The association of occupational stress and sleep duration with anxiety symptoms among healthy employees: A cohort study

Correlation analysis between occupational stress and metabolic syndrome in workers of a petrochemical enterprise: based on two assessment models of occupational stress

BACKGROUND

Occupational stress is becoming a common phenomenon around the world. Being in a high occupational stress state for a long time may destroy the metabolic balance of the body, thereby increasing the risk of metabolic diseases. There is limited evidence regarding the correlation between occupational stress and metabolic syndrome (MetS), particularly in the petrochemical workers.

METHODS

A total of 1683 workers of a petrochemical enterprise in China were included in the survey by cluster sampling method. The occupational stress assessment was carried out by the Job Content Questionnaire and the Effort-Reward Imbalance Questionnaire, and the general demographic characteristics, work characteristics, occupational hazards, lifestyle and health examination data of the participants were collected. Logistic regression and multiple linear regression were used to analyze the correlations and influencing factors between occupational stress and its dimensions with MetS and its components.

RESULTS

A total of 1683 questionnaires were sent out, and 1608 were effectively collected, with an effective recovery rate of 95.54%. The detection rates of occupational stress in Job Demand-Control (JDC) and Effort-Reward Imbalance (ERI) models were 28.4% and 27.2%, respectively. In this study, 257 participants (16.0%) were diagnosed with MetS. Compared with the non-MetS group, body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglycerides (TG) and fasting blood-glucose (FBG) levels were significantly higher in the MetS group, and high density lipoprotein-cholesterol (HDL-C) levels were significantly lower (P < 0.001). The results of multiple linear regression showed that after adjusting for nation, marital status, education, work system, smoking and drinking, and further adjusting for occupational hazards, the D/C ratio was significantly negatively correlated with SBP in the JDC model. Social support was negatively correlated with WC. In the ERI model, there was a significant positive correlation between over-commitment and FBG.

CONCLUSIONS

The detection rates of occupational stress and MetS were high in workers of a petrochemical enterprise. In the JDC model, occupational stress was negatively correlated with SBP, and social support was negatively correlated with WC. In the ERI model, there was a significantly positive correlation between over-commitment and FBG.

Sleep mediates the relationship between precarious employment and mental health

Background

Current evidence suggests that precarious employment is a risk factor for poor mental health. Although the mechanisms underpinning this relationship are unclear, poor sleep has been proposed to have a role in this relationship. This study explored the mediating effects of poor sleep quality and duration on the relationship between precarious employment and mental health.

Methods

Data were obtained from wave 17 of the Household, Income and Labour Dynamics in Australia survey. A novel precarious employment score (PES) was developed using exploratory and confirmatory factor analyses (CFA) in 8127 workers (4195 female, aged 18-65). Structural equation modelling (SEM) was used to evaluate the mediating effect of sleep quality and duration on the relationship between precarious employment and mental health (SF-36 mental health subscale).

Results

The PES identified 650 workers with a high level of precariousness, 2417 with a moderate level of precariousness, and 5060 workers with a low level of precariousness out of 8127 in total. There was a significant direct association between precarious employment and mental health; with higher precarity increasing the likelihood of poor mental health. The SEM results revealed that sleep quality partially mediated the association between precarious employment and mental health (Coefficient = 0.025, 95 % CI [0.015, 0.034], P ≤ 0.001). However, a mediation effect was not found for sleep duration.

Conclusion

Encouraging precarious employees to improve sleep quality may mitigate the adverse effects of precarious work on their mental health. Further objective measurement of sleep duration warrants a more accurate insight into this mediating effect in this group.

Take a break! Leisure participation moderates the workaholism-work stress relationship

Our primary aim was to gain a better understanding of how leisure activities (i.e., physical activity, mindfulness, and vacation) may beneficially relate to workaholism and work stress. Secondary aims included exploring motivations for participating in the three types of leisure activities. The job demands-resources theory; conservation of resources theory; and detachment-recovery, autonomy, mastery, meaning, and affiliation model provided context for hypothesized relationships among the variables. Full-time employees in the United States (N = 367) were recruited via Amazon's Mechanical Turk community, and they completed an online survey. Leisure participation significantly moderated the relationship between workaholism and work stress (weakening it). The majority of motivations for mindfulness and vacation were related to mental/emotional health, with a more even split between mental/emotional health and physical health/appearance motivations for physical activities. Several policy and practice-based recommendations for prioritizing leisure engagement are provided.

