This paper studies how the perceived work strain of first-line and middle managers affects their leadership towards their own employees. Further, it also examines how the availability of a manager can affect the perceived work strain, as a resource. The study answers the two following questions: “What experiences do first line and middle managers have of factors affecting their work strain and their leadership efficiency?” and “How do first line and middle managers balance demands, expectations, work strain and leadership?” This is a qualitative study based on the theoretical framework “Job-Demands-Resource model”. The data collected from five interviews were analyzed using thematic analysis methods. The findings of this study indicate that work strain can be a positive or negative thing, depending on the allocated resources at hand for the first line or middle managers. Having enough resources makes the high work strain translate to motivation and accomplishment, while high work strain without enough resources leads to a lack of motivation and accomplishment. The biggest effect the high work strain without resources has on leadership is that there is no time to be present with the employees, leading to a negative cycle.

Increasing parts of the world are facing ageing societies with growing figures of morbidity and disability. Focus of attention for European countries is directed towards prevention of old age impairment. As considerable time is spent at work, preventative psychosocial work environment measures could be entry points for a healthier ageing. The aims of this study are to i) explore the impact of mid-life work strain on old age disability ii) to examine the independent effects of the work strain components on disability, iii) to analyse the relation between education and disability and whether work strain mediates parts of this association. Work strain and baseline data will be collected from Level of Living Survey (LNU) 1981 and disability data from Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) 2004 (n=626). Multiple logistic regression analysis showed that persons in high strain work had the lowest odds of being IADL disabled compared to the passive group. Low demand was not associated to disability, low control group had more than twice the odds of being ADL disabled. Further results indicated that work strain may mediate the association between education and disability. Finally the results support that psychosocial work environment plays a part in the health of individuals at old age.

Tirta metalo gaminių įmonės moterų – pakuotojų krovos rankomis darbai atsižvelgiant į darbo aplinkos sąlygas: darbo sunkumą, mikroklimatą bei triukšmą. Įvairių darbų (vinių pakavimo, supakuotų dėžučių nešimo ir krovimo) sunkumas buvo tiriamas teoriniais skaičiavimais ir eksperimentiniais tyrimais, naudojant žmogaus organizmo fiziologinių pokyčių tyrimo metodą – širdies pulso matavimą. Šiluminė aplinka vertinta rudens ir žiemos periodais. Atlikus matavimus pakuotojų darbo vietoje buvo nustatyta, kad sunkiausias darbas yra dėžučių krovimas – širdies ritmas pakilo iki 135 dūžių per minutę, kuriuos pagal Tarptautinės darbo organizacijos klasifikaciją galima priskirti sunkiems (pulsas 125–150 min-1) darbams. Šiluminė aplinka darbo vietoje labai nepalanki žmogaus organizmui, nes rudens periodu temperatūra yra 9 – 12 °C, o žiemos periodu temperatūra dar žemesnė – nuo 6 iki 9 °C. Santykinis drėgnis daugiau kaip 75 %, Ištyrus triukšmą nustatyta, kad darbuotoją veikiantis triukšmas neviršija žemutinės 80 dBA ribinės vertės veiksmams pradėti. / In this work was studied of metal products company of women - works hand-loading packer according to working environment conditions: work heaviness, microclimate and noise. A strain of various works (pegs packing, packaged in boxes carrying solutions, and loading) was studied with theoretical calculations and with experiments. For this experiment was used a research method of human’s organism physiological changes – a measurement of heart beats. A thermal environment was evaluated in autumn and winter periods. When the measurement in a packaging in the workplace was finished, was established the fact, that the most hard work on boxes loading, according to International Labor organization (ILO), this work can be ascribed to hard works group (pulse 125-150 min-1). Thermal environment in the workplace is very unfavourable to human’s organism, because in autumn period temperature is 9-12°C, in winter period from 6 to 9 °C. Relative moisture top 75 %. When a noise in the workplace was studied, was established the fact, that a noise, which have an effect on worker, do not overdraw ground 80 dBA limit.

