Effort-reward imbalance, “locked in” at work,and long-term sick leave

Objectives  The objective was to study the relationship between a situation characterized as being in a “locked-in” position (LIP) in occupation and/or place of work, Effort-reward imbalance (ERI), and long-term sick leave. Methods  The study population derived from one section of a cross-sectional study SKA (sick-leave, culture and attitudes), and comprised all employees at the Swedish Social Insurance Agency responsible for management and compensation of illness in the working population. The analyses were performed for 2,951 women and 534 men who had complete data. Logistic regression was used to calculate odds ratio (OR) for ERI and sick-leave, the latter only for women. Results  The results showed a strong association between LIP within the place of work and ERI (for women OR = 3.28 95% CI 2.65–4.07, and for men 2.74 1.75–4.30). Also LIP within occupation resulted in high ERI (for women OR = 1.96 1.57–2.41, and for men 1.92 1.22–3.03). In women, ERI (OR = 1.40 1.15–1.70) as well as LIP within place of work (1.88 1.50–2.36) and within occupation (1.48 1.12–1.86) were associated with sick leave. ERI showed a significant mediating effect between LIP and sick leave, within place of work and within occupation (Z value 2.20 and 2.88, respectively). Conclusions  High ERI is associated with a situation characterized by being locked-in within an occupation or/and within a place of work. The results thereby support the theoretical model of Effort-reward imbalance. The results show that high ERI and being locked in are associated with long-term sick leave. ERI is a potential mediator of the association between being locked in and sick leave.     

Health,migration and border management: analysis and capacity-building at Europe’s borders

Objectives  

Three key elements were analysed in Hungary, Poland and Slovakia as a basis for strengthening the capacity of staff and structures related to health, migration and border management: public health concerns linked to migration, health needs and rights of migrants and the occupational health of staff.     

Triple jeopardy? Mental health at the intersection of gender,race, and class

Structural theories of stratification predict that groups with low positions in social hierarchies experience high rates of mental health problems. Extensions of this approach such as a triple jeopardy hypotheses claim that groups that are subordinate in multiple stratification systems such as gender, race and class are at especially high risk. Multiple minority statuses affect mental health in paradoxical ways, however, that refute triple jeopardy approaches. This paper presents a theoretical perspective based in cultural as well as structural theories that offers an alternative to triple jeopardy. I predict that certain relational schemas are jointly shaped by gender, race, and class and help explain their anomalous effects on mental health. These schemas of self-salience refer to beliefs about the relative importance of the self and others in social relations; they affect mental health by forming subjective alternative hierarchies to larger societal stratification systems. I use secondary analyses of two U.S. data sets to investigate this perspective. Results of regression analysis show that self-salience helps explain the paradoxical patterns of mental health by gender, race, and social class. The findings underscore the importance of using an intersectional approach and integrating cultural and structural factors to understand how stratification shapes mental health.     

Cholera management and prevention at Hôpital Albert Schweitzer, Haiti

In October 2010, Hopital Albert Schweitzer Haiti treated some of the first patients with cholera in Haiti. Over the following 10 months, a strategic plan was developed and implemented to improve the management of cases at the hospital level and to address the underlying risk factors at the community level.     

Do long workhours impact health, safety, and productivity at a heavy manufacturer?

OBJECTIVES: To test the health, safety, and productivity effects of long workhours. METHODS: Secondary analyses of a longitudinal employee panel (n = 2746). Average hours worked during spring 2001 were assessed relative to health, safety, and productivity outcomes spanning summer 2001 through spring 2002. RESULTS: Employees working overtime were no more likely to incur adverse physical or mental health, presenteeism, or disability outcomes. Those working 60+ hours were more likely to report new injuries and diagnoses, but these effects were overwhelmed by prior health, demographics, and compensation type. CONCLUSIONS: Much previous work has suggested that long workhours generate a wide range of adverse outcomes across the employee continuum. This study found no evidence for pervasive workhour effects. Rather, long workhours--especially weekly schedules at the 60 hour or above mark--can lead to problems in certain areas of health and safety. More research is needed that tests group differences across segmented characteristics (eg, poor versus good health) but keeps workhour impact in perspective.     

Fruits, vegetables, milk, and sweetened beverages consumption and access to à la carte/snack bar meals at school

OBJECTIVES: We assessed the impact of access to school snack bars on middle school students' fruit, vegetable, milk, and sweetened beverage consumption. METHODS: Five hundred ninety-four fourth- and fifth-grade students completed lunch food records 4 times during a 2-year period. RESULTS: The fourth-grade cohort consumed fewer fruits, regular (not fried) vegetables, and less milk and consumed more sweetened beverages and high-fat vegetables during year 2. CONCLUSIONS: Middle school students who gained access to school snack bars consumed fewer healthy foods compared with the previous school year, when they were in elementary schools and only had access to lunch meals served at school. Healthy food choices and school policies that require healthier foods at school snack bars should be promoted.     

