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Padrosa E, Julià M, Bolíbar M, Gutiérrez-Zamora M, Escrig-Piñol A. Non-standard employment and mental health during the COVID-19 pandemic in Spain: a qualitative study. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The COVID-19 pandemic entailed a deep economic crisis that affected working populations globally. However, non-standard workers (NSW, understood as workers with temporary contracts, not working full-time, self-employed or not paying taxes/making active pension contributions) were more severely hit than workers with more stable and protected jobs. The aim of this study thus was to explore the experiences of NSW during the pandemic and how these affected their mental health in Spain, one of the countries in Europe with the highest shares of temporary and self-employment and the one that applied the most restrictive containment measures during the first waves of the pandemic.
Methods
As part of a larger multi-country study, 41 semi-structured interviews with NSW aged 25-55 were conducted between March-July 2021 and analyzed thematically.
Results
Analyses revealed that job loss or insecurity and subsequent reductions in income were central to the experience of NSW during the pandemic in Spain, which affected their mental health negatively. Both the existing social protection framework and the policies deployed during the pandemic to outweigh these consequences were perceived by NSW as insufficient or could not access them due to their condition of NSW. This was particularly the case for self-employed and temporary agency workers. Moreover, NSW expressed that containment measures and reductions in income prevented them from engaging in activities to cope with such adversities, aggravating their mental health.
Conclusions
These findings suggest that, in Spain, the pandemic intensified but also made more visible the defenselessness of NSW (especially self-employed and temporary agency workers) in terms of social protection in the event of sudden unemployment or reductions in income. This situation had harmful consequences for their mental health. Yet, new policies and measures fall short in fitting the necessities of an increasing share of the workforce.
Key messages
• In Spain, non-standard workers are more vulnerable to and defenseless against sudden unemployment or reductions in income.
• The pandemic intensified this problem and put them at higher risk of suffering from poor mental health.
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Affiliation(s)
- E Padrosa
- ESIMar, Parc de Salut Mar, Universitat Pompeu Fabra , Barcelona, Spain
- SDHEd, IMIM , Barcelona, Spain
- GREDS, Universitat Pompeu Fabra , Barcelona, Spain
| | - M Julià
- ESIMar, Parc de Salut Mar, Universitat Pompeu Fabra , Barcelona, Spain
- SDHEd, IMIM , Barcelona, Spain
- GREDS, Universitat Pompeu Fabra , Barcelona, Spain
| | - M Bolíbar
- Department of Sociology, Universitat de Barcelona , Barcelona, Spain
- GREDS, Universitat Pompeu Fabra , Barcelona, Spain
| | - M Gutiérrez-Zamora
- GREDS, Universitat Pompeu Fabra , Barcelona, Spain
- JHU-UPF Public Policy Center, Universitat Pompeu Fabra , Barcelona, Spain
| | - A Escrig-Piñol
- ESIMar, Parc de Salut Mar, Universitat Pompeu Fabra , Barcelona, Spain
- SDHEd, IMIM , Barcelona, Spain
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Padrosa E, Julià M. Precarious employment and mental health in European welfare state regimes: a multilevel approach. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.1353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Precarious employment (PE) is a key social determinant of health that is, in turn, shaped by the broader institutional framework of the country in which it is embedded. At the same time, evidence sustains that welfare state regimes (WSRs) have a decisive role in determining people's health. However, the interaction effect between them is yet to be studied from a public health perspective. This article examines how WSRs, PE and mental health (MH) relate in Europe, and whether this relationship differs between women and men.
Methods
Data were derived from the European Working Conditions Survey 2015. PE was measured through the Employment Precariousness Scale for Europe (EPRES-E), validated for comparative research in 22 European countries, which were classified into five WSRs (Bismarckian, Anglo-Saxon, Scandinavian, Southern and Central-Eastern). MH was measured through the WHO-5 Well-Being Index. In a sample of 30,795 formal employees, we performed multilevel poisson regression models stratified by women and men.
Results
Results show a gradual association between PE quartiles and poor MH (PR Q2=1.37 CI95% [1.13-1.65], Q3=1.86[1.51-2.30], Q4=2.96[2.31-3.81] men; PR Q2=1.15[0.97-1.37], Q3=1.48[1.22-1.79], Q4=2.06[1.64-2.58] women) after adjusting for control variables. Further, the Scandinavian WSR displayed an overall protective effect for MH among men, as compared with the Bismarckian (PR = 0.58[0.34-0.99]). Regarding the interaction effects, these were only significant in the Central-Eastern WSR, which was found to boost the negative association between PE and MH among women (PR = 1.17[1.03-1.33]).
Conclusions
These findings point to a differential effect of WSRs on the negative relationship between PE and MH according to gender.
Key messages
European welfare state regimes unequally affect the negative association between precarious employment and mental health. This differential is also gender-based, since the Central-Eastern regime further deteriorates the mental health of precarious employees only among women, as compared to the Bismarckian.
