Women's work roles and their impact on health, well-being, and career: comparisons between the United States, Sweden, and The Netherlands

Virtual focus groups among individuals with use disorders: assessing feasibility and acceptability in an underserved clinical population

Objective

There are substantial barriers to conducting research among individuals with stigmatized and complicated health conditions like substance use disorders. These barriers slow progress when developing, refining, and assessing interventions to better treat underserved populations. Virtual focus groups are an innovative method for collecting data from individuals via a discreet and accessible platform which can inform novel as well as existing treatment approaches. This article reports on the feasibility and acceptability of virtual focus groups as a mechanism to recruit and engage geographically and demographically diverse samples of participants with substance use disorders that are otherwise logistically difficult to assess.

Method

Participants were assessed for eligibility for a virtual focus group study based on demographic features, drug use history, and psychiatric history via a remote, interview-based screening. Focus groups were completed anonymously without video or name-sharing. Discussion contributions, quantified with number of times speaking and total number of words spoken, were compared across gender, and treatment status. Participants provided quantitative and qualitative feedback on the focus group experience in a follow-up survey.

Results

Focus groups (N=26) based in geographical areas throughout the United States were conducted with 88 individuals with opioid use disorder or stimulant use disorder. Discussion contributions were comparable between genders and among individuals in treatment versus those seeking treatment. A follow-up survey (n=50, 57% of focus group participants) reflected high levels of enjoyment, comfort, and honesty during focus group discussions.

Discussion

Findings suggest virtual focus groups can be an effective and efficient tool for substance use research.

Gender representation among speaking and leader roles at European cardio-thoracic surgical annual meetings

OBJECTIVES

Our goal was to evaluate gender representation among session leaders and abstract presenters at European cardio-thoracic surgical annual meetings.

METHODS

We did a descriptive study of the gender distribution among session leaders and abstract presenters at 2 European cardio-thoracic international meetings from 2017 to 2022. Data from publicly available programmes were used to generate a list of session leaders and abstract presenters. The primary outcome was to evaluate the proportion of female sessions leaders at the annual meetings. Descriptive analyses were performed including the Cochran-Armitage trend test for linear trend of proportions.

RESULTS

A total of 1025 sessions of 11 annual meetings of the European Association for Cardio-Thoracic Surgery (EACTS) and the European Society of Thoracic Surgeons were examined. A total of 397 (13.2%) out of 3007 total session leaders and 955 (15.2%) out of 6251 abstract presenters were female. From 2017 to 2022, the proportions of both female session leaders and abstract presenters trended significantly [10.4% to 21.9% (P < 0.001) and 13.7% to 18.3% (P < 0.001), respectively]. The EACTS female members and female meeting attendees significantly increased from 2017 to 2022 [11.1% to 15.9% (P < 0.001) and 23.7% to 26.9% (P < 0.001)], respectively. Most of the women attendees at the EACTS and the European Society of Thoracic Surgeons meetings who were session leaders and speakers came from Germany, Italy, the United Kingdom and the United States.

CONCLUSIONS

Women are under-represented compared to men in leadership and speaking roles at European cardio-thoracic surgical annual meetings. In the past few years, an encouraging positive trend over time for female leadership roles has been noted; as a result, the proportion of female society members is represented at the annual meetings. However, a substantial gender gap still exists in leading roles of meeting attendees.

Gender equality related to gender differences in life expectancy across the globe gender equality and life expectancy

Life expectancy (LE) depends on the wider determinants of health, many of which have gendered effects worldwide. Therefore, this study aimed to investigate whether gender equality was associated with LE for women and men and the gender gap in LE across the globe. Gender equality in 156 countries was estimated using a modified global gender gap index (mGGGI), based on the index developed by the World Economic Forum between 2010 and 2021. Linear regression was used to investigate the association between the mGGGI and its economic, political, and education subindices and the gender gap in LE and women and men's LE. Overall, the mGGGI increased from 58% in 2010 to 62% in 2021. Globally, changes in the mGGGI and its economic and political subindexes were not associated with changes in the gender gap in LE or with LE for women and men between 2010 and 2020. Improvements in gender equality in education were associated with a longer LE for women and men and widening of the gender gap in LE. In 2021, each 10% increase in the mGGGI was associated with a 4.3-month increase in women's LE and a 3.5-month increase in men's LE, and thus with an 8-month wider gender gap. However, the direction and magnitude of these associations varied between regions. Each 10% increase in the mGGGI was associated with a 6-month narrower gender gap in high-income countries, and a 13- and 16-month wider gender gap in South and Southeast Asia and Oceania, and in Sub-Saharan Africa, respectively. Globally, greater gender equality is associated with longer LE for both women and men and a widening of the gender gap in LE. The variation in this association across world regions suggests that gender equality may change as countries progress towards socioeconomic development and gender equality.

Gender differences in the experience of burnout and its correlates among Chinese psychiatric nurses during the COVID-19 pandemic: A large-sample nationwide survey

Psychiatric nurses often experience burnout and other mental health symptoms. However, few studies have examined these phenomena and gender-specific associated factors during the COVID-19 pandemic. We surveyed a national sample of psychiatric nurses (N = 8971) from 41 tertiary psychiatric hospitals in China as part of a large national survey conducted during the pandemic. The Maslach Burnout Inventory-Human Service Survey was used to assess burnout and the Depression, Anxiety, and Stress Scale-21 was used to assess mental health symptoms. Binary logistic regression analyses were used to explore factors associated with burnout in the entire sample and separately by gender. The overall prevalence of burnout was 27.27%, with the rate in male psychiatric nurses (32.24%) being significantly higher than that in female psychiatric nurses (25.97%). Many key demographic factors (such as the male gender and marital status), work-related variables (such as a mid-level professional title, having an administrative position, longer working hours, more monthly night shifts, and the perceived negative impact of the COVID-19 pandemic on medical work) were significantly associated with burnout in the whole sample. Moreover, burnout was associated with depression, anxiety, and stress symptoms in the whole sample. Gender-specific factors associated with burnout were also identified: burnout was associated with night shifts in male psychiatric nurses, whereas it was associated with single or married marital status, a mid-level professional title, and having an administrative position among female psychiatric nurses. The high rates of burnout and mental health symptoms in psychiatric nurses need attention from hospital administrators. While mental health symptoms, longer working hours, and the perceived impact of COVID-19 are associated with burnout in both genders, gender-specific factors also warrant special attention when developing gender-specific interventions.