Acupuncture Use in the United States: Who,Where, Why,and at What Price?

Despite the increase in acupuncture uses and greater than ever before interest of funding agencies to fund biomedical research in acupuncture, little is known about the profile of acupuncture users. We examined who these individuals are, where they reside, why they use acupuncture, and what price they pay. The increased use and high costs associated with each acupuncture visit poses questions to health care insurers regarding its coverage. Profiling will help conventional providers identify the segment of the population who are more likely to use acupuncture and educate them on the possible risks and benefits of using it with conventional medicine.     

Job strain, effort--reward imbalance, and stress at work: competing or complementary models?

BACKGROUND: The Demand Control Model (DCM) and the Effort Reward Imbalance Model (ERI) offer putative explanations of the relationship between stressful working conditions, job strain, and psychological and physical ill health. AIMS: The aims of this study are to: (a) compare the predictive powers of the two models for explaining perceived job stress and mental distress amongst workers as a whole, (b) identify whether a model which combines dimensions of the DCM and ERI might have more predictive power than either of them separately, and (c) ascertain whether the models make distinct contributions to explaining stress at work in specific occupational settings. METHODS: Statistical analysis was carried out on data collected from a cross-sectional postal survey of a random sample (n = 7,069), of the adult population in an urban area in Southern England. The analysis focused on the 4,135 respondents who were in paid employment. RESULTS: There was little support for combining the models as the combined model was dominated by the predictive power of dimensions from the ERI. However, the results also showed that the models or dimensions of the models made distinct contributions to explaining perceived work stress in different types of occupation. CONCLUSIONS: There is little evidence to support a combined model of work characteristics. The ERI appears to be the stronger of the two models although the DCM has explanatory value for specific occupations.     

Investigation and Control of Anthrax Outbreak at the Human–Animal Interface,Bhutan, 2010

In 2010, we investigated anthrax outbreak in Bhutan. A total of 43 domestic animals died, and cutaneous anthrax developed in 9 persons, and 1 died. All affected persons had contact with the carcasses of infected animals. Comprehensive preparedness and response guidelines are needed to increase public awareness of anthrax in Bhutan.     

Doctors, patients and influenza-like illness: clinicians or patients at risk?

BACKGROUND: Healthcare providers can transmit influenza and influenza-like illness (ILI) to patients and vice versa. However, the magnitude of this problem in the healthcare system as a whole is unknown. Using population-based administrative health data, we tested the hypothesis of a temporal association of ILI diagnosis among clinicians and their patients. METHODS: Healthcare providers under study included physicians (85%) and a variety of other medical professionals (such as chiropractors, dentists and optometrists). Cases of ILI were defined as having an ICD-9 code of influenza (487), pneumonia (480-486) or bronchitis (466 and 490) in a province-wide healthcare-provider billing system. Rates of ILI among persons who saw a sick (case) and non-sick (control) doctor were calculated and compared. RESULTS: The rate of ILI was lower among providers than among patients for every year of the study. The mean number of exposures to patients diagnosed with ILI was higher among case providers than among control providers (P = 0.044). However, exposure to case providers did not significantly increase the risk of ILI diagnosis among patients (OR=1.11; 95% confidence intervals 0.85-1.36). INTERPRETATION: Our findings are consistent with the hypothesis of patient-to-provider transmission. However, we may have underestimated the association and magnitude of this effect. Our results do not support the hypothesis that infectious doctors transmit disease to their patients, although this may be partly accounted for by the lower rates of ILI among the provider population in general.     

Does stage at diagnosis influence the observed relationship between socioeconomic status and breast cancer incidence, case-fatality, and mortality?

Historically, lower socioeconomic status (SES) has been reported to be associated with decreased breast cancer incidence and mortality and increased case-fatality, although recent trends in breast cancer screening and treatment may alter these relationships. This study assessed the associations between SES and breast cancer incidence, case-fatality, and mortality by stage of disease at diagnosis using recent data in the United States. Breast cancer incidence and survival data from the Surveillance, Epidemiology, and End Results (SEER) tumor registry for black and white women aged 55 and above were linked to county level SES and population data based on place of residence. Poisson regression was used to calculate age-adjusted relative rates associated with SES levels and breast cancer incidence, case-fatality, and mortality. As SES decreased, localized breast cancer incidence rates decreased, while incidence rates of distant disease increased. Five-year localized and regional breast cancer case-fatality rates increased as SES decreased. Localized breast cancer mortality rates decreased as SES declined, whereas regional breast cancer mortality rates tended to increase. These results confirm some previously reported findings and suggest that associations between lower SES and lower localized breast cancer mortality rates are influenced mainly by underlying associations between SES and localized breast cancer incidence, whereas regional breast cancer mortality rates appear to reflect the underlying association between SES and regional case-fatality rates.     

