The mediating effect of health behaviors on the association between job strain and mental health outcome: a national survey of police officers.

Police officers often face emotionally challenging interpersonal situations and numerous studies have demonstrated that policing is a stressful occupation. A study revealed a significant positive correlation between emotional demands among police officers and emotional dissonance, as well as burnout. Health-promoting behaviors can contribute to better overall health outcomes and reduce the risk of developing health problems, but there is limited research evaluating the association of job strain and health behaviors with mental health outcomes in police officers. The objective of this study was to assess the job strain associated with mental health mediated by health behaviors in Taiwanese police officers. This was a cross-sectional quantitative study conducted in Oct 2016. A total of 41,871 police officers (response rate was 79.7%) participated questionnaire that consisted of demographic information, job characteristics, health behaviors, and mental component summary (MCS) scores of the Short-Form Health Survey. Independent t-tests and one-way analysis of variance (One-way ANOVA) were conducted to assess the differences in mean MCS scores across various demographics, health behavior, and job characteristics. Multivariate regression analyses were used to assess the relationship between job strain and health behaviors with mental health outcomes. MCS scores were associated with job characteristics and health behaviors among police officers except for gender. After adjusting for covariates, multivariate analysis indicated that police officers with high job demands and high job strain index exhibited poor MCS scores. Job strain was significantly associated with MCS mediated by health behaviors (consumption of fruits and vegetables, and physical activity) in Taiwanese police officers. Since regular physical activity and increased vegetable and fruit consumption might alleviate the effects of job strain on mental health status, it is recommended that institutional policies be established to promote health-enhancing behaviors among police officers.

Job-related stress associated with work-related upper extremity musculoskeletal disorders (UEMDs) in municipal waste collectors: the moderation and mediation effect of job support.

BACKGROUND: Since the policy of "keeping trash off of the ground" in Taiwan, long-term exposure to repetitive motion in waste collection process results in high risk of upper extremity musculoskeletal disorders (UEMDs). Thus, we assessed the moderation and mediation effects of job-related stress and job support on work-related UEMDs among municipal waste collectors. METHODS: A cross-sectional study was conducted in two cities located at northern Taiwan during 2018-2019. 626 municipal waste collectors voluntarily participated and anonymously filled out a structured questionnaire. The moderation and mediation effects of effort-reward imbalance (ERI) and social support on UEMDs were analyzed by Haye's Process Macro Model. RESULTS: Prevalence of UEMDs in municipal waste collectors were 43.4% for neck, 56.0% for shoulder, 24.1% for upper back, and 33.1% for hand/wrist. There was high prevalence of shoulder (72.2%), neck (48%), and upper back (30%) in female workers compared to male, most significantly in shoulders. In univariate and multivariate analysis, high ERI and low job support were significantly associated with ORs of 3.11 (95% CI:1.58-6.13) for elbow, 2.79 (95% CI:1.39-5.56) for shoulder, 3.39 (95% CI:1.64-7.00) for upper back and 3.83 (95% CI:1.98-7.41) for hand/wrist. Prevalent UEMDs were positively associated with high ERI in municipal waste collectors but negatively with job support. The moderation effects of ERI and job support on UEMDs, of which the measured synergy index exceeded one, were 18.24 for shoulder, 3.32 for elbow, and 2.45 for hand/wrist, but mediation effects were not significant. CONCLUSIONS: This study found municipal waste collectors with work-related upper extremity disorders were significantly associated with work-related psychological risk factors. Therefore, waste collection cannot only to be improved by semi-automatic and automatic processes but immediate intervention programs for the reduction of psychological risk factors is needed promptly.

Effort-reward imbalance and job strain index associated with health-related quality of life for civil servants in a national survey: the mediation effect of job support and over-commitment.

