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By exploring management in a study of different municipal departments, this paper contributes to a theoretical and empirical understanding of how the type of work shapes and reproduces management practices and inequality in working conditions within a horizontally segregated public sector. A structural theoretical model guides the design of the empirical qualitative study within education, elderly care and water supply in several Swedish municipalities. The comparative analysis shows that, while managers within water supply take control over management and are allowed to do so, managers in education and care are instructed to take personal responsibility when handling goal conflicts and lack of resources. Gendered norms and values inscribed in the type of work seem to be fundamentally integral to management practices, which affect the local manager’s authority and actions. The results of this study illustrate how management is practiced and reinforces differences in status between different types of work.

The demands on managers seem to have increased as a consequence of management reforms. This study evaluates interventions aimed at improving working conditions and performance of managers in the Swedish public sector by changing organizational conditions. Six intervention organizations were compared to 34 reference organizations. Organizational conditions relevant for managerial work were surveyed and the results presented to the management teams who decided on the action plans and implemented changes. Fidelity to the intentions and contextual circumstances were documented. A psychometrically tested questionnaire was used for pre- and post-measurements of effects among a sample of 303 managers. The results showed that the interventions were associated with changes in managers’ quality of work and performance. The evaluation design made it possible to show that organizational conditions can be changed in order to improve the operations managers’ situation if there is fidelity to the intentions and support from the strategic level management.

The chapter aims to contribute to the understanding of increased gender differences in sickness absence and health by applying a structural approach, and by analysing and describing the development of and differences in psychosocial working conditions in differently gendered industries. Some psychosocial work factors are expected to vary by differently gendered industries, and others are expected to vary by differently gendered industries and gender combined. Descriptive and comparative data of psychosocial working conditions for women and men in Sweden from the 1990s and onwards are presented. The results show that job demands and decision authority have developed more negatively in female-gendered industries for both genders since the early 1990s, although more negatively for women. Job demands are furthermore higher and decision authority lower in these industries among both men and women. Gender-based and sexual harassment, on the other hand, show a pattern between gendered industries and gender combined, such that more harassment occurs for men in female-gendered industries and for women in male-gendered industries. The results are discussed in relation to contextual and gender perspectives.

It was a step forward when quantitative research began several decades ago to stratify survey data and analyses of working conditions by sex. However, more information is needed to uncover the mechanisms behind the gender differences that are often observed in such data. According to structuration and inequality theories (Tilly, 1999; Acker, 2012), explanations for differences between groups tend to be searched for mainly in individual-related factors when distinct categories such as women and men are compared. Differences in structural conditions such as how work is organized and how resources are allocated may not be apparent and therefore risk not to be approached in preventive actions. The horizontal gender segregation of the labour market is very consistent, although gendering and gender-typing are dynamic processes. Sectors, industries, services, production technologies, workplaces, work objects and job tasks are gendered, both with regard to symbolic gender connotations and the sex composition of the workers. The responsibility for organizing work and the work environment is placed on the employers at workplaces within industries. Also, structural and technological changes at the labour market are framed by the logic of industries. In this chapter, it is suggested that knowledge of the work environment as surveyed, analysed, and reported by industry type is suitable as a basis for identification of processes that contribute to inequality. Such information can be applied in the creation of healthy workplaces and prevention of work-related ill health for both women and men in differently gendered segments of the labour market.

In contrast to much research concerned with differences in male and female managers’ leadership strategies, this study focuses on how organizational arrangements vary for managers in differently genderized contexts; it explores the opportunities for frontline managers in municipal services to fulfil their assignment. The organisational preconditions for over 400 managers of municipal health and social care, education and technical services are analysed in a cross-level and comparative research design. The results indicate that managers of feminized care services work in an environment with fewer resources, less organisational support and larger spans of control, than managers in masculinized municipal services. These results shed light on meso-level mechanisms involved in the unequal distribution of health risks among men and women in working life.

An important challenge for public organizations is to attract and retain skilled managers. The present study explores how profiles of psychosocial working conditions, assessed by the combination of managerial-specific job demands and job resources, longitudinally predict managers’ turnover intentions and actual turnover in Swedish municipalities. Considerable effects of managers’ psychosocial working conditions on turnover intentions but not on actual turnover were found. Thus, poor working conditions may result in psychologically detached managers in public organizations, which may have considerable and costly effects on both the organizations and the managers, in terms of decreased commitment, performance, and impaired health.