Objectives The aim of this thesis was to assess the importance of general practitioners (GP) and patient related factors for the GPs’ decision to sick certify or not to sick certify the patients. Study population and methods The data were obtained from a cross-sectional questionnaire study of GP-patient consultations. 65 GPs responded to one questionnaire about themselves and one questionnaire about each of the altogether 642 consultations. The patients responded to a questionnaire about themselves and the consultation, altogether 521 consultations. Various combinations of the three questionnaires were used in the four papers on which this thesis is based. Results Among GPs, long experience of family medicine and working part-time were significant determinants for issuing more sick leave certificates. Complaints perceived as clearly somatic by the physician decreased the chance of sick certifications, and complaints resulting in severe limitation of occupational work capacity, as assessed by the patient as well as the physician, increased the chance of sick certification, as did appointments for loco-motor complaints. Among work related factors, high ‘authority over decisions’ and high ‘social support’ were associated with reduced sickness certification probability. Worrying about illness or injury risks from work increased sickness certification. GPs and their patients took a fairly similar view to statements on health related and insurance system related matters. GPs’ opinions seem to have a greater impact than patients’ on the GPs’ decision to sickness certify a patient or not. Conclusions A number of patient and GP related factors were associated with the probability of getting sick certified. The patient’s own judgement of impaired work ability was important for sickness certification, but a shared judgement and decision between the GP and the patient appears probable in most cases. / Försäkringsmedicin

Manual accuracy in microsurgery is reduced by tremor and limited access. A surgical approach through the middle ear also puts delicate structures at risk, while the surgeon is often working at an unergonomic position. At this point a micromanipulator could have a positive influence. A system was developed to measure “working accuracy”, time and precision during manipulation in the middle ear. 10 ENT- surgeons simulated a perforation of the stapedial footplate on a modified 3D print of a human skull in a mock OR. Each trial was repeated more than 200 times aiming manually and using a micro-manipulator. Data of over 4000 measurements was tested and graphically processed. Work strain was evaluated with a questionnaire. Accuracy for manual and micromanipulator perforation revealed a small difference. Learning curves showed a stronger decrease both in deviation and time when the micromanipulator was used. Also a lower work strain was apparent. The micromanipulator has the potential as an aiding device in ear surgery. / Die manuelle Genauigkeit in der Mikrochirurgie wird duch Tremor und limitierten Zugang eingeschränkt. Ein chirurgischer Eingriff am Mittelohr birgt außerdem ein Verletzungspotential für empfindliche anatomische Strukturen. Überdies ist die Sitzposition des Operateurs oft unergonomisch. Ein neuartiger Mikromanipulator kann auf diese Faktoren einen positiven Einfluss haben. Eine spezielle Software wurde entwickelt und Genauigkeit, Zeit und Präzision bei einem Eingriff am Mittelohr zu bestimmen. 10 Kopf- Hals- Chirurgen simulierten die Perforation der Steigbügelfußplatte an einem 3D Modell eines menschlichen Schädels in einem Demonstrations- OP. Jeder Versuch wurde mehr als 200 mal zunächst manuell und später mit Hilfe des Mikromanipulators wiederholt. Die Daten von mehr als 4000 Messversuchen wurden getestet und grafisch dargestellt. Die Arbeitsbelastung wure mittels eines Fragebogens evaluiert. Manuelle und mikromanipulatorgestütze Genauigkeit zeigten einen signifikanten, jedoch ,absolut betrachtet,sehr geringen Unterschied der Genauigkeit. Die Lernkurven zeigten einen steileren Verlauf sowohl im Hinblick auf Genauigkeit als auch Versuchszeit, wenn der Mikromanipulator zur Anwendung kam. Weiterhin war eine geringere Arbeitsbelastung zu erkennen. Der Mikromanipulator birgt Potential als kompaktes Hilfsmittel für die Ohrchirurgie.