OBJECTIVES: Work-related stress (WRS) is significantly associated with health-related quality of life (HRQoL), but the amounts of evidence on differences of effort-reward imbalance (ERI) and job strain index (JSI) remain sparse and have limited generalizability. Therefore, we aimed to assess the association between ERI and JSI with HRQoL and assess the mediation effect of social support (JS) and over-commitment (OC) on this association in Taiwan's civil servants. MATERIAL AND METHODS: A cross-sectional national survey was given to registered civil servants in Taiwan - 20 046 civil servants from 647 institutions were enrolled using multistage stratified random cluster sampling. A web-questionnaire collected demographic information, job characteristics, and different indexes of ERI and job-control-demand-support (JCDS) models. Structural equation model (SEM) was used to examine the association between ERI and JSI with HRQoL, and the mediation effect of JS and OC on the associations. RESULTS: In the ERI model, ERI and OC were consistently negatively associated with the mental component score (MCS) (r = -0.46 and r = -0.37) and physical component score (PCS) (r = -0.45 and r = -0.34), which were higher than job demand (r = -0.28 and r = -0.22) and JSI (r = -0.38 and r = -0.29). Using hierarchical multiple regression analyses, ERI was significantly correlated with MCS and PCS, which was consistently higher than JSI. The ERI and JSI were significantly correlated with MCS (ß = -0.170 and ß = -0.140) and PCS (ß = -0.150 and ß = -0.082) using SEM analysis, whereas ERI was considerably higher than in JSI. In addition, OC and JS mediated the association between The ERI and JSI with HRQoL. CONCLUSIONS: We found the ERI index is significantly correlated with HRQoL superior to JSI, in particular among Taiwan civil servants. Further longitudinal studies are needed to determine the causality and spatiotemporal relation of these differences. Int J Occup Med Environ Health. 2022;35(4):425-36.

Modification Effect of Job Demand and Contingent Work Schedule on Overweight and Obesity Among Civil Servants in Taiwan.

Objective: Evidence indicated that shift work is a contributing factor to risk of obesity and leads to cardiovascular diseases (CVDs), but few researches have examined the moderating effects of job demand and contingent work schedule on overweight and obesity. Thus, we assessed the modification effect of contingent work schedules and job demand on overweight and obesity among Taiwan's civil servants. Methods: Multistage stratified random cluster sampling was used based on a proportional probabilistic sampling (PPS) in a national survey for civil servants. A total of 20,046 participants from 647 registered governmental institutions were enrolled and anonymously and voluntarily filled out web-based questionnaires. Results: Compared to fixed work schedule, odd ratios (ORs) of obesity and overweight were 1.63 and 1.78 times in contingent work schedule, respectively. In addition, the modification effects of contingent work schedule and high job demand on overweight and obesity with Rothman's synergy index were 2.43 and 2.56, respectively. Using a hierarchical regression model adjusted for covariates, both high job demand and contingent work schedule were interactively associated with overweight and obesity compared to low job demand and fixed work schedule. Conclusion: Since precarious schedules affect employee's obesity through work-related stress and unhealthy behaviors, further research is needed to determine whether interventions aimed at modification of work schedule may be useful in combating obesity.

Moderating and Mediating Effects of Over-Commitment on the Association Between Effort-Reward Imbalance (ERI) with Upper Back and Hand/Wrist Disorders in Municipal Solid Waste Collectors.