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Affiliation(s)
- E Padrosa
- GREDS-EMCONET, Universitat Pompeu Fabra, Barcelona, Spain
- Public Policy Center, Johns Hopkins University - Universitat Pompeu Fabra, Barcelona, Spain
| | - M Julià
- GREDS-EMCONET, Universitat Pompeu Fabra, Barcelona, Spain
- Public Policy Center, Johns Hopkins University - Universitat Pompeu Fabra, Barcelona, Spain
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Julià M, Pozo O, Gómez-Gómez A, Bolíbar M. Precarious employment and stress: any differences between objective or subjective measures of stress? Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.1352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Precarious employment is an emerging social determinant of health and health inequalities. It is known that it has an impact on health and could be a potential stressor. This study aims to examine the association between precarious employment and stress measured in two different ways: subjectively (questionnaire) and objectively (cortisol and its metabolites concentrations in hair, considered biomarkers of chronic stress).
Methods
Cross-sectional study in a sample of 256 workers of Barcelona, Spain, aged 25-60. We conducted a survey including questions on multidimensional precarious employment assessed by EPRES (Precarious Employment Scale), and perceived stress (measured through the Perceived Stress Scale (PSS)). We also collected hair samples to measure cortisol and metabolites concentrations. The associations between precarious employment and stress were assessed using lineal regression models, stratified by sex and adjusted for age and BMI.
Results
Preliminary analyses show an association between precarious employment and perceived stress for both men and women (B = 5.4,CI95%:3.8-7.1 and B = 5.4,CI95%:3.2-7.7 respectively). While we did not find significant association between precarious employment and Cortisol, we did in several biomarkers of the Hypothalamic-pituitary-adrenal axis for the case of women: 20α-Dihydrocortisol (B = 2.4;CI95%:0.1-4.6), 20β-Dihydrocortisol (B = 1.6;CI95%:-0.4-2.7) and 11-Dehydrocorticosterone (B = 0.6;CI95%:0.0-1.2).
Conclusions
This study found evidence of association between precarious employment and stress. The results were more robust when stress is measured by means of subjective self-reports than by objective measures of cortisol metabolites, implying that precarious employment has a clearer impact on wellbeing and mental health than in physical and hormonal responses. Further research is needed to validate and understand differences among outcomes, as well as differences between men and women.
Key messages
Some evidence of association between precarious employment and stress, measured both by subjective self-reported measures and by objective measures of cortisol metabolites existed. More research is needed to understand the differences between objective and subjective stress on the impact of precarious employment and differences among indicators for men and women.
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Affiliation(s)
- M Julià
- Health Inequalities Research Group, Universitat Pompeu Fabra, Barcelona, Spain
| | - O Pozo
- Integrative Pharmacology and Systems Neuroscience Group, IMIM. Hospital del Mar, Barcelona, Spain
| | - A Gómez-Gómez
- Integrative Pharmacology and Systems Neuroscience Group, IMIM. Hospital del Mar, Barcelona, Spain
| | - M Bolíbar
- Health Inequalities Research Group, Universitat Pompeu Fabra, Barcelona, Spain
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Julià M, Consuegra-Fernández M, Guilabert A, Muñoz C, Esteve A, Armiger-Borràs N, Santiago F, Arias M, Romaní J, Ferrándiz C, Carrascosa J, Pedrosa E, Alsina-Gibert M, Lozano F, Mascaró-Galy J. Corrigendum to “Genetically defined variants of toll-like receptors 3, 7 and 9 as phenotype and risk modifier factors for psoriasis” [89 (March (3)) (2018) 301–304]. J Dermatol Sci 2018; 91:342. [DOI: 10.1016/j.jdermsci.2018.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Julià M, Consuegra-Fernández M, Guilabert A, Muñoz C, Esteve A, Armiger-Borràs N, Santiago F, Arias M, Romaní J, Ferrándiz C, Carrascosa J, Pedrosa E, Alsina-Gibert M, Lozano F, Mascaró-Galy J. Genetically defined variants of toll-like receptors 3, 7 and 9 as phenotype and risk modifier factors for psoriasis. J Dermatol Sci 2018; 89:301-304. [DOI: 10.1016/j.jdermsci.2017.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 11/19/2017] [Accepted: 12/11/2017] [Indexed: 10/18/2022]
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Julià M, Tarafa G, Benach J. Informal employment related to health in the European Union. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku161.