Parenting in place: Young children's living arrangement and migrants' sleep health in South Africa

Migration research tends to treat childrearing as a secondary role for migrants. By prioritising the economic objectives of migration, most models present migrants as either delaying childbearing or, if they have young children, not living with them. However, migration has become increasingly feminised, the types of mobility more varied, while the returns to migration remain uncertain at best. At the same time, norms around childrearing are shifting, and the capacity of kin to take care of children may be weakening. In such contexts, migrants may not want to or be able to be separated from their children. Confronting such difficult decisions and their consequences may be reflected in poor sleep health for the migrant parent. We draw on data from the Migration and Health Follow-Up Study (MHFUS) in South Africa to examine the following questions: (i) To what extent is children's coresidence associated with sleep health for migrant parents? (ii) Do effects vary by sex of migrant? and (iii) Do effects vary by location of migrant? Results from propensity score matching confirm that migrants who coreside with all their young children are more likely to experience healthy sleep compared to those who have nonresident or no young children. However, stratified analysis shows that these effects are only significant for women and those not living in Gauteng province. The value of these findings is underscored by the need for research on the well-being of migrant parents who are negotiating multiple agendas in economically precarious and physically insecure destinations.

Correlation of Depression, Anxiety, and Stress with Coping Strategies Among Dentistry Students: A Cross-Sectional Study

Aim: The aim of the study is to examine the level of stress and coping strategies of dentistry students in Türkiye in terms of variables such as sleep, personality, alcohol consumption, and smoking. Methods: A questionnaire including socio-demographic questions, Depression, Anxiety, and Stress Scale, and COPE Inventory was administered to 293 students. Results: The students' Depression, Anxiety, and Stress Scale scores were 13.88±10.03, 14.60±8.98, and 19.41±9.64, respectively. Income perception and the dentistry-personality relationship were the largest stress factors. No significant difference was found between years in terms of stress level. Problem-focus and emotional-focus coping strategies were negatively correlated, while less-useful coping strategies showed positive correlation with Depression, Anxiety, and Stress Scale scores. While the students who reported their sleep duration as "adequate" showed high problem-focus and emotional-focus coping scores, they had low less-useful coping strategies and Depression, Anxiety, and Stress Scale scores. The students who deemed dentistry suitable for their personality had higher problem-focus and emotional-focus coping scores and lower low less-useful coping strategies scores. Although alcohol consumption and smoking were unrelated to stress, they showed positive correlation with low less-useful coping strategies scores. Conclusion: No difference was observed between the level and sources of Depression, Anxiety, and Stress Scale and the grade. Students utilizing effective coping strategies had lower stress than those using less-useful coping strategies. Therefore, dental education should include how to acquire and use effective coping strategies. Keywords: depression, anxiety, coping strategies, dentistry, dental education

Cross-cultural adaptation and validation of the Job Content Questionnaire (JCQ-22)

BACKGROUND

Although the Job Content Questionnaire (JCQ-22) has been translated into numerous languages and applied in various countries, its cultural applicability in China remains unclear.

OBJECTIVE

To adjust the JCQ-22 for cross-cultural use and optimize the scoring method for suitability for Chinese working populations.

METHODS

We first used the original JCQ-22 questionnaire to measure occupational stress. Cross-cultural adjustment involved reorganization of scale items (adjusted-I scale) and deletion of inefficient redundant items during reorganization of scale items (adjusted-II scale). Structural validity and the relationship between stress and health outcomes (insomnia and self-conscious symptoms) before and after adjustment were compared.