Manual accuracy in microsurgery is reduced by tremor and limited access. A surgical approach through the middle ear also puts delicate structures at risk, while the surgeon is often working at an unergonomic position. At this point a micromanipulator could have a positive influence. A system was developed to measure “working accuracy”, time and precision during manipulation in the middle ear. 10 ENT- surgeons simulated a perforation of the stapedial footplate on a modified 3D print of a human skull in a mock OR. Each trial was repeated more than 200 times aiming manually and using a micro-manipulator. Data of over 4000 measurements was tested and graphically processed. Work strain was evaluated with a questionnaire. Accuracy for manual and micromanipulator perforation revealed a small difference. Learning curves showed a stronger decrease both in deviation and time when the micromanipulator was used. Also a lower work strain was apparent. The micromanipulator has the potential as an aiding device in ear surgery.:Inhaltsverzeichnis 2 Bibliografische Beschreibung 3 Referat 3 1 Einführung 4 1.1. Mittelohrchirurgie= Mikrochirurgie 4 1.1.1. Stapedotomie- Operationsprinzip 4 1.1.2. Mögliche Komplikationen einer Stapedotomie durch manuelle Manipulation 4 1.2. Chirurgische Genauigkeit 5 1.3. Störfaktoren der Genauigkeit bei einem mittelohrchirurgischen Eingriff 6 1.3.1. Physiologische Limitationen der menschlichen Hand 6 1.3.2. Ergonomie des mittelohrchirurgischen Eingriffs 7 1.3.3. Besondere Bedingungen des mikrochirurgischen Eingriffs 8 1.4. Chirurgische Assistenzsysteme 8 1.5. Ziel der Arbeit 13 2 Publikationsmanuskript 15 3 Zusammenfassung 24 4 Literaturverzeichnis 30 Erklärung über die eigenständige Abfassung der Arbeit 36 Curriculum Vitae 37 Danksagung 39 / Die manuelle Genauigkeit in der Mikrochirurgie wird duch Tremor und limitierten Zugang eingeschränkt. Ein chirurgischer Eingriff am Mittelohr birgt außerdem ein Verletzungspotential für empfindliche anatomische Strukturen. Überdies ist die Sitzposition des Operateurs oft unergonomisch. Ein neuartiger Mikromanipulator kann auf diese Faktoren einen positiven Einfluss haben. Eine spezielle Software wurde entwickelt und Genauigkeit, Zeit und Präzision bei einem Eingriff am Mittelohr zu bestimmen. 10 Kopf- Hals- Chirurgen simulierten die Perforation der Steigbügelfußplatte an einem 3D Modell eines menschlichen Schädels in einem Demonstrations- OP. Jeder Versuch wurde mehr als 200 mal zunächst manuell und später mit Hilfe des Mikromanipulators wiederholt. Die Daten von mehr als 4000 Messversuchen wurden getestet und grafisch dargestellt. Die Arbeitsbelastung wure mittels eines Fragebogens evaluiert. Manuelle und mikromanipulatorgestütze Genauigkeit zeigten einen signifikanten, jedoch ,absolut betrachtet,sehr geringen Unterschied der Genauigkeit. Die Lernkurven zeigten einen steileren Verlauf sowohl im Hinblick auf Genauigkeit als auch Versuchszeit, wenn der Mikromanipulator zur Anwendung kam. Weiterhin war eine geringere Arbeitsbelastung zu erkennen. Der Mikromanipulator birgt Potential als kompaktes Hilfsmittel für die Ohrchirurgie.:Inhaltsverzeichnis 2 Bibliografische Beschreibung 3 Referat 3 1 Einführung 4 1.1. Mittelohrchirurgie= Mikrochirurgie 4 1.1.1. Stapedotomie- Operationsprinzip 4 1.1.2. Mögliche Komplikationen einer Stapedotomie durch manuelle Manipulation 4 1.2. Chirurgische Genauigkeit 5 1.3. Störfaktoren der Genauigkeit bei einem mittelohrchirurgischen Eingriff 6 1.3.1. Physiologische Limitationen der menschlichen Hand 6 1.3.2. Ergonomie des mittelohrchirurgischen Eingriffs 7 1.3.3. Besondere Bedingungen des mikrochirurgischen Eingriffs 8 1.4. Chirurgische Assistenzsysteme 8 1.5. Ziel der Arbeit 13 2 Publikationsmanuskript 15 3 Zusammenfassung 24 4 Literaturverzeichnis 30 Erklärung über die eigenständige Abfassung der Arbeit 36 Curriculum Vitae 37 Danksagung 39