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Introduction: The experiences of UK Government response-focused employees, who were considered frontline workers during the coronavirus response, are missing from current literature. Meeting the demands of being on the frontline, whilst also adjusting from a normal and practiced way of working to having to work from within one's home, may bring a plethora of new barriers and facilitators associated with providing an effective pandemic response., Method: This interview study collected and analysed data from 30 UK Civil servants who worked on the COVID-19 pandemic response from their own homes. Interviews aimed to: (1) explore UK Government employee's experiences of working from home whilst contributing to the pandemic response; and, (2) establish what support and guidance employees were offered, and what they would recommend for future public health emergencies requiring homeworking., Results: Seven themes were extracted from the data: overall experience of working from home; preparedness for working from home; experience of contributing to the response effort; work life balance; relationships with colleagues; space and equipment; and, inclusivity. Findings suggested that during the pandemic, participants reported feeling a strong sense of purpose and achievement for contributing to the response. But, the work was demanding, particularly for those who had to rapidly, and unexpectedly, transition from office or lab work to home working. More generally, the nature of their homeworking experience depended on a range of practical (e.g., space in the home), organisational (e.g., relationships with managers) and personal factors (e.g., caring responsibilities). Many participants were underprepared to work from home, but participants provided a plethora of information relating to what support offers they would find useful during future work on the frontline from their own homes., Conclusion: The results of this study demonstrate that frontline UK Civil servants may need more tailored and flexible multilevel support (i.e., from peers, managers, organisations) during future public health emergencies when they are required to work from home. A series of data-informed recommendations are created and discussed., Competing Interests: Declarations. Ethics approval and consent to participate: Ethical approval for this study was provided by the Psychiatry, Nursing and Midwifery Research Ethics Subcommittee at King’s College London (ethical clearance reference number: HR/DP-22/23-34829). Informed consent to participate was obtained from all of the participants in the study. This study adhered to the Declaration of Helsinki. Consent for publication: Not applicable. Competing interests: DW and CEH both work within UK Government. NG and SKB have history of working collaboratively with the UK Government. All authors have experience of working from home whilst contributing to the COVID-19 response. During the initial stages of the pandemic, NG ran the mental health strategy at the London Nightingale Hospital and subsequently contributed to the mental health plans for various government departments. Registry and the Registration No. Of the study/Trial: Not applicable. Animal studies: Not applicable., (© 2025. The Author(s).)

Objective: This study investigates perceptions of homeworking in UK Government response-focused employees that contributed to the COVID-19 pandemic response., Method: A cross-sectional online survey with open-ended questions was conducted. Free-text responses detailing participants' perceptions of barriers, facilitators, advantages, and disadvantages were analyzed using content analysis., Results: A total of 1943 free-text responses (from 150 participants) were analyzed. There were many conflicting advantages and disadvantages provided by participants, but crudely more positive statements were provided than negative. Flexibility associated with working from home was the most common positive factor, and the isolation and impact on working relationships was the most reported negative factor of working from home., Conclusions: We suggest a 'one size fits all' approach to supporting staff working from home is not fit for purpose due to individual circumstances and contextual factors., Competing Interests: Conflict of interest: D.W. and C.E.H. have both worked within the UK Government. N.G. and S.K.B. have history of working collaboratively with the UK Government. All authors have experience of working from home while contributing to the COVID-19 response. During the initial stages of the pandemic, N.G. ran the mental health strategy at the London Nightingale Hospital and subsequently contributed to the mental health plans for various government departments., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Occupational and Environmental Medicine.)

Problem drinking affects not only the health of a population but also the productivity of a nation, especially if it is rampant among the working population. This study examines the association between problem drinking and work characteristics, work-family status, and social situations among the Japanese working population. Multivariable logistic regression analysis was performed on the basis of gender on 3136 participants (men: 65.1%, women: 34.9%) adopted from the Japanese Civil Servants Study in 2014 (response rate: 87.8%), to examine the factors related to problem drinking, after adjusting for frequency and quantity of drinking. Problem drinking was assessed using the Cutdown, Annoyed, Guilty, and Eye-opener (CAGE) questionnaire. The presence of problem drinking was found in 24.3% of men and 10.3% of women. The analysis showed that in men, poor work performance (OR: 1.34, 95% CI: 1.00-1.79), high family-to-work conflict (OR: 1.54, 95% CI: 1.14-2.09), and high work-to-family conflict (OR: 1.63, 95% CI: 1.14-2.34) were significantly associated with problem drinking, whereas in women, high work-to-family conflict (OR: 2.45, 95% CI: 1.21-4.95) was significantly associated with problem drinking. Although the number of close friends is negatively associated with problem drinking in women, the significance disappeared in the fully adjusted model. It can be concluded that it is important for both men and women to strike a balance between work and family life. Moreover, owing to gender differences, work performance may be important for men, and the presence of close friends may be important for women, in reducing the risk of problem drinking., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Problem drinking causes a decline in labor productivity among working population. This study examined whether work characteristics, work-family status, and social activities are associated with future problem drinking behavior among Japanese civil servants. A total of 1,535 participants (men: 63.1%, women: 36.9%) with no problem drinking behavior were followed up from 2014 to 2019. A multivariable logistic regression analysis was performed to examine the factors associated with future problem drinking behavior. During the five-year follow-up period, the cumulative incidence of problem drinking was 9.6% and 5.8% in men and women, respectively. In both men and women, frequent drinking around three times a week or more and alcohol consumption of two units or more at baseline were associated with future problem drinking. In men, compared with low-grade employees, high-grade employees were less likely to become problem drinkers (OR: 0.56, 95% CI: 0.33-0.95). Shift workers were significantly associated with the incidence of problem drinking (OR: 2.96, 95% CI: 1.46-6.00). In women, poor own work performance was significantly associated with problem drinking (OR: 5.30, 95% CI: 1.57-17.86). In conclusion, disadvantaged work characteristics are associated with the development of problem drinking. To prevent problem drinking, attention should be paid to poor work characteristics.

Purpose: Although mental disorders are common in the workplace, they often go unnoticed. There is frequently a gap in the recognition and effective management of these disorders, leading to delayed recovery and worsening conditions. This study evaluates the level of Mental Health Literacy (MHL) among employees of the Finance and Planning Departments in the Federal District, Brazil, and proposes preventive measures and de-stigmatization strategies for mental health in the workplace., Methods: MHL among active employees was assessed using the Mental Health Literacy Scale (MHLS), developed by O'Connor and Casey (2015) and validated for Brazilian Portuguese by Buta et al. (2024). The data analysis included descriptive and inferential statistics, with nonparametric tests used to compare MHL across different groups., Results: The results showed that 27.6% of participants had adequate literacy, 67.9% had problematic levels, and 4.5% had inadequate levels. Women were observed to have higher literacy levels than men. Additionally, significant variations in literacy levels were noted among individuals with different health conditions; those diagnosed with cancer, depression, or other illnesses had higher literacy than those without diagnosed conditions., Conclusion: To address MHL challenges, educational actions such as awareness campaigns, training, and consultancy programs are essential., (© 2024. The Author(s).)

