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Chinawa AT, Ossai EN, Chinawa JM, Odinka PC, Nduagubam OC, Odinka JI, Aronu AE. The unique contributions of depression and anxiety to suicidal ideation among Nigerian secondary school students: a cross-sectional survey. Afr Health Sci 2023; 23:537-550. [PMID: 38974260 PMCID: PMC11225466 DOI: 10.4314/ahs.v23i4.57] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2024] Open
Abstract
Background It is important to establish the pattern of suicidal ideation among adolescents with depression and anxiety. This will help the schools prevent possible complete suicide among these groups of adolescents' trough counseling and education. Objectives This work is therefore aimed at determining the effects of depression and anxiety on adolescent suicide ideation and factors that predict suicidal ideation among adolescents attending secondary school in southeast Nigeria. Methods A cross-sectional study among 450 secondary school adolescents in Enugu state, Nigeria. Information was obtained using the Columbia suicide severity rating scale and the Hospital Anxiety and Depression Scale (HADS). Chi-square test, correlation analysis and Hierarchical logistic regression were used in the analysis, and the level of statistical significance was determined using a P-value of <0.05. Results The prevalence of anxiety was 36.4% while that of depression was 30.7%. The prevalence of suicidal ideation was 8.4%. The prevalence of suicidal ideation among adolescents who were <15 years was 8.0% while those who were between 15 - 18 years was 13.5% and those more than 19 years of age was 22.5%. The prevalence of suicidal ideation among adolescents with depression is 21.7% and 78.3 % for those without depression while the prevalence of suicidal ideation among adolescents with anxiety is 20.1% and 79.9 % for those without anxiety. The prevalence of suicidal ideation among the poorest half was 16.4% and 10.2% in the richer half. There was a higher prevalence of suicidal ideation among the urban dwellers (53.3%) than the rural dwellers (46.7%).There was a positive correlation between suicide and age in years and this was found to be statistically significant, (n=450, r=0.107, p=0.023). A significantly higher proportion of respondents who had depression, 21.7% had suicidal ideation when compared with those who were not, (χ 2=12.170, p<0.001). Similarly, a significantly higher proportion of respondents who had an anxiety disorder, (20.1%) had suicidal ideation when compared with those who were not, 9.4%, (χ 2=10.291, p=0.001). The respondents who were 19 years and above had increased suicidal ideation, and the difference in proportions was found to be statistically significant, (χ 2=6.440, p=0.040). A significantly higher proportion of females, 16.6% had suicidal intentions when compared with the males, 7.1%, (χ 2=7.958, p=0.005). Conclusion There is an increasing prevalence of suicidal ideation among adolescents with a preponderance of older age and female gender. There is a link between depression/anxiety and suicidal ideation. The prevalence of suicidal ideation among the poorest half was higher than that of the richer half. There was a higher prevalence of suicidal ideation among the urban dwellers than the rural dwellers.
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Affiliation(s)
- Awoere T Chinawa
- Consultant Community Physician and Senior Lecturer Enugu State University Teaching hospital, Enugu State, Nigeria
| | - Edmund N Ossai
- Department of Community Medicine, College of Health Sciences, Ebonyi State University Abakaliki, Nigeria
| | - Josephat M Chinawa
- Department of Paediatrics, College of Medicine, University of Nigeria Enugu Campus, Nigeria
| | - Paul C Odinka
- Department of Psychological Medicine, University of Nigeria Enugu Campus, Nigeria
| | - Obinna C Nduagubam
- Department of Paediatrics, Enugu State University Teaching hospital, Enugu State, Nigeria
| | - Jaclyn I Odinka
- Social Sciences Unit, School of General Studies, University of Nigeria Nsukka, Nigeria
| | - Ann E Aronu
- Department of Paediatrics, College of Medicine, University of Nigeria Enugu Campus, Nigeria
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Yang L, Iwami M, Chen Y, Wu M, van Dam KH. Computational decision-support tools for urban design to improve resilience against COVID-19 and other infectious diseases: A systematic review. PROGRESS IN PLANNING 2023; 168:100657. [PMID: 35280114 PMCID: PMC8904142 DOI: 10.1016/j.progress.2022.100657] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
The COVID-19 pandemic highlighted the need for decision-support tools to help cities become more resilient to infectious diseases. Through urban design and planning, non-pharmaceutical interventions can be enabled, impelling behaviour change and facilitating the construction of lower risk buildings and public spaces. Computational tools, including computer simulation, statistical models, and artificial intelligence, have been used to support responses to the current pandemic as well as to the spread of previous infectious diseases. Our multidisciplinary research group systematically reviewed state-of-the-art literature to propose a toolkit that employs computational modelling for various interventions and urban design processes. We selected 109 out of 8,737 studies retrieved from databases and analysed them based on the pathogen type, transmission mode and phase, design intervention and process, as well as modelling methodology (method, goal, motivation, focus, and indication to urban design). We also explored the relationship between infectious disease and urban design, as well as computational modelling support, including specific models and parameters. The proposed toolkit will help designers, planners, and computer modellers to select relevant approaches for evaluating design decisions depending on the target disease, geographic context, design stages, and spatial and temporal scales. The findings herein can be regarded as stand-alone tools, particularly for fighting against COVID-19, or be incorporated into broader frameworks to help cities become more resilient to future disasters.