Purpose – This study aims at developing a measure that can be used to evaluate organizational capacity to perform across local government jurisdictions, using operational managers' own assessments. Design/methodology/approach – The “management matters” literature that links organizational capacity to service performance is far from reaching any consensus on how to operationalize organizational capacity. In this study, over 400 operational managers were asked, at two different time points and in thirty different local government departments, about what opportunities they have to fulfill their responsibilities and about their perceptions of service performance. The data are factor analyzed, and the proportion of higher level variance of the resulting capacity measure is explored. Findings – Organizational capacity to perform represents a consistent measure that covers essential aspects of the managerial assignment and is empirically distinct, yet positively related to the managers' perceptions of service performance. Results further show that up to 12 percent of the variance in organizational capacity to perform can be attributed to the organization in which managers work. Practical implications – A service-neutral measure of organizational capacity to perform should be useful to strategic managers in organizations as guidance for resource allocation, and for the design of solid organizational structures and support systems for operational managers. Originality/value – Recent public management research indicates that rationalistic management models are often inadequately grounded in the day-to-day practices of operative managerial work. The construct of organizational capacity to perform presented in this study could be a valuable instrument that can bridge this strategic-operational disconnect and provide an insider perspective of the organizational prerequisites that underpin any public service achievement.

This chapter reports how managers in healthcare organizations in India and Sweden understand the organizational values of CSR and EO and describes the perceived importance of these values for workplace attractiveness. The chapter provides a general description of the healthcare sector in both countries on the basis of their national statistics. Most healthcare organizations sampled from India are private, corporate or trust-owned, whereas the Swedish healthcare organizations in the sample are public-owned. The understanding of these values is based on three data sources: (a) qualitative data collected through cognitive interviews of managers; (b) interviews with administrative heads/HR managers regarding the demographic composition of the sampled organizations; and (c) a quantitative survey of first-line healthcare managers. The chapter discusses how healthcare organizations practice CSR and EO based on the perceptions of healthcare managers from the two countries regarding the different components of these values. The relationship between perceived attractiveness and effectiveness is rated and profiled to present a comparative picture. The perceived importance of the two values and of competitive performance for attractiveness is also discussed.

This chapter reports how managers in the IT sector in India and Sweden understand the organizational values of CSR and EO and their importance for workplace attractiveness. A general description of the sector in the two countries is provided on the basis of their respective national statistics. We then present integrated information based on qualitative data collected through cognitive interviews with managers regarding the conceptualization of the values in their national perspectives; data collected through organizational interviews with HR managers regarding the demographic composition of their organizations and a quantitative survey of first-line managers in 15 sample organizations. The chapter discusses how IT organizations formalize, implement and communicate these values based on the perceptions of existing managers regarding the different components of these organizational values. Managers’ ratings of attractiveness (organizational commitment and intention to leave) and perceived effectiveness, supported by tests of differences between the countries on these parameters, are also reported. Finally, we discuss the perceived importance of these values and of competitive performance for the attractiveness of IT organizations.

The chapter offers a comprehensive presentation of the inferences drawn by the authors on the basis of the major findings of their research. The first part of the chapter presents the generic implications and recommendations based on similarities and differences in perceptions and practices of CSR and EO as values in organizations across sectoral and national cultures and the gender composition of employees. The second part of the chapter offers specific recommendations for different stakeholders, like policy makers, HR managers, first-line managers and potential employees in these sectors, as also for employer branding purposes. The recommendations are based on the importance of organizational values and their effect on perceptions regarding the attractiveness and effectiveness of an organization. In addition, the chapter discusses issues and learnings in research methodology in cross-cultural research in the field of organizational behaviour and management.

This chapter introduces and discusses the concepts of CSR and EO as these have evolved in the context of the national cultures of India and Sweden respectively. It deliberates on different approaches to understanding CSR and EO as important values within organizations. The chapter highlights how legislative regulation can multiply the impact of these organizational values. It also discusses the important contribution of organizational and national cultures in the practice and expression of such values. The chapter argues that values like CSR and EO can help organizations in both India and Sweden to develop attractive and sustainable workplaces, despite the different laws and labour market environments in the two countries.

This chapter discusses the major results of the research presented in the book. It interprets the quantitative and qualitative findings from the results presented in Chaps. 6– 11. It presents the national and sectoral contexts of the organizations based on their socio-demographic characteristics and deliberates on differential perceptions of CSR and EO from the perspective of employer branding. A comprehensive understanding and comparative view are offered about organizational values and practices in a multicultural perspective (across sectors, nations and genders). These findings are consolidated and an overall understanding of the relationship between organizational values and the attractive workplace is offered. Additionally, the chapter discusses the limitations of this research and summarizes the major findings in its conclusion.

This chapter reports how managers in the manufacturing sector in India and Sweden understand the values of CSR and EO, and discusses the importance of these values for workplace attractiveness. It begins by describing the manufacturing sectors of the two countries on the basis of their respective national statistics. Thereafter, we present an understanding of the two values based on three data sources: (a) qualitative data collected through cognitive interviews of managers; (b) data collected through interviews of administrative heads or HR managers regarding the demographic composition of organizations and (c) a quantitative survey of first-line healthcare managers. The chapter discusses how manufacturing organizations formulate, implement and communicate their policies on organizational values, besides reporting on managers’ perceptions of CSR and EO. Further, managers’ ratings of attractiveness (organizational commitment and intention to leave) and perceived effectiveness, supported by tests of differences between the countries on these parameters, are reported. The importance that managers attach to these organizational values when they evaluate the organization’s attractiveness is then discussed.