Sick Leave Due to Stress, What are the Costs for Dutch Employers?

Purpose Stress-related illnesses are prevalent in Western society, causing sick leave and putting a heavy economic burden on employers and society. For Dutch employers it is particularly relevant to have insight into the costs of absenteeism due to stress-related illness, as they are legally obligated to continue payment of wages. Therefore, this study assessed the duration and costs of an episode of sick leave due to stress-related illness for Dutch employers. Methods Data on sick leave due to various stress-related illnesses were obtained from a nationwide occupational health service database. Stress-related illnesses included tension complaints, burn-out, overexertion, and other reactions to stress. The duration per sick leave episode was estimated in working days, after which the average cost per sick leave period was estimated using age- and gender-specific price weights. Results During the study period, 16,676 employees took 17,338 episodes of sick leave due to stress-related illness. On average, one episode of sick leave lasted 101 working days, for which the costs for the employer were on average €19,151 per worker. Women were responsible for most episodes of sick leave and were on average 37 days more absent per episode compared to men. Moreover, of all kinds of stress-related illnesses, burn-out had the longest duration of sick leave with 313 calendar days and 163 working days, resulting in an average cost of €30,770. Conclusions Sick leave due to stress-related illness places a heavy burden on employers and thus society. Further research should be conducted on how to reduce this burden.

Factors that impact recruitment and retention of veterinarians in emergency practice

OBJECTIVE

To examine factors that impact emergency veterinarians' decisions in selecting a place of employment and their perceptions of factors important in fostering a work environment conducive to long-term employment.

SAMPLE

433 Veterinary Information Network members who reported practicing emergency medicine in the US and were not diplomates of the American College of Veterinary Emergency and Critical Care.

PROCEDURES

An electronic survey distributed via the Veterinary Information Network data collection portal, made available from May 25, 2022, through June 15, 2022.

RESULTS

Factors rated as most important in selecting a place of employment included working with a highly trained support staff and collegiality of coworkers. Factor analysis was used to extract factors that can influence emergency medicine practitioners' views of a work environment conducive to long-term employment. The factor found to be most important was leadership. All factors, except for professional growth, were rated as more important by female practitioners when compared to male practitioners.

CLINICAL RELEVANCE

Aspects promoted in emergency medicine veterinarian recruitment efforts should include, in addition to the innate nature of the position, the elements identified as most attractive to current practitioners. By better understanding the impact of gender, children status, and years practicing emergency medicine on the relative importance in creating workplace environments conducive to long term employment, hospitals can be better equipped to meet the needs of both their current employees as well as potential new hires.

And Still She Rises: Policies for Improving Women's Health for a More Equitable Post-Pandemic World

The COVID-19 pandemic has spawned crises of violence, hunger and impoverishment. Maternal and Infant Health Canada (MIHCan) conducted this policy action study to explore how changes that have arisen during the COVID-19 pandemic may catalyze potential improvements in global women's health toward the creation of a more equitable post-pandemic world. In this mixed methods study, 280 experts in women's health responded to our survey and 65 subsequently participated in focus groups, including professionals from India, Egypt/Sudan, Canada and the United States/Mexico. From the results of this study, our recommendations include augmenting mental health through more open dialogue, valuing and compensating those working on the frontlines through living wages, paid sick leave and enhanced benefits and expanding digital technology that facilitates flexible work locations, thereby freeing time for improving the wellbeing of caregivers and families and offering telemedicine and telecounseling, which delivers greater access to care. We also recommend bridging the digital divide through the widespread provision of reliable and affordable internet services and digital literacy training. These policy recommendations for employers, governments and health authorities aim to improve mental and physical wellbeing and working conditions, while leveraging the potential of digital technology for healthcare provision for those who identify as women, knowing that others will benefit. MIHCan took action on the recommendation to improve mental health through open conversation by facilitating campaigns in all study regions. Despite the devastation of the pandemic on global women's health, implementing these changes could yield improvements for years to come.

Shifting Perspectives in Polar Research: Global Lessons on the Barriers and Drivers for Securing Academic Careers in Natural Sciences

The polar regions provide valuable insights into the functioning of the Earth’s regulating systems. Conducting field research in such harsh and remote environments requires strong international cooperation, extended planning horizons, sizable budgets and long-term investment. Consequently, polar research is particularly vulnerable to societal and economic pressures during periods of austerity. The global financial crisis of 2008, and the ensuing decade of economic slowdown, have already adversely affected polar research, and the current COVID-19 pandemic has added further pressure. In this article we present the outcomes of a community survey that aimed to assess the main barriers and success factors identified by academic researchers at all career stages in response to these global crises. The survey results indicate that the primary barriers faced by polar early and mid-career researchers (EMCRs) act at institutional level, while mitigating factors are developed at individual and group levels. Later career scientists report pressure toward taking early retirement as a means of institutions saving money, reducing both academic leadership and the often unrecognized but vital mentor roles that many play. Gender and social inequalities are also perceived as important barriers. Reorganization of institutional operations and more effective strategies for long-term capacity building and retaining of talent, along with reduction in non-research duties shouldered by EMCRs, would make important contributions toward ensuring continued vitality and innovation in the polar research community.

