months was assessed as: (i) returning to health insurance; (ii) number of reimbursed health insurance days during follow-up; (iii) self-reported change in working hours; (iv) a composite measure of self-reported change in work-related engagement. Results: The mean age of the Swedish study population was 48.5 years (standard deviation (SD) 6.3 years) and the mean time on sick leave 7.5 years (SD 3.2 years). There were no significant differences in reimbursed days or returning to the health insurance at 12 months. The multidisciplinary assessment and individualized rehabilitation interventions group, compared with control, reported a significant increase in working hours per week, as well as a significant increase in work-related engagement. Conclusion: Multidisciplinary assessments and individual rehabilitation interventions may improve the chance of return-to-work in women with long-term sick leave due to pain condition or mental illness