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Affiliation(s)
- Liu Yang
- School of Architecture, Southeast University, Nanjing, China
- Research Center of Urban Design, Southeast University, Nanjing, China
| | - Michiyo Iwami
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, UK
| | - Yishan Chen
- Architecture and Urban Design Research Center, China IPPR International Engineering CO., LTD, Beijing, China
| | - Mingbo Wu
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Koen H van Dam
- Centre for Process Systems Engineering, Department of Chemical Engineering, Imperial College London, UK
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Janzen B, Hellsten LA. Household Income and Psychological Distress: Exploring Women's Paid and Unpaid Work as Mediators. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6402. [PMID: 34199194 PMCID: PMC8296249 DOI: 10.3390/ijerph18126402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 06/10/2021] [Accepted: 06/11/2021] [Indexed: 11/16/2022]
Abstract
Research suggests that a socioeconomic gradient in employed adults' mental health may be partially mediated by their work conditions. Largely ignored in this body of research is the potential role of unpaid domestic labor. The objectives of this paper were to determine whether socioeconomic disparities in mental health were present in a sample of employed, partnered mothers, and if so, identify the intervening mechanisms which contributed to the disparity. Participants for this cross-sectional study were 512 women recruited from an online research panel of residents living in Saskatchewan, Canada. Household income was the primary exposure and psychological distress was the dependent variable. Potential mediators included material deprivation, job control, job demands, work-family conflict, and the conditions of domestic labor. Descriptive analyses followed by simple and multiple mediation analyses were performed. Lower income was associated with greater distress, with material deprivation, work-family conflict, and inequity in responsibility for domestic work acting as mediators. These results suggest that in addition to more well-established mechanisms, the conditions of unpaid domestic labor, particularly how that labor is shared within households, may play a role in the genesis of mental health inequities among employed partnered mothers. Limitations of the study are discussed as are implications for future research.
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Affiliation(s)
- Bonnie Janzen
- Department of Community Health & Epidemiology, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
| | - Laurie-Ann Hellsten
- Faculty of Education, The University of Winnipeg, Winnipeg, MB R3B 2E0, Canada;
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4
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Ruck DJ, Bentley RA, Borycz J. Early warning of vulnerable counties in a pandemic using socio-economic variables. ECONOMICS AND HUMAN BIOLOGY 2021; 41:100988. [PMID: 33636583 PMCID: PMC8054145 DOI: 10.1016/j.ehb.2021.100988] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 01/11/2021] [Accepted: 01/29/2021] [Indexed: 05/31/2023]
Abstract
In the U.S. in early 2020, heterogenous and incomplete county-scale data on COVID-19 hindered effective interventions in the pandemic. While numbers of deaths can be used to estimate actual number of infections after a time lag, counties with low death counts early on have considerable uncertainty about true numbers of cases in the future. Here we show that supplementing county-scale mortality statistics with socioeconomic data helps estimate true numbers of COVID-19 infections in low-data counties, and hence provide an early warning of future concern. We fit a LASSO negative binomial regression to select a parsimonious set of five predictive variables from thirty-one county-level covariates. Of these, population density, public transportation use, voting patterns and % African-American population are most predictive of higher COVID-19 death rates. To test the model, we show that counties identified as under-estimating COVID-19 on an early date (April 17) have relatively higher deaths later (July 1) in the pandemic.
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Affiliation(s)
- Damian J Ruck
- Anthropology Dept., University of Tennessee, Knoxville, TN 37996, USA; Network Science Institute, Northeastern University, Boston, MA 02115, USA
| | | | - Joshua Borycz
- Sarah Shannon Stevenson Science and Engineering Library, Vanderbilt University, Nashville, TN 37203, USA
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Kim KJ, An JH, Kim KJ, Yu JH, Kim NH, Yoo HJ, Kim HY, Seo JA, Kim NH, Choi KM, Baik SH, Kim SG. Prevalence of osteoporosis among North Korean women refugees living in South Korea: a comparative cross-sectional study. BMJ Open 2020; 10:e036230. [PMID: 32532773 PMCID: PMC7295412 DOI: 10.1136/bmjopen-2019-036230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 02/16/2020] [Accepted: 05/05/2020] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE To investigate the prevalence of osteoporosis among North Korean women refugees when compared with South Korean women, who have identical genetic backgrounds but experience different environments. DESIGN Comparative cross-sectional study. SETTING North Korean Refugee Health in South Korea (NORNS) study in South Korea. PARTICIPANTS We evaluated 122 North Korean women who participated in NORNS study and 366 age-matched/menopausal status-matched South Korean women from the Korea University Medical Center (KUMC) health examination cohort. The median age of the NORNS participants was 46 years (IQR, 40-60 years) with 52 women (42.6%) being postmenopausal. RESULTS Among the postmenopausal women, NORNS participants had a higher body mass index and number of pregnancies and lower physical activity than the KUMC participants. The overall prevalence of osteoporosis was 48% (25/52) and 17% (27/156) in NORNS and KUMC participants, respectively. The bone mineral density (BMD) values at the lumbar spine, femur neck and total hip were significantly lower in postmenopausal NORNS women than in the postmenopausal KUMC women. Old age, low body weight and late age of menarche were associated with low BMD among the postmenopausal North Korean refugees. In premenopausal participants, the NORNS women had lower body weight and physical activity than the KUMC women at baseline. All the NORNS women had normal Z-scores, although the BMD at the lumbar spine was significantly lower in NORNS women than in the KUMC women (0.952 vs 1.002 g/cm2, p<0.001). CONCLUSIONS Osteoporosis is a prevalent health problem in postmenopausal North Korean women refugees living in South Korea. It is conceivable to prepare vigilant countermeasures for bone health deterioration in this growing population, especially for postmenopausal women. Further research is warranted to determine the cause of the differences between participants of the same ethnic group.