PURPOSE: Despite repetitive activities and the frequency of high workload for municipal solid waste (MSW) collectors, the risks of work-related stress on upper extremity pain are inconclusive. The objective of this study is to assess the moderation and mediation effect of effort-reward imbalance (ERI) and over-commitment (OC) on upper back and hand/wrist disorders in MSW collectors. METHODS: A cross-sectional study was conducted with MSW collectors from two cities in Taiwan. Each participant was asked to anonymously fill out a structured questionnaire. Work-related stress, including ERI and OC, was assessed by a Chinese version of the Job Content Questionnaire (C-JCL). Upper back and hand/wrist disorders were assessed using the Nordic musculoskeletal questionnaire. Multivariate analysis was used to assess moderation and mediation effect of OC and ERI on upper extremity pain. RESULTS: The moderation effect of ERI and OC on upper back and hand/wrist disorders in MSW collectors was found. Disorders were higher in the group with both ERI ≥1 and high OC (OR (odds ratio) = 3.25 and OR = 3.00) than in the group with ERI ≥1 and low OC (OR = 2.66 and OR = 1.87) and in the ERI <1 and high OC group (OR = 2.27 and OR = 1.26). Synergy indexes were 0.77 and 1.77, respectively. Using multivariate analysis after adjusting for covariates, the mediation effect of OC was significant for the association between ERI and upper back and hand/wrist pains. The indirect effects of OC for upper back and hand/wrist pains accounted for 35% and 42%, respectively, and OC appears to mediate the relationship between ERI and upper back and hand/wrist disorders in MSW collectors. CONCLUSION: Work-related stress measured ERI and OC may play a role in moderating and mediating effects on upper extremity pain. Encouraging provisions of work modification and stress management is needed to mitigate the occurrence of upper extremities pain in MSW collectors.

Additive Interaction of Work-Related Stress and Sleep Duration on Arthritis Among Middle-Aged Civil Servants.

AIM: Occupational strain is recognized as a risk for arthritis, yet little is known about how psychological stress affects arthritis moderated by sleep duration. The objective of this study is to assess work-related stress using the effort-reward imbalance (ERI) model and the job-demand-support (JDS) model on arthritis moderated by sleep duration. METHODS: A nationwide cross-sectional study randomly collected a total of 11,875 middle-aged, employed civil servants from 647 registered governmental institutions. Each participant anonymously and voluntarily filled out a web-based questionnaire and informed consent at the time of the study. Psychosocial work stress was assessed by ERI and JDS measured by a Chinese version of the job content questionnaire. RESULTS: There were significant odds ratios (ORs) of arthritis positively associated with high ERI (OR = 1.58), high overcommitment (OC) (OR = 1.57), and job demand (OR = 1.31) and negatively associated with job support (OR = 0.69) using multivariate analysis after being adjusted for covariates. For the short sleep duration group, there was an interaction effect of both high ERI and OC on arthritis, with a synergy index of 18.91 and 1.52, respectively. Similarly, there are high ORs of arthritis in both the high job demand and low job support groups. CONCLUSION: Work-related stress related to arthritis moderated by sleep duration for civil servants. Civil servants with high job demand and low job support should use caution to reduce the risk of arthritis.

Association of health checkups with health-related quality of life among public servants: a nationwide survey in Taiwan.

BACKGROUND: Preventive health checkups have gained in importance over the last decade. The association of health checkups and the number of diseases with health-related quality of life (HRQoL), including physical and mental health, remains unclear. We sought to investigate the aforementioned association among Taiwanese public servants. METHODS: A cross-sectional survey was conducted using randomized and multistage stratified cluster sampling based on proportional probabilistic sampling. The questionnaires addressed demographics, job characteristics, health behaviors, health status, 3 types of health checkups during the preceding 3 years (government-paid health checkup [GPHC], self-paid health checkup [SPHC], and no health checkup [NOHC]), and physical component summary (PCS) and mental component summary (MCS) scores of the Short-Form Health Survey. In total 11,454 middle-aged public servants were analyzed. A multivariate general linear model (GLM) was used to estimate PCS and MCS scores by using least square means. RESULTS: Health checkup types were associated with a significant difference in PCS scores among the public servants. Scores of PCS and MCS were both significantly higher in the GPHC group than in the NOHC group for those with no chronic diseases (51.20 vs. 50.66 [P = 0.008] and 46.23 vs. 45.58 [P = 0.02], respectively). Compared with the NOHC group, both scores of GPHC and SPHC groups were significantly associated with higher PCS scores for public servants with ≥ 2 chronic diseases (46.93 vs. 45.13 [P = 0.002] and 46.52 vs. 45.13 [P = 0.009], respectively). CONCLUSION: In Taiwan, public servants undergoing GPHCs are more likely to report higher PCS scores than are those undergoing SPHCs. It is crucial that encourage periodically using the health checkup to improve health status and HRQoL.