Background: In 2022, the World Health Organization highlighted the alarming state of oral health (OH) worldwide and urged action to include OH in initiatives on noncommunicable diseases. The population needs improved OH skills and attitudes and an adequate level of OH literacy (OHL) and general health literacy (HL). The implementation of health promotion actions in the workplace, which is a part of most people's lives, appears to be an opportunity. In France, civil servants have several socioprofessional levels and represent an excellent model with results transposable to the population., Objective: This study aimed at determining the OHL and HL level of civil servants in France in order to implement specific prevention actions in their workplaces., Methods: A cross-sectional study of French civil servants was conducted in France from October 2023 to February 2024. Participants completed three validated questionnaires in French: (1) a questionnaire on OH knowledge, (2) the Oral Health Literacy Instrument, French version (OHLI-F; this is composed of reading comprehension and numeracy sections) to assess the OHL level, and (3) the Short Test of Functional Health Literacy in Adults, French version (s-TOFHLA-F) to assess the HL level. The scores for OH knowledge, the OHLI-F, and the s-TOFHLA-F were reported as means (SD) and the 95% CI. These scores were classified into 3 categories: adequate (75-100), marginal (60-74) and inadequate (0-59). ANOVA and binary logistic regression were performed. The OHLI-F reading comprehension and OHLI-F numeracy scores were compared using the Welch 2-sample t test and a paired t test (both 2-tailed). For the correlation matrix, the Pearson correlation and related tests were computed., Results: A total of 1917 persons completed the 3 questionnaires, with adequate levels of OHL (n=1610, 84%), OH knowledge (n=1736, 90.6%), and HL (n=1915, 99.9%). The scores on the s-TOFHLA-F (mean 98.2, SD 2.8) were higher than the OHLI-F (mean 80.9, SD 7.9) and OH knowledge (mean 87.6, SD 10.5). The OHLI-F was highly correlated with OH knowledge (P<.001), but the OHLI-F and OH knowledge had a low correlation with s-TOFHLA-F (P=.43). The OHLI-F reading comprehension score was significantly higher than the OHLI-F numeracy score (P<.001). Age, education level, and professional category impacted the 3 scores (P<.001). The professional category was a determinant of adequate OHLI-F and OH knowledge scores., Conclusions: Some French civil servants had inadequate or marginal levels of OH knowledge (n=181, 9.5%) and OHL (n=307, 16%) but none had an inadequate level of HL. Results highlighted the relevance of implementing OH promotion programs in the workplace. They should be nonstandardized, adapted to the literacy level of professional categories of workers, and focused on numeracy skills. Thus, appropriate preventive communication and improved literacy levels are the means to achieve greater disease equity and combat the burden of noncommunicable diseases., (© Florence Carrouel, Benjamin du Sartz de Vigneulles, Céline Clément, Virginie-Eve Lvovschi, Elise Verot, Valeria Tantardini, Michel Lamure, Denis Bourgeois, Romain Lan, Claude Dussart. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org).)

Introduction: Working on the frontline during the COVID-19 pandemic has been associated with increased risk to mental health and wellbeing in multiple occupations and contexts. The current study aimed to provide an insight into the rate of probable mental health problems amongst United Kingdom (UK) Government employees who contributed to the COVID-19 response whilst working from home, and to ascertain what factors and constructs, if any, influence mental health and wellbeing in the sample population., Method: This paper reports on the findings from two studies completed by UK Government employees. Study 1: A cross-sectional online survey, containing standardised and validated measures of common mental health disorders of staff who actively contributed to the COVID-19 response from their own homes. Binary logistic regression was used to assess factors associated with mental health outcomes. Study 2: A secondary data analysis of cross-sectional survey data collected across three timepoints (May, June, and August) in 2020 focusing on the wellbeing of employees who worked from home during the COVID-19 pandemic., Results: Study 1: 17.9% of participants met the threshold criteria for a probable moderate anxiety disorder, moderate depression, or post-traumatic stress disorder. Younger, less resilient, less productive individuals, with lower personal wellbeing and less enjoyment of working from home, were more likely to present with poorer mental health. Study 2: Found lower wellbeing was consistently associated with having less opportunities to look after one's physical and mental health, and having unsupportive line managers and colleagues., Conclusion: It is important to ensure UK Government employees' psychological needs are met whilst working from home and responding to enhanced incidents. It is recommended that workplaces should be seeking to continually build and improve employee resilience (e.g., through opportunities to increase social ties and support networks), essentially ensuring employees have necessary resources and skills to support themselves and others., (© 2024. The Author(s).)

Purpose: A local healthcare organisation providing healthcare to 288,000 residents in Sweden struggled with a longstanding budget deficit. Several attempts to overcome the demanding financial situation have failed. A decommissioning programme was launched, and two years later, an evaluation indicated positive outcomes. The aim of this study was to explore factors politicians and public servants perceived as enablers to the successful implementation of the programme., Design/methodology/approach: A deductive content analysis approach using a framework of factors facilitating successful implementation of decommissioning decisions was applied to analyse interviews with 18 informants., Findings: Important factors were: (1) a review report contributing to the clarity of evidence, which (2) made the clarity of the rationale for change undeniable and (3) strengthened the political support for change. Additional factors were: (4) the strength of executive leadership, (5) the strength of clinical leadership supported by (6) the quality of project management and (7) a cultural and behavioural change seen as an important outcome for the path forward. A way to maximise the potential for a successful implementation of a large-scale decommissioning programme is to build a shared vision and a collaboration grounded in convincing evidence. Include public servants with a clinical background in the executive leadership team to contribute with legitimacy, competence, and trust in the decommissioning programme's intention., Originality/value: The paper addresses the limited knowledge of best practices in decommissioning processes and contributes empirical knowledge from a successful case., (© Inga-Britt Gustafsson, Lars Wallin, Ulrika Winblad and Mio Fredriksson.)

Background: Health is partly determined by the physical environment in which people live. It is therefore crucial to consider health when designing the physical living space. This requires collaboration between the social and physical domains within municipalities. Collaboration is not self-evident, however, and it is difficult to achieve due to barriers relating to culture, language and work processes. Additionally, improvements in collaboration are desperately needed to address complex health issues, and working according to the new Environment and Planning Act in the Netherlands requires more collaboration. One relevant question concerns how civil servants describe the current collaboration between the social and physical domain and the concrete improvements they propose to improve such collaboration to build a healthier living environment., Methods: In this qualitative study, the Collaborative Governance framework was used to present data from semi-structured interviews with 21 civil servants in five Dutch municipalities. Respondents were asked to reflect on their current experiences with collaboration and suggest concrete opportunities for improving collaboration., Results: The results indicate that enhancing collaboration between the social and physical domains can be achieved by proceeding from the inhabitants' perspective, as well as by encouraging aldermen and managerial personnel to take a more active and committed role in collaboration. This involves formulating and communicating a joint vision, in addition to guiding and facilitating collaboration through integrated assignments, forming multidisciplinary teams and appointing boundary-spanners. Civil servants see a clear role for themselves in the collaborative process. They recognize their own contributions to and obligations in enhancing collaboration by actively seeking contact, absorbing each other's perspectives and pursuing common ground, starting today., Conclusion: There are many concrete opportunities to improve collaboration between the social and physical domains. This could be initiated immediately if civil servants, managers and aldermen approach collaboration as an essential part of their jobs and acknowledge the interdependency that exits., Competing Interests: Researcher KM also works as a policy adviser for the Municipality of Nijmegen, the Netherlands. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Mourits, Spitters, van der Velden, Bekker and Molleman.)

Objective: Although work, family, and lifestyle factors were associated with job satisfaction, prospective studies are lacking. This longitudinal study clarified the predisposing factors for job satisfaction., Methods: Datasets were obtained from the Japanese Civil Servants Study and included 1429 participants. We assessed the relationship between job satisfaction and specific work and lifestyle factors. Logistic regression analyses evaluated the association between deteriorating job satisfaction and poor work and lifestyle factors at baseline and changes in these factors at follow-up., Results: Poor sleep quality and limited job control at baseline were associated with deterioration in job satisfaction. Furthermore, deterioration in job control and work-to-family conflict at follow-up was associated with job dissatisfaction., Conclusion: Work and lifestyle characteristics were associated with job dissatisfaction. Employees with limited job control and high work-to-family conflict at baseline were more likely to develop job dissatisfaction., Competing Interests: Conflicts of interest: None declared., (Copyright © 2024 American College of Occupational and Environmental Medicine.)