This book offers a multicultural perspective on attractive work, deliberating the impact of national culture, sectoral culture, organizational culture and gender composition on the understanding of the attractiveness and effectiveness of organizations. In addition, the book argues that employees’ perceptions of specific organizational values may influence the attractiveness of the workplace. With this overview, the present chapter discusses attractive work as it has been understood in the existing literature, and explores the different perspectives from which attractive work and workplaces have been studied. It dwells on the importance of understanding attractive work in today’s globalized context to attract and retain employees particularly from the human resources (HR) and employer branding perspectives, with specific reference to a multicultural and diverse workforce. It also seeks to understand whether attractive work has different indicators and implications for different sectors, e.g. manufacturing, information technology, health and education. The chapter highlights the importance of certain organizational values which influence the perceptions of employees regarding the attractiveness and effectiveness of an organization. It concludes by delineating the possible outcomes of having an attractive workplace.

This chapter reports how managers in educational institutions in India and Sweden understand the organizational values of CSR and EO, and the importance of these values for workplace attractiveness. A general description of the sector in the two countries is provided on the basis of their national statistics. Most sampled higher educational institutions from India are private or trust-owned, whereas in Sweden the sample comprises mostly government universities. The chapter presents integrated information based on cognitive interviews of managers regarding the conceptualization of these values; interviews of administrative heads/HR managers regarding the demographic composition of the institutions; and a quantitative survey of faculty members in managerial positions in sample institutions. A discussion of how higher educational institutions practice CSR and EO is supported by perceptions of employed academicians with regard to the different components of these values. In addition, the institutions are profiled in terms of their perceived attractiveness and effectiveness to present a comparative picture. The perceived importance of the values and of competitive performance for the attractiveness of educational institutions is presented.

This chapter discusses methodological issues pertaining to the studies reported in this book. It addresses some concerns and challenges in cross-cultural research with reference to concept measurement equivalence as well as methods for invariance testing of measures. It then provides an overview of the four studies, starting with the first survey questionnaire study through which we tested the factor structure, reliability and invariance of the instruments for the measurement of CSR and EO. Next, a description of the cognitive interviews with selected managers is provided, as well as methodological details of organizational interviews with HR managers with regard to socio-demographic characteristics of the organizations. The further development and validation of measures of CSR and EO practices in the second survey questionnaire study are described as well as the results from the testing of these measures for measurement equivalence between Indian and Swedish managers. This detailed account of the development and validation of research instruments for our study is presented in such a way as to be indicative for cross-cultural research designs in management and organizational behaviour research.

This chapter provides an overall perspective of the expressions of the organizational values of CSR and EO across different sectors in Sweden and India. It examines whether the expressions of these values are shared between managers in the same organization. The chapter also maps the sample organizations selected from different sectors in the two countries in terms of CSR and EO. The findings are described and interpreted to understand the effect of national culture, sectoral culture and their interaction on the expressions of CSR and EO in the studied organizations. On the basis of higher statistical analysis, we then discuss how important CSR and EO are for perceptions regarding the attractiveness of work and the organization’s effectiveness. In addition, we compare the moderating effect of national and sectoral culture on the relationship between expressions of organizational values and the perceived attractiveness and effectiveness of the organization.

This chapter explores whether, in a world where organizations act globally and managers interact worldwide, the meaning of organizational values for managers is universal or context-specific. We discuss the need to consider culture as a multifaceted concept in cross-cultural studies. The chapter discusses national, sectoral (pertaining to different types of industries) and gendered cultures, all of which may affect employees’ perceptions and behaviour in organizations. It has not so far been tested whether managers share perceptions of organizational values across nations, or whether different sectors or variations in gender composition among different industries have a greater impact on what values are considered important in workplace attractiveness for male and female managers. We present a comparative design that is suitable for testing different cultural perspectives in different contexts. Later chapters apply this comparative design and a cross-level methodology to a large sample of managers and strategically selected organizations in different sectors and types of industries.

In order to become attractive employers to both potential and existing employees, organizations work with employer branding. This chapter introduces the concept of ‘employer branding’, which is presented here in accordance with earlier research on this topic. Employer branding is discussed from both an external and an internal perspective, in relation to perceptions regarding an attractive workplace. The chapter emphasizes that existing employees (who know the organization from the inside) as well as potential employees have to be considered in an organization’s employer branding strategy. From the perspective of both these groups, the chapter gives examples of organizational attributes that have been found attractive. Thereafter, the chapter focuses on the importance of branding organizational values as being embedded in the organizational culture. Finally, employer branding is discussed from an HRM perspective where the HR function is described as essential to create a successful employer brand that can be sustained.