Sleep Duration and Effort-Reward Imbalance (ERI) Associated with Obesity and Type II Diabetes Mellitus (T2DM) among Taiwanese Middle-Aged Public Servants.

(1) Limited evidence has shown the mediating effects of work characteristics and sleep duration on obesity and type 2 diabetes mellitus (T2DM) among adults. The objective of this study is to assess the interaction effects between sleep duration and effort-reward imbalance (ERI) on the risk of obesity and T2DM among Taiwanese public servants aged 40-60. (2) A national survey for Taiwanese public servants was conducted by multistage stratified random cluster sampling based on proportional probabilistic sampling. A total of 11,875 participants aged 40-60 years old were collected; (3) 3.6% of participants had self-reporting T2DM diagnosed by a physician and the prevalence of overweight and obesity were 44.0% and 15.8%, respectively. There was a significant correlation between sleep hours for the workday and risk of T2DM in non-obese and obese groups (odds ratio, OR = 1.48 and 1.39, respectively), but this did not exist for the weekend/vacation group. Similar trends in the two groups by sleep hours on a workday, obesity and overweight were significantly associated with the risks of T2DM. Clearly, sleep duration and ERI were moderating factors on the association between BMI and on the prevalence of T2DM. (4) A short sleep duration and heavy job stress contributes to the risk of weight gain and T2DM development.

Environmental tobacco smoke (ETS) and hyperlipidemia modified by perceived work stress.

BACKGROUND: Accumulating evidence has shown that exposure to environmental tobacco smoke (ETS) is associated with cardiovascular diseases (CVDs) However, few studies have assessed both exposure to ETS and high-perceived work stress on hyperlipidemia. The aim of the present study is to assess the interaction effect of ETS exposure and high-perceived work stress on the risk of hyperlipidemia. METHODS: A total of 11,875 middle-aged civil servants from 647 registered institutions employed by the Taiwan government were randomly selected using multistage stratified cluster sampling based on proportional probabilistic sampling. Each participant anonymously and independently filled out a web-based questionnaire and informed consent. RESULTS: The prevalence of hyperlipidemia in middle-aged civil servants diagnosed by physicians was 11.5% for men and 6.1% for women. Hyperlipidemia was significantly associated with smoking, alcohol consumption, betel nut chewing, weight gain and perceived work stress. In both the obesity and smoking groups, there were consistent interaction effects of ETS exposure and perceived work stress on hyperlipidemia for middle-aged civil servants. Non-obese and non-smoking groups were more at risk for hyperlipidemia from exposure to both ETS and high-perceived work stress. CONCLUSION: There is an interaction effect of ETS exposure and high-perceived work stress on hyperlipidemia, regardless of obesity and smoking. It is crucial to immediately reduce ETS exposure and stressful work by enforcing smoke-free policies and reducing pressure for civil servants.

Seeding of a soft-x-ray laser in a plasma waveguide by high harmonic generation.

A strongly saturated waveguide-based optical-field-ionization soft-x-ray laser seeded by high harmonic generation was demonstrated for Ni-like Kr lasing at 32.8 nm. Compared with the same laser seeded only with spontaneous emission, seeding with high harmonics yields much smaller divergence, enhanced spatial coherence, and controlled polarization. The integration of high harmonic seeding, optically preformed plasma waveguide, and optical-field-ionization pumping forms one of the optimal archetypes of an ultrashort-pulse soft-x-ray laser.

Spontaneous perirenal urinoma associated with ureteropelvic junction obstruction in a child: a case report.

We report a case of a 10-year-old Taiwanese boy with a perinephric urinoma, whose health had previously been good, but who experienced a sudden onset of severe Left flank pain. Radiological examination revealed ureteropelvic junction obstruction with grade IV hydronephrosis and perinephric urinoma of the left kidney. ercutaneous drainagewas performed successfully to relieve these symptoms. ication of congenital obstruction of the urinary tract, and it following renal trauma.