A growing literature finds that the way governments are organized can impact the societies they serve in important ways. The same is apparent with respect to civil service organizations. Numerous studies show that the recruitment of civil servants based on their credentials rather than on nepotism or patronage reduces corruption in government. Political corruption in turn appears to harm population health. Up to this time, however, civil service organization is not a recognized determinant of health and is little discussed outside of political science disciplines. To provoke a broader conversation on this subject, the following study proposes that meritocratic recruitment of civil servants improves population health. To test this proposition, a series of regression models examines comparative data for 118 countries. Consistent with study hypotheses, meritocratic recruitment of civil servants corresponds longitudinally with both lower rates of corruption and lower rates of infant mortality. Results are similar after robustness checks. Findings with regard to life expectancy are more mixed. However, additional tests suggest meritocratic recruitment contributes to life expectancy over a longer span of time. Findings also offer more support for a direct pathway from meritocratic recruitment to population health rather than via changes in corruption levels per se, although this may depend on a country's level of economic development. Overall, this study offers first evidence that civil service organization, particularly the recruitment of civil servants based on the merits of their applications rather than on whom they happen to know in government, is a positive determinant of health. More research in this area is needed., Competing Interests: Declaration of competing interest The author declares that he has no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: The provision of equitable and accessible healthcare is one of the goals of universal health coverage. However, due to high out-of-pocket payments, people in the world lack sufficient health services, especially in developing countries. Thus, many low and middle-income countries introduced different prepayment mechanisms to reduce large out-of-pocket payments and overcome financial barriers to accessing health care. Though many studies were conducted on willingness to pay for social health insurance in Ethiopia, there is no aggregated data at the national level. Therefore, this systematic review and meta-analysis aimed to estimate the pooled magnitude of willingness to pay for social health insurance and its associated factors among public servants in Ethiopia., Method: Studies conducted before June 1, 2022, were retrieved from electronic databases (PubMed/Medline, Science Direct, African Journals Online, Google Scholar, and Web of Science) as well as from Universities' digital repositories. Data were extracted using a data extraction format prepared in Microsoft Excel and the analysis was performed using STATA 16 statistical software. The quality of the included studies was assessed using the Newcastle-Ottawa Scale for cross-sectional studies. To evaluate publication bias, a funnel plot, and Egger's regression test were utilized. The study's heterogeneity was determined using Cochrane Q test statistics and the I2 test. To determine the pooled effect size, odds ratio, and 95% confidence intervals across studies, the DerSimonian and Laird random-effects model was used. Subgroup analysis was conducted by region, sample size, and publication year. The influence of a single study on the whole estimate was determined via sensitivity analysis., Result: To estimate the pooled magnitude of willingness to pay for the Social Health insurance scheme in Ethiopia, twenty articles with a total of 8744 participants were included in the review. The pooled magnitude of willingness to pay for Social Health Insurance in Ethiopia was 49.62% (95% CI: 36.41-62.82). Monthly salary (OR = 6.52; 95% CI:3.67,11.58), having the degree and above educational status (OR = 5.52; 95%CI:4.42,7.17), large family size(OR = 3.69; 95% CI:1.10,12.36), having the difficulty of paying the bill(OR = 3.24; 95%CI: 1.51, 6.96), good quality of services(OR = 4.20; 95%CI:1.97, 8.95), having favourable attitude (OR = 5.28; 95%CI:1.45, 19.18) and awareness of social health insurance scheme (OR = 3.09;95% CI:2.12,4.48) were statistically associated with willingness to pay for Social health insurance scheme., Conclusions: In this review, the magnitude of willingness to pay for Social Health insurance was low among public Civil servants in Ethiopia. Willingness to pay for Social Health Insurance was significantly associated with monthly salary, educational status, family size, the difficulty of paying medical bills, quality of healthcare services, awareness, and attitude towards the Social Health Insurance program. Hence, it's recommended to conduct awareness creation through on-the-job training about Social Health Insurance benefit packages and principles to improve the willingness to pay among public servants., Competing Interests: The authors have declared that no competing interests exist, (Copyright: © 2024 Kaso et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Sickness absences are a significant public health and economic problem worldwide. However, sickness absence diagnoses and trends have not been reported in much detail in Japan. This study was a retrospective cohort study. We examined data on certified diagnoses and the durations of sickness absence lasting over 90 days (long-term sickness absence) from 2009-2018 among city public servants in Japan. We found that 1) "Mental and behavioral disorders" (495.0-780.6 per 100,000 employees) was the most prevalent reason for long-term sickness absence, and "Mood disorders" (318.6-584.3 per 100,000 employees) was the most prevalent mental disorders diagnosis in each study year; 2) the prevalence of long-term sickness absence for mental disorders showed decreasing trends (781/100,000 in 2009 to 622/100,000 in 2018; [p=0.005, for the trend test]); 3) the trends differed by gender (p<0.05) and age (p<0.001); and 4) the duration of long-term sickness absence related to mental disorders (13.2 ± 9.0 months) was longer than long-term sickness absence resulting from all physical disorders except for diseases of the circulatory system (15.1 ± 11.6 months). Increased focus on significant depressive and neurotic disorders is needed when promoting mental health in the workplace.

The use of dietary supplements is prevalent among many groups worldwide. However, few studies have examined their use among government employees. The aim of this cross-sectional study was to determine the association among sociodemographic characteristics, body weight status, and energy intake with dietary supplement use among government employees in Putrajaya, Malaysia. Simple random sampling was used to select a sample of 460 government employees from six ministries in Putrajaya, Malaysia. The data used in this study were collected through anthropometric measurements (height, weight, % body fat, waist and hip circumferences), a self-administered questionnaire (sociodemographic characteristics and dietary supplements use), and an interviewer-administered questionnaire (24-hour dietary recall; fruit and vegetable intake). The results indicated that the prevalence of dietary supplement use was 55.4%, with vitamin C (38.4%) being the most popular type of dietary supplement. Health issues (80.8%) were the most common reason for usage, internet (59.2%) was the main source of information, and pharmacies (71.8%) were the most indicated places to purchase dietary supplements. A multivariate analysis showed that participants who were female, married, had better monthly income, lived within a smaller household size, had a normal body mass index, classified as having unhealthily high body fat percentage, did not skip breakfast, and consumed at least five servings of fruits and vegetables per day were significantly more likely to use dietary supplements. In conclusion, health-conscious groups were more prone to consume dietary supplements, and due to the high prevalence of dietary supplement use, dissemination of accurate scientific information regarding dietary supplements is highly recommended among government employees.

This study proposes a model in which organizational identification mediates the correlations among state-owned enterprises (SOEs), authentic leadership, Christian religiousness, and unethical pro-organizational behavior (UPB). The proposed theoretical framework is based on moral identity theory, social identity theory, and social exchange theory. We tested the hypothesized model using data (N  =  389) from employees of various companies and industries in Poland. Of the respondents, 49.1% worked in SOEs. The reliability and validity of the measures were established. The correlation coefficients among the analyzed variables were obtained using the bootstrap confidence interval method. To thoroughly examine the causal relationships among the variables, covariance-based structural equation modeling (CB-SEM) was adopted. Path analysis was conducted and used to verify a model in which organizational identification mediated the correlations among state involvement in the ownership of an enterprise, authentic leadership, Christian religiousness, and UPB. State involvement in the ownership of an enterprise, authentic leadership, and Christian religiousness were linked to increased organizational identification, which in turn was linked to the intensification of UPB. With the level of organizational identification controlled, state ownership of an enterprise was linked to lower UPB intensity. Limitations, implications and future research directions are discussed., Competing Interests: The authors have declared that no competing interests exist.