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Affiliation(s)
- Kyeong Jin Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, The Republic of Korea
| | - Jee Hyun An
- Department of Internal Medicine, Korea University College of Medicine, Seoul, The Republic of Korea
| | - Kyoung Jin Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, The Republic of Korea
| | - Ji Hee Yu
- Department of Internal Medicine, Korea University College of Medicine, Seoul, The Republic of Korea
| | - Nam Hoon Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, The Republic of Korea
| | - Hye Jin Yoo
- Department of Internal Medicine, Korea University College of Medicine, Seoul, The Republic of Korea
| | - Hee Young Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, The Republic of Korea
| | - Ji A Seo
- Department of Internal Medicine, Korea University College of Medicine, Seoul, The Republic of Korea
| | - Nan Hee Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, The Republic of Korea
| | - Kyung Mook Choi
- Department of Internal Medicine, Korea University College of Medicine, Seoul, The Republic of Korea
| | - Sei Hyun Baik
- Department of Internal Medicine, Korea University College of Medicine, Seoul, The Republic of Korea
| | - Sin Gon Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, The Republic of Korea
- Department of Healthcare and Medicine for Unified Korea, Korea University College of Medicine, Seoul, The Republic of Korea
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Skogen JC, Thørrisen MM, Bonsaksen T, Vahtera J, Sivertsen B, Aas RW. Effort-Reward Imbalance Is Associated With Alcohol-Related Problems. WIRUS-Screening Study. Front Psychol 2019; 10:2079. [PMID: 31607975 PMCID: PMC6755332 DOI: 10.3389/fpsyg.2019.02079] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 08/27/2019] [Indexed: 11/26/2022] Open
Abstract
There is ample evidence of associations between a perceived stressful working environment and several health-related outcomes. To better understand potential mechanisms behind these observations some studies have focused on the relationship between effort-reward imbalance at work and alcohol consumption. So far, the findings have been inconsistent. One reason for this inconsistency might come from the focus on alcohol consumption per se, while disregarding other aspects such as adverse consequences related to the consumption of alcohol. The aim of the present study was to explore associations between perceived effort and reward, effort-reward imbalance and overcommitment, and alcohol-related problems. Using data from the alcohol screening component in the Norwegian WIRUS-project (N = 5,080), we ascertained the perceived effort, reward, effort-reward imbalance (ERI) and overcommitment using the effort-reward imbalance questionnaire. Alcohol-related problems was determined using a cut-off ≥8 on the Alcohol Use Disorder Identification Test (AUDIT). Associations were estimated using crude and adjusted logistic regression models. Covariates were age, gender and education. We found associations between different aspects of ERI and overcommitment, and alcohol-related problems. Specifically, the main analysis indicated that there was an increased odds for alcohol-related problems among those who reported high levels of ERI in conjunction with high overcommitment [adjusted OR: 1.40 (CI 95% 1.10–1.78)] compared to those with low levels of ERI and low overcommitment. Our findings suggest that ERI and overcommitment is associated with increased likelihood of alcohol-related problems. These findings indicate that individual and work-related factors should be taken into account collectively when aiming to determine the impact of psychosocial work environment on alcohol-related problems. Due to the cross-sectional nature of the present study, we are not able to determine the direction of the associations, and future studies should aim to investigate this.
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Affiliation(s)
- Jens Christoffer Skogen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Alcohol and Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway.,Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Mikkel Magnus Thørrisen
- Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Tore Bonsaksen
- Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.,Faculty of Health Studies, VID Specialized University, Sandnes, Norway
| | - Jussi Vahtera
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
| | - Børge Sivertsen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Department of Research and Innovation, Helse Fonna HF, Haugesund, Norway.,Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Randi Wågø Aas
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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7
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Ren C, Li X, Yao X, Pi Z, Qi S. Psychometric Properties of the Effort-Reward Imbalance Questionnaire for Teachers (Teacher ERIQ). Front Psychol 2019; 10:2047. [PMID: 31572259 PMCID: PMC6751258 DOI: 10.3389/fpsyg.2019.02047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 08/22/2019] [Indexed: 11/24/2022] Open
Abstract
The effort-reward imbalance (ERI) model is a theoretical model of a psychosocial work environment with adverse effects on health and well-being that focuses on a mismatch between high efforts spent and low rewards received at work. This study aimed to develop and psychometrically test an effort-reward imbalance questionnaire for teachers (Teacher ERIQ) based on the ERI model. The structure validity, reliability, and criterion validity of the new questionnaire’s scores were evaluated in a sample of 475 Chinese teachers. The results of exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) showed that a structure of four factors of effort (workload, emotional demands, student-related issues, and social responsibility) and two factors of reward (emotional reward and material reward) in accordance with the ERI model had significant factor loadings and acceptable model fit. The Cronbach’s Alpha coefficients of all dimensions’ scores showed that the questionnaire scores had good reliability. Criterion validity was indicated by significant correlation coefficients of scores of most dimensions along with teachers’ self-reported job burnout and non-reciprocal social relations, as well as the ANOVA results showing that the differences of the scores of the two criterion scales in different ERI ratio levels were significant. The results also showed that teacher’s ERI level varied with demographic variables such as age, gender and school type. The Teacher ERIQ is a valid and reliable new measurement for assessing teachers’ psychosocial work characteristics. It can be an important tool to provide new explanations of stress-related health risks among teachers and to guide the development of preventive measurements.