Managers in many public domains have to meet major challenges today, which is why it is essential to focus on their working conditions in order to develop a sustainable situation. In the present study, the aim was to explore different types of managerial situations and how they discriminate in health, motivation, and performance outcomes. Using the job demands-resources model as a framework, four demands and three resources were included in a cluster analysis in order to answer the research question. In total, 548 managers in Sweden participated, including heads of department, middle managers, firstline managers, team leaders, and functional managers. The most important finding was that the eight clusters of managerial situations that were found discriminated in a distinct way against each other regarding health, motivation, and performance. The results can be used as guidance for organizational intervention as both very satisfactory and very unsatisfactory situations are identified.

New methods are needed to complement traditional epidemiological methods in the analyses of complex multivariate exposures. Contextual and comprehensive analyses such as multilevel and cluster analyses are particularly suitable for comparisons of women's and men's risk factors for health in working life as well as for guidance in preventive action. Such methodologies are presented in this discussion paper. Contextual and comprehensive (or holistic) approaches help identify the gender-structured situations for women and men and facilitate the discovery of differences among all women and all men. Empirical studies using these approaches show that it is important to take gender composition in both the workplace and the sector into consideration when exploring risk factors for health.

The aim of the study was to explore bureaucratic and post-bureaucratic characteristics of organizational structure. A further aim was to investigate whether differences were related to types of industries. Eight organizational characteristics were measured, based on interviews with local managers at 90 workplaces in a broad sample of industries in mid-Sweden. The study showed that post-bureaucratic as well as bureaucratic characteristics coexisted in most workplaces. The results are not in accordance with the rhetoric that considers bureaucracy obsolete in contemporary organizations. Significant differences were revealed between industries in seven of the eight characteristics.

With the expansion of the service sector, working conditions have changed during recent decades and it has become more relevant to highlight psychosocial factors as a complement to physical aspects of work. The main scope of this article concerns legal forms of ownership (i.e. the public sector, public enterprises, private enterprises and cooperatives), different types of operations within the service sector, and whether these organizational characteristics create differences in psychosocial working conditions for the individual employee. A total of 1384 employees in 60 workplaces within 25 establishments participated, and the data consisted of both a survey answered by the employees and structured interviews conducted with the local managers in each participating organization. Multilevel analysis showed that a rather high degree of variance in working conditions could be attributed to factors outside/above the individual level, and furthermore, that both ownership and type of operation were significant and relevant variables in order to explain differences in working conditions.

Background Segregation of men and women into different jobs is often cited as one of the most plausible explanations for gender differences in exposure and musculoskeletal disorders. Methods Direct measurements of sitting, arm, and trunk postures were taken with two different technical instruments on 156 subjects (78 matched pairs of one female and one male worker) over one full workday in diverse labor markets. Results Exposure differences between workers were strongly associated with vertical occupational segregation (measured as level of status/authority). The results showed that this association was strongest for female-dominated jobs. Workers in female-dominated jobs with a low status/authority experienced longer duration in standing posture (P = 0.001), and higher frequency of arm elevation (P = 0.028 and 0.040 for the dominant and the non-dominant arm, respectively). They also had longer duration of work with bent trunk compared to corresponding workers with high status/authority (P = 0.035). The association was less pronounced for male-dominated jobs, and no such association was found for gender-integrated jobs. Conclusion The findings have implications for prevention as well as for future research. Am. J. Ind. Med. 47:381–393, 2005. © 2005 Wiley-Liss, Inc.

The aim was to investigate organizational impact on working conditions and to explore the associations between sector, different types of organizational change, and working conditions. A strategic selection was made of representative staff members from 72 work sites. Data pertaining to organizational factors were collected from managers, and to working conditions from employees. Multilevel analyses were performed, with 10 aspects of self-reported and expert assessed psychosocial and ergonomic/physical working conditions as the dependent variables, and patterns of organizational change and sector as the explanatory variables. The results showed that the variance in working conditions was significantly attributed to organizational level (16 – 65% of the variance), and that both the pattern of change and the sector were important. Organizations that had not undergone change provided the best work conditions. The “standardizing” and “market-adjusting” patterns of change had deleterious effects, while the “lea...

The aim of the present study was to estimate the influence of total work hours, paid work in the labor market and unpaid work in the family domain, on care-seeking for low back and neck/shoulder disorders in the female population. The exposure assessments considered a typical working' day during the previous twelve months and were assessed by interviews and questionnaires; 704 cases and 984 referents were examined. The cases had sought professional care during the study period; the referents were randomly selected from the same source population. There was no increased relative risk for care-seeking for low back and neck/shoulder disorders for gainfully employed women compared to those not employed, or for full-time compared to part-time working women. At least 60 hours per week of paid work, or at least 40 hours per week of unpaid work, separately, indicated an increased relative risk for care-seeking. The present results did not strengthen the hypothesis that a high amount of hours of work is an independent risk factor for musculoskeletal disorders.