Objective: To investigate sociodemographic factors associated with the willingness to take the pandemic influenza vaccine., Methods: This is a cross-sectional study of Brazilian civil servants participating in the fourth wave (2012-2013) of the longitudinal Pró-Saúde Study. Associations were expressed as odds ratios (OR) and 95% confidence intervals (95%CI), estimated by multivariate logistic regression models., Results: Among 2,828 participants, 15.9% would not be willing to vaccinate in the future if the Brazilian Ministry of Health promoted a new vaccination campaign against pandemic influenza. Not willing to vaccinate in the future was strongly associated with not taking the pandemic influenza vaccine in 2010 (OR = 9.0, 95%CI 6.9 - 11.6). Among the unvaccinated, females, those aged > 60 years, and non-health care workers were less willing to vaccinate in the future. Again, in the vaccinated group, females were less willing to vaccinate., Conclusion: Multidisciplinary efforts should be encouraged in order to identify reasons for refusing vaccination, focusing on the individual and group perceptions of susceptibility, severity, benefits, and barriers to vaccination. Such information is needed to identify target groups for the delivery of customized interventions towards preventing emerging pandemics, such as avian influenza and COVID-19.

Drawing on over 4,000,000 individual and 2,000 agency observations across five countries, this paper examines the relationship between features of an employee's work environment and intrinsic motivation in public agencies. It finds that practices which foster employees' sense of autonomy, competence, and relatedness are associated with substantially higher levels of intrinsic motivation across a broad range of settings. This is true both at the individual and agency level and when examining changes within agency over time. These patterns appear to be at least partially a result of differential selection in and out of the agency, with lower levels of supportive practices associated with greater desire to exit for employees with higher levels of intrinsic motivation. Nonfinancial elements of job design are strongly associated with intrinsic motivation, as are potentially more difficult to alter features of an agency, such as satisfaction with compensation and managerial quality. There is also suggestive evidence that the relationship between agency practices and employee intrinsic motivation is stronger when tasks are more difficult to monitor., Competing Interests: The author declares no competing interest.

Background: Social health insurance is one of the possible organizational mechanisms for raising and pooling funds to finance health services, private health insurance, community insurance, and others., Objective: The study was aimed to assess willingness to pay for social health insurance and associated factors among government employees in Mujja town, Ethiopia., Methods: An institutional-based cross-sectional study was conducted on the total sample size of 375 study respondents. A simple random sampling technique was employed. Data were entered into EPI info 7 and analyzed by Statistical Package for Social Sciences version 22.0. Multivariable logistic regression was used to identify independent predictors by controlling confounding variables. Statistical significance was declared at p < 0.05., Results: This study revealed that 37.6% (95% CI: 33.1%, 42.61%) respondents were willing to pay for social health insurance. In the final model, respondents who ever heard about health insurance schemes were seven times (AOR = 7.205; 95% CI: 1.385, 37.475) more likely willing to pay for social health insurance. Thos who had history of difficulty and having other source to cover medical bills were 92.6% (AOR = 0.074; 95% CI: 0.009, 0.612) and 94.6% (AOR = 0.054; 95% CI: 0.011, 0.257) less likely to pay, respectively., Conclusions: Willingness to pay for social health insurance was low. Being heard about health insurance, history of difficulty, and having other sources to cover medical bills were associated factors. Thus, it is recommended that media promotion and these factors should be considered for the successful implementation of the scheme., Competing Interests: The authors declare that there are no conflicts of interest., (Copyright © 2021 Feleku Mekonnen Degie et al.)

The Japanese government has made efforts towards the advancement of women into society; thereby, the proportion of female managers has been increasing. Recent reports have shown that managers tend to be in poor health condition. However, little research has been conducted to examine the psychological health of female managers. Therefore, the aim of our study was to reveal the difference of psychological distress by occupational position in female workers with focus on occupational stress. A cross-sectional survey was conducted in 2017 via an anonymous, self-administered questionnaire distributed to workers in Tsukuba City, Japan. Student unpaired t test was used to compare occupational stress and psychological distress by occupational position. Binomial logistic regressions were used to analyze factors that affect psychological distress separately in managers and non-managers. A total of 1543 women (168 managers, 1375 non-managers) were analyzed. Managers showed higher occupational stress but lower psychological distress than non-managers. Problems in interpersonal relationships was positively associated with psychological distress, whereas occupation as a researcher/academic was negatively associated with psychological distress in managers. Mental workload and problems in interpersonal relationships were positively associated with psychological distress, whereas reward from work and support were negatively associated with psychological distress in non-managers. Managers and non-managers both showed an association between psychological distress and problems of interpersonal relationships. Non-managers might have higher psychological distress due to lower reward from work. It is important to increase reward from work and to develop female workers' interpersonal skills in order to reduce the psychological distress of female workers., Competing Interests: Nagisa Shiraki, Tomohiko Ikeda, Yu Ikeda, Tsukasa Takahashi, Shotaro Doki, Daisuke Hori, Yuichi Oi, Shin-ichiro Sasahara and Ichiyo Matsuzaki are volunteer members of the working group for the survey conducted by Tsukuba Science City Network. Shotaro Doki, Daisuke Hori, Yuichi Oi, Shin-ichiro Sasahara and Ichiyo Matsuzaki are volunteer members of the Occupational Health Committee of Tsukuba Science City Network. The authors declare no financial relationships.

This retrospective study aimed to describe the federal employee population who participated in Federal Occupational Health's (FOH) smoking cessation intervention and to examine relationships and factors that influenced smoking cessation within this population. A large-scale national database of federal employees who participated in the smoking cessation intervention from January 2009 to January 2019 was obtained from FOH's administrators. The sample included 1265 participants who completed the survey 6 months post intervention. Descriptive statistics, chi square (c2), Pearson's correlation, and logistic regression were used to describe and correlate variables. Out of 1243 smokers, 590 (47.5%) successfully quit smoking while 653 (52.5%) did not quit smoking post intervention. Employees smoked, on average, for 23 years and smoked 18 cigarettes (more than ½ pack) per day before quitting. There was a positive correlation between the number of cigarettes smoked and number of years smoked before quitting. As the number of cigarettes and length of time smoking increased, the odds of quitting increased. FOH's cessation intervention helped participants quit smoking. FOH is positioned to integrate cessation strategies with its health promotion and protection programs to help end tobacco-related illnesses and diseases. The investigators' findings provide important evidence and support for FOH's work-site smoking cessation intervention. FOH could collaborate with other federal entities and provide evidence-based smoking cessation interventions with limited or no barriers., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright© by the National Black Nurses Association, Inc.)

High level of work-family conflict (WFC) is an important risk factor for stress-related health outcomes. However, many studies are cross-sectional studies. In this study, we aimed to clarify how changes in WFC levels over a period 5 yr can affect workers' mental and physical health, and to clarify whether there are gender differences of them. This study examined 1,808 civil servants (1,258 men and 550 women) aged 20-65 yr working in a local government in the west coast of Japan from 2003 to 2008. Logistic regression analyses were used to examine whether the change in WFC contributes to workers' health problems and whether there are gender differences. This study revealed association sustained high WFC and deterioration of WFC conflict with poor mental health and poor job satisfaction for both men and women. In men high WFC conflict and deterioration was associated with poor mental health (OR=2.74). On the other hand, women had strong relationship between WFC changes and poor physical health (OR=2.64). WFC was an important factor as a social determinant of health of Japanese civil servants, and the change in WFC affects subsequent health problems with different trends in men and women.