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Affiliation(s)
- Chuang Ren
- MOE Key Laboratory of Modern Teaching Technology, Shaanxi Normal University, Xi'an, China.,Qiqihar Experimental High School, Qiqihar, China
| | - Xiying Li
- MOE Key Laboratory of Modern Teaching Technology, Shaanxi Normal University, Xi'an, China
| | - Xuemei Yao
- School of Foreign Languages, Xi'an University of Finance and Economics, Xi'an, China
| | - Zhongling Pi
- MOE Key Laboratory of Modern Teaching Technology, Shaanxi Normal University, Xi'an, China
| | - Senqing Qi
- MOE Key Laboratory of Modern Teaching Technology, Shaanxi Normal University, Xi'an, China
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8
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Kiene SM, Ediau M, Schmarje KA, Kintu M, Tumwesigye NM. Exploring the Potential of Savings-Led Economic Strengthening HIV Interventions Among High-Risk Economically Vulnerable Fishing Communities in Uganda: Associations Between Use of Commitment Savings, Sexual Risk Behavior, and Problematic Alcohol Use. AIDS Behav 2019; 23:2347-2360. [PMID: 30924063 DOI: 10.1007/s10461-019-02475-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Fishing communities are a most-at-risk population for HIV in Uganda. Alcohol use and abuse and economic vulnerability fuel risky sexual practices and lead to increased risk of HIV infection in these communities. Economic strengthening is an emerging intervention approach and interventions promoting saving money via mechanisms with a "soft commitment" in the form of restricting or charging small fees for withdrawals, may serve to reduce spending on alcohol and spending that leads to HIV risk behaviors in cash-based economies. However, little research has been conducted to explore the potential for commitment savings-led economic strengthening interventions to address alcohol use and sexual risk behavior among fisherfolk. This cross-sectional study explored the associations between commitment savings, HIV sexual risk behavior, and problematic alcohol among fisherfolk. We also determined whether commitment savings moderated the associations between problematic alcohol use and risky sexual behaviors. 300 (132 male, 168 female) residents of fishing communities on Lake Victoria, Uganda completed a structured interviewer-assisted interview. Over half (55.3%) used commitment savings by saving money in a bank or savings cooperative or via mobile money. Having problematic alcohol use increased the rate of risky unprotected sex with: all partners (adjIRR 6.08, 95% CI 4.30-8.60) and with casual partners and CSWs/clients (adjIRR 4.90, 95% CI 3.09-7.78), and increased the odds of having met a sex partner at an alcohol venue (adjOR 2.84, 95% CI 1.46-5.51) compared to those without problematic alcohol use. Commitment savings was associated with lower odds of: problematic alcohol use (adjOR 0.50, 95% CI 0.26-0.96), meeting a sex partner at an alcohol venue (adjOR 0.43, 95% CI 0.24-0.78), as well as lower rates of risky unprotected sex with all partners (adjIRR 0.68, 95% CI 0.48-0.96), and with causal partners, CSWs/clients (adjIRR 0.38, 95% CI 0.17-0.85). Use of commitment savings moderated the associations between problematic alcohol use and unprotected sex. However, the moderating effects of commitment savings varied by gender. These findings suggest that promoting saving money in savings mechanisms which involve a commitment may be a potentially viable avenue for HIV prevention among fishing communities and may be particularly helpful for those who have problematic alcohol use.
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Affiliation(s)
- Susan M Kiene
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, 5500 Campanile Drive (MC-4162), San Diego, CA, 92182, USA.
- Alcohol Research Center on HIV, Brown University School of Public Health, Providence, RI, USA.
| | - Michael Ediau
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, 5500 Campanile Drive (MC-4162), San Diego, CA, 92182, USA
- Makerere University School of Public Health, Kampala, Uganda
| | - Katherine A Schmarje
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, 5500 Campanile Drive (MC-4162), San Diego, CA, 92182, USA
| | - Michael Kintu
- Wakiso Integrated Rural Development Association, Entebbe, Uganda
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Beauregard N, Marchand A, Bilodeau J, Durand P, Demers A, Haines VY. Gendered Pathways to Burnout: Results from the SALVEO Study. Ann Work Expo Health 2019; 62:426-437. [PMID: 29471461 DOI: 10.1093/annweh/wxx114] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 12/20/2017] [Indexed: 11/13/2022] Open
Abstract
Aim Burnout is a pervasive mental health problem in the workforce, with mounting evidence suggesting ties with occupational and safety outcomes such as work injuries, critical events and musculoskeletal disorders. While environmental [work and non-work, work-to-family conflict (WFC)] and individual (personality) pathways to burnout are well documented, little is known about how gender comes to influence such associative patterns. The aim of the study consisted in examining gendered pathways to burnout. Methods Data were derived from the SALVEO study, a cross-sectional study of 2026 workers from 63 workplaces from the province of Québec (Canada). Data were analyzed using multilevel path analysis. Results Direct effects of gendered pathways were evidenced for work (e.g. decision latitude) and non-work (e.g. child-related strains) environmental pathways, as well as for individual pathways (i.e. internal locus of control). Indirect effects of gendered pathways were also evidenced, with women reporting higher levels of burnout compared to men due to lower levels of decision latitude and of self-esteem, as well as higher levels of WFC. Women also reported lower burnout levels through investing more time into domestic tasks, which could represent a recovery strategy to highly demanding work. WFC further mediated the associations between working hours and burnout, as well as the between irregular work schedules and burnout. These result suggest than men distinctively reported higher levels of burnout due to the specific nature of their work contract negatively impacting on WFC, and incidentally, on their mental health. Conclusion Study results supported our hypotheses positing that gender distinctively shapes environmental and individual pathways to burnout. OHS prevention efforts striving for better mental health outcomes in the workforce could relevantly be informed by a gendered approach to burnout.
