Selahadin Ibrahim

Examining the relationship between work-family spillover and sleep quality.

The present study examined the relationship between work-family spillover, job characteristics, and sleep quality in a sample of health care workers (N = 168) recruited from 3 Canadian hospitals. A multiple regression analysis revealed that positive family-to-work spillover is associated with better sleep quality, after controlling for age, physical health, depressive symptomatology, work situation, and number of children. These findings are discussed within a theoretical framework drawing on the concepts of effort and recovery.

Work correlates of back problems and activity restriction due to musculoskeletal disorders in the Canadian national population health survey (NPHS) 1994-5 data.

OBJECTIVES To describe the prevalence of musculoskeletal problems in the Canadian working population and to determine cross sectional associations between such problems and work factors, particularly job strain and physical demand variables. METHODS The Canadian 1994 national population health survey (NPHS) sampled 4230 working men and 4043 working women (ages 18–64) who answered an abbreviated version of the job content questionnaire. Workers were classified into four strain categories: high, passive, active, and low. Outcomes were restricted activity due to musculoskeletal disorders and the diagnosis of a back problem (both yes or no). Survey weights were incorporated to allow for different probabilities of selection. Logistic regression analyses were carried out separately for women and men, controlling for sociodemographic factors. RESULTS Prevalence of chronic back problems diagnosed by a health practitioner was 14.5% among men and 12.5% among women. Men had a 6.6% prevalence of restricted activity due to musculoskeletal disorders, whereas the corresponding figure for women was 5.3%. Women, but not men, in high strain jobs were more likely to report both back problems (odds ratio (OR) 1.60, 95% confidence interval (95% CI) 1.14 to 2.28) and restricted activity (OR 1.98, 95% CI 1.16 to 3.48) compared with those in low strain jobs. High physical exertion was an independent predictor of back problems in both sexes. For both men and women, low social support at work and high job insecurity were independent predictors of restricted activity due to musculoskeletal disorders. Conversely, chronic back problems contributed to explanation of high job strain among women (OR 1.76, 95% CI 1.30 to 2.39) and high physical exertion among men (OR 1.39, 95% CI 1.09 to 1.77), whereas restricted activity due to musculoskeletal disorders contributed to explanation of high job insecurity in both sexes. CONCLUSIONS Associations of interest between work stressors and musculoskeletal problems in this cross sectional study provide evidence for physical and psychosocial factors both affecting disability and being affected by disability in a working population.

Predictors of Work-Related Repetitive Strain Injuries in a Population Cohort

OBJECTIVES We assessed predictors of work-related repetitive strain injuries using data from 4 waves of the Canadian National Population Health Survey. METHODS Participants were 2806 working adults who completed an abbreviated version of the Job Content Questionnaire in 1994-1995 and did not experience repetitive strain injuries prior to 2000-2001. Potential previous wave predictors of work-related repetitive strain injuries were modeled via multivariate logistic regression. RESULTS Female gender (odds ratio [OR] = 1.98; 95% confidence interval [CI]=1.24, 3.18), some college or university education (OR=1.98; 95% CI=1.06, 3.70), job insecurity (OR=1.76; 95% CI=1.07, 2.91), high physical exertion levels (OR = 2.00; 95% CI = 1.29, 3.12), and high levels of psychological demands (OR = 1.61; 95% CI = 1.02, 2.52) were all positively associated with work-related repetitive strain injuries, whereas working less than 30 hours per week exhibited a negative association with such injuries (OR=0.2; 95% CI=0.1, 0.7). CONCLUSIONS Modifiable job characteristics are important predictors of work-related repetitive strain injuries.

A multi-group cross-lagged analyses of work stressors and health using Canadian National sample.