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Gual A, Mascaró J, Rojas-Farreras S, Guilabert A, Julià M, Iranzo P. Mortality of bullous pemphigoid in the first year after diagnosis: a retrospective study in a Spanish medical centre. J Eur Acad Dermatol Venereol 2012; 28:500-6. [DOI: 10.1111/jdv.12065] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bennàssar A, Mas A, Julià M, Iranzo P, Ferrando J. Placas anulares en grandes pliegues: cuatro casos de liquen plano pigmentoso-inverso. Actas Dermo-Sifiliográficas 2009. [DOI: 10.1016/s0001-7310(09)71908-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Piquer S, Casas S, Quesada I, Nadal A, Julià M, Novials A, Gomis R. Role of iduronate-2-sulfatase in glucose-stimulated insulin secretion by activation of exocytosis. Am J Physiol Endocrinol Metab 2009; 297:E793-801. [PMID: 19602578 DOI: 10.1152/ajpendo.90878.2008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Iduronate-2-sulfatase (IDS) is a lysosomal enzyme expressed in pancreatic islets responsible for the degradation of proteoglycans such as perlecan and dermatan sulfate. Previous findings of our group demonstrated the involvement of IDS in the normal pathway of lysosomal degradation of secretory peptides, suggesting a role of this enzyme in beta-cell secretory functionality. The present study was undertaken to characterize the effect of IDS overexpression on insulin release. INS1E cells were transiently transfected with a construct encoding human IDS (hIDS). hIDS overexpression was associated with a gain of function detected by a reduction in heparan sulfate content. hIDS potentiated the glucose-stimulated insulin secretory response compared with controls (61%) with no changes in insulin mRNA levels or insulin peptide content. Results on quantification of the exocytotic process showed a significant increase in hIDS-transfected cells compared with controls. Furthermore, ultramorphological analysis demonstrated an increase in the number of granules in the immediate vicinity of the plasma membrane in hIDS-transfected cells and a decrease in total vesicles per square micrometer. hIDS overexpression induced phosphorylation of protein kinase C (PKC) alpha and its newly myristoylated alanine-rich C kinase substrate, MARCKS. We conclude that IDS has a role in glucose-stimulated insulin secretion via a mechanism that involves the activation of exocytosis through phosphorylation of PKCalpha and MARCKS.
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Affiliation(s)
- S Piquer
- Endocrinology and Diabetes Unit, Laboratory of Diabetes and Obesity, Institut d' Investigacions Biomediques August Pi iSunyer-Fundació Clínic, Hospital Clínic, Barcelona, Spain
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Bennàssar A, Mas A, Julià M, Iranzo P, Ferrando J. [Annular plaques in the skin folds: 4 cases of lichen planus pigmentosus-inversus]. Actas Dermosifiliogr 2009; 100:602-605. [PMID: 19715645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
We report 4 patients with relatively asymptomatic, annular brownish plaques arising in the skin creases.The lesions had remained stable for months despite many topical treatments. Histological examination revealed an atrophic epidermis with a dermal lichenoid inflammatory infiltrate showing marked pigmentary incontinence.These clinical and pathological features were consistent with lichen planus pigmentosus-inversus,a rare, recently described variant of lichen planus, with only 10 cases reported to date. It has been suggested that he intensity and speed of onset of the inflammatory response could be modulated by keratinocyte surface markers, which could also determine the typical morphology of the lesions of this disease.
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Affiliation(s)
- A Bennàssar
- Servicio de Dermatología, Hospital Clínic, Barcelona, España.
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Bennàssar A, Mas A, Julià M, Iranzo P, Ferrando J. Annular Plaques in the Skin Folds: 4 Cases of Lichen Planus Pigmentosus-Inversus. Actas Dermo-Sifiliográficas (English Edition) 2009. [DOI: 10.1016/s1578-2190(09)70128-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Moreno-Romero JA, Segura S, Mascaró JM, Cowper SE, Julià M, Poch E, Botey A, Herrero C. Nephrogenic systemic fibrosis: a case series suggesting gadolinium as a possible aetiological factor. Br J Dermatol 2007; 157:783-7. [PMID: 17627792 DOI: 10.1111/j.1365-2133.2007.08067.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Nephrogenic systemic fibrosis (NSF) or nephrogenic fibrosing dermopathy is a rare fibrotic condition that presents in patients with a history of renal disease. The aetiology is unknown, but it has recently been proposed that gadolinium, a paramagnetic contrast agent, may be a trigger of this disease. We report three patients with NSF with a history of use of gadolinium in magnetic resonance angiography a few weeks before the onset of symptoms. In the future, gadolinium should probably be avoided as much as possible in renal insufficiency patients until its role in the development of NSF is clarified.
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Affiliation(s)
- J A Moreno-Romero
- Department of Dermatology, Hospital Clinic de Barcelona, Universitat de Barcelona, Villarroel 170, Barcelona 08036, Spain.
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Ramos-Casals M, Brito-Zerón P, Nardi N, Claver G, Risco G, Parraga FD, Fernandez S, Julià M, Font J. Successful treatment of severe Raynaud's phenomenon with bosentan in four patients with systemic sclerosis. Rheumatology (Oxford) 2004; 43:1454-6. [PMID: 15502001 DOI: 10.1093/rheumatology/keh340] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hurtado I, Julià M, Fiol C. LDL and Lp(a) oxidation: Protective role of HDL. Atherosclerosis 1999. [DOI: 10.1016/s0021-9150(99)80177-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Julià M. Human T-cell response to P. aeruginosa antigens in vitro. Immunol Lett 1997. [DOI: 10.1016/s0165-2478(97)87769-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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