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Affiliation(s)
- Nancy Beauregard
- School of Industrial Relations, University of Montreal, Montreal, Quebec, Canada.,Public Health Research Institute, University of Montreal, Montreal, Quebec, Canada
| | - Alain Marchand
- School of Industrial Relations, University of Montreal, Montreal, Quebec, Canada.,Public Health Research Institute, University of Montreal, Montreal, Quebec, Canada
| | - Jaunathan Bilodeau
- School of Industrial Relations, University of Montreal, Montreal, Quebec, Canada.,Department of Sociology, University of Montreal, Montreal, Quebec, Canada
| | - Pierre Durand
- School of Industrial Relations, University of Montreal, Montreal, Quebec, Canada.,Public Health Research Institute, University of Montreal, Montreal, Quebec, Canada
| | - Andrée Demers
- Department of Sociology, University of Montreal, Montreal, Quebec, Canada
| | - Victor Y Haines
- School of Industrial Relations, University of Montreal, Montreal, Quebec, Canada.,Public Health Research Institute, University of Montreal, Montreal, Quebec, Canada
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10
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Sileo KM, Wanyenze RK, Kizito W, Reed E, Brodine SK, Chemusto H, Musoke W, Mukasa B, Kiene SM. Multi-level Determinants of Clinic Attendance and Antiretroviral Treatment Adherence Among Fishermen Living with HIV/AIDS in Communities on Lake Victoria, Uganda. AIDS Behav 2019; 23:406-417. [PMID: 29959718 PMCID: PMC6492274 DOI: 10.1007/s10461-018-2207-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
This cross-sectional study assessed determinants of HIV clinic appointment attendance and antiretroviral treatment (ART) adherence among 300 male fisherfolk on ART in Wakiso District, Uganda. Multi-level factors associated with missed HIV clinic visits included those at the individual (age, AOR = 0.98, 95% CI 0.97-0.99), interpersonal (being single/separated from partner, AOR: 1.25, 95% CI 1.01-1.54), normative (anticipated HIV stigma, AOR: 1.55, 95% CI 1.05-2.29) and physical/built environment-level (travel time to the HIV clinic, AOR: 1.11, 95% CI 1.02-1.20; structural-barriers to ART adherence, AOR: 1.27, 95% CI 1.04-1.56; accessing care on a landing site vs. an island, AOR: 1.35, 95% CI 1.08-1.67). Factors associated with ART non-adherence included those at the individual (age, β: - 0.01, η2 = 0.03; monthly income, β: - 0.01, η2 = 0.02) and normative levels (anticipated HIV stigma, β: 0.10, η2 = 0.02; enacted HIV stigma, β: 0.11, η2 = 0.02). Differentiated models of HIV care that integrate stigma reduction and social support, and reduce the number of clinic visits needed, should be explored in this setting to reduce multi-level barriers to accessing HIV care and ART adherence.
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Affiliation(s)
- K M Sileo
- Graduate School of Public Health, San Diego State University, San Diego, CA, USA.
- Center for Interdisciplinary Research on AIDS at Yale University, New Haven, CT, USA.
| | - R K Wanyenze
- Makerere School of Public Health, Makerere University, Kampala, Uganda
| | | | - E Reed
- Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | - S K Brodine
- Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | | | | | | | - S M Kiene
- Graduate School of Public Health, San Diego State University, San Diego, CA, USA
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11
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Hilger-Kolb J, Diehl K, Herr R, Loerbroks A. Effort-reward imbalance among students at German universities: associations with self-rated health and mental health. Int Arch Occup Environ Health 2018; 91:1011-1020. [DOI: 10.1007/s00420-018-1342-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 07/16/2018] [Indexed: 11/30/2022]
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Janzen B, Hellsten LAM. Does the psychosocial quality of unpaid family work contribute to educational disparities in mental health among employed partnered mothers? Int Arch Occup Environ Health 2018; 91:633-641. [PMID: 29691657 DOI: 10.1007/s00420-018-1310-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Accepted: 04/18/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE The contribution of unpaid family work quality to understanding social inequalities in women's mental health has been understudied and further limited by a scarcity of psychometrically sound instruments available to measure family work. Therefore, using a multi-item scale of family work quality with evidence of validity and reliability, the overall aim of the present study was to determine whether psychosocial qualities of unpaid family work contribute to educational inequities in women's mental health. METHODS Study participants in this cross-sectional study were 512 employed partnered mothers living in a Canadian province and recruited from an online research panel. The dependent variable was psychological distress. In addition to a 28-item measure assessing five dimensions of unpaid family work quality, independent variables included material deprivation, job decision latitude, job demands and several measures of the work-family interface. Multiple linear regression was the primary analysis. RESULTS Compared to women with high school or less, university educated women reported lower psychological distress [b = - 2.23 (SE = 0.50) p = 0.001]. The introduction of material deprivation into the model resulted in the largest reduction to the education disparity (51%), followed by equity in responsibility for unpaid family work (25%), family-to-work facilitation (22%), and decision latitude in paid work (21%). When entered simultaneously into the final model, the association between education and psychological distress was reduced by 70% and became statistically non-significant [b = - 0.68 (SE = 0.47) p = 0.10]. CONCLUSIONS In addition to the more established mechanisms of material conditions and decision latitude to explain mental health disparities, inequity in responsibility for unpaid family work may also play a role.
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Affiliation(s)
- Bonnie Janzen
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
| | - Laurie-Ann M Hellsten
- Department of Educational Psychology and Special Education, College of Education, University of Saskatchewan, Saskatoon, SK, Canada
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Sileo KM, Kintu M, Kiene SM. The intersection of intimate partner violence and HIV risk among women engaging in transactional sex in Ugandan fishing villages. AIDS Care 2018; 30:444-452. [PMID: 29063817 PMCID: PMC5799003 DOI: 10.1080/09540121.2017.1391985] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Intimate partner violence (IPV) may increase risk for HIV/AIDS among women engaging in transactional sex in Ugandan fishing communities. In this cross-sectional study, 115 women reporting engaging in transactional sex in Lake Victoria fishing communities completed a computerized interview. We tested associations between IPV and other HIV risk factors, with unprotected sex and HIV status, and tested moderators of the IPV-HIV risk relationship. Women reporting recent sexual IPV reported 3.36 times more unprotected sex acts (AdjExp[B] = 3.36, 95% CI = 1.29-8.69, p = 0.07). The effect of sexual IPV on sexual risk was significantly greater among alcohol and fish sellers compared to sex workers (interaction: Exp[B] = 12.29, 95% CI = 5.06-29.85, p < 0.001). Women reporting any sexual IPV were nearly four times more likely to report being HIV positive than women reporting no sexual IPV (AOR = 3.94, 95% CI = 1.22-12.66, p = 0.02). Integrated IPV and HIV interventions are needed in this context, especially among alcohol and fish sellers engaging in transactional sex.