An Analysis of Male and Female Managers' Responses to Work Stress: Focused on the Case of South Korea

This study aims to determine how work the stress of female and male managers in Korean companies influences their capabilities and career development behavior and analyzes how it affects their turnover intention. According to the analysis results determined using the panel data from the Korean Women’s Development Institute, first, work stress experienced by managers increases their turnover intentions regardless of gender. Secondly, more work stress decreases the development behavior of male mangers but strengthens the career development behavior of female managers. Thirdly, greater work stress decreases manager capabilities but strengthens the capabilities of female managers. Fourthly, career development behavior and capabilities as a mediator variable act differently according to gender on the relationship between work stress and turnover intention. We discussed the results of this study while considering the peculiarities of Korea, which has strong male-centered corporate culture, and presented theoretical and practical implications of the results of this study.

Prevalence of ideal cardiovascular health in young adults: A birth cohort from southern Brazil

BACKGROUND

Ideal cardiovascular health (ICH) aims at primordial prevention of cardiovascular diseases in the population. However, there is a lack of research describing ICH in youth from middle-income countries. The aims of this study were to describe the prevalence of ICH at 18- and 22-year-old and to investigate the influence of socioeconomic status.

METHODS

The sample consisted of participants from the Pelotas 1993 birth-cohort followed-up at 18- (n = 4,106) and 22-year-old (n = 3,810). Ideal metrics were created for diet, smoking, body mass index, physical activity, blood pressure, total cholesterol, and blood glucose. The presence of 4 or more ideal metrics was defined as ICH. Socioeconomic status was obtained using wealth quintiles calculated with factor analysis based on analysis based on the ownership of household and education. The impact of socioeconomic status on ICH metrics was statistically measured using the slope index of inequality.

RESULTS

The prevalence of ICH was 84.5% (95% confidence interval [CI] = 82.7-86.2%) and 84.1% (82.3-85.8%) at 18-year-old and decreased to 61.1% (58.4-63.7%) and 68.7% (66.2-71.2%) at 22-years old, for male and female, respectively. Socioeconomic status influenced ICH and its components differently in males and females. Wealthiest females had ICH prevalence 19 percentage points (pp) (11-27 pp) higher compared to the poorest, whereas poorest males had ICH prevalence 12 pp (1-21 pp) higher compared to the wealthiest. Longitudinal decreases in ICH components were mostly present in the poorest females.

CONCLUSIONS

In middle-income countries, the prevalence of ICH is high at 18-year-old and decreases in a 4-year follow-up. Socioeconomic status influences differently individuals' ICH between sexes. Efforts are needed to maintain ICH in youth and different strategies may be required between the social status.

More Depression-Related Public Concern After the Suicide of a Pop Star in China: Evidence From the Online Big Data Platform

Background: In China, we have seen dramatic increases in public concern over depression and mental health after the suicide of some famous persons. The objective of this study is to investigate the changes of search-engine query patterns to monitor this phenomenon based on the tragic suicide of a young Chinese pop star, Kimi Qiao. Methods: The daily search volume for depression was retrieved from both the Baidu Index (BDI) and the Sina MicroBlog Index (SMI). Besides, the daily BDI for suicide, schizophrenia, obsessive-compulsive disorder, common cold, stomach cancer, and liver cancer were collected for comparison. According to the time of Qiao's suicide, all data were divided into two periods (i.e., Period One from 1 September 2015 to 31 August 2016 while Period Two ranged from 1 October 2016 to 30 September 2017). The paired t-test was used to compare the differences in search volumes between two periods. The Pearson correlation analysis was used to estimate correlations between the BDI and SMI for depression. Results: The average BDI for depression, BDI for suicide, and SMI for depression in Period Two were significantly higher than in Period One (p < 0.05). There was a strong positive correlation between the BDI and SMI for depression (r = 0.97, p < 0.001). And no significant difference in BDI for other diseases between the two periods was found. Conclusions: The changes of search-engine query patterns indicated that the celebrity's suicide might be able to improve the netizens' concern about depression in China. The study suggests publishing more practical knowledge and advice on depression through the Internet and social media, to improve the public's mental health literacy and help people to cope with their depressive symptoms appropriately.

Work stress, family stress, and suicide ideation: A cross-sectional survey among working women in Shenzhen, China

BACKGROUND

This study aimed to explore the associations of work characteristics, work stress, and family stress with suicide ideation among working women, further to detect potential joint effects between different types of stress.

METHODS

From March to June in 2015, a cross-sectional survey on working women were conducted in Shenzhen, China. Demographic and work characteristics, work stress, family stress, and suicide ideation were collected. Multivariate logistic regression models were applied to assess possible associations by calculating the odds ratios (OR) and 95% confident intervals (CI).

RESULTS

Totally 968 working women were included with a mean age of 31.62 (standard deviation: 7.43) years. The prevalence of suicide ideation was 19.4%. We found that night shift work, sickness absence, work stress, and family stress were positively associated with suicide ideation, after adjusting for age, education level, marital status, and occupation type. None joint effect on multiplicative or additive scale of work stress and family stress on suicide ideation was found (P for multiplicative and additive interaction: 0.736 and 0.595, respectively), however, women with both high work stress and high family stress appeared more than five-time odds of suicide ideation (OR: 5.253, 95%CI: 2.982∼9.252).

LIMITATIONS

We did not collect information on other psychosocial profiles and failed to explore potential mediated effects within current associations.

CONCLUSIONS

This study lends support to suicide prevention that immediate relief allocated to working women with both high level of work stress and family stress is warranted of necessity.

Weekly Working Hours and Mental Health Status in Different Occupations: Evidence From the 2015 to 2016 California Health Interview Survey

OBJECTIVE

The aim of this paper was to identify shapes of the curves between weekly working hours (WWH) and mental health status (MHS) and determine WWH for the best MHS in 13 occupations.

METHODS

This cross-sectional study applied public data of the 2015 to 2016 California Health Interview Survey. Restricted cubic spline regression was used to determine non-linear trends.

RESULTS

A statistically significant nearly V-shaped curve was demonstrated between WWH and MHS in total population, men and management, business and finance occupations. WWH for the best MHS were 42, 45, and 46 hours, respectively.