The objective of the study was to develop a multivariate approach to occupational health studies that is: capable of identifying groups with similar working conditions; relevant for studies of associations between working and living conditions and health; and an appropriate basis for preventive actions. Data at the individual level were obtained through measurements, observations, interviews and questionnaires, and at the organizational level, through interviews with managers. Cluster analyses were applied with the purpose of identifying groups of individuals with small, within-group differences. Eighty work sites and a sample of employees at each site were strategically selected. The study group comprised 203 men and women, and was characterized by large variation. The final analysis produced eight clusters of individuals, denoted according to their best-defining characteristic, i.e. 'decent', 'boundary-less', 'locked', 'exposed', 'heavy and monotonous', 'changed', 'mobile' and 'restrained'. The clusters...

The aim of the study was to evaluate eight questions concerning physical loads, used in public health questionnaires. Working women and men (203) completed a self-administered questionnaire twice, following a test-retest method. The questions were also validated with a structured interview. Response agreement was calculated with Cohen's kappa statistics with quadratic weights (kappa w). Test-retest agreement varied from 0.74 to 0.92, and inter-method agreement from 0.38 to 0.81. The lowest coefficients were for the questions concerning bent/twisted work postures (kappa w 0.38) and repetitive movements (kappa w 0.39). The results did not indicate any substantial influence of gender, type of work or musculoskeletal complaint. The questions concerning general physical activity and sitting work postures, and physical exercise/sports during leisure times, had good validity. The questions concerning bent/twisted work posture and repetitive movements need to be re-designed.

This paper investigates job-related distress and satisfaction with the work--family interface in various combinations of professional work and family responsibilities in Sweden. The study is based on the self-reports of 1,764 male and female university graduates in paid employment and with children at home. For both women and men, conditions at work seem to be most important. However, the division of responsibilities between partners was also found to have an impact, but in different ways for women and men. Only in families where both partners are gainfully employed and share the domestic work and financial responsibilities, was the psychological well-being and the work--family interface satisfactory for both women and men. In other families, negative effects for either women or men are noticed. The conclusion is that multiple roles and shared responsibilities and demands in the private sphere promote health among both women and men.

This study investigated whether there is a relationship between high physical work load and adverse psychosocial work factors, and whether this relationship is different for women and men. Separate analyses for female registered nurses and assistant nurses were made because these are common occupations involving high physical and psychological demands. This study was part of the MUSIC-Norrtalje study, a population study with the overall aim of identifying risk factors for musculoskeletal disorders. The respondents, 1423 gainfully employed men and women, were randomly selected from the study population. The exposure assessments referred to a typical workday during the previous 12 months. Physical exposure was investigated by interview, psychosocial work factors by interview and questionnaire. For the women, but not the men, mainly routine work and a job strain situation, according to the model of Karasek and Theorell, increased the probability of having a high physical work load, assessed as a time-weighted average of energy expenditure in multiples of the resting metabolic rate. Results indicated that in female-dominated occupations, high physical work load might also imply adverse psychosocial conditions. A higher frequency of high physical work load and job strain was observed among assistant nurses compared with registered nurses. Covariance between physical and psychosocial demands makes it difficult to determine the relative influence of each in health problems. Results of the present study imply that this is a larger problem in studies of women than men.

In what does healthy work for persons with an academic background consist, and how great is the perceived gulf between actual work and healthy work? A random sample of 5,700 members of the Swedish Confederation of Professional Associations (SACO) was taken in order to investigate their images of healthy work (in a very broad sense). Two groupings of work aspects emerged as particularly important. The first can be designated as work intellectuality—that work provides intellectual stimulation and is performed freely and independently, that innovative thinking and initiative-taking are appreciated, and that personal qualities can be utilized constructively. Great discrepancies between ideal and reality were evident in the latter two aspects. The second significant set of aspects was the value of work—benefit of the work to society and the extent to which it accorded with personal values. Here, the correspondence between ideal and actual work was relatively high. Lowest ranked of the twelve aspects which were judged to constitute healthy work were being well paid and having opportunities for career advancement. Rank orders and discrepancies are analyzed for seven occupational groups: physicians, dentists, teachers, engineers, university teachers, lawyers and economists. Comparisons are made by gender, age, employer, and position.