This article examines the reciprocal relationships between work variables and health outcomes and if these relationships differ by social class (measured by occupational grouping). We used longitudinal data from the 1994/95--2002/03 Canadian National Population Health Survey (NPHS). Karaseks work stress variables were measured in the 1994/95 (cycle 1, time 1), 2000/01 (cycle 4, time 2) and 2002/03 (cycle 5, time 3) surveys. Analyses were limited to 2556 respondents aged 18-56 at time 1 and who remained in the same social class (as defined by occupational position) for all the three time points. Work variables used were job strain ratio, work social support and job insecurity. Health outcomes used were distress, depression and self-rated health. Multi-group path analyses were used to investigate the reciprocal relationships between work and health variables and if these relationships differed by social class. Analyses controlled for age, gender, marital status and work status. We find there is a differential burden of work psychosocial factors and health outcomes by social class. The cross-lagged relationships between work and health depended on the outcome, social class and time lag. More significant paths from work to health were observed than reverse paths from health to work. More significant relationships between work and health were observed for the shorter time lag (2 years) compared to longer time lags (6 years). Low work social support and job insecurity were more detrimental to health for respondents in lower social class positions. Findings from this study highlight the importance of time lag, and to some extent social class, in the reciprocal relationships between work and health.

Job Strain and Self-Reported Health Among Working Women and Men: An Analysis of the 1994/5 Canadian National Population Health Survey

SUMMARY This paper explores the associations, for working women and men, of high strain jobs with self-rated health in the 1994/95 Canadian National Population Health Survey (NPHS). NPHS data were obtained on men (n = 4230) and women (n = 4043), aged 18–64 who answered an abbreviated version of the job content questionnaire (JCQ). Using the upper and lower tertiles of psychological demands and decision latitude as cut points we classified workers into high strain and other jobs. Self-rated health was the outcome. We used polytomous logistic regression analyses and controlled for potential personal and home confounders; two risk parameters were estimated: for the odds of reporting poor/fair and good health both vs. very good/excellent health. High strain work was reported by 11% of women and 9% of men. After adjusting for potential confounders, high job strain was consistently associated with worse self-rated health in both models for each gender.

Food and Nutritional Security of Children of Urban Farmers in Kampala, Uganda

Background Urban agriculture is an important livelihood strategy to increase access to and availability of food in urban settings. Objective We examined the impact of sociodemographic and farming variables on the household food security and nutritional security of an index child aged 2 to 5 years. Our hypothesis was that dietary quality (percentage of energy from animal-source foods [%ASF] and dietary diversity) would have an impact on infection (as measured by C-reactive protein [CRP]), which in turn would have an impact on biochemical indices (hemoglobin and retinol) and anthropometric indices (weight-for-age z-score [WAZ] and body mass index z-score [ZBMI]). We examined the relationships among urban agricultural activities, household food security, and child nutritional security. Methods We conducted a cross-sectional survey of 296 households within each randomly selected study zone in Kampala, Uganda. Correlations were calculated and bivariate and exploratory path analysis was conducted to explore relationships. Results Household food security score was significantly positively correlated with the number of tropical livestock units (r = 0.142, p = .017), dietary diversity (r = 0.230, p < .001), %ASF (r = 0.185, p = .002), and WAZ (r = 0.149, p = .017). Exploratory path analysis demonstrated a significant positive relationship between household food security and %ASF, which in turn was positively associated with retinol. Consumption of animal-source food was significantly negatively associated with C-reactive protein level, which in turn was significantly negatively associated with hemoglobin level, and hemoglobin was significantly positively associated with WAZ. Conclusions Our findings are supportive of efforts to enhance access to land for urban farming and engagement in activities aimed at improving the quality of dietary intake of urban residents, in particular by increasing consumption of animal-source foods.

Examining the impact of worker and workplace factors on prolonged work absences among Canadian nurses.

Objective:To evaluate the impact of worker and workplace factors and of their relationships on work absence duration. Methods:Structural equation modeling of 11,762 female, Canadian nurses from the 2005 National Survey of the Work and Health of Nurses. Results:Worker and workplace factors were associated with prolonged work absence. Key proximal predictors were pain-related work interference, depression, pain severity, and respect and support at work. More distal predictors were multimorbidity, abuse at work, and organizational culture. Conclusions:Worker health and workplace factors are important in explaining work absence duration. Self-management for pain and mood, adapted to the work context, may be useful for nurses with chronic pain or depression. Policy makers and administrators should focus on creating respect and support at work, and improving organizational culture.