CONCLUSION

These results suggest MHS be susceptible to WWH in total population, men and management, business and finance occupations. WWH for the best MHS for relevant populations could provide evidence for better work hours regulations in California.

Challenges and coping strategies faced by female scientists-A multicentric cross sectional study

Women can play a pivotal role in the progress and sustainability of the world if they are empowered through education and employment opportunities in Science, technology, innovation and through changing the social stereotypes that restrain them in certain workplaces. In the literature, few recently published studies exist that document the challenges faced by female scientists in their workplaces. The purpose of this study was to understand the challenges and coping strategies faced by female scientists around the world today, in order to contribute to their improved performance. A multi-centre electronic cross-sectional survey across 55 countries was conducted to profile female scientists and to identify the challenges that they experience throughout their career as well as the coping mechanisms that they use to overcome the barriers. A total of 263 female scientists from different countries across the world participated in our study and most participants were from the South East Asian Region. Most female scientists in our study belong to the middle and junior level career category and earning around 1250 USD per month. Most of the scientists reported availability of maternity leave at their workplace but less than a third reported presence of a creche at work. Workplace sexual harassment was reported by 24% of the study population. Work related stress (71.5%) and work life imbalance (46%) are also major challenges faced by female scientists. Self-confidence, dedication and hard work are the most commonly adopted coping strategy. Flexible work timings, woman-friendly management policies, fair appraisal and mentorship appear to reduce the work-related stress and improve work-life balance among female scientists. In conclusion, female scientists face numerous challenges, which can greatly affect both their individual and career growth. Intrinsic (personal) and extrinsic (institutional) factors are important for improving female scientists' wellbeing and productivity.

Constrained choices: Combined influences of work, social circumstances, and social location on time-dependent health behaviors

BACKGROUND

Physical activity and sleep are two time-dependent behaviors with important health implications. The amount of time people have to engage in these behaviors may vary based on their everyday work, social circumstances (e.g., parenthood), and social location (e.g., gender).

AIMS

The current study aimed to explore the ways work, social circumstances, and social locations combine that lead to heterogeneity in the time-dependent health behaviors of physical activity and time spent in bed (i.e., sleep) among a young adult population. We drew upon two conceptual frameworks-Constrained Choices and an intersectionality perspective-and examined multiple work characteristics (e.g., number of jobs), social circumstances (e.g., household income), and social locations (e.g., U.S. nativity) relevant to young adulthood.

METHODS

2015-2016 data from a Minneapolis-St. Paul, U.S. cohort of 1830 young adults (25-36 years) were analyzed using conditional inference tree (CIT)-a data-driven approach which identifies population sub-groups that differ in their outcome values as well as in the interacting factors that predict outcome differences. Sensitivity analyses to evaluate CIT robustness were also performed.

RESULTS

CITs revealed four relevant sub-groups for physical activity (sub-group averages ranged = 2.9-4.9 h per week), with working mothers achieving the least activity, and six relevant sub-groups for time in bed (range = 7.8-8.7 h per day), with full-time working men obtaining the least. In both models, parent status and employment status/hours were found to consistently differentiate behavior among women but not men.

CONCLUSION

According to these data, time to engage in physical activity and time in bed was constrained by particular everyday contexts (work and parent status) and the extent to which these contexts mattered also depended on gender. If replicated in other studies, results suggest equitable strategies are necessary to assist all parents and workers in engaging in these time-dependent health behaviors for long-term health.

Factors influencing the need for recovery in employees with hearing loss: a cross-sectional study of health administrative data

Objective

Need for recovery is a predictor of work stress and health problems, but its underlying factors are not yet well understood. We aimed to identify hearing-related, work-related, and personal factors influencing need for recovery in hearing-impaired employees.

Methods

We retrospectively identified hearing-impaired employees (N = 294) that were referred to the Amsterdam University Medical Center between 2004 and 2019. Routinely obtained healthcare data were used, including a survey and hearing assessments. A directed acyclic graph was constructed, revealing the hypothesized structure of factors influencing need for recovery as well as the minimal set of factors needed for multiple regression analysis.

Results

Four variables were included in the regression analysis. In total, 46.1% of the variance in need for recovery was explained by the factors feeling that something should change at work (B = 19.01, p < 0.001), self-perceived listening effort (B = 1.84, p < 0.001), personal adaptations scale score (B = − 0.34, p < .001), and having a moderate/poor general health condition (B = 20.06, p < 0.001). Although degree of hearing loss was associated with self-perceived listening effort, the direct association between degree of hearing loss and need for recovery was not significant.

Conclusions

The results suggest that the way employees perceive their hearing loss and how they cope with it directly influence need for recovery, rather than their measured degree of hearing loss. Additionally, general health condition was found to be an independent factor for need for recovery. The results should be confirmed by future, longitudinal research.

Enhancing Women's Well-Being: The Role of Psychological Capital and Perceived Gender Equity, With Social Support as a Moderator and Commitment as a Mediator

The study aims to determine the role of psychological capital and perceived gender equity on employee well-being, particularly women, and assess if commitment mediates and social support moderates the relationships between psychological capital, perceived gender equity, and well-being. A personal survey method was employed for data collection using standardized measures from a representative sample of 433 managers (201 women and 233 men) from private sector companies in India. The findings revealed that perceived gender equity in the workplace positively impacts employee well-being for both men and women, with the greater impact being on women's well-being. To Facilitate employee well-being, organizations can leverage the strengths of psychological capital through training interventions and can promote perceived gender equity through appropriate policies and practices. This bridges the knowledge gap in developing and utilizing psychological capital to enhance employee well-being, especially for women, who are under pressure due to their demanding multiple roles at work and home.