The last decade has seen a lively debate emerge about the proper scope of public health research and the value of examining broad social and environmental factors as interacting determinants of morbidity and mortality.1 2 In occupational health and safety, the broader socio-ecological system of most obvious interest is that of the organisations in which workers are employed. However, occupational health researchers have been slow to incorporate broader workplace features into their exposure assessment protocols and epidemiological study designs. The dominant exposure paradigm remains largely confined to the characterisation of risk factors at the job level (fig 1, arrow B). While application of this paradigm has contributed much to our understanding of the association between work and worker health and safety, failure to consider the organisational factors and conditions that are antecedents to job-level hazards could limit our ability to design and implement effective and sustainable hazard controls (affecting arrows A, C, D in fig 1). Examples of this broader perspective already exist within systems safety and macroergonomics models3–7 but we suggest that the importance of the organisational context is relevant for all exposure domains—including chemical hazards. We seek to stimulate dialogue within the occupational health community about the organisational context in which worker injury and illness occurs—and its implications for aetiological research and hazard control. Figure 1 Conceptual pathways that link organisational characteristics with workplace health and safety hazards and worker health outcomes. The box “work organisation” potentially represents multiple levels above the job level. The investigative foci in occupational health and the organisational sciences differ significantly, from job-level to organisational-level.8 While each contributes to our understanding of how working …

Two aspects of Human Resource Management (HRM), a main trend in modern personnel management, are considered in this study: A 'hard' version stressing performance monitoring and competition, and a 'soft' version stressing communication with employees. The aim of the investigation was to examine whether these two aspects of modern management are reflected in dentists' perceptions of differences in work conditions compared with other professionals. A questionnaire was answered by 312 publicly employed dentists and 3,600 other professionals in Sweden. The response rate was 66-77%. Effects from HRM on work, conditions and perceived efficiency were confirmed. The interaction effects, reflecting the duality of HRM, resulted in poorer work conditions, e.g. worse balance between effort and reward and worse opportunities for developing competence and collaboration in the workplace. This pertains especially in the case of dentists, where the positive effects of 'soft' HRM did not compensate for the negative effects of 'hard' HRM. Dentists in Sweden's Public Dental Health Service appear as a vulnerable group among Swedish professionals.

In the public service sector in Sweden, including dentistry, changes in management control systems have occurred. The extent and content of such self-assessed changes are described and analyzed for dentists in relation to other academicians. A questionnaire was answered by 306 dentists in the Public Dental Health Service and 3600 other academicians in Sweden. The response rate was 67%-77%. Three areas of change were found in factor analysis: management by objectives, by dialogue, and by hierarchy. In logistic regression models, dentists reported fivefold increases in management by objectives as compared with other academicians. Reported increases in management by dialogue were less for dentists. Having a female supervisor was related to increase of management by hierarchy. It is concluded that clear changes in management style have occurred and that dentists are notable for increase of management by objectives.

Background We have previously studied prospective associations between computer use and mental health symptoms in a selected young adult population. The purpose of this study was to investigate if high computer use is a prospective risk factor for developing mental health symptoms in a population-based sample of young adults. Methods The study group was a cohort of young adults (n = 4163), 20–24 years old, who responded to a questionnaire at baseline and 1-year follow-up. Exposure variables included time spent on computer use (CU) in general, email/chat use, computer gaming, CU without breaks, and CU at night causing lost sleep. Mental health outcomes included perceived stress, sleep disturbances, symptoms of depression, and reduced performance due to stress, depressed mood, or tiredness. Prevalence ratios (PRs) were calculated for prospective associations between exposure variables at baseline and mental health outcomes (new cases) at 1-year follow-up for the men and women separately. Results Both high and medium computer use compared to low computer use at baseline were associated with sleep disturbances in the men at follow-up. High email/chat use was negatively associated with perceived stress, but positively associated with reported sleep disturbances for the men. For the women, high email/chat use was (positively) associated with several mental health outcomes, while medium computer gaming was associated with symptoms of depression, and CU without breaks with most mental health outcomes. CU causing lost sleep was associated with mental health outcomes for both men and women. Conclusions Time spent on general computer use was prospectively associated with sleep disturbances and reduced performance for the men. For the women, using the computer without breaks was a risk factor for several mental health outcomes. Some associations were enhanced in interaction with mobile phone use. Using the computer at night and consequently losing sleep was associated with most mental health outcomes for both men and women. Further studies should focus on mechanisms relating information and communication technology (ICT) use to sleep disturbances.

