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Biomedical subjects

Johannes Siegrist

Publications and source records attributed to Johannes Siegrist.

At least 19 recordsLinked to original sources

Quality of work, well-being, and intended early retirement of older employees: baseline results from the SHARE Study.

BACKGROUND: Given the challenge of a high proportion of older employees who retire early from work we analyse associations of indicators of a poor psychosocial quality of work with intended premature departure from work in a large sample of older male and female employees in 10 European countries. METHODS: Baseline data from the 'Survey of Health, Ageing and Retirement in Europe' (SHARE) were obtained from 3523 men and 3318 women in 10 European countries. Data on intended early retirement, four measures of well-being (self-rated health, depressive symptoms, general symptom load, and quality of life), and quality of work (effort-reward imbalance; low control at work) were obtained from structured interviews and questionnaires. Country-specific and total samples are analysed, using logistic regression analysis. RESULTS: Poor quality of work is significantly associated with intended early retirement. After adjustment for well-being odds ratios (OR) of effort-reward imbalance [OR 1.72 (1.43-2.08)] and low control at work [OR 1.51 (1.27-1.80)] on intended early retirement are observed. Poor quality of work and reduced well-being are independently associated with the intention to retire from work. CONCLUSION: The consistent association of a poor psychosocial quality of work with intended early retirement among older employees across all European countries under study calls for improved investments into better quality of work, in particular increased control and an appropriate balance between efforts spent and rewards received at work.

Adaptation, Psychological↗

Algorithms for converting random-zero to automated oscillometric blood pressure values, and vice versa.

Many surveys and cohort studies have used a random-zero sphygmomanometer blood pressure device (RZS) to measure subjects' blood pressure and to assess the value of blood pressure in predicting cardiovascular events. Recent studies used automated oscillometric blood pressure devices (AODs) that systematically measure higher blood pressure values than RZSs do, hampering comparability of values between these studies. In 2000-2003, the authors randomly used both an RZS and an AOD in an ongoing cohort study in Germany. This analysis aimed to compare blood pressure values by device and to develop an algorithm to convert estimates of blood pressure values from one device to the other. In a randomized subset of 2,365 subjects aged 45-75 years, each subject was measured three times with each device in a randomized order. The mean difference (AOD-RZS) between the devices was 3.9 mmHg for systolic blood pressure and 2.6 mmHg for diastolic blood pressure. The authors found that linear regression models including age, sex, and blood pressure level can be used to convert RZS blood pressure values to AOD blood pressure values, and vice versa. Results may help to better compare blood pressure values in epidemiologic studies that used different blood pressure devices.

Aged↗

Coronary atherosclerosis and cardiovascular risk in masters male marathon runners. Rationale and design of the "marathon study".

BACKGROUND: Regular physical exercise is recommended to reduce cardiovascular mortality. And yet, atherosclerosis is the main cause of exercise-associated death in persons beyond age 35. The need for risk stratification in marathon runners is under discussion. The predictive value of modern imaging- and non-imaging-based markers of risk that can be used for risk stratification in masters endurance athletes still deserves exploration. METHODS: Male runners > 50 years who have completed at least five marathon races during the preceding 3 years and do not suffer from coronary artery disease, angina nor diabetes mellitus are studied to assess the predictive value of established and modern imaging- based and biochemical cardiovascular risk factors. Laboratory parameters including clinical chemistry, hematology and hormone measurements are determined. Lifestyle-related risk factors, psychosocial and socioeconomic variables are explored using standardized questionnaires. Coronary, carotid, femoral and aortic atherosclerosis is measured using electronbeam computed tomography and ultrasound. In addition, a resting ECG, a bicycle stress test and heart rate variability are performed. Myocardial morphology and function are assessed using echocardiography and magnetic resonance imaging. Participants are invited to compete in a marathon race to quantify the association of coronary atherosclerosis with marathon-related changes of cardiac troponin levels and the extent of marathon-induced inflammation. At the cellular level, the effect on the amount of circulating progenitor cells (EPCs) is determined by FACS analysis. Changes in laboratory parameters and hormone levels are also studied. Annual long-term follow-up including hospital records and death certificates is performed. Data are compared with those from a general unselected cohort from the Heinz Nixdorf Recall Study. CONCLUSION: This study should contribute to cardiovascular risk assessment in the growing number of masters marathon runners with a focus on assessing the predictive value of modern imaging techniques and biochemical markers for comprehensive risk stratification.

Adult↗

Prevalence of peripheral arterial disease - results of the Heinz Nixdorf recall study.