Mental and physical health effects of meaningful work and rewarding family responsibilities

Positive feelings about work and family responsibilities benefit psychological well-being, but their physical health effects remain unexplored. The study assessed whether meaningful work and reward from taking care of family benefitted physical health to the same degree as mental health. Participants were 181 Danes aged 49–51. Participants reported on working conditions, providing care to family, depressive symptoms, and perceived stress. Physical health was operationalized as a physiological dysregulation (e.g., hypertension, high levels of blood sugar and cholesterol, high body mass index). A multidimensional index of physiological dysregulation was created using parameters of cardiovascular, metabolic, and immune function. As expected, meaningful work and sense of reward from taking care of family members were associated with better mental health. However, in women, the very same factors were positively associated with higher physiological dysregulation. We conclude that work and family factors promoting psychological well-being may have physical health trade-offs, particularly in women.

Struggling with everyday life after mild stroke with cognitive impairments – The experiences of working age women

Introduction

The aim of this study was to explore how women of working age who have had a mild stroke resulting in cognitive impairment experience and manage their everyday lives.

Method

Data were collected using semi-structured interviews. The participants consisted of 10 women of working age who had sustained cognitive impairment after a mild stroke. The interviews were analysed using qualitative content analysis.

Results

Three main categories appeared: The everyday is affected by the symptoms, Living strategies, and The social environment effects and changes. Participants feel insecure about their abilities and capabilities, experience anxiety and fear in relation to work, and find it hard to live up to demands and expectations. They are required to plan their daily activities in a new way and to prioritise chores that benefit the family, rather than follow their own interests and social activities. In order to cope with everyday life, they need to allocate chores to other family members.

Conclusions

The constant impact of fatigue and cognitive impairments affects everyday life. The women said that they had to learn to continuously manage their limitations through their experience of everyday life, something that can be facilitated with occupational therapy.

A qualitative study on coping behaviors and influencing factors among mothers in Japan raising children under three years old while experiencing physical and mental subjective symptoms

BACKGROUND

No studies illustrating the coping behaviors of mothers experiencing physical and mental subjective symptoms, or the factors that contribute to these behaviors, have been investigated. Therefore, the present study sought to develop a conceptual framework on the coping behaviors and contributing factors of mothers experiencing physical and mental subjective symptoms.

METHODS

This qualitative study involved theoretical sampling and semi-structured interviews of mothers who were raising children under 3 years of age in Japan and had experienced physical and mental subjective symptoms since giving birth. Women who were pregnant, required regular medical exams, or had difficulty communicating in Japanese were excluded. All mothers were recruited via personal contacts, snowball sampling, and posters at a community center and nursery schools. Analysis was conducted using the constant comparative method. The interview data were extracted in contextual units based on analytical themes, and concepts were generated. Relationships between concepts were investigated and categorized. To confirm theoretical saturation and ensure the validity of the data, a study supervisor was appointed, four qualitative researchers examined the results, and the interview respondents underwent member checking.

RESULTS

There were a total of 21 participants. Thirteen categories were created from 29 concepts identified from the analytical theme "What do mothers do when raising children under 3 years of age while experiencing physical and mental subjective symptoms?" While experiencing subjective symptoms, mothers raising children under 3 years of age tended to lead a child-centric lifestyle and were hesitant to visit the doctor, not only because of typical reasons such as time and costs, but also because of factors related to their child. Some circumstances occurring while experiencing physical and mental subjective symptoms led mothers to put their own needs first and attempt to cope on their own as much as possible. As a result, most mothers would only visit a doctor after becoming seriously ill.

CONCLUSION

Mothers raising children under 3 years of age in Japan tend to put their own needs on hold when experiencing subjective symptoms. As a result, they attempt to cope on their own and, at times, only visit a doctor after becoming seriously ill.

Total workload and recovery in relation to worktime reduction: a randomised controlled intervention study with time-use data

Objectives

A 25% reduction of weekly work hours for full-time employees has been shown to improve sleep and alertness and reduce stress during both workdays and days off. The aim of the present study was to investigate how employees use their time during such an intervention: does total workload (paid and non-paid work) decrease, and recovery time increase, when work hours are reduced?

Methods

Full-time employees within the public sector (n=636; 75% women) were randomised into intervention group and control group. The intervention group (n=370) reduced worktime to 75% with preserved salary during 18 months. Data were collected at baseline, after 9 months and 18 months. Time-use was reported every half-hour daily between 06:00 and 01:00 during 1 week at each data collection. Data were analysed with multilevel mixed modelling.

Results

Compared with the control group, the intervention group increased the time spent on domestic work and relaxing hobby activities during workdays when worktime was reduced (P≤0.001). On days off, more time was spent in free-time activities (P=0.003). Total workload decreased (−65 min) and time spent in recovery activities increased on workdays (+53 min). The pattern of findings was similar in subgroups defined by gender, family status and job situation.

Conclusions

A worktime reduction of 25% for full-time workers resulted in decreased total workload and an increase of time spent in recovery activities, which is in line with the suggestion that worktime reduction may be beneficial for long-term health and stress.

The Job Content, Context, and Requirements of Regulated Home-Based Childcare Workers

Contrary to a large and growing literature on center-based childcare workers, we know little about the work and health experiences of those providing childcare services in their homes. This study examines the job content, context, and requirements of regulated Home-Based Childcare workers in Canada. It is based on the qualitative analysis of eleven individual semistructured interviews. These workers perform business administration tasks and more housekeeping and domestic work than those in the center-based childcare, which affect their health and well-being. In addition, they reported factors related to the context and the content of their job such as the high physical and mental efforts, the absence of contact with other adults during working hours, the lack of external help, the exposure to noise and bad odors, the interference of work with personal and family life, the precarious remuneration, and the lack of benefits as potential factors that may affect their health.

Stress in paid and unpaid work as related to cortisol and subjective health complaints in women working in the public health care sector

Purpose

Focusing on 420 women employed within the woman-dominated health care sector, the purpose of this paper is to investigate how any variation in their total workload (TWL) in terms of paid and unpaid work relate to various subjective health complaints (SHC) (n=420) and the neuroendocrine stress marker cortisol (n=68).

