Job stress as a preventable upstream determinant of common mental disorders: a review for practitioners and policy-makers

There is growing recognition of the important role of mental health in the workforce and in the workplace. At the same time, there has been a rapid growth of studies linking job stress and other psychosocial working conditions to common mental disorders, and a corresponding increase in public concern media attention to job stress and its impact upon worker health and well-being. This article provides a summary of the relevant scientific and medical literature on this topic for practitioners and policy-makers. It presents a primer on job stress concepts, an overview of the evidence linking job stress and common mental disorders, a summary of the intervention research on ways to prevent and control job stress, and a discussion of the strengths and weakness of the evidence base. We conclude that there is strong evidence linking job stress and common mental disorders, and that it is a substantial problem on the population level. On a positive note, however, the job stress intervention evidence also shows that the problem is preventable and can be effectively addressed by a combination of work- and worker-directed intervention.

Does workplace social capital buffer the effects of job stress? A cross-sectional, multilevel analysis of cigarette smoking among U.S. manufacturing workers

Objective: To investigate whether workplace social capital buffers the association between job stress and smoking status. Methods: As part of the Harvard Cancer Prevention Project's Healthy Directions—Small Business Study, interviewer-administered questionnaires were completed by 1740 workers and 288 managers in 26 manufacturing firms (84% and 85% response). Social capital was assessed by multiple items measured at the individual level among workers and contextual level among managers. Job stress was operationalized by the demand-control model. Multilevel logistic regression was used to estimate associations between job stressors and smoking and test for effect modification by social capital measures. Results: Workplace social capital (both summary measures) buffered associations between high job demands and smoking. One compositional item—worker trust in managers—buffered associations between job strain and smoking. Conclusion: Workplace social capital may modify the effects of psychosocial working conditions on health behaviors.

Implications of radically transformational challenges confronting education business leadership

This paper highlights the radical and rapid changes occurring at all levels of education that are having a profound impact on educational leadership, governance, business and administration. These far-reaching transformations include: competition from a rapidly expanding unregulated private sector; the international impact of de-regulation; the demise of union power secure education jobs, time-honoured hours and working conditions; constant, rapid education policy change and the proliferation of open access technologies which are rendering physical education campuses less relevant or obsolete. The paper suggests that at this stage in history we are witnessing game-changing forces that are fundamentally altering educational provision, the nature of education work, the education workforce, educational outcomes, educational leadership, governance and business. Most importantly, it argues that educational leaders and education business managers need to be ready for them and more instrumental in policy debates arising in their wake. The paper concludes with ideas for responsive action from education business leaders.

Occupational safety in China: safety climate and its influence on safety-related behavior

The improvement of health and safety standards within the organizational context is an important issue of global concern. China’s occupational health and safety (OHS) has increasingly drawn national and international attention as it has not kept pace with its globalization of production and trade. The traditional approach to managing workplace safety in China has focused on the technical aspects of engineering systems and processes, and it has attributed the majority of workplace accidents and injuries to unsafe working conditions instead of the unsafe work practices of employees. However, there has been a fundamental shift in the safety management research carried out in many countries and across diverse industries, which aims to measure the impact of attitudinal, organizational, cultural, and social dimensions on occupational safety. This article examines the relationship between safety climate and safety-related behavior in the Chinese context and draws implications for the management of occupational safety in China.

Blokey' newsrooms still a battleground for female journalists

This paper reports on the largest survey of female journalists in the Australian news media. The goal was to investigate issues confronting women, including the extent of perceived gender discrimination in promotion, job segregation and working conditions. It is the first quantitative research of its type in 16 years, building on a smaller survey by the Australian media industry union, the Media, Entertainment and Arts Alliance (MEAA) and the International Federation of Journalists (IFJ). That 1996 report found there was significant gender discrimination in Australian newsrooms and that sexual harassment, in particular, was a systemic problem. This 2012 online survey of 577 female journalists working across all media platforms in metropolitan, regional, rural and suburban news media organisations demonstrates that little has changed. The paper compares and contrasts key data from the 2012 and 1996 surveys to ascertain the challenges still evident for female journalists.

Protecting and promoting mental health in the workplace : developing a systems approach to job stress

Issue addressed: Job stress has been linked to a wide range of adverse effects on mental, physical, and organisational health. Despite the evidence that systems approaches are most effective in reducing the adverse impact of job stress, prevalent practice is dominated by worker- or individual-focused strategies in the absence of commensurate intervention on working conditions. Methods: A literature review and cross-disciplinary conceptual synthesis were combined in the articulation of a systems approach to job stress. Results: An outline of the job stress process is followed by explanation of how a systems approach addresses the various steps in the stress process. Systems approaches to job stress emphasise primary prevention or focusing on stressors as the upstream determinants of job stress. Additionally, systems approaches integrate primary with worker-directed secondary and illness-directed tertiary intervention, include the meaningful participation of groups targeted by intervention, and are context- sensitive. Systems approach intervention principles are illustrated by concrete examples of intervention strategies and activities. Conclusions: Further efforts are needed to promote, disseminate, implement, and evaluate systems approaches to job stress and to improve cross-disciplinary cooperation in this effort. (author abtract)