Honesty is one of the most valued traits in politicians. Yet, because lies often remain undiscovered, it is difficult to study if some politicians are more honest than others. This paper examines which individual characteristics are correlated with truth-telling in a controlled setting in a large sample of politicians. We designed and embedded a game that incentivizes lying with a nonmonetary method in a survey answered by 816 Spanish mayors. Mayors were first asked how interested they were in obtaining a detailed report about the survey results, and at the end of the survey, they had to flip a coin to find out whether they would be sent the report. Because the probability of heads is known, we can estimate the proportion of mayors who lied to obtain the report. We find that a large and statistically significant proportion of mayors lied. Mayors that are members of the two major political parties lied significantly more. We further find that women and men were equally likely to lie. Finally, we find a negative relationship between truth-telling and reelection in the next municipal elections, which suggests that dishonesty might help politicians survive in office., Competing Interests: The authors declare no competing interest.

Background: Employee engagement, exemplified by positive perceptions of supervisors, workplace, and job, improves productivity and employee retention. We identified the extent of and barriers to employee engagement at Centers for Disease Control and Prevention's (CDC) National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP). Methods: In 2015, NCHHSTP's leadership collected baseline data through a centerwide Employee Engagement Pulse Survey (EEPS) from NCHHSTP's full-time Civil Service employees, U.S. Public Health Service Commissioned Corps officers, and Title 42 service fellows. EEPS included six demographic questions; nine Likert-type scale questions measuring 26 perceptions related to immediate supervisors, the work environment, and job satisfaction; and four open-ended questions soliciting recommendations for improvement. Findings: Among 727 of 1,171 staff (response rate = 62%), positive perceptions of supervisors ranged from a high of 94% (supervisor conducts performance reviews) to a low of 63% (supervisor assists employees with career development). Perceptions of work experience ranged from 98% (respondents were willing to put in extra effort to get a job done) to 68% (respondents' talents were used well in the workplace). Perceptions of job satisfaction ranged from 87% (support from their coworkers) to 69% (satisfaction with opportunities to learn or grow professionally). Conclusion/Application to Practice: Overall, NCHHSTP staff have positive perceptions of their work, their leaders, and the agency. Other public- and private-sector employers might be able to improve their employees' engagement and retention by listening to their opinions and needs and frequently recognizing their individual achievements. NCHHSTP's workforce development initiatives can be used as a model for assessing a baseline of their employees' engagement.

Purpose: Workplace bullying can be very stressful and it has detrimental effects on health and well-being which makes it an important area of study. Social support has traditionally been seen as important in moderating work-related stress. It was hypothesised that the negative association between exposure to bullying behaviours, and health and well-being is moderated by (a) perceived support from close co-workers and (b) perceived supportive leadership. In the study, we also investigated a three-way interaction between exposure to bullying behaviours, perceived support from close co-workers and perceived supportive leadership. This association has not been studied before and add new knowledge to the research field., Methods: We used a moderated moderation analysis of workplace bullying, co-worker support and supervisor support using cross-sectional data from a work environment survey with 1383 respondents (75% response rate)., Results: The moderated moderation analysis confirmed the moderating effect of perceived co-worker support but not the moderating effect of perceived supervisor support. There was a three-way interaction, but not in the case of the lowest 12.6% of perceived supervisor support scores., Conclusions: These results indicate that the negative effect of workplace bullying on health and well-being is weaker if victims perceive that they have co-worker support, but this protective effect seems to be conditional on the perceived level of supervisor support. In other words, lack of supportive leadership may block the beneficial effect of perceived co-worker support.

Gathering of uncultivated food from green spaces, also known as foraging, is observed in urban areas across the world, but the literature focuses predominantly on the global north. Our study examines the existing urban land management structure and its approach to urban foraging in the eastern coastal region of South Africa. Through interviews with municipal officials in nine cities, we identified different stakeholders and their roles in urban green space management. We then used network analysis to represent interactions and influence of these stakeholders, and environmental worldviews to determine organisational and perceptual barriers to and enablers of foraging in urban green spaces. The policy on urban green space management, as well as land managers themselves are amenable to the concept of foraging in public spaces. Lack of knowledge on wild indigenous species and sustainable offtake, ambiguous, coarse, or lacking policy, and normative views of pristine nature may hinder foraging. We recommend pathways for policy and stakeholder partnerships to incorporate sustainable foraging in their biodiversity conservation and land stewardship strategies., Competing Interests: The authors have declared that no competing interests exist.

Background: School wellness legislation has potential to impact the health of children and alter the obesity crisis in the United Sates. Little is known about how state lawmakers perceive child wellness legislation effectiveness relative to obesity prevention. Our purpose was to understand state lawmakers' perceptions of childhood obesity and school wellness policies relative to the Social Ecological Model (SEM)., Methods: Twenty-one state representatives and nine state senators from one US state completed in-depth interviews. Member checks and peer debriefing occurred throughout data collection and analysis. Transcripts were coded and triangulated. A conventional content analysis generated consistent themes., Results: Five main themes developed: (1) child overweight and obesity is problematic; (2) current legislation is ineffective; (3) funding and enforcing child wellness legislation is difficult; (4) it is difficult to legislate personal behavior; and (5) efforts from other levels of the SEM are more effective at promoting wellness., Conclusions: Lawmakers understand negative impacts of child obesity, but perceive immediate legislative issues like budgetary concerns inhibit robust policy-oriented action. Participants believe parents, guardians, and individuals should ultimately be responsible for child wellness. Community, school, and family efforts to address childhood obesity and support wellness may be more effective in achieving positive outcomes than state and federal policy., (© 2020, American School Health Association.)