Background Because of the quick development and widespread use of mobile phones, and their vast effect on communication and interactions, it is important to study possible negative health effects of mobile phone exposure. The overall aim of this study was to investigate whether there are associations between psychosocial aspects of mobile phone use and mental health symptoms in a prospective cohort of young adults. Methods The study group consisted of young adults 20-24 years old (n = 4156), who responded to a questionnaire at baseline and 1-year follow-up. Mobile phone exposure variables included frequency of use, but also more qualitative variables: demands on availability, perceived stressfulness of accessibility, being awakened at night by the mobile phone, and personal overuse of the mobile phone. Mental health outcomes included current stress, sleep disorders, and symptoms of depression. Prevalence ratios (PRs) were calculated for cross-sectional and prospective associations between exposure variables and mental health outcomes for men and women separately. Results There were cross-sectional associations between high compared to low mobile phone use and stress, sleep disturbances, and symptoms of depression for the men and women. When excluding respondents reporting mental health symptoms at baseline, high mobile phone use was associated with sleep disturbances and symptoms of depression for the men and symptoms of depression for the women at 1-year follow-up. All qualitative variables had cross-sectional associations with mental health outcomes. In prospective analysis, overuse was associated with stress and sleep disturbances for women, and high accessibility stress was associated with stress, sleep disturbances, and symptoms of depression for both men and women. Conclusions High frequency of mobile phone use at baseline was a risk factor for mental health outcomes at 1-year follow-up among the young adults. The risk for reporting mental health symptoms at follow-up was greatest among those who had perceived accessibility via mobile phones to be stressful. Public health prevention strategies focusing on attitudes could include information and advice, helping young adults to set limits for their own and others' accessibility.

Background Prospective associations have been found between high use of information and communication technology (ICT) and reported mental symptoms among young adult university students, but the causal mechanisms are unclear. Our aim was to explore possible explanations for associations between high ICT use and symptoms of depression, sleep disorders, and stress among young adults in order to propose a model of possible pathways to mental health effects that can be tested epidemiologically. Methods We conducted a qualitative interview study with 16 women and 16 men (21-28 years), recruited from a cohort of university students on the basis of reporting high computer (n = 28) or mobile phone (n = 20) use at baseline and reporting mental symptoms at the one-year follow-up. Semi-structured interviews were performed, with open-ended questions about possible connections between the use of computers and mobile phones, and stress, depression, and sleep disturbances. The interview data were analyzed with qualitative content analysis and summarized in a model. Results Central factors appearing to explain high quantitative ICT use were personal dependency, and demands for achievement and availability originating from the domains of work, study, social life, and individual aspirations. Consequences included mental overload, neglect of other activities and personal needs, time pressure, role conflicts, guilt feelings, social isolation, physical symptoms, worry about electromagnetic radiation, and economic problems. Qualitative aspects (destructive communication and information) were also reported, with consequences including vulnerability, misunderstandings, altered values, and feelings of inadequacy. User problems were a source of frustration. Altered ICT use as an effect of mental symptoms was reported, as well as possible positive effects of ICT on mental health. Conclusions The concepts and ideas of the young adults with high ICT use and mental symptoms generated a model of possible paths for associations between ICT exposure and mental symptoms. Demands for achievement and availability as well as personal dependency were major causes of high ICT exposure but also direct sources of stress and mental symptoms. The proposed model shows that factors in different domains may have an impact and should be considered in epidemiological and intervention studies.

Aims: To explore externally assessed demands and control for both women and men in each of the groups of the job demand—control (JDC) model, which itself was based on self-reported data. A specific aim was to better understand why health conditions among women with active jobs were as bad as those among women with high-strain jobs in some earlier studies. Methods: Expert assessments were made through direct observation and interviews concerning time pressure, hindrances, influence, and creative work tasks. The sample consisted of 203 men and women in 85 occupations. The four groups of the JDC model (high strain, low strain, active, and passive) were constructed from self-reported data. Results: Most comparative analyses of the JDC groups showed that external assessments corresponded to self-reports in the expected direction for both women and men, although not always statistically significant. However, in the active job situation, external assessments deviated from self-reports in different directions for women and men. Women had more hindrances and less influence over their work, while the situation was reversed for men. Women in active jobs worked more often than men in an organization with mostly female staff and in a predominantly female occupation. Conclusions: Associations between self-reported working conditions and health might be underestimated among women reporting an active job situation. Our findings contribute to the discussion on why the results in some studies show that active jobs among women are as hazardous for health as high-strain jobs.

This study explores the use of plasma cortisol as an indicator of psychologically straining work. As plasma cortisol and liver function might be associated through biological mechanisms, this paper has a secondary object, namely to explore the interaction between cortisol and liver function. As an index of liver function the serum level of gamma-glutamyl transpeptidase (GT) was used. The study sample was 2,000 prison employees from 67 different prisons in Sweden. Questionnaires and health examinations were used as well as measurements of plasma cortisol and serum GT. Very few work-related factors were associated with plasma cortisol unless analyzed separately for high and low level of serum GT. Two-way analyses of variance showed significant differences in the physiological "responses" to straining work with regard to psychic strain at work (men), social support at work (men), job role (men), loneliness at work (men and women), management style (women) and overtime work (women) between "low serum GT" and "high serum GT" individuals. Aggregated analyses showed that prison means of work-related factors were in some respects associated with prison means of plasma cortisol. The conclusion is that in individually based analyses plasma cortisol is difficult to use as an indicator of straining work, especially if the level of serum GT is unknown.

