Interventional radiology in the provision and maintenance of long-term central venous access.

Establishing and maintaining venous access forms an increasing proportion of the workload in interventional radiology. Several patient groups require medium-term to long-term venous catheters for a variety of purposes, including chemotherapy, long-term antimicrobials, parenteral nutrition, short-term access for haemodialysis or exhausted haemodialysis. Often, these catheters are required for treatment and frequent blood testing, which can quickly exhaust the peripheral veins. Long-term venous access devices minimize the discomfort of frequent cannulation while preserving the peripheral veins. Venous access devices include implantable catheters (ports), tunnelled catheters and peripherally inserted central catheters, which have different functions, advantages and limitations. Imaging-guided placement is the preferred method of insertion in many institutions because of higher success rates and radiologists are well suited to address catheter complications.

The changing workforce, job stress, and psychological distress.

The change in the United States from a manufacturing economy to a service economy has important implications for theoretical models of the relationships between job characteristics and workers' psychological distress. A sample of 600 men and women employed full-time were recruited to test 2 theoretical models. The job demand-control model posits that jobs that are both high in job demands and low in decision latitude are associated with greater psychological distress. The job demand-service model posits that jobs that are high in job demands and low in service to others are associated with greater psychological distress. Results show that the job demand-control model is a significant predictor of psychological distress among employees in the manufacturing industry, whereas the job demand-service model is a significant predictor of psychological distress among employees in the services industries.

Change in job and marital experiences and change in psychological distress: a longitudinal study of dual-earner couples.

Are changes in job quality more closely linked to changes in distress for men than for women? Conversely, are changes in marital quality more closely linked to changes in distress for women than for men? These questions were addressed in a longitudinal analysis of a random sample of 210 full-time employed dual-earner couples. Change over time in job role quality was significantly associated with change over time in distress, and the magnitude of the relationship differed little, if at all, by gender. In contrast, change over time in marital role quality was also associated with change in distress, but the magnitude of the association depended on gender. Among full-time employed married women, change in marital experience was more closely linked to change in distress than among their husbands.

Gender and the relationship between job experiences and psychological distress: a study of dual-earner couples.

This article examines the association between job role quality and psychological distress in a sample of 300 full-time employed dual-earner couples, controlling for such individual level variables as age, education, occupational prestige, and marital quality and for such couple level variables as length of marriage, parental status, and household income. The magnitude of this effect is compared for men and for women. Results indicate that job role quality is significantly negatively associated with psychological distress for women as well as for men and that the magnitude of the effect depends little, if at all, on gender, casting doubt on the widely held view that job experiences more significantly influence men's mental health states than women's. The results are discussed in the context of differentiating between sex differences and gender differences.

Men, family-role quality, job-role quality, and physical health.

The relationship between the quality of men's family roles, as spouse and as parent, and the quality of men's job role, on the one hand, and their reports of physical symptoms, on the other, was examined in men drawn from a random sample of 300 dual-earner couples. The main effect of marital-role quality (i.e., rewards and concerns) on physical health was estimated, as was the Marital-Role Quality x Job-Role Quality interaction effect. With respect to the parent role, the effect of both parent-role occupancy and parent-role quality was estimated. After controlling for job-role quality, it was found that parent-role occupancy had neither main nor interactive effects. However, among the men who occupied all 3 roles (n = 180), only parent-role concerns were a significant predictor of physical health reports. Thus, concerns in the parent role are a major unmeasured source of variance in studies of the stress-illness relationship in men.

Job experiences over time, multiple roles, and women's mental health: a longitudinal study.

Are changes over time in the quality of a woman's job associated with changes in her psychological distress? Do family roles moderate these relationships? We addressed these questions using longitudinal data from a 2-year 3-wave study of a stratified random sample of 403 employed women who varied in occupation, race, partnership, and parental status. After estimating individual rates of change for each woman on each of the predictors and the outcome, we modeled the relationships between family role occupancy and change in job-role quality on the one hand, and change in psychological distress on the other. Among single women and women without children, as job-role quality declined, levels of psychological distress increased. Among partnered women and women with children, change in job-role quality was unrelated to change in psychological distress.

Positive-spillover effects from job to home: a closer look.

What is the association between subjective experiences in two roles, employee and mother, and women's psychological distress? Previous research indicated that employed mothers with troubled mother-child relationships reported high levels of psychological distress, unless they were in rewarding jobs. In this paper, using data from the same sample of 228 employed mothers, we explored further the above finding by addressing two related questions: (1) which job rewards mitigate the relationship between parent-role quality and psychological distress?; and (2) which parental concerns are buffered by these stress mitigators? The main finding was that having a rewarding job per se did not automatically serve as a parent-stress mitigator. Although several job-reward factors (e.g., Helping Others at Work, Challenge), were associated with reports of low distress, Challenge was the only job-reward factor that mitigated parental stress. Thus, the previously reported positive-spillover effect from work to home was attributable to the presence of rewards from challenging work. However, Challenge buffers only particular parent concerns. For employed mothers, a job high in rewards from Challenge mitigates the distress associated with Disaffection (not Burden or Safety) in their relationships with their children.

Worker and mother roles, spillover effects, and psychological distress.

This paper examines the relationship between the occupancy and quality of multiple-roles and psychological distress in a stratified random sample of 403 women employed as licensed practical nurses and social workers. We examined the main effects of the quality of the employee and parent roles and the interaction effects between these variables. Negative- and positive-spillover effects, from job to parenting and from parenting to job, were examined in an attempt to illuminate the processes by which multiple roles affect employed mothers' vulnerability or resilience to psychological distress. We found no negative-spillover effects from job to parenting or from parenting to job, but we did find positive-spillover effects from job to parenting. Women with rewarding jobs were protected from the negative mental-health effects of troubled relationships with their children. This protection accrued to employed mothers regardless of their partnership status or the age of their children. Although based on cross-sectional analyses, these findings suggest mechanisms by which employed mothers reap a mental-health advantage from multiple roles, even when some of those roles are stressful.

Physical symptoms and the interplay of work and family roles.

The paradigm underlying research on the relationship between work and physical-health symptoms in men has focused on workplace stressors and has ignored men's family roles. Research on women, work, and health suggests several necessary additions to this paradigm, including (a) a focus on job rewards and job concerns and (b) attention to the impact of family roles on the relationship between job rewards and concerns and physical health. We included these variables in a study of a disproportionate random sample of 403 employed 25- to 55-year-old women. Major findings are that (a) work rewards (e.g., helping others at work) are related to reports of low levels of physical symptoms; (b) work concerns (e.g., overload) are associated with reports of high levels of physical symptoms; (c) particular work rewards, which may be different for women than for men, mitigate the negative health effects of work concerns; (d) among employed mothers, satisfaction with salary is negatively related to physical-health symptoms; and (e) women in positive marriages or partnerships were more likely to reap physical-health benefits from the rewards of helping others at work and from supervisor support.

Race, class and multiple role strains and gains among women employed in the service sector.

Race and social class differences in the quality of job and parenting experiences, and multiple role gains and strains, are examined in a sample of 229 black and white female social workers and licensed practical nurses. Both race and class differences in job-role quality were found, but only class differences were found in parenting concerns. Race and class differences were found in multiple role gains and strains.