A nationally representative sample (N = 1050) responded to a survey testing possible connections between Americans' attention to media about President Donald J. Trump's preference for fast food, their perceptions of Trump, and public perceptions and behavioral intentions regarding fast food consumption. This survey utilized measures aimed at integrating theory about audience responses to celebrity health issues with the Theory of Planned Behavior and found a significant positive relationship between attention to media about Trump's diet and perceptions that fast food is socially acceptable, as well as intentions to consume it. Some, but not all, media-related variables in the analyses were positively associated with fast food perceptions and intentions, even after controlling for demographic and psychosocial factors. Attention to media specifically about Trump's dietary habits was more often associated with fast food-related perceptions and outcomes than were other types of media attention. Additionally, having a positive parasocial relationship with Trump was positively associated with increased perceived acceptability of fast food. There were also differences in the connections between attention to media about Trump's diet, parasocial relationships with Trump, and fast food perceptions and consumption intentions for audiences with different political affiliations. For instance, attention to media about Trump in general was positively associated with more positive attitudes toward fast food for Republicans, but not for Democrats are those unaffiliated with either political party. Attention to media specifically about Trump's diet was positively related to fast food attitudes for both Republicans and Democrats but not unaffiliated individuals. This study demonstrates the important role of social, political, and media influences in shaping fast food related perceptions and preferences and offers many potential avenues for future research in this area., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Objective: To explore the association between the psychosocial work environment and the risk of sick leave among governmental employees with symptom-defined post-traumatic stress disorder (PTSD) after a workplace bomb attack., Design: A prospective study on employees who met the symptom criteria for PTSD. Questionnaire data on the psychosocial work environment 10 months after the terrorist attack was linked to registry data on doctor-certified sick leave in the period 12-22 months after the attack., Setting: The bombing of the government ministries in Oslo, Norway, 22 July 2011., Participants: The study sample consists of 94 Norwegian governmental employees, all with symptom-defined PTSD from the Norwegian version of the PTSD checklist (Post-traumatic Stress Disorder Checklist-Specific) measured 10 months after the attack., Results: After adjustment for sex and severity of PTSD symptoms, predictability at work reduced the odds of sick leave (adjusted OR=0.62, 95% CI 0.40 to 0.98). Sense of control over decisions at work was associated with fewer absence days for employees with sick leave (adjusted rate ratio=0.61, 95% CI 0.38 to 0.98)., Conclusions: Employees with PTSD after workplace terrorism would benefit from control over their workplace conditions and increased predictability to reduce the risk of sick leave. The findings suggest that the work environment can facilitate employees' work ability after stressful events, independent of severity of PTSD symptoms., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Improved capabilities in microfluidics, electrochemistry, and portable assays have resulted in the development of a wide range of point-of-use sensors intended for environmental, medical, and agricultural applications in resource-limited environments of developing countries. However, these devices are frequently developed without direct interaction with their often-remote intended user base, creating the potential for a disconnect between users' actual needs and those perceived by sensor developers. As different analytical techniques have inherent strengths and limitations, effective measurement solution development requires determination of desired sensor attributes early in the development process. In this work, we present our findings on design priorities for point-of-use microbial water sensors based on fieldwork in rural India, as well as a guide to fieldwork methodologies for determining desired sensor attributes. We utilized group design workshops for initial identification of design priorities, and then conducted choice-based conjoint analysis interviews for quantification of user preferences among these priorities. We found the highest user preference for integrated reporting of contaminant concentration and recommended actions, as well as significant preferences for mostly reusable sensor architectures, same-day results, and combined ingredients. These findings serve as a framework for future microbial sensor development and a guide for fieldwork-based understanding of user needs., Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: The authors have submitted a utility patent application for potential sensor designs based on the results of this study: Bono MS, Beasley SB, Hanhauser EB, Vaishnav C, Hart AJ, Karnik RN. Systems, Devices, and Methods for Point-of-Use Testing for Fluid Contamination; Filed Oct. 18, 2017. U.S. PCT Patent Application No. PCT/US2017/057265. At the time of article submission, none of the sensor designs described in this patent application have been commercialized, nor are there current agreements in place to commercialize them. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Objectives: Retirement could be a stressor or a relief. We stratify according to previous psychosocial working conditions to identify short-term and long-term changes in mental health., Method: Using data from the Whitehall II study on British civil servants who retired during follow-up (n = 4,751), we observe mental health (General Health Questionnaire [GHQ] score) on average 8.2 times per participant, spanning up 37 years. We differentiate short-term (0-3 years) and long-term (4+ years) changes in mental health according to retirement and investigate whether trajectories differ by psychosocial job demands, work social support, decision authority, and skill discretion., Results: Each year, mental health slightly improved before retirement (-0.070; 95% CI [-0.080, -0.059]; higher values on the GHQ score are indicative of worse mental health), and retirees experienced a steep short-term improvement in mental health after retirement (-0.253; 95% CI [-0.302, -0.205]), but no further significant long-term changes (0.017; 95% CI [-0.001, 0.035]). Changes in mental health were more explicit when retiring from poorer working conditions; this is higher psychosocial job demands, lower decision authority, or lower work social support., Discussion: Retirement was generally beneficial for health. The association between retirement and mental health was dependent on the context individuals retire from., (© The Author(s) 2019. Published by Oxford University Press on behalf of The Gerontological Society of America.)

Governments' attempts to manage immigration increasingly restrict immigrants' eligibility to healthcare, education, and welfare benefits. This article examines the operation of these restrictions in the United Kingdom. It draws on qualitative research with civil servants and NGO expert advisors, and applies sociological theories on bureaucracy as a lens to interpret these data. Conceptually, the paper employs a generative synthesis of Ritzer's notion of "irrational rationality" and Foucault's perspective on "governmentality" to explain observed outcomes. Findings show that public service workers struggle with complex and opaque regulations, which grant different entitlements to different categories of migrants. The confusion results in mistakes, arbitrary decisions, and hypercorrection, but also a system-wide indifference to irrational outcomes, supported by human factors in contexts of austerity. I consider this a form of governmentality-effected neglect, where power operates as much through inaction as well as through intention, but which results in exclusions of legal migrants that are harsher in practice than in law., (© 2019 London School of Economics and Political Science.)

Limited progress in nutrition policy action is often blamed on the close relationships the food industry has with health policy decision-makers. This analysis sought to examine this belief through the analysis of health ministers' diaries. Entries were downloaded from health ministers' diaries from two states in Australia from January 2013 to June 2018. Entries were coded according to which interest group met with the minister or whether general parliamentary business was undertaken. Coding was also undertaken for any meeting topics related to nutrition policy. Analysis of health ministers' diaries found that the food industry has limited documented interaction with the two state health ministers in Australia. Instead, medical associations, private hospitals and health services, and sporting associations (rugby league associations) had the most interactions with health ministers. Poor representation was seen on nutrition issues, and there was an apparent lack of nutrition advocates interacting with the health ministers. There are opportunities for nutrition advocates to increase their level of interaction with state health ministers. This could include building alliances with medical associations, as they are in a powerful position, to advocate directly to health ministers. Health ministers' diaries can provide valuable insights into who is meeting officially with ministers. However, there are also limitations with the dataset.

Background: With increasing demand for red meat in Tanzania comes heightened potential for zoonotic infections in animals and humans that disproportionately affect poor communities. A range of frontline government employees work to protect public health, providing services for people engaged in animal-based livelihoods (livestock owners and butchers), and enforcing meat safety and food premises standards. In contrast to literature which emphasises the inadequacy of extension support and food safety policy implementation in low- and middle-income countries, this paper foregrounds the 'street-level diplomacy' deployed by frontline actors operating in challenging contexts., Methods: This research is based on semi-structured interviews with 61 government employees, including livestock extension officers/meat inspectors and health officers, across 10 randomly-selected rural and urban wards., Results: Frontline actors combined formal and informal strategies including the leveraging of formal policy texts and relationships with other state employees, remaining flexible and recognising that poverty constrained people's ability to comply with health regulations. They emphasised the need to work with livestock keepers and butchers to build their knowledge to self-regulate and to work collaboratively to ensure meat safety. Remaining adaptive and being hesitant to act punitively unless absolutely necessary cultivated trust and positive relations, making those engaged in animal-based livelihoods more open to learning from and cooperating with extension officers and inspectors. This may result in higher levels of meat safety than might be the case if frontline actors stringently enforced regulations., Conclusion: The current tendency to view frontline actors' partial enforcement of meat safety regulations as a failure obscures the creative and proactive ways in which they seek to ensure meat safety in a context of limited resources. Their application of 'street-level diplomacy' enables them to be sensitive to local socio-economic realities, to respect local social norms and expectations and to build support for health safety interventions when necessary. More explicitly acknowledging the role of trust and positive state-society relations and the diplomatic skills deployed by frontline actors as a formal part of their inspection duties offers new perspectives and enhanced understandings on the complicated nature of their work and what might be done to support them.