Musculoskeletal disorders (MSDs) have a multifactorial etiology. Therefore, a holistic approach to identifying target groups for primary/secondary prevention is essential. In this study, an exploratory person-oriented approach was applied, using cluster analysis of variables related to physical and psychosocial work conditions, and conditions in the private sphere, on a data set of 1,341 Swedish women and men who had not sought care for MSDs the 6 months preceding enrollment in the study. Three groups at risk and five "healthy" groups regarding MSDs were identified. Two of the risk groups had a strained situation regarding psychosocial work conditions or domestic/family conditions, respectively. The majority of individuals in these groups were women. The third risk group had a strained situation regarding both physical and psychosocial work conditions. This group consisted largely of men working in male-dominated jobs. The five healthy groups had low/moderate metabolic demands at work, and all of them having high proportions of subjects with moderate to high education, and fairly even distributions of men and women. In conclusion, the results indicate that gender-specific working and living conditions are associated with an increased risk for MSDs. The identification of these subgroups in the population may facilitate a selective prevention approach.

The aim is to investigate the association between different kinds of organizational changes during the last years and how the working conditions have been affected. In a study of working conditions for women and men in Swedish work life of today (the MOA-study1), data were collected on the organizational as well as on the individual level. Characteristics of 72 private and public work sites were assessed by using interviews with managers and written documents about the organizations. More changes were identified in the public compared to the private sector. Five different patterns of organizational changes were identified by means of a cluster analysis. 104 women and 104 men were selected for the investigation of working conditions by using open personal interviews and questionnaires regarding perceived consequences of the changes. The results of logistic regressions showed that the pattern of organizational changes was significantly associated with self-reported work load, development and control possibilities, job security and salary in relation to effort. Organizational changes directed at lean production systems seem to have a great impact on psychosocial working conditions, particularly for women.

This article has a two-fold purpose. First, it provides an explanation for the increase in occupational stress and sick leaves in Sweden in terms of the structural and organizational conditions. Second, it discusses measures that address these issues. Results of a study of 72 establishments are presented. The study investigated these establishments at both the organizational and individual employee level. It examined management strategies and working conditions in the establishments, classifying these elements by type of operations and company position. Both classifications point to differences in how work is organized and in working conditions. The results indicate that management technologies distribute risks between segments of the labor market, thus, also between different groups of the labor force. The developments were most favorable in high tech and knowledge-based operations. The situation was least favorable in labor-intensive services and, the most negative development had taken place in human services. Establishments serving as contractors appeared to organize their work differently from those with core activities. Working conditions in contracting businesses were particularly problematic. Since organizational changes work differently from one company to the next, there is a need to develop a variety of strategies for enacting change in the work environment. This article proposes strategies for different segments of the labor market. These strategies are adapted to the particular problems facing each segment.

Segregation of men and women into different jobs is often cited as one of the most plausible explanations for gender differences in exposure and musculoskeletal disorders.Direct measurements of sitting, arm, and trunk postures were taken with two different technical instruments on 156 subjects (78 matched pairs of one female and one male worker) over one full workday in diverse labor markets.Exposure differences between workers were strongly associated with vertical occupational segregation (measured as level of status/authority). The results showed that this association was strongest for female-dominated jobs. Workers in female-dominated jobs with a low status/authority experienced longer duration in standing posture (P = 0.001), and higher frequency of arm elevation (P = 0.028 and 0.040 for the dominant and the non-dominant arm, respectively). They also had longer duration of work with bent trunk compared to corresponding workers with high status/authority (P = 0.035). The association was less pronounced for male-dominated jobs, and no such association was found for gender-integrated jobs.The findings have implications for prevention as well as for future research.

This study attempted to identify work and leisure-time conditions and life-style factors associated with excess metabolic levels (metabolic demands exceeding one-third of a person's aerobic capacity) at work among men and women.The study focused upon psychological, ergonomic, and physically loading factors and chemical and physical environmental conditions. Data were obtained through self-reports, interviews, workplace analyses, technical measurements, and observations. Gender-specific calculations were used in univariate analyses and in stepwise logistic regression models for excess metabolic level.Twenty-seven percent of the men and twenty-two percent of the women worked at an excess metabolic level during their workday. Awkward work postures, heavy manual materials handling, high circulatory strain, chemical exposures, noise levels, much routine work, and many obstacles to job performance characterized their work conditions. The women had low skill discretion and more often atypical workhours, while the men showed high circulatory strain during leisure-time activities. Important negative life-style factors were a high consumption of alcohol for the men and a high body mass index and no or little regular physical exercise for the women.Metabolic demands in worklife today remain high. The women who exceeded the recommended metabolic level at work in this study were characterized by low pay, poor health, and children at home, in addition to high physical load and psychosocial strain at work. These characteristics indicate a group with few possibilities to leave a hazardous job for a less physically demanding one. The men who worked at an excess metabolic level seemed to be characterized more by a life-style common in some male-dominated work cultures with monotonous work.