Approximately 14% of the working-age Swedish population are either on long-term sick leave or early retirement due to disability. Substantial increase of sick listing, reports of work disabilities and early retirement due to stress and musculoskeletal chronic pain suggest a need for methods of preventing loss of function resulting from these conditions. The present preliminary investigation examined the effects of a brief Acceptance and Commitment Therapy (ACT) intervention for the treatment of public health sector workers who showed chronic stress/pain and were at risk for high sick leave utilization. ACT was compared in an additive treatment design with medical treatment as usual (MTAU). A group of 19 participants were randomly distributed into 2 groups. Both conditions received MTAU. The ACT condition received four 1-hour weekly sessions of ACT in addition to MTAU. At post and 6-month followup, ACT participants showed fewer sick days and used fewer medical treatment resources than those in the MTAU condition. No significant differences were found in levels of pain, stress, or quality of life. Improvements in sick leave and medical utilization could not be accounted for by remission of stress and pain in the ACT group as no between-group differences were found for stress or pain symptoms.According to a recent report from the State Department of Sweden, the frequency of persons on long-term sick leave and subsequent early disability pension is one of the highest in the world (Rydh, 2002). During the past 4 years

Managers need to have a strategic plan for how to create a working environment for caregivers with no formal competence. Caregivers' self-determination seems to be important for stress symptoms. Meaning, self-determination, impact and opportunities appear to be important for job satisfaction and competence, opportunities, resources and formal power for quality of care.

Disulfide cyclization is a powerful method for reducing the conformational space of a peptide. This in turn may enable the study of its bioactive conformation. Several analogues of angiotensin II (Ang II) containing a disulfide bridge between amino acids 3 and 5 have been reported. Among these the cyclic octapeptides c[Hcy3,5]-Ang II, c[Cys3,5]-Ang II, and c[Pen 3,5]-Ang II showed significant activity at Ang II receptors. We have performed conformational analysis studies using theoretical calculations and 1H-NMR spectroscopy on tripeptide model compounds of these cyclic octapeptides which show that the cyclic moieties of c[Cys3,5]-Ang II and c[Pen3,5]-Ang II preferentially assume an inverse gamma-turn conformation. On the basis of these results, we substituted amino acid residues 3-5 in Ang II with two different gamma-turn mimetics giving four diastereomeric Ang II analogues. Interestingly, two of these are equipotent to Ang II in binding to AT1 receptors. In the contractile test using rabbit aorta rings, one of the analogues is an agonist with full contractile activity approximately equipotent to c[Pen3,5]-Ang II but 300-fold less potent than Ang II. This low potency may suggest that Ang II does not adopt a gamma-turn in the 3-5 region when interacting with the receptor.

PurposeThe aim of the present study was to investigate relationships between sense of coherence, emotion-focused coping, problem-focused coping, coping efficiency, and mental quality of life (QoL) in patients with chronic illness. A model based on Lazarus’ and Folkman’s stress and coping theory tested the specific hypothesis: Sense of coherence has a direct and indirect effect on mental QoL mediated by emotion-focused coping, problem-focused coping, and coping efficiency in serial adjusted for age, gender, educational level, comorbidity, and economic status.MethodsThe study used a cross-sectional and correlational design. Patients (n = 292) with chronic diseases (chronic heart failure, end-stage renal disease, multiple sclerosis, stroke, and Parkinson) completed three questionnaires and provided background data. Data were collected in 2012, and a serial multiple mediator model was tested using PROCESS macro for SPSS.ResultsThe test of the conceptual model confirmed the hypothesis. There was a significant direct and indirect effect of sense of coherence on mental QoL through the three mediators. The model explained 39% of the variance in mental QoL.ConclusionsSelf-perceived effective coping strategies are the most important mediating factors between sense of coherence and QoL in patients with chronic illness, which supports Lazarus’ and Folkman’s stress and coping theory.