Design/methodology/approach

The authors explored how any variation in their TWL in terms of paid and unpaid work related cross-sectionally to SHC (n=420), and the neuroendocrine stress marker cortisol (n=68).

Findings

Hierarchical regression analyses showed that stress of unpaid work was most strongly related to diurnal variations in cortisol. Both stress of paid and unpaid work as well as TWL stress, but not hours spent on TWL, were related to SHC.

Practical implications

Taken together, objective measures of hours spent on various TWL domains were unrelated to outcome measures while perceptions of having too much TWL and TWL stress were linked to both cortisol and SHC, i.e. how individuals perceive a situation seem to be more important for health than the actual situation, which has implications for research and efforts to reduce individual TWL.

Originality/value

This study is unique in showing that unpaid work and perceptions having too much TWL relate to stress markers in women working in the public health care sector.

Upper trapezius muscle activity in healthy office workers: reliability and sensitivity of occupational exposure measures to differences in sex and hand dominance

Patterns of cervical muscle activity may contribute to overuse injuries in office workers. The purpose of this investigation was to characterise patterns of upper trapezius muscle activity in pain-free office workers using traditional occupational exposure measures and a modified Active Amplitude Probability Distribution Function (APDF), which considers only periods of active muscle contraction. Bilateral trapezius muscle activity was recorded in 77 pain-free office workers for 1-2 full days in their natural work environment. Mean amplitude, gap frequency, muscular rest and Traditional and Active APDF amplitudes were calculated. All measures demonstrated fair to substantial reliability. Dominant muscles demonstrated higher amplitudes of activity and less muscular rest compared to non-dominant, and women demonstrated less muscular rest with no significant difference in amplitude assessed by Active APDF compared to men. These findings provide normative data to identify atypical motor patterns that may contribute to persistence or recurrence of neck pain in office workers. Practitioner Summary: Upper trapezius muscle activity was characterised in a large cohort of pain-free workers using electromyographic recordings from office environments. Dominant muscles demonstrated higher activity and less rest than non-dominant, and women demonstrated less rest than men. Results may be used to identify atypical trapezius muscle activity in office workers.

Flying Into Depression

A growing body of evidence suggests long work hours adversely affect mental health across a variety of domains. Mental health issues have been found to negatively affect work performance. This finding was highlighted in the aviation industry by the 2015 Germanwings incident in which 150 people died. Further investigation into work hours and their associated factors (e.g., demographic characteristics and experiences of sleep and fatigue in the cockpit) contributing to mental health issues among pilots is warranted. A cross-sectional survey investigating attitudes and experiences of fatigue was developed and distributed to commercial airline pilots. Results found pilots who reported typically spending longer hours on duty per week were twice as likely to report feeling depressed or anxious. Pilots' experiences of job-related sleep disturbance and fatigue may explain why pilots who typically spend long hours on duty each week are more likely to report feeling depressed or anxious.

Gender differences in the duration of non-work-related sickness absence episodes due to musculoskeletal disorders

BACKGROUND

There is wide evidence that women present longer duration of sickness absence (SA) than men. Musculoskeletal disorders are influenced by gender due to the sexual division of work.

METHODS

354 432 episodes of non-work-related SA due to musculoskeletal disorders, which were registered in Catalonia between 2005 and 2008, were selected. The outcome variable was the duration of SA. Frailty survival models, stratified by sex and adjusted for explanatory variables (age, employment status, case management, economic activity and repeated episode), were fitted to study the association between each variable and the duration of SA, obtaining HRs.

RESULTS

Women presented longer SA episodes than men in all variable categories. A trend from shorter to longer duration of SA with increasing age was observed in men, whereas in women, it had a fluctuating pattern. Analysing most frequent diagnostic subgroups from the sample, only 'non-specific lumbago' and 'sciatic lumbago' showed these age patterns. Frailty survival models applied to these 2 subgroups confirmed the described age patterns in SA duration.

CONCLUSIONS

Women have longer non-work-related SA due to musculoskeletal disorders than men. However, while men have longer absences as their age increases, in women some older groups have shorter absences than younger ones. These findings could be explained by gender differences in the interaction between paid work and family demands. Our results highlight the need for continued research on SA from a gender perspective, in order to improve management of SA in terms of clinical practice and public policies.

Unequal depression for equal work? How the wage gap explains gendered disparities in mood disorders

Mood disorders, such as depression and anxiety, are more prevalent among women than men. This disparity may be partially due to the effects of structural gender discrimination in the work force, which acts to perpetuate gender differences in opportunities and resources and may manifest as the gender wage gap. We sought to quantify and operationalize the wage gap in order to explain the gender disparity in depression and anxiety disorders, using data from a 2001-2002 US nationally representative survey of 22,581 working adults ages 30-65. Using established Oaxaca-Blinder decomposition methods to account for gender differences in individual-level productivity, our models reduced the wage gap in our sample by 13.5%, from 54% of men's pay to 67.5% of men's pay. We created a propensity-score matched sample of productivity indicators to test if the direction of the wage gap moderated the effects of gender on depression or anxiety. Where female income was less than the matched male counterpart, odds of both disorders were significantly higher among women versus men (major depressive disorder OR: 2.43, 95% CI: 1.95-3.04; generalized anxiety disorder OR: 4.11, 95% CI: 2.80-6.02). Where female income was greater than the matched male, the higher odds ratios for women for both disorders were significantly attenuated (Major Depressive Disorder OR: 1.20; 95% CI: 0.96-1.52) (Generalized Anxiety Disorder OR: 1.5; 95% CI: 1.04-2.29). The test for effect modification by sex and wage gap direction was statistically significant for both disorders. Structural forms of discrimination may explain mental health disparities at the population level. Beyond prohibiting overt gender discrimination, policies must be created to address embedded inequalities in procedures surrounding labor markets and compensation in the workplace.