BACKGROUND: This report presents population-based estimates of the prevalence of peripheral arterial disease (PAD), chronic critical limb ischemia (CLI), and Moenckeberg's medial calcinosis (MC) in Germany. PATIENTS AND METHODS: From the year 2000 to 2003, a total of 4,814 subjects aged 45-75 years were included in the study. In 30 of the subjects (0.6%), determination of the ankle brachial index (ABI) was not possible, leaving 4,735 subjects (99.4%) in the data set. PAD was considered present in all subjects with an ABI < 0.9 in one leg, and/or a history of prior treatment for PAD. CLI was considered present if the highest ankle artery pressure measured < 70 mmHg. Prevalence of MC was calculated for ABI cut-off values of 1.3 and 1.5. FINDINGS: The overall prevalence of PAD according to the ABI criteria was 6.4% among men and 5.1% among women. After accounting for history of PAD, the prevalence increased to 8.2% among men and 5.5% among women. Taking the ABI criteria and medical history into account, males had a higher prevalence of PAD, with large increases in males aged 65-69 and 70-75 years. Chronic CLI was rare in the investigated population, and was found in only five older subjects (0.1%). With the criterion of ABI > 1.3, about 13.3% of males and 6.9% of females had MC. In contrast to PAD, the prevalence of MC did not increase with age. With the criterion of ABI > 1.5, MC was present in only 1.1% and 0.5% of men and women, respectively, but only 30 (0.6%) subjects had incompressible ankle arteries with a cuff pressure > 260 mmHg. CONCLUSION: Prevalences of PAD based only on ABI generally underestimate the true prevalence of PAD in population-based studies. CLI predominantly affects older subjects. In addition, cut-off values for MC must be newly determined.

Aged↗

Psychosocial work stress is associated with poor self-rated health in Danish nurses: a test of the effort-reward imbalance model.

Nursing staff are exposed to stressful work load which in turn is associated with poor physical and psychological health, sickness absence and job exit. The effort-reward imbalance (ERI) model is a validated approach to measure chronic psychosocial work stress by identifying nonreciprocity between occupational efforts spent and rewards received, and has been found to predict poor health. The aim of this cross-sectional study (n = 367 nurses and nurses aides) was first to test the psychometric properties of the Danish questionnaire measuring ERI, and secondly to analyse whether psychosocial work stress is associated with six indicators of poor self-rated health. Results derived from confirmatory factor analysis indicate satisfying psychometric properties. Elevated risks of poor self-rated health (odds ratios varying from 1.92 to 4.76) are observed in nursing staff characterized by high effort in combination with low reward. Effects are enhanced in those respondents who additionally exhibit a high level of work-related overcommitment. In conclusion, despite methodological limitations, this study contributes to the validation of the ERI questionnaire in Danish language. Furthermore, by documenting associations with poor self-rated health, it supports efforts of theory-guided prevention of work stress in health care professions.

Adaptation, Psychological↗

Psychosocial determinants of premature cardiovascular mortality differences within Hungary.

OBJECTIVES: The life expectancy gap between Central-Eastern European (CEE) countries, including Hungary, and Western Europe (WE) is mainly attributable to excess cardiovascular (CV) mortality in midlife. This study explores the contribution of socioeconomic, work related, psychosocial, and behavioural variables to explaining variations of middle aged male and female CV mortality across 150 sub-regions in Hungary. DESIGN: Cross sectional, ecological analyses. SETTING: 150 sub-regions of Hungary. PARTICIPANTS AND METHODS: 12 643 people were interviewed in Hungarostudy 2002 survey, representing the Hungarian population according to sex, age, and sub-regions. Independent variables were income, education, control in work, job insecurity, weekend working hours, social support, depression, hostility, anomie, smoking, body mass index, and alcohol misuse. MAIN OUTCOME MEASURES: Gender specific standardised premature (45-64 years) total CV, ischaemic heart disease, and cerebrovascular mortality rates in 150 sub-regions of Hungary. RESULTS: Low education and income were the most important determinants of mid-aged CV mortality differences across sub-regions. High weekend workload, low social support at work, and low control at work account for a large part of variation in male premature CV mortality rates, whereas job insecurity, high weekend workload, and low control at work contribute most noticeably to variations in premature CV mortality rates among women. Low social support from friends, depression, anomie, hostility, alcohol misuse and cigarette smoking can also explain a considerable part of variations of premature CV mortality differences. CONCLUSION: Variations in middle aged CV mortality rates in a rapidly changing society in CEE are largely accounted for by distinct unfavourable working and other psychosocial stress conditions.