An integrated approach to workplace mental health : an Australian feasibility study

We developed and implemented an integrated workplace mental health promotion intervention combining job stress reduction with a workplace mental health literacy program. The intervention was evaluated using an uncontrolled design, with organizationorganisation-wide census employee surveys of working conditions and mental health literacy pre-intervention, followed by a 1-year action planning and intervention period, then a post-intervention survey. All employees were invited to be surveyed, and all respondents were included in analysis, independent of participation in intervention activities or employment status (44% response rate at baseline, 37% at final). No significant changes were observed in the targeted psychosocial working conditions – job control, job demands, and social support at work. In contrast, significant improvements in some aspects of mental health literacy were observed, particularly in helping behaviours. Acknowledging the limitations of this being an uncontrolled pilot study, our results suggest that it is feasible to integrate job stress and mental health literacy intervention, as well as evidence of sustained improvements in mental health literacy and the need for more intensive and sustained efforts to improve psychosocial working conditions.

Protecting and promoting mental health in the workplace: developing a systems approach to job stress

Issue addressed: Job stress has been linked to a wide range of adverse effects on mental, physical, and organisational health. Despite the evidence that systems approaches are most effective in reducing the adverse impact of job stress, prevalent practice is dominated by worker- or individual-focused strategies in the absence of commensurate intervention on working conditions. Methods: A literature review and cross-disciplinary conceptual synthesis were combined in the articulation of a systems approach to job stress. Results: An outline of the job stress process is followed by explanation of how a systems approach addresses the various steps in the stress process. Systems approaches to job stress emphasise primary prevention or focusing on stressors as the upstream determinants of job stress. Additionally, systems approaches integrate primary with worker-directed secondary and illness-directed tertiary intervention, include the meaningful participation of groups targeted by intervention, and are context- sensitive. Systems approach intervention principles are illustrated by concrete examples of intervention strategies and activities. Conclusions: Further efforts are needed to promote, disseminate, implement, and evaluate systems approaches to job stress and to improve cross-disciplinary cooperation in this effort.

Fair relationships and policies to support family day care educators’ mental health: a qualitative study

High quality child care is a population health investment that relies on the capacity of providers. The mental health and wellbeing of child care educators is fundamental to care quality and turnover, yet sector views on the relationship between working conditions and mental health and wellbeing are scarce. This paper examines child care educators' and sector key informants' perspectives on how working in family day care influences educator's mental health and wellbeing.

Investigation of hybrid ion-exchange membranes reinforced with non-woven metal meshes for electro-dialysis applications

Salt and solvent permeations across ion-exchange membranes used in electro-dialysis are directly related to the membrane material structure and chemistry. Although primarily used for aqueous effluents desalination, electro-dialysis was recently shown to be a promising technology for industrial wastewater and co-solvent mixtures purification. The harsh working conditions imposed by these liquid effluents, including high suspended solids, require the development of more chemically and mechanically resistant membranes. In this study, commercial porous stainless steel media filters (240 μm thick) were used as a backbone to prepare hybrid ion-exchange membranes by casting ion-exchange materials within the porous metal structure. The surface of the metal reinforcements was modified by plasma treatment prior to sol-gel silane grafting to improve the interface between the metal and the ion-exchange resins. The morphology of novel hybrid materials and the interface between the metal fibers and the ion-exchange material have been characterized using techniques such as scanning electron microscopy and FTIR mapping. The thickness of the silane coating was found to lie between 1 and 2 μm while water contact angle tests performed on membrane surfaces and corrosion test behaviors revealed the formation of a thin passivating oxide layer on the material surfaces providing anchoring for the silane grafting and adequate surface energy for the proper incorporation of the ion-exchange material. The hybrid membranes desalination performance were then tested in a bench top electro-dialysis cell over a range of flow rate, current densities and salt concentration conditions to evaluate the ability of the novel hybrid materials to desalinate model streams. The performance of the hybrid membranes were benchmarked and critically compared against commercially available membranes (Selemion™). Although the salt transfer kinetics across the hybrid ion-exchange composite membranes were shown to be comparable to that of the commercial membranes, the low porosity of the stainless steel reinforcements, around 60%, was shown to impede absolute salt permeations. The hybrid ion-exchange membranes were however found to be competitive at low current density and low flow velocity desalination conditions.