[Workplace stress and its impact on the 16-year risk of myocardial infarction and stroke in an open female population aged 25-64 years in Russia/Siberia (WHO MONICA-psychosocial program)]

AIM

To determine the impact of workplace stress on the hazard ratio (HR) of myocardial infarction (M) and stroke in an open female population aged 25-64 years in Russia/Siberia (Novosibirsk) for 16 years.

SUBJECTS AND METHODS

A random representative sample of 25-64-year-old women (n=870) residing in a Novosibirsk district was surveyed within the framework of the WHO <<MONICA-psychological>> program. Workplace stress was investigated using the Karasek scale; an attitude towards work and health prophylactic examinations was studied applying the Health Awareness and Attitude questionnaire of the WHO <<MONICA-psychological>> program. For 16 years (1994 to 2010), a cohort of all new cases of MI and stroke was examined employing the WHO <<Acute MI Registry>> program and all possible medical records. The Cox regression model was used to determine HR for MI and stroke in the open female population aged 25-64 years for 16 years.

RESULTS

The prevalence of high-level stress in the open female population aged 25-64 years was 31.6%. The high level of job stress was associated with a high responsibility, impossibility to have a rest at the end of a working day, frequent professional dissatisfaction, and a reduced work capacity. During 16 years, the women having high-level job stress showed a 3.22- and 1.96-fold increases in the HR of MI (p<0.05) and stroke (p<0.05), respectively. The incidence of MI and stroke was higher in married women expressing job stress as managers or manual laborers and having high and low educational attainment.

CONCLUSION

The prevalence of high-level workplace stress was substantial in the open population of 25-64-year-old women in Russia/Siberia (Novosibirsk). The stress-related HR of Ml and stroke was 3-2 times higher than in those without high-level stress. The HR of MI and stroke is affected by a social gradient.

Health-related quality of life in type 1 and type 2 diabetic patients in a Portuguese central public hospital

BACKGROUND

Diabetes mellitus is a chronic metabolic disease, the prevalence of which has registered a considerable increase, mainly in adults and elderly. The purpose of this study was to assess the relationship between health-related quality of life in patients with diabetes and sex, body mass index, type of diabetes and treatment regimens (type 1 diabetes: intensive versus conventional treatment; type 2 diabetes: insulin use versus non-insulin use), and duration of diabetes.

METHODS

One hundred and twenty-four patients with diabetes were interviewed. Health-related quality of life was evaluated using the age-adjusted Short-Form 36 dimensions (physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, and mental health), and related to demographic and clinical variables. Independent samples t-tests and One-Way Analysis of Variance were used to compare means of independent samples. The degree of association between pairs of variables was measured by Pearson's (r) or Spearman's (rs ) correlation coefficients.

RESULTS

The mean age of the study population was 55.7±16.4 years; 54.8% were male, and 77.4% had type 2 diabetes. Females reported worse quality of life than males in all dimensions of the Short-Form 36, except for role-physical and bodily pain. Obese patients had worse physical functioning than normal weight and overweight patients, and worse vitality than their normal weight counterparts. Type 2 diabetic patients taking insulin had lower physical functioning and vitality than those without insulin therapy. Longer duration of diabetes was associated with lower physical functioning, role-physical, general health, vitality, role-emotional, and mental health.

CONCLUSION

Being female, obese, having type 2 diabetes and taking insulin, and having a longer disease duration are characteristics associated with worse age-adjusted quality of life in patients with diabetes.

Work situation and self-perceived economic situation as predictors of change in burnout--a prospective general population-based cohort study

BACKGROUND

Sick leave rates due to mental and behavioural disorders have increased in Sweden during the last decades. The aim of this prospective study was to investigate changes in the level of burnout in a working subset of the general population and to identify how such changes relate to changes in work situation and self-perceived economic situation.

METHODS

A cohort of 1000 persons from a subset of the 2004 northern Sweden MONICA (Multinational Monitoring of Trends and Determinants in Cardiovascular Disease) general population survey was followed over a five-year period (2004-2009). In total, 623 persons (323 women and 300 men) were included in the analysis. Burnout levels were measured at baseline and follow-up using the Shirom Melamed Burnout Questionnaire. Risk factors were assessed at both measuring points.

RESULTS

In the whole study cohort, a small (-0.15) but statistically significant reduction in burnout level was found. No differences in change of burnout were found between men and women. Constant strain at work, an increased risk of unemployment, and a perceived worsening of economic situation during the study time period were related to an increased burnout level. An accumulation of these risk factors was associated with increased burnout level.

CONCLUSIONS

Risk factors in work situation and self-perceived economy are related to changes in burnout level, and special attention should be directed towards persons exposed to multiple risk factors.

Gender differences in psychosocial work factors, work-personal life interface, and well-being among Swedish managers and non-managers

PURPOSE

To explore differences in psychosocial work factors, work-personal life interface, and well-being between managers and non-managers, female and male managers, and managers in the public and private sectors.

METHODS

Data were drawn from the Swedish Longitudinal Occupational Survey of Health (SLOSH) 2010, including 602 female managers, 4174 female non-managers, 906 male managers, and 2832 male non-managers. Psychosocial work factors, work-personal life interface, satisfaction, and well-being were investigated among non-managers and managers and male and female managers, using logistic regression analyses adjusted for age, educational level, staff category, and labour market sector.

RESULTS

Both female and male managers reported high job demands and interference between work and personal life, but also high influence, high satisfaction with work and life, and low amount of sickness absence more often than non-managers of the same sex. However, female managers reported high quantitative and emotional demands, low influence, and work-personal life interference more frequently than male managers. More psychosocial work stressors were also reported in the public sector, where many women work. Male managers more often reported conflicts with superiors, lack of support, and personal life-work interference. Female managers reported poor well-being to a greater extent than male managers, but were more satisfied with their lives.

CONCLUSION

Lack of motivation due to limited increase in satisfaction and organisational benefits is not likely to hinder women from taking on managerial roles. Managerial women's higher overall demands, lower influence at work, and poorer well-being relative to men's could hinder female managers from reaching higher organisational levels.