Exposure to famine during gestation, size at birth, and blood pressure at age 59 y: evidence from the dutch famine

We compared blood pressure of individuals (mean age 59 y) born in western Holland between January 1945 and March 1946 (mothers exposed to the Dutch Famine before or during gestation; n = 359) to blood pressure of unexposed individuals born before or conceived after the famine (n = 299) or same-sex siblings of subjects in series 1 or 2 (n = 313). Mean (SD) systolic and diastolic blood pressure were 140.3 (20.3) and 85.8 (11.0) mmHg, respectively; prevalence of hypertension (prior diagnosis of hypertension or with measured systolic/diastolic blood pressure above 140/90 mmHg) was 61.8%. Birth weight was inversely related to systolic (−4.14 mmHg per kg; 95% confidence interval (CI) −7.24, −1.03; p < 0.01) and diastolic (−2.09 mmHg per kg; 95% CI −3.77, −0.41; p < 0.05) blood pressure and to the prevalence of hypertension (odds ratio 0.67 per kg, 95% CI: 0.49, 0.93) (all age- and sex-adjusted). Any famine exposure of at least 10 weeks duration was associated with elevated systolic (2.77 mmHg; 95% CI 0.25, 5.30; p < 0.05) and diastolic (1.27 mmHg; 95% CI −0.13, 2.66; p = 0.08) blood pressure and with hypertension prevalence (odds ratio 1.44; 95% CI 1.04, 2.00; p < 0.05) in age- and sex-adjusted models. Exposure to famine during gestation may predispose to the development of hypertension in middle age.     

Sunshine and suicide at the tropic of Capricorn, São Paulo, Brazil, 1996-2004

Several studies have confirmed seasonal variation in suicide rates according to hours of sunshine. The suicide pattern was assessed in S?o Paulo, southeastern Brazil, at the tropic of Capricorn from 1996 to 2004. Poisson regression was employed to estimate parameters of seasonality, as well as to verify associations for each day between daylight duration and suicide. During the nine-year study period, there were 3,984 suicides (76.9% in men; median age=38.7 years old). Seasonal averages of suicides were similar, as were monthly averages. Poisson regression did not reveal any association between suicide rates and hours of sunshine (p=0.45) for both sexes. In conclusion, no seasonal pattern was observed for suicides.     

Do you need to shop around? Age at marriage,spousal alternatives,and marital dissolution

"This article attempts to shed light on the oft-observed relationship between age at marriage and marital dissolution by first deriving a hypothesis from marital search theory that relates both variables to the supply of spousal alternatives in the local marriage market. This hypothesis states that, relative to people who marry later in life, persons who marry at comparatively young ages will be especially susceptible to divorce when confronted with abundant alternatives to their current spouse. Marital history data from the National Longitudinal Survey of Youth were then merged with aggregated data from the Public Use Microdata Samples of the 1980 U.S. census to test this hypothesis." The author finds that "discrete-time event history analyses offer no support for this hypothesis. Although the risk of marital dissolution is highest where either husbands or wives chance numerous spousal alternatives, the impact of age at marriage on divorce is significantly weaker in marriage markets containing abundant remarriage opportunities. Some of the effect of age at marriage on marital dissolution is attributable to the detrimental impact of early marriage on educational attainment."     

Anemia and malnutrition in children at public schools in Osasco,São Paulo,Brazil

The authors studied a sample of students entering the first grade in the Osasco public school system in order to determine both the prevalence of anemia and nutritional status. Osasco is part of the Greater S o Paulo Metropolitan Area. Diagnosis of anemia was made through the hemoglobin concentration of blood from digital puncture. World Health Organization (WHO) levels were used to define anemia. Nutritional Status assessment. was made through weight/age and height/age indices, using Z score distribution and the National Center for Health Statistics (NCHS) reference levels. Prevalence of anemia was 51%. Prevalence levels varied according to the schools' geographic location: 56.9% in peripheral neighborhoods and 41.7% in central areas. Children with illiterate parents had a higher prevalence of this condition. Risk of anemia was higher for children who were over eight years of age when entering the first grade. Acute malnutrition was not found. Prevalence was higher than expected and points to the urgent need to establish an anemia control program for schoolchildren in this population.