RESULTS

Exploratory factor analysis revealed that the two-factor cumulative variance contribution rate of job demand and control of the adjusted-II scale was 52.47% , compared with 48.44% and 48.44% in the original version and adjusted-I scale, respectively. Among the 16 fitness indicators in confirmatory factor analysis, 9 items of the adjusted-II scale met the standard, compared with 4 items of the original and adjusted-I scales. The Pearson's correlation coefficients between occupational stress and insomnia as well as self-conscious symptoms from the adjusted-II scale were 0.15 and 0.32, respectively, which were higher than those of the original scale (0.10 and 0.20). Receiver operating characteristic analysis revealed that the adjusted-II scale exhibited a better area under the curve and Youden index values than the original scale.

CONCLUSION

The adjusted-II scale exhibited superior structural validity with more reasonable health outcome predictions and fewer items, making it more suitable for measuring occupational stress in Chinese populations.

Hussenoeder F, Conrad I, Riedel-Heller S, Romero Starke K. Psychosocial Occupational Exposures and Mental Illness

BACKGROUND

The purpose of this study is to investigate the exposure-risk relationship between psychosocial occupational stress and mental illness.

METHODS

We conducted a systematic review with meta-analyses as an update of a systematic review published in 2014. The study protocol was registered in PROSPERO (CRD42020170032). Literature searches were carried out in the MEDLINE, PsycINFO, and Embase databases. All procedural steps were performed independently by two reviewers; discordances were solved by consensus. All of the included full texts were subject to a methodological appraisal. Certainty of evidence was determined with the GRADE procedure.

RESULTS

The pooled risk of depression was found to be approximately doubled in workers exposed to high job strain, which is defined as high work demands combined with low job control (effect estimate [EE] = 1.99, 95% CI [1.68; 2.35], heterogeneity [I2] = 24.7%, n = 8). In particular, high work demands are associated with incident depression (ES = 13.8 [1.19; 1.61], I2 = 69.0%, n = 9) and with incident anxiety disorder (ES = 1.79 [1.44; 2.23], I2 = 48.1%, n = 5). There were only a small number of methodologically adequate studies available on burnout, somatoform disorders, suicidal ideation, and suicide. Thus, no pooled risk estimates were calculated, although some individual studies showed a considerably increased risk.

CONCLUSION

Psychosocial occupational stress is clearly associated with depression and anxiety disorders.

Evaluating the role of rare genetic variation in sleep duration

OBJECTIVES

To explore the roles of rare and high-impact variants in sleep duration.

DESIGN

Based on the recently released UK Biobank 200k exome dataset, an exome-wide association study was conducted to detect rare variants (minor allele frequency <0.01) contributing to sleep duration. Variant annotations were performed by the software tool ANNOVAR. Gene-based burden tests of sleep duration were conducted by the SKAT R-package. After quality control, 137,047 subjects were included in this study. CAUSALdb database was used to explore the related mental traits of identified genes.

RESULTS

We detected 730,572 variants with MAF < 1%, including 3873 frameshift variants, 3977 nonframeshift variants, 449,632 nonsynonymous variants, 1293 startloss variants, 10,254 stopgain variants, 413 stoploss variants, 261,130 synonymous variants, and 3102 variants are annotated as unknown. The burden test of exonic variants detected two exome-wide significant associations for sleep duration including TMIE at 3p21.31 (P_{Bonferroni adjusted} = 0.015) and ZIC2 at 13q32.3 (P_{Bonferroni adjusted} = 0.047). There are only nonsynonymous contained in TMIE; as for ZIC2, we detected 2 annotations of variants: nonsynonymous (P_{Bonferroni adjusted} =2.04 × 10^-4) and nonframeshift (P_{Bonferroni adjusted} =0.85). TMIE and ZIC2 were reported to be associated with several mental traits, such as chronotype, depression, and brain natriuretic peptide in published study.

CONCLUSION

This study reported 2 novel candidate genes for a sleep duration, supporting the roles of rare genetic variants in the regulation of sleep duration.

Educational, psychosocial, and clinical impact of SARS-CoV-2 (COVID-19) pandemic on medical students in the United States

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic altered education, exams, and residency applications for United States medical students.

AIM

To determine the specific impact of the pandemic on US medical students and its correlation to their anxiety levels.