Multiple social roles, health, and sickness absence--a five-year follow-up study of professional women in Sweden

The aim of this study was to analyze associations between changes in social roles and physical health, mental well-being, psychiatric disorder, and long-term sickness absence over a five-year period. The study was part of a general population-based multipurpose project. Professional women from six birth cohorts born in 1935, 1945, 1955, 1965, 1970, or 1975 (N = 532) were interviewed twice. Self-rated information on physical health, mental well-being, long-term sickness absence, and changes in social roles was used. Information on psychiatric disorders was based on Diagnostic and Statistical Manual of Mental Disorders-III-R and Diagnostic and Statistical Manual of Mental Disorders-IV diagnoses. Multivariate logistic regressions were adjusted for age, socio-economic position, alcohol dependence and abuse, and health at baseline. An increase in number of social roles was associated with lower odds for poor mental well-being, odds ratio (OR) 0.4 (confidence interval [CI] 0.2 to 0.8), while a decrease was associated with higher odds for poor mental well-being, OR 4.5 (CI 1.8 to 11.0), psychiatric disorder, OR 2.6 (1.0 to 6.8), and sickness absence, OR 4.4 (1.6 to 11.7). The results indicated that an increase in number of social roles might be protective against poor mental well-being, while a decrease in number of roles might be related to increased psychiatric disorders and long-term sickness absence. More studies on long-term health implications of gender-specific experiences are needed.

Gender analysis of musculoskeletal disorders and emotional exhaustion: interactive effects from physical and psychosocial work exposures and engagement in domestic work

The objective of this study was to assess the relationships between physical and psychosocial work exposures, engagement in domestic work and work-home imbalance in relation to symptoms of musculoskeletal disorders and emotional exhaustion in white- and blue-collar men and women. Three thousand employees from 21 companies were asked to answer a questionnaire on family structure, household and child care tasks, work exposure, work-home imbalance and symptoms of neck/shoulder disorders, low back disorders and emotional exhaustion. Women reported more musculoskeletal disorders and engagement in domestic work. Adverse at-work exposures were highest in blue-collar women. High engagement in domestic work was not separately associated with symptoms but paid work exposure factors were associated. High engagement in domestic work interacted with adverse work exposure and increased risk estimates for low back disorders and emotional exhaustion. Reported work-home imbalance was associated with neck/shoulder disorders in women and with emotional exhaustion in both women and men.

PRACTITIONER SUMMARY

The current article adds to earlier research by showing that high engagement in domestic work is not separately associated with increased symptoms, but interacts with psychosocial work exposure variables to produce emotional exhaustion in both women and men and low back disorders in women.

Long working hours and symptoms of anxiety and depression: a 5-year follow-up of the Whitehall II study

BACKGROUND

Although long working hours are common in working populations, little is known about the effect of long working hours on mental health.

METHOD

We examined the association between long working hours and the onset of depressive and anxiety symptoms in middle-aged employees. Participants were 2960 full-time employees aged 44 to 66 years (2248 men, 712 women) from the prospective Whitehall II cohort study of British civil servants. Working hours, anxiety and depressive symptoms, and covariates were measured at baseline (1997-1999) followed by two subsequent measurements of depressive and anxiety symptoms (2001 and 2002-2004).

RESULTS

In a prospective analysis of participants with no depressive (n=2549) or anxiety symptoms (n=2618) at baseline, Cox proportional hazard analysis adjusted for baseline covariates showed a 1.66-fold [95% confidence interval (CI) 1.06-2.61] risk of depressive symptoms and a 1.74-fold (95% CI 1.15-2.61) risk of anxiety symptoms among employees working more than 55 h/week compared with employees working 35-40 h/week. Sex-stratified analysis showed an excess risk of depression and anxiety associated with long working hours among women [hazard ratios (HRs) 2.67 (95% CI 1.07-6.68) and 2.84 (95% CI 1.27-6.34) respectively] but not men [1.30 (0.77-2.19) and 1.43 (0.89-2.30)].

CONCLUSIONS

Working long hours is a risk factor for the development of depressive and anxiety symptoms in women.

A longitudinal analysis of total workload and women's health after childbirth

OBJECTIVES

To examine the association of women's postpartum health with total workload (TWL), work and personal factors in the year after childbirth.

METHODS

Employed women from Minneapolis and St Paul, Minnesota, were recruited while hospitalized for childbirth. Longitudinal analyses, using fixed effects regression models, estimated the associations of TWL, job satisfaction and stress, social support, perceived control, breastfeeding and infant characteristics with women's health at 5 weeks, 11 weeks, 6 months, and 12 months postpartum.

RESULTS

Increased TWL over time was associated with significantly poorer mental health and increased symptoms.

CONCLUSIONS

High TWL--including reduced time for rest, recovery, and sleep--is a risk factor for women's mental health and symptoms 12 months after childbirth. Women's postpartum health was positively associated with social support, which may help to decrease the negative effects of excess work.

Exploring causal effects of combining work and intergenerational support on depressive symptoms among middle-aged women

In debates about ageing western societies it is often assumed that many middle-aged women struggle to combine paid employment and intergenerational support, and that the subsequent stress leads them to experience an increase in depressive symptoms. Cross-sectional studies have supported this notion, but the question remains whether combining work and intergenerational support actually causes an increase in depressive symptoms. In order to fill a gap in the literature, this study examines the proportion of middle-aged women combining paid work and support to an adult child and/or parent, and the extent to which combining these roles affects women's depressive symptoms over time. For this purpose, we make use of the Survey of Health, Ageing, and Retirement in Europe (SHARE) data set which includes longitudinal data collected on European women aged 50+. Descriptive analyses indicated that 14 per cent of middle-aged women combine the roles of employee, support provider to an adult child, and/or support provider to a parent. Results from semi-dynamic and full-dynamic regression analyses indicate that combining roles can take away some, of the positive mental health effects of fulfilling a role. These findings support the role combination stress hypothesis.