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Affiliation(s)
- Katelyn M. Sileo
- Division of Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | - Michael Kintu
- Wakiso Integrated Rural Development Association, Entebbe, Uganda
| | - Susan M. Kiene
- Division of Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University, San Diego, CA, USA
- Alcohol Research Center on HIV, Brown University School of Public Health, Providence, PI, USA
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The Influence of Recognition and Social Support on European Health Professionals' Occupational Stress: A Demands-Control-Social Support-Recognition Bayesian Network Model. BIOMED RESEARCH INTERNATIONAL 2017; 2017:4673047. [PMID: 29250540 PMCID: PMC5700549 DOI: 10.1155/2017/4673047] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 09/11/2017] [Accepted: 10/03/2017] [Indexed: 12/02/2022]
Abstract
Healthcare professionals undergo high levels of occupational stress as a result of their working conditions. Thus, the aim of this study is to develop a model that focuses on healthcare professionals so as to analyze the influence that job demands, control, social support, and recognition have on the likelihood that a worker will experience stress. The data collected correspond to 2,211 healthcare workers from 35 countries, as reported in the sixth European Working Condition Survey (EWCS). The results obtained from this study allow us to infer stress under several working condition scenarios and to identify the more relevant variables in order to reduce this stress in healthcare professionals, which is of paramount importance to managing the stress of workers in this sector. The Bayesian network proposed indicates that emotional demands have a greater influence on raising the likelihood of stress due to workload than do family demands. The results show that the support of colleagues, in general, has less effect on reducing stress than social support from superiors. Furthermore, the sensitivity analysis shows that, in high-demand and low-control situations, recognition clearly impacts stress, drastically reducing it.
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Fekete C, Brinkhof MWG, Tough H, Siegrist J. Longitudinal study of social participation and well-being among persons with spinal cord injury and their partners (pro-WELL). BMJ Open 2017; 7:e011597. [PMID: 28122827 PMCID: PMC5278270 DOI: 10.1136/bmjopen-2016-011597] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
PURPOSE Social participation is an important determinant of well-being. Among persons with disabilities, and with spinal cord injury (SCI) in particular, opportunities for social participation are restricted and may impact well-being. The longitudinal pro-WELL study aims to investigate associations of 2 major domains of social participation with well-being: (1) availability and quality of close social relationships and (2) acting in core social roles (eg, paid work). The joint inclusion of persons with SCI and their partners is a major innovative aspect of this study enabling an in-depth analysis of interpersonal dynamics in coping with disability. PARTICIPANTS Pro-WELL is a nested project of the Swiss Spinal Cord Injury Cohort Study (SwiSCI) and involves community-dwelling persons aged 30-65 with SCI and their partners living in Switzerland. Baseline data were collected from mid-2015 to early 2016 by telephone interviews and questionnaires. The first and second follow-up assessments are scheduled with a 6 months interval. FINDINGS TO DATE The baseline sample consists of 133 persons with SCI and their partners. We provide an overview of baseline characteristics and well-being and describe recruitment outcomes and participation rates. A comprehensive non-response analysis demonstrates adequate representation of the source population with negligible selection bias regarding sociodemographic and lesion characteristics. FUTURE PLANS The prospective data collection and analysis of month 6 and 12 assessments are ongoing and tests of the main research hypotheses will be performed. Findings will be disseminated through peer-reviewed journals and scientific conferences. A workshop and a newsletter on study findings are proposed to feed back findings to participants and other stakeholders.
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Affiliation(s)
| | - Martin W G Brinkhof
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Hannah Tough
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Johannes Siegrist
- Faculty of Medicine, Senior Professorship ‘Work Stress Research’, University of Duesseldorf, Life-Science-Center, Duesseldorf, Germany
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Abedi H, Abbaszadeh A, Motaghi M. Factors Influencing School Health in Elementary Schools in Isfahan, Iran: A Qualitative Study. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2016; 4:352-362. [PMID: 27713898 PMCID: PMC5045979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Students' health and future health of the community are related to providing health care in schools and since in every society, different contextual factors affect this matter, the present study aims to recognize the factors influencing the health care elementary students are provided with. METHODS This qualitative content analysis was performed in 2014 in Isfahan. This study was conducted on school health instructors of elementary schools. Through targeted sampling, 15 health care providers, two mothers and 3 principals from 23 elementary schools were selected. Twenty-two semi-structured interviews were performed. Qualitative data analysis was done using qualitative content analysis. RESULTS In this study, 3 concepts were extracted: family umbrella over health (with two sub-categories of 'family's social status and its effect on health' and 'family and health'), functional resources (with two sub-categories of 'opportunity', 'availability of resources for diagnosis') and health components (with two sub-categories of 'culture', 'the value of school health'). These contextual factors must be considered in providing health care for schools. CONCLUSIONS Consideration of effective contextual factors on providing elementary students with health care can help improve health for this group.