Cardiovascular Diseases↗

Does occupational gender segregation influence the association of effort-reward imbalance with myocardial infarction in the SHEEP study?

The objective of this study was to investigate whether occupational gender segregation moderates the association between job stress in terms of effort-reward imbalance and the risk of myocardial infarction. This analysis was conducted in 1,381 cases and 1,697 referents of the Swedish SHEEP case control study aged 45-70 years. Information on myocardial infarction and biological coronary risk factors (e.g. hypertension, blood lipids) was achieved from clinical screenings. Information on socio-demographic variables, effort-reward imbalance, behavioral coronary risk factors (e.g., smoking), and additional coronary risk factors (e.g., diabetes, family history of coronary heart disease) was derived from well-tested standardized questionnaires. After adjustment for confounders the strongest association between overcommitment (the intrinsic component of effort-reward imbalance) and risk of belonging to the myocardial infarction group was found among women in male-dominated jobs (odds ratio [OR] = 2.71, 95% CI = 1.13-6.52) as compared to the remaining group (OR = 1.52, 95% CI = 1.01-2.31). Moreover, a significant interaction between pronounced overcommitment and male domination in relation to myocardial infarction was observed among women (OR = 2.44, 95% CI = 1.05-5.67). In men, an association between the ratio of effort and reward (the extrinsic component of the model) and risk of myocardial infarction was found for the majority, that is the group not working in women-dominated jobs (OR = 1.39, 95% CI = 1.04-1.86). Despite methodological limitations, this study gives preliminary evidence of a moderating effect of occupational gender segregation on the association of effort-reward imbalance (i.e., the intrinsic model component overcommitment) with acute myocardial infarction risk among women, but not among men.

Adult↗

Work stress and health risk behavior.

This contribution discusses current knowledge of associations between psychosocial stress at work and health risk behavior, in particular cigarette smoking, alcohol consumption and overweight, by reviewing findings from major studies in the field published between 1989 and 2006. Psychosocial stress at work is measured by the demand-control model and the effort-reward imbalance model. Health risk behavior was analyzed in the broader context of a health-related Western lifestyle with socially and economically patterned practices of consumption. Overall, the review, based on 46 studies, only modestly supports the hypothesis of a consistent association between work stress and health risk behavior. The relatively strongest relationships have been found with regard to heavy alcohol consumption among men, overweight, and the co-manifestation of several risks. Suggestions for further research are given, and the need to reduce stressful experience in the framework of worksite health promotion programs is emphasized.

Alcohol Drinking↗

Differential brain activation according to chronic social reward frustration.

Neural correlates of reward frustration are increasingly studied in humans. In line with prediction error theory, omission of an expected reward is associated with relative decreases of cerebral activation in dopaminergic brain areas. We investigated whether a history of chronic work-related reward frustration influences this reward-dependent activation pattern by means of functional magnetic resonance imaging. Solving arithmetic tasks was followed by either monetary reward or omission of reward. Hyperactivations in the medial prefrontal, anterior cingulate and dorsolateral prefrontal cortex were observed in a group of healthy adults with high susceptibility to reward frustration as compared with a group with low susceptibility. Findings indicate a compromised ability of adapting brain activation among those suffering form chronic social reward frustration.

Adult↗

A prospective study of cumulative job stress in relation to mental health.

BACKGROUND: This study tests associations between psychosocial stress at work measured by the effort-reward imbalance model in a dynamic perspective, and multiple indicators of poor mental health, in a prospective design. METHODS: 1986 male and female employees from four Belgian enterprises were followed-up over one year within the framework of the Somstress study. Based on two consecutive measurements, an index of cumulative job stress was constructed and its associations with five indicators of mental health were studied, excluding caseness at entry (for depression, anxiety, somatisation, chronic fatigue and psychotropic drug consumption respectively). Taking into account the longitudinal design, four categories of job stress are defined: 1) employees free from stress at both measures, 2) job stress present at first measure but not at the second one, 3) recent onset of job stress as evidenced by second measure 4) workers exposed to stress at both measures. Multivariate logistic regression with appropriate adjustments was applied. RESULTS: In bivariate analysis, a clear graded association of cumulative job stress with all five mental health indicators is observed, both in men and women. In multivariate logistic regression analysis, recent onset of stress is strongly associated with poor mental health among men (odds ratios ranging from 1.8 to 4.6), while cumulative stress shows strongest effects on mental health in women (odds ratios ranging from 1.4 to 7.1). CONCLUSION: Cumulative experience and recent onset of job stress in terms of high effort spent and low reward received is associated with elevated risk of all five indicators of poor mental health at follow-up in a large cohort of employees.