Investigation of hybrid ion-exchange membranes reinforced with non-woven metal meshes for electro-dialysis applications

Salt and solvent permeations across ion-exchange membranes used in electro-dialysis are directly related to the membrane material structure and chemistry. Although primarily used for aqueous effluents desalination, electro-dialysis was recently shown to be a promising technology for industrial wastewater and co-solvent mixtures purification. The harsh working conditions imposed by these liquid effluents, including high suspended solids, require the development of more chemically and mechanically resistant membranes. In this study, commercial porous stainless steel media filters (240. μm thick) were used as a backbone to prepare hybrid ion-exchange membranes by casting ion-exchange materials within the porous metal structure. The surface of the metal reinforcements was modified by plasma treatment prior to sol-gel silane grafting to improve the interface between the metal and the ion-exchange resins. The morphology of novel hybrid materials and the interface between the metal fibers and the ion-exchange material have been characterized using techniques such as scanning electron microscopy and FTIR mapping. The thickness of the silane coating was found to lie between 1 and 2. μm while water contact angle tests performed on membrane surfaces and corrosion test behaviors revealed the formation of a thin passivating oxide layer on the material surfaces providing anchoring for the silane grafting and adequate surface energy for the proper incorporation of the ion-exchange material. The hybrid membranes desalination performance were then tested in a bench top electro-dialysis cell over a range of flow rate, current densities and salt concentration conditions to evaluate the ability of the novel hybrid materials to desalinate model streams. The performance of the hybrid membranes were benchmarked and critically compared against commercially available membranes (Selemion™). Although the salt transfer kinetics across the hybrid ion-exchange composite membranes were shown to be comparable to that of the commercial membranes, the low porosity of the stainless steel reinforcements, around 60%, was shown to impede absolute salt permeations. The hybrid ion-exchange membranes were however found to be competitive at low current density and low flow velocity desalination conditions.

A longitudinal analysis of changes in job control and mental health

Deteriorating job control has been previously shown to predict poor mental health. The impact of improvement in job control on mental health is less well understood, yet it is of policy significance. We used fixed-effects longitudinal regression models to analyze 10 annual waves of data from a large Australian panel survey (2001-2010) to test within-person associations between change in self-reported job control and corresponding change in mental health as measured by the Mental Component Summary score of Short Form 36. We found evidence of a graded relationship; with each quintile increase in job control experienced by an individual, the person's mental health increased. The biggest improvement was a 1.55-point increase in mental health (95% confidence interval: 1.25, 1.84) for people moving from the lowest (worst) quintile of job control to the highest. Separate analyses of each of the component subscales of job control-decision authority and skill discretion-showed results consistent with those of the main analysis; both were significantly associated with mental health in the same direction, with a stronger association for decision authority. We conclude that as people's level of job control increased, so did their mental health, supporting the value of targeting improvements in job control through policy and practice interventions.

Patient and carer identified factors which contribute to safety incidents in primary care: a qualitative study

BACKGROUND: Patients can have an important role in reducing harm in primary-care settings. Learning from patient experience and feedback could improve patient safety. Evidence that captures patients' views of the various contributory factors to creating safe primary care is largely absent. The aim of this study was to address this evidence gap. METHODS: Four focus groups and eight semistructured interviews were conducted with 34 patients and carers from south-east Australia. Participants were asked to describe their experiences of primary care. Audio recordings were transcribed verbatim and specific factors that contribute to safety incidents were identified in the analysis using the Yorkshire Contributory Factors Framework (YCFF). Other factors emerging from the data were also ascertained and added to the analytical framework. RESULTS: Thirteen factors that contribute to safety incidents in primary care were ascertained. Five unique factors for the primary-care setting were discovered in conjunction with eight factors present in the YCFF from hospital settings. The five unique primary care contributing factors to safety incidents represented a range of levels within the primary-care system from local working conditions to the upstream organisational level and the external policy context. The 13 factors included communication, access, patient factors, external policy context, dignity and respect, primary-secondary interface, continuity of care, task performance, task characteristics, time in the consultation, safety culture, team factors and the physical environment. DISCUSSION: Patient and carer feedback of this type could help primary-care professionals better understand and identify potential safety concerns and make appropriate service improvements. The comprehensive range of factors identified provides the groundwork for developing tools that systematically capture the multiple contributory factors to patient safety.

The work-based predictors of job engagement and job satisfaction experienced by community health professionals

Background: Job engagement represents a critical resource for community-based health care agencies to achieve high levels of effectiveness. However, studies examining the organisational sources of job engagement among health care professionals have generally overlooked those workers based in community settings.
Purpose: This study drew on the demand-control model, in addition to stressors that are more specific to community health services (e.g., unrewarding management practices), to identify conditions that are closely associated with the engagement experienced by a community health workforce. Job satisfaction was also included as a way of assessing how the predictors of job engagement differ from those associated with other job attitudes.
Methodology/Approach: Health and allied health care professionals (n = 516) from two
Australian community health services took part in the current investigation. Responses from the two organisations were pooled and analysed using linear multiple regression.
Findings: The analyses revealed that three working conditions were predictive of both job engagement and job satisfaction (i.e., job control, quantitative demands and unrewarding management practices). There was some evidence of differential effects with cognitive demands being associated with job engagement, but not job satisfaction.
Practice Implications: The results provide important insights into the working conditions that, if addressed, could play key roles in building a more engaged and satisfied community health workforce. Further, working conditions like job control and management practices are amenable to change and thus represent important areas where community health services could enhance the energetic and motivational resources of their employees.