The attitudes of the general public and lawmakers toward suicide can influence the degree to which suicide prevention is prioritized in public policymaking. In this study, we compared the attitudes of urban residents, lawmakers, and community mental health workers toward suicide. Urban residents (N = 501) were surveyed through a telephone interview, while self-reported questionnaire was administered by lawmakers (N = 156) and community mental health workers (N = 121) through office visit and post, respectively. We used the Suicide Opinion Questionnaire to measure attitudes toward suicide in all three samples. Both the general public and legislators had insufficient knowledge and more permissive and uncaring attitudes toward suicide, whereas community mental health workers were more inclined to have sufficient knowledge of suicide and more intolerant and caring attitudes towards suicide. Therefore, lawmakers and the general public require education on suicide and suicide prevention, which may help lower South Korea's high suicide rate ranking among the Organization for Economic Co-operation and Development member states., (Copyright © 2019. Published by Elsevier B.V.)

Background: The relationship between positivity, i.e., the proportion of positive and negative emotions, and job burnout may be of a curvilinear shape. From a theoretical point of view, it is a causal relationship, since positivity can be regarded as a proximal dimension of occupational well-being, and burnout as a distal one. However, previous studies have been mostly cross-sectional and have tested only linear relationships between these variables. Therefore, the aim of the study is to examine the shape of the relationship between positivity and burnout using both cross-sectional and longitudinal designs, on the example of civil servants., Material and Methods: The study involved 238 civil servants (73.5% of whom were women). Positivity was assessed with the Job-related Affective Well-being Scale . Exhaustion and disengagement, 2 components of job burnout, were measured twice, at a 4-month interval, using the Oldenburg Burnout Inventory ., Results: The cross-sectional models assuming the curvilinear relationship between positivity and job burnout were better fitted to the data than models with the linear relationship only. Thus, positivity was curvilinearly related to both exhaustion and disengagement, with an inflection point around 2. In the longitudinal models, for exhaustion the curvilinear model was again better fitted to the data, while for disengagement it was the linear model., Conclusions: The relationship between positivity and exhaustion was curvilinear among the civil servants. This may indicate personal costs of maintaining a high ratio of positive to negative emotions at work. Nevertheless, the role of positivity for disengagement seems more complex, with a possible long-term protective function. Med Pr. 2019;70(2):201-11., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

Objective: This study examined the associations between changes in common mental disorders (CMD) and subsequent diagnosis-specific sickness absence (SA) among midlife and ageing municipal employees., Methods: Data from the Helsinki Health Study phase I (2000-2002) and phase II (2007) surveys among employees of the City of Helsinki, Finland, were linked with prospective register data from the Social Insurance Institution of Finland on diagnosis-specific (mental, musculoskeletal, other causes) SA (n=3890). Associations between change in CMD (General Health Questionnaire 12) from phase I to phase II and the first SA event in 2007-2014 were analysed using Cox regression modelling. Sociodemographic, work and health-related covariates from phase I, and SA from the year preceding phase I were controlled for., Results: Having CMD at one or two time points, that is, favourable and unfavourable change in CMD and repeated CMD, were all associated with a higher risk of SA due to mental, musculoskeletal and other diagnoses compared with women and men with no CMD. Favourable change in CMD reduced the risk of SA when compared with repeated CMD. The strongest associations were observed for repeated CMD (HR range: 1.44 to 5.05), and for SA due to mental diagnoses (HR range: 1.15 to 5.05). The associations remained after adjusting for the covariates., Conclusions: Changing and repeated CMD increased the risk of SA due to mental, musculoskeletal and other diagnoses. CMD should be tackled to prevent SA and promote work-ability among ageing employees., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing in China; however, awareness and knowledge of NAFLD is lacking among the Chinese public., Aims: We investigated knowledge about NAFLD and the impact of a brief educational seminar among office employees in Beijing., Methods: Educational seminar on knowledge about NAFLD and recommendations on diet and physical activity and a pre- and a post-survey in 8 offices in Beijing., Results: A total of 420 participants (24.7% with a diagnosis of NAFLD) completed both the pre- and post-surveys. Median age was 42, 39.1% were men, 93.9% participants had some college education, 50.5% were overweight/obese, and 74.9% were inactive/minimally active. Only 31.2% had awareness of NAFLD. Median baseline knowledge score (of a total of 25) was 17 in participants with and 16 in those without a diagnosis of NAFLD. After the seminar, 30.9% of participants with and 50.8% without a diagnosis of NAFLD increased their knowledge score by ≥ 3 points, and 92.9% indicated they will improve their diet and physical activity. Multivariate logistic regression analyses found baseline knowledge score was associated with personal diagnosis of NAFLD and family history of dyslipidemia while improvement in knowledge was associated with lower baseline knowledge score and absence of a personal diagnosis of NAFLD., Conclusion: We found a high prevalence but a low awareness of NAFLD among office employees in Beijing. A brief educational seminar improved knowledge about NAFLD and motivated lifestyle changes. More educational efforts are needed to decrease the burden of NAFLD in China.

What produces the power of senior civil servants at ministries of finance, positioned at the top of the bureaucratic hierarchy? Max Weber has claimed that a hierarchical organization, meritocratic recruitment and procedural work provide bureaucracies with legitimacy. In particular he insisted on the role of Fachwissen (disciplinary knowledge) obtained through formal education. However, he also argued for the role of Dienstwissen, forms of knowledge and skills stemming from the experience of service in itself. Weber did not elaborate on this concept in detail, and few analysts of governmental expertise have examined this notion. We draw on the practice-turn in sociology, combining the study of governmental expertise with micro-sociological studies of administrative practices. By analysing interviews with 48 senior civil servants at the British, French and Norwegian ministries of finance about their daily practices, this article demonstrates that bureaucratic note-writing and the procedural evaluation of such notes constitute a key form of expertise that yields authority. The study provides an analytical framework for understanding what administrative expertise consists of, how it is integral to procedural work, the forms bureaucratic hierarchies take in practice and how these three dimensions provide authority., (© London School of Economics and Political Science 2018.)

Objective: To examine the prevalence and context of racism self-reported by older Aboriginal and Torres Strait Islander people., Methods: The 2015 National Aboriginal and Torres Strait Islander Survey was used to measure the prevalence, contexts and demographic differences in reports of racism. Multivariable logistic regression was used to examine the association of age with racism in later life., Results: A sizeable minority of older Aboriginal people reported experiences of unfair treatment (31%) and avoidance (15%), oftentimes occurring in contexts critical to human capital investments. Specific demographic groups, including those with higher levels of education, were more likely to report experiences of unfair treatment. The prevalence of unfair treatment and avoidance remains relatively high in later life (albeit lower than younger ages), with a significant reduction from age 65., Conclusion: Addressing racism, particularly in contexts crucial to human capital, is important for the health and well-being of older Aboriginal people., (© 2019 AJA Inc.)

The aim of this study is to identify the influence of social dimensions of the work environment and the employees' felt responsibility on the transfer of safety training. We tested a model in which responses and reactions from safety players such as coworkers, supervisors, and safety professionals are positively related to the transfer of training (TT), through the mediating effect of the employees' felt responsibility and the moderating influence of supervisor support and sanctions. A two-time data collection was implemented among blue-collar employees, all low qualified, from four city councils who attended a fundamental safety training program delivered by in-house safety trainers, all safety professionals ( n = 203). Data analysis revealed that (a) supervisors' safety responses, coworkers' safety responses, and safety professionals' reactions positively influenced the TT, an effect (b) mediated by employees' felt responsibility and (c) moderated by supervisor sanctions, but not by supervisor support. The results suggest that high sanctions enhance the positive effect of high self-responsibility on TT, and, importantly, aggravate the negative effect of low self-responsibility on TT. This is the first study to empirically test both the influence of felt responsibility and the safety professionals' reactions in the transfer process. Research should continue to examine the former construct's influence on the transfer process including, for example, its effect on supervisor support, and the latter as a safety-related social dimension variable of the work environment. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Objective: To examine the associations between work-stress and physical activity (PA) with sleep quality while controlling for covariates, including social support., Methods: A cross-sectional study among employees of a municipality (n = 2765). Data from respondents (n = 1973) with good/poor sleep quality were included. Prevalence ratios (PR) were estimated using modified Poisson regression analyses., Results: A significant interaction was observed between job-strain and self-reported health in the explanation of sleep quality. Consequently, interaction (job strain × self-rated health) adjusted PRs were calculated. The PRs for high job strain were 1.986 (95% CI 1.58 to 2.49) and 1.220 (95% CI 1.04 to 1.44) compared with the reference groups., Conclusions: Findings show that high job strain and low PA levels are associated with poor sleep quality, and that self-rated health plays an important moderating role in the association between job strain and sleep quality.