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Affiliation(s)
- Heidarali Abedi
- Department of Nursing, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran;
| | - Abbas Abbaszadeh
- Department of Medical-Surgical Nursing, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran;
| | - Minoo Motaghi
- Department of Nursing, Kerman University of Medical Sciences, Kerman, Iran
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Vasconcellos IRRD, Griep RH, Portela L, Alves MGDM, Rotenberg L. Transcultural adaptation to Brazilian Portuguese and reliability of the effort-reward imbalance in household and family work. Rev Saude Publica 2016; 50:S0034-89102016000100223. [PMID: 27355466 PMCID: PMC4917360 DOI: 10.1590/s1518-8787.2016050006138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 07/20/2015] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To describe the steps in the transcultural adaptation of the scale in the Effort-reward imbalance model to household and family work to the Brazilian context. METHODS We performed the translation, back-translation, and initial psychometric evaluation of the questionnaire that comprised three dimensions: (i) effort (eight items, emphasizing quantitative workload), (ii) reward (11 items that seek to capture the intrinsic value of family and household work, societal esteem, recognition from the spouse/partner, and affection from the children), and (iii) overcommitment (four items related to intrinsic effort). The scale was included in a sectional study conducted with 1,045 nursing workers. A subsample of 222 subjects answered the questionnaire for a second time, seven to 15 days thereafter. The data were collected between October 2012 and May 2013. The internal consistency of the scale was evaluated using Cronbach’s alpha and test-retest reliability analysis, square weighted kappa, prevalence and bias adjusted Kappa, and intraclass correlation coefficient. RESULTS Prevalence and bias-adjusted Kappa (ka) of the scale dimensions ranged from 0.80-0.83 for overcommitment, 0.78-0.90 for effort, and 0.76-0.93 for reward. In most dimensions, the values of minimum and maximum scores, average, standard deviation, and Cronbach’s alpha were similar in test and retest scores. Only on societal esteem subdimension (reward) was there little variation in standard deviation (test score of 2.24 and retest score of 3.36) and in Cronbach’s alpha coefficient (test score of 0.38 and retest score of 0.59). CONCLUSIONS The Brazilian version of the scale was found to have proper reliability indices regarding time stability, which suggests adapting it to be used in population with characteristics that are similar to the one in this study.
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Affiliation(s)
| | - Rosane Härter Griep
- Laboratório de Educação em Ambientes e Saúde. Instituto Oswaldo Cruz. Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil
| | - Luciana Portela
- Programa de Pós-Graduação em Saúde Pública. Escola Nacional de Saúde Pública. Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil
| | | | - Lúcia Rotenberg
- Laboratório de Educação em Ambientes e Saúde. Instituto Oswaldo Cruz. Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil
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Binkley T, Specker B. The negative effect of sitting time on bone is mediated by lean mass in pubertal children. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2016; 16:18-23. [PMID: 26944819 PMCID: PMC5089450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Effects of time in moderate to vigorous physical activity (MVPA) and sitting (SIT) on bone were tested, hypothesizing that high MVPA would be positively associated with bone size and strength, offset effects of high SIT, and be mediated by lean mass. METHODS 155 children (79 male, 58 pubertal), 6-20 years (10.2±3.5 yr) were measured by dual-energy x-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT). MVPA and SIT were measured by 7-day activity recall. Regression analyses tested effects of MVPA and SIT on bone. Mediation analysis was conducted to determine if lean mass mediated the effect of activity on bone. RESULTS In pubertal boys, SIT was negatively associated with tibial endosteal and periosteal circumference as well as bone strength (β= -0.19, -0.14, and -5.68, respectively; all p<0.05). Effects of SIT on bone circumferences and strength were mediated by lean mass. MVPA did not offset the effects of SIT. In pubertal girls, MVPA was positively associated with cortical thickness (β=0.01, p<0.05) and the association was not mediated by lean mass. CONCLUSIONS Current health communications that encourage increased physical activity should include additional messaging to decrease time spent sitting, especially in pubertal boys.
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Affiliation(s)
- T.L. Binkley
- Ethel Austin Martin Program in Human Nutrition, South Dakota State University, United States,Corresponding author: Teresa Binkley, SWC Box 506, SDSU, Brookings, SD 57007, United States E-mail:
| | - B.L. Specker
- Ethel Austin Martin Program in Human Nutrition, South Dakota State University, United States
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The mediating effect of effort-reward imbalance in household and family work on the relationship between education and women's health. Soc Sci Med 2015; 131:58-65. [PMID: 25753286 DOI: 10.1016/j.socscimed.2015.03.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Occupational stress as a key determinant for explaining health inequalities has been well established while the impact of stress related to family work has rarely been considered. This study investigates whether stress in household and family work may contribute to health inequalities in women. We used a population-based sample of German mothers (n = 3129) to determine the total, direct and indirect effects of education on somatic complaints by means of OLS regression-based mediation models. Inference about indirect effects was determined by 95% bias corrected bootstrap confidence intervals. Education was assessed by a measure combining school education and vocational training. Stress was measured using the adopted effort-reward-imbalance (ERI) questionnaire for household and family work. The von Zerssen list of somatic complaints was used as measure of subjective health. We found a significant total effect of education on somatic complaints (p ≤ 0.001) as well as significant indirect effects through 'effort' (p = 0.006) and 'reward' in household and family work (p ≤ 0.001). However, the subscales of ERI pointed into different directions: while levels of 'effort' increased with women's educational attainment, levels of distress related to low 'reward' decreased with higher levels of education. Our findings suggest that the effect of women's education on somatic complaints is mediated through stress related to low reward for household and family work. In particular, lack of 'societal esteem' for household and family work contributed to health disadvantages in lower educated mothers. We conclude that research on health inequality would benefit from taking stressful experiences in household and family work greater into account.
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The impact of social and family-related factors on women's stress experience in household and family work. Int J Public Health 2015; 60:375-87. [PMID: 25613282 DOI: 10.1007/s00038-015-0654-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 11/13/2014] [Accepted: 01/12/2015] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVES This study explores the contribution of social and family-related factors to women's experience of an effort-reward imbalance (ERI) in household and family work. METHODS Using a population-based sample of German mothers (n = 3,129), we performed stepwise logistic regression analysis in order to determine the relative impact of social and family-related factors on ERI. RESULTS All factors investigated showed a significant association with at least one ERI component. Considering all predictors simultaneously in the multivariate analysis resulted in a decrease in significance of socioeconomic status in explaining the effort-reward ratio while the impact on low reward partly remained significant. In addition, age of youngest child, number of children, lower levels of perceived social support, domestic work inequity and negative work-to-family spillover, irrespective of being half- or full-time employed, revealed to be important in predicting ERI. CONCLUSIONS The experience of ERI in domestic work is influenced by the social and family environment. Particularly among socially disadvantaged mothers, lack of social recognition for household and family work proved to be a relevant source of psychosocial stress.