Time trends in musculoskeletal disorders attributed to work exposures in Ontario using three independent data sources, 2004-2011

Objective Work-related musculoskeletal disorders (MSDs) are the leading cause of work disability in the developed economies. The objective of this study was to describe trends in the incidence of MSDs attributed to work exposures in Ontario over the period 2004–2011. Methods An observational study of work-related morbidity obtained from three independent sources for a complete population of approximately six million occupationally active adults aged 15–64 in the largest Canadian province. We implemented a conceptually concordant case definition for work-related non-traumatic MSDs in three population-based data sources: emergency department encounter records, lost-time workers’ compensation claims and representative samples of Ontario workers participating in consecutive waves of a national health interview survey. Results Over the 8-year observation period, the annual per cent change (APC) in the incidence of work-related MSDs was −3.4% (95% CI −4.9% to −1.9%) in emergency departments’ administrative records, −7.2% (−8.5% to −5.8%) in lost-time workers’ compensation claims and −5.3% (−7.2% to −3.5%) among participants in the national health interview survey. Corresponding APC measures for all other work-related conditions were −5.4% (−6.6% to −4.2%), −6.0% (−6.7% to −5.3%) and −5.3% (−7.8% to −2.8%), respectively. Incidence rate declines were substantial in the economic recession following the 2008 global financial crisis. Conclusions The three independent population-based data sources used in this study documented an important reduction in the incidence of work-related morbidity attributed to non-traumatic MSDs. The results of this study are consistent with an interpretation that the burden of non-traumatic MSDs arising from work exposures is declining among working-age adults.

Understanding recovery: Changes in the relationships of the International Classification of Functioning (ICF) components over time

The International Classification of Functioning, Disability and Health framework describes human functioning through body structure and function, activity and participation in the context of a persons social and physical environment. This work tested the temporal relationships of these components. Our hypotheses were: 1) there would be associations among physical impairment, activity limitations and participation restrictions within time; 2) prior status of a component would be associated with future status; 3) prior status of one component would influence status of a second component (e.g. prior activity limitations would be associated with current participation restrictions); and, 4) the magnitude of the within time relationships of the components would vary over time. Participants from Canada with primary hip or knee joint replacement (n = 931), an intervention with predictable improvement in pain and disability, completed standardized outcome measures pre-surgery and five times in the first year post-surgery. These included physical impairment (pain), activity limitations and participation restrictions. ICF component relationships were evaluated cross-sectionally and longitudinally using path analysis adjusting for age, sex, BMI, hip vs. knee, low back pain and mood. All component scores improved significantly over time. The path coefficients supported the hypotheses in that both within and across time, physical impairment was associated with activity limitation and activity limitation was associated with participation restriction; prior status and change in a component were associated with current status in another component; and, the magnitude of the path coefficients varied over time with stronger associations among components to three months post surgery than later in recovery with the exception of the association between impairment and participation restrictions which was of similar magnitude at all times. This work enhances understanding of the complexities of the ICF component relationships in evaluating disability over time. Further longitudinal studies including evaluation of contextual factors are required.

Welfare State Regimes, Gender, and Depression: A Multilevel Analysis of Middle and High Income Countries

Using the 2002 World Health Survey, we examine the association between welfare state regimes, gender and mental health among 26 countries classified into seven distinct regimes: Conservative, Southeast Asian, Eastern European, Latin American, Liberal, Southern/Ex-dictatorship, and Social Democratic. A two-level hierarchical model found that the odds of experiencing a brief depressive episode in the last 12 months was significantly higher for Southern/Ex- dictatorship countries than for Southeast Asian (odds ratio (OR) = 0.12, 95% confidence interval (CI) 0.05–0.27) and Eastern European (OR = 0.36, 95% CI 0.22–0.58) regimes after controlling for gender, age, education, marital status, and economic development. In adjusted interaction models, compared to Southern/Ex-dictatorship males (reference category), the odds ratios of depression were significantly lower among Southeast Asian males (OR = 0.16, 95% CI 0.08–0.34) and females (OR = 0.23, 95% CI 0.10–0.53) and Eastern European males (OR = 0.41, 95% CI 0.26–0.63) and significantly higher among females in Liberal (OR = 2.00, 95% CI 1.14–3.49) and Southern (OR = 2.42, 95% CI 1.86–3.15) regimes. Our results highlight the importance of incorporating middle-income countries into comparative welfare regime research and testing for interactions between welfare regimes and gender on mental health.