METHODS

An 81-question survey was distributed via email, Facebook and social media groups using REDCap^TM. To investigate risk factors associated with elevated anxiety level, we dichotomized the 1-10 anxiety score into low (≤ 5) and high (≥ 6). This cut point represents the 25^th percentile. There were 90 (29%) shown as low anxiety and 219 (71%) as high anxiety. For descriptive analyses, we used contingency tables by anxiety categories for categorical measurements with chi square test, or mean ± STD for continuous measurements followed by t-test or Wilcoxson rank sum test depending on data normality. Least Absolute Shrinkage and Selection Operator was used to select important predictors for the final multivariate model. Hierarchical Poisson regression model was used to fit the final multivariate model by considering the nested data structure of students clustered within State.

RESULTS

397 medical students from 29 states were analyzed. Approximately half of respondents reported feeling depressed since the pandemic onset. 62% of participants rated 7 or higher out of 10 when asked about anxiety levels. Stressors correlated with higher anxiety scores included “concern about being unable to complete exams or rotations if contracting COVID-19” (RR 1.34; 95%CI: 1.05-1.72, P = 0.02) and the use of mental health services such as a “psychiatrist” (RR 1.18; 95%CI: 1.01-1.3, P = 0.04). However, those students living in cities that limited restaurant operations to exclusively takeout or delivery as the only measure of implementing social distancing (RR 0.64; 95%CI: 0.49-0.82, P < 0.01) and those who selected “does not apply” for financial assistance available if needed (RR 0.83; 95%CI: 0.66-0.98, P = 0.03) were less likely to have a high anxiety.

CONCLUSION

COVID-19 significantly impacted medical students in numerous ways. Medical student education and clinical readiness were reduced, and anxiety levels increased. It is vital that medical students receive support as they become physicians. Further research should be conducted on training medical students in telemedicine to better prepare students in the future for pandemic planning and virtual healthcare.

Sleep in times of crises: A scoping review in the early days of the COVID-19 crisis

During the early days of the pandemic and in the context of a seemingly unknown global threat, several potential major sleep disruptors were identified by sleep researchers and practitioners across the globe. The COVID-19 pandemic combined several features that, individually, had been shown to negatively affect sleep health in the general population. Those features included state of crisis, restrictions on in-person social interactions, as well as financial adversity. To address the lack of a comprehensive summary of sleep research across these three distinctive domains, we undertook three parallel systematic reviews based on the following themes: 1) Sleep in times of crises; 2) Sleep and social isolation; and 3) Sleep and economic uncertainty. Using a scoping review framework, we systematically identified and summarized findings from these three separated bodies of works. Potential moderating factors such as age, sex, ethnicity, socioeconomic status, psychological predisposition, occupation and other personal circumstances are also discussed. To conclude, we propose novel lines of research necessary to alleviate the short- and long-term impacts of the COVID-19 crises and highlight the need to prepare the deployment of sleep solutions in future crises.

Sleep as a Priority: 24-Hour Movement Guidelines and Mental Health of Chinese College Students during the COVID-19 Pandemic

Research on the combined role of 24-hour movement behaviors (sleep, sedentary behavior [SB], and physical activity) in adult mental health, though important, is in its infancy. In the context of Canadian 24-hour movement guidelines integrating quantitative recommendations for sleep, SB, and moderate-to-vigorous physical activity (MVPA), this study aimed to examine the associations between meeting guidelines and mental health among college students. The study used a cross-sectional sample of 1846 Chinese college students surveyed online in August 2020. Through network analysis and multivariate analysis of covariance, the individual and combined associations between meeting 24-hour movement guidelines and the levels of depression and anxiety after adjusting sociodemographic factors were analyzed. Results indicated that meeting the sleep guideline had stronger associations with depression and anxiety than meeting the SB or MVPA guideline. Specifically, compared to meeting no guidelines, meeting the sleep guideline (alone or in combination with other guidelines) was associated with significantly lower levels of depression and anxiety; meeting both SB and MVPA guidelines was also associated with a significantly lower level of depression. Hence, meeting more guidelines, especially adhering to a healthy sleep routine, may play an important role in promoting the mental health of young adults.