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Kaur H, Luckhaupt SE, Li J, Alterman T, Calvert GM. Workplace psychosocial factors associated with hypertension in the U.S. workforce: a cross-sectional study based on the 2010 national health interview survey. Am J Ind Med 2014; 57:1011-21. [PMID: 25137617 DOI: 10.1002/ajim.22345] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2014] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To explore associations between self-reported hypertension and workplace psychosocial factors that are common among U.S. workers and to identify industries and occupations (I&Os) that are associated with a high prevalence of hypertension, even after adjustment for common known risk factors. METHODS Data from the 2010 National Health Interview Survey were used to examine relationships between the prevalence of self-reported hypertension and job insecurity, hostile work environment, work- family imbalance, work hours and I&O. RESULTS Job insecurity (adjusted prevalence ratio (aPR): 1.11; 95% confidence interval (CI): 1.04-1.19)) and hostile work environment (aPR: 1.15; 95% CI: 1.03-1.29) were significantly associated with hypertension. Hypertension prevalence was significantly elevated among those employed in Healthcare Support occupations and Public Administration industries. CONCLUSION Addressing hostile work environments and the stress associated with job insecurity may improve workers' health. Other occupational factors that contribute to the variation in prevalence of hypertension by I&O should be sought.
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Affiliation(s)
- Harpriya Kaur
- University of Nebraska Medical Center; Omaha Nebraska
| | - Sara E. Luckhaupt
- Division of Surveillance; Hazard Evaluations and Field Studies; National Institute for Occupational Safety and Health; Centers for Disease Control and Prevention; Cincinnati Ohio
| | - Jia Li
- Division of Surveillance; Hazard Evaluations and Field Studies; National Institute for Occupational Safety and Health; Centers for Disease Control and Prevention; Cincinnati Ohio
| | - Toni Alterman
- Division of Surveillance; Hazard Evaluations and Field Studies; National Institute for Occupational Safety and Health; Centers for Disease Control and Prevention; Cincinnati Ohio
| | - Geoffrey M. Calvert
- Division of Surveillance; Hazard Evaluations and Field Studies; National Institute for Occupational Safety and Health; Centers for Disease Control and Prevention; Cincinnati Ohio
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Abstract
OBJECTIVE Menopause symptoms result from the interaction of estrogen deprivation, psychosocial influences, and genetic factors. We examined the influence of stress and of estrogen receptor-α (ER-α; PvuII and XbaI) and serotonin transporter (5-HTT) polymorphisms on symptoms at postmenopause. METHODS We studied 290 urban women from three cities in Mexico. General characteristics, menopause symptoms, and scores of perceived stress, effort-reward imbalance, dominance, and submission were collected. A fasting blood sample was obtained for hormone measurements and genotypification. RESULTS Women had a mean ± SD age of 54.4 ± 4.5 years and BMI of 29.5 ± 4.9 kg/m. The frequency of hot flashes was 75.5%; vaginal dryness, 57.8%; and diminished sexual interest, 78.7%. Follicle-stimulating hormone and estradiol levels were 59 ± 27 mIU/mL and 22 ± 29 pg/mL, respectively. Women from Torreón had higher schooling and less parity but higher scores for depression and lower submission. Hot flashes were more frequent in women from León. Genotype distribution was similar among cities. Lower scores for dominance were found in women with the pp and xx ER-α genotypes. Increased smoking habit was found for the SS genotype of 5-HTT. Factors significantly associated with symptoms were years since menopause, with hot flashes (negative), and with diminished sexual interest (positive); dominance was negatively associated with depression, perceived stress, and vaginal dryness; submission was positively associated with depression, perceived stress, anxiety, and hot flashes; and effort-reward imbalance was positively associated with anxiety, hot flashes, and perceived stress. CONCLUSIONS Symptoms at postmenopause were associated mainly with dominance, submission, and effort-reward imbalance. The pp genotype of ER-α showed lower scores of dominance.
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Sperlich S, Arnhold-Kerri S, Siegrist J, Geyer S. The mismatch between high effort and low reward in household and family work predicts impaired health among mothers. Eur J Public Health 2012; 23:893-8. [PMID: 23002240 DOI: 10.1093/eurpub/cks134] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND So far, Siegrist's model of effort-reward imbalance (ERI) has been tested almost exclusively for paid employment. This article reports results on a newly developed questionnaire measuring ERI in unpaid household and family work. METHODS Using data of a population-based sample of 3129 German mothers, logistic regression analyses were performed to test the following three main assumptions: (i) high effort combined with low reward in household and family work increases the risk of poor health; (ii) a high level of overcommitment may enhance the risk of poor health; and (iii) mothers reporting an extrinsic high ERI and a high level of overcommitment have an even higher risk of poor health. RESULTS ERI was significantly related to self-rated health, somatic complaints and mental health. A high level of overcommitment increased the risk of poor health, whereas ERI and overcommitment combined was associated with the highest risk of poor health. Statistically significant synergy effects of combined exposure of ERI and overcommitment were found for 'anxiety'. CONCLUSIONS With some limitations, all three assumptions underlying the ERI model were confirmed. Thus, we conclude that ERI is applicable to domestic work and may provide an explanatory framework to assess stress experiences in mothers.
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