Enrollment navigators and government-employed Medicaid workers were an important element in the Affordable Care Act's (ACA) initial enrollment success. The Centers for Medicare and Medicaid Services eliminated 41% of funding for 2017 navigator programs and 90% of funding for outreach, arguing less investment was needed. Given that many remain uninsured, it is critical to identify effective enrollment practices. This study characterizes barriers and enrollment strategies from the perspective of California's Medicaid government and community-based enrollment workers (n=101 in eight focus groups). Participants identified a need for communication with policymakers, the state exchange, and each other regarding changing enrollment processes. Solutions include increased contact between enrollment workers to share strategies and policy updates regarding application processing, uniform policy interpretation, and details of ACA-related immigration law. Given efforts to weaken the ACA, it is critical to engage frontline workers in problem solving to streamline enrollment strategies, particularly for vulnerable populations.

Forced migration has spread and grown across continents in recent decades. This has had an impact at various levels such as societal communication, health and education priorities, as well as political agendas and economic stability. As a result of the combined forces of migration, globalisation, advances in communication technology and education, there is an exceptional research interest in individuals seeking refugee status or asylum. The literature is sporadic on forced migrants' communication and social adaptation. The perception of residents and professionals who encounter the challenges faced by these individuals on a regular basis needs to be evaluated, as well as the perception of the migrants themselves. This paper presents the current state of affairs and reviews the relevant literature with the intention of providing a more coordinated overview of forced migrants' and relevant stakeholders' views. A case scenario is presented that discusses the communication challenges faced by forced migrants. Strategic recommendations are also discussed., (© 2019 S. Karger AG, Basel.)

While inferences of traits from unfamiliar faces prominently reveal stereotypes, some facial inferences also correlate with real-world outcomes. We investigated whether facial inferences are associated with an important real-world outcome closely linked to the face bearer's behavior: political corruption. In four preregistered studies ( N = 325), participants made trait judgments of unfamiliar government officials on the basis of their photos. Relative to peers with clean records, federal and state officials convicted of political corruption (Study 1) and local officials who violated campaign finance laws (Study 2) were perceived as more corruptible, dishonest, selfish, and aggressive but similarly competent, ambitious, and masculine (Study 3). Mediation analyses and experiments in which the photos were digitally manipulated showed that participants' judgments of how corruptible an official looked were causally influenced by the face width of the stimuli (Study 4). The findings shed new light on the complex causal mechanisms linking facial appearances with social behavior.

Despite its widespread recognition as a successful model of participatory forest management, the community forestry program in Nepal is often criticized for its protection-oriented emphasis. Recognizing the need for more active timber management, the government of Nepal recently adopted a scientific forest management (SFM) policy in the lowland tropical region. In this study, strength, weakness, opportunity, and threat analytical hierarchical process criteria were employed to understand stakeholder perceptions concerning SFM implementation in Nepal. The overall perception was prioritized in the order of strengths (35%), threats (28%), opportunities (22%), and weaknesses (16%). The study results suggest that there is agreement among stakeholders regarding the need for active management of forests in the tropical lowland region. However, the perceptions of academic researchers and non-government organization professionals differed from those of the other stakeholders in that those two groups were more concerned about potential corruption and uncertainties surrounding policy and legal issues. The findings suggest that the long-term success of SFM may depend on the ability of the government to develop a mechanism that is transparent and capable of ensuring equitable benefit sharing among stakeholders. While the stakeholder perception analysis performed in this study was focused on SFM implementation in Nepal, the results could have implications for other countries that practice the participatory model of forest governance as well., Competing Interests: The authors have declared that no competing interests exist.

Occupational health nurses motivate employees to engage in healthy behaviors. Both clinicians and researchers need strong theories on which to base decisions for health programs (e.g., healthy diet) and experimental interventions (e.g., workplace walking). The self-determination theory could be useful as it includes concepts of individual autonomy, competence to perform healthy behaviors, and relationships as predictors of health behaviors and outcomes. In this article, the self-determination theory is described and evaluated using Walker and Avant's criteria. The theory is applied to a population of federal employees who smoke. By increasing employees' ability to autonomously choose smoking cessation programs, support their competence to stop smoking, and improve their relationships with both others who smoke and employee health services, smoking cessation should increase.

Objective: To analyze the understanding of municipal managers of health about public policies destined to the elderly population and the way they are effected in the city., Method: Qualitative study, developed with 14 municipal managers of health. Data were collected through a semi-structured interview and analyzed according the precepts of content analysis., Results: The results show the lack of knowledge of the municipal health managers, related to public policies of attention to the elderly. Also, the attention given to the elderly in the studied municipalities focuses on measures to control health problems., Conclusion: The municipalities do not have specific health care policies for the elderly population. Thus, these results can support reflections about care for the elderly in health services, their relationship with legislation, and the applicability of public health policies.

A microscale built environment was the focus in this cross-sectional study which aimed to investigate the associations between platescapes, foodscapes, and meal energy intake among subjects. A total of 133 subjects (54 male, 79 female) with mean age 36.8 ± 7.3 years completed a self-administered questionnaire on sociodemographic characteristics, platescapes, and foodscape preferences. For platescapes, a plate mapping method was used, where subjects were required to place various sizes of food models on two different sized plates (23 cm and 28 cm) based on their preferences. For foodscape preferences, subjects were given a 23-cm plate and various food models differentiated by shapes and colours. Then, 24-h daily recalls (for one weekday and one weekend day) were obtained using interviews. Significant differences were observed in meal energy intake ( p < 0.05) between males (1741 ± 339 kcal) and females (1625 ± 247 kcal) and also between age groups ( p < 0.05). There was a significant difference ( p < 0.0001) in terms of subjects&rsquo; meal energy intake when comparing 23-cm plates (419 ± 124 kcal) and 28-cm plates (561 ± 143 kcal). The bigger plate (28 cm) ( p < 0.01) was significantly associated with subjects&rsquo; meal energy intakes, but this was not so for the 23-cm plate. There were significant differences in subjects&rsquo; meal energy when comparing white rice and multicoloured rice ( p < 0.0001), unicoloured and multicoloured proteins ( p < 0.0001), and unicoloured and multicoloured vegetables ( p < 0.0001). There was a significant difference found between round- and cube-shaped proteins ( p < 0.05). The colours of rice ( p < 0.01), protein ( p < 0.05), and vegetables ( p < 0.05) were significantly associated with subjects&rsquo; meal energy. Only the shape of carrots in vegetables ( p = 0.01) was significantly associated with subjects&rsquo; meal energy. Subconsciously, platescapes and foodscapes affect an individual&rsquo;s energy intake, and thus these elements should be considered in assessing one&rsquo;s dietary consumption.