Achievement↗

Effort-reward imbalance at work and job dissatisfaction in Chinese healthcare workers: a validation study.

OBJECTIVE: The aim of this study was to test the reliability and validity of the Chinese version of the 23-item effort-reward imbalance (ERI) questionnaire and to analyze its association with job dissatisfaction in a sample of Chinese healthcare workers. METHODS: A self-reported survey was conducted, in university hospitals of China, among 192 male and 608 female healthcare workers. RESULTS: Appropriate internal consistencies of the three scales: effort, reward, and overcommitment, were obtained. Exploratory factor analysis replicated the theoretically assumed structure of the ERI construct in men and women. Evidence of criterion validity was obtained from cross-correlations of the scales and from their correlations with gender, education and job dissatisfaction. Finally, all three scales were associated with an elevated odds ratio of job dissatisfaction, and the effect was strongest for the ERI ratio as predicted by theory. CONCLUSION: Based on the results of this study the Chinese version of the ERI questionnaire is considered a reliable and valid instrument for measuring psychosocial stress at work. It is applicable to Chinese working populations and, in particular, to the healthcare sector.

Adult↗

Social reciprocity and health: new scientific evidence and policy implications.

The work contract is based on the norm of social reciprocity where appropriate rewards are provided for efforts and achievements at work. The effort-reward imbalance model of work stress maintains that contractual non-reciprocity in terms of high efforts spent and low rewards received is frequent if people have no alternative choice in the labour market, if they are exposed to heavy competition or if they are intrinsically motivated to engage in excessive work-related commitment. According to the model, long-term exposure to effort-reward imbalance increases the risk of stress-related disorders. An overview of results from prospective epidemiological investigations testing the model is given. Overall, people who experience failed reciprocity at work are twice as likely to suffer from incident cardiovascular disease, depression or alcohol dependence compared to those who are not exposed. Associations are stronger for men than for women. Policy implications of findings for improved worksite health promotion are discussed.

Health↗

Organisational downsizing and work stress: testing synergistic health effects in employed men and women.

STUDY OBJECTIVE: To systematically study the separate and combined effects of organisational downsizing and work related stress on a measure of health in "survivors of layoffs". DESIGN: Using Rothman's approach, separate and combined effects of the two exposures in estimating the risk of poor self rated health (work related symptoms) are analysed in a large sample of male and female employees. SETTING: 0.1% cross sectional sample of the German working population. PARTICIPANTS: 12 240 men and 10 319 women, aged 16 to 59 years, surveyed in 1998-1999. MAIN RESULTS: Compared with the reference group, the group of participants who were simultaneously exposed to downsizing and work related stress (effort-reward imbalance) exhibited odds ratios (OR) of three or more work related symptoms that were by far higher (OR 4.41 in men and OR 5.37 in women) than those associated with single exposures. Altogether 21% (men) and 31% (women) of the effect size of the combined exposure was attributable to synergistic interaction. CONCLUSION: Although reduced health associated with organisational downsizing is partly attributable to an increase in work related stress these findings show an additional synergy effect produced by the combined exposure to both conditions.

Adolescent↗

[Non-reciprocity in close social relationships, depressive symptoms, and poor self-rated health].

OBJECTIVES: Associations of experienced non-reciprocity in close social relationships with health are analyzed in a group of middle-aged employed men and women using depressive symptoms and self-rated health as indicators. METHODS: Non-reciprocity is measured by a newly developed questionnaire containing three scales: "partnership", "parent-child", and "non-specific close relationships". Depressive symptoms are assessed by the German version of the CES-D scale and self-rated health by a single widely tested item. The factorial structure of the questionnaire measuring non-reciprocity is analyzed. Subsequently, associations are explored using logistic regression analyses with age, gender, socio-economic status, and social support as control variables. RESULTS: The factorial structure of the questionnaire is confirmed. Significantly elevated odds ratios (OR) of depressive symptoms are observed in people who experience non-reciprocity (partnership OR = 2.97; parent-child OR = 2.70; non-specific OR = 1.84). Similarly, the risk of poor self-rated health is significantly elevated in these conditions, except for non-specific non-reciprocity. CONCLUSIONS: Based on the newly developed measurement consistent associations of non-reciprocity in close social relationships with depressive symptoms and poor self-rated health are documented.

Adult↗