How Education Shapes Women's Work and Family Lives Across Race and Ethnicity.

Drawing on life course and intersectional approaches, this study examines how education shapes the intertwined domains of work and family across race and ethnicity. By applying multichannel sequence analysis and cluster analysis to the National Longitudinal Survey of Youth 1979, we identify a typology of life course trajectories of work and family and test for the interactive associations of race and ethnicity with college education for different trajectory types. While our results show statistically significant and often sizable education effects across racial and ethnic groups for most of the work‒family clusters, they also suggest that the size and direction of the education effect vary widely across groups. Educational attainment plays an outsize role in shaping Black women's work‒family lives, increasing their access to steady work and partnerships, while educational attainment primarily works to increase White women's participation in part-time work. In contrast, Latina women's work‒family trajectories are less responsive to their educational attainment. In combination, the racialized role of education and persistent racial and ethnic gaps across the education distribution yield unequal patterns in work‒family strategies among Black, Latina, and White women.

Work-life interference and health by race/ethnicity and sex in the United States.

Work-life interference has detrimental impacts on health outcomes. However, there are potential differences in these associations at the intersection of race/ethnicity and sex. The aim of this study was to examine whether race/ethnicity moderates the associations of work-life interference with health outcomes among women and men. Using data from the 2015 National Health Interview Survey on adults (age ≥ 18 years) who self-identified as non-Hispanic Asian, non-Hispanic Black, Hispanic, or non-Hispanic White in the U.S. (n = 17,492), the associations of work-life interference with self-rated health, psychological distress, and body mass index (BMI) were assessed using multiplicative interaction terms. Work-life interference was associated with higher log-odds of worse self-rated health (log-odds = 0.17, standard error (s.e.) = 0.06) and more psychological distress (ß = 1.32, s.e. = 0.13) in men. Work-life interference was similarly positively associated with worse self-rated health (log-odds = 0.27, s.e. = 0.06) and psychological distress (ß = 1.39, s.e. = 0.16) among women as well. A stronger association between work-life interference and psychological distress was observed among non-Hispanic Asian women compared to non-Hispanic White women (ß = 1.42, s.e. = 0.52) and a stronger association between work-life interference and BMI was observed among non-Hispanic Black women compared to non-Hispanic White women (ß = 3.97, s.e. = 1.93). The results suggest detrimental impacts of work-life interference on self-rated health and psychological distress. Yet, the variation in the associations of work-life interference with psychological distress and BMI among women suggest that an intersectional lens should be applied. Efforts to understand and address the negative effects of work-life interference on health should consider potentially unique associations across race/ethnicity and sex.

Experiences of Work-Family Conflict and Mental Health Symptoms by Gender Among Physician Parents During the COVID-19 Pandemic.

Importance: The COVID-19 pandemic has placed increased strain on health care workers and disrupted childcare and schooling arrangements in unprecedented ways. As substantial gender inequalities existed in medicine before the pandemic, physician mothers may be at particular risk for adverse professional and psychological consequences. Objective: To assess gender differences in work-family factors and mental health among physician parents during the COVID-19 pandemic. Design, Setting, and Participants: This prospective cohort study included 276 US physicians enrolled in the Intern Health Study since their first year of residency training. Physicians who had participated in the primary study as interns during the 2007 to 2008 and 2008 to 2009 academic years and opted into a secondary longitudinal follow-up study were invited to complete an online survey in August 2018 and August 2020. Exposures: Work-family experience included 3 single-item questions and the Work and Family Conflict Scale, and mental health symptoms included the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 scale. Main Outcomes and Measures: The primary outcomes were work-to-family and family-to-work conflict and depressive symptoms and anxiety symptoms during August 2020. Depressive symptoms between 2018 (before the COVID-19 pandemic) and 2020 (during the COVID-19 pandemic) were compared by gender. Results: Among 215 physician parents who completed the August 2020 survey, 114 (53.0%) were female and the weighted mean (SD) age was 40.1 (3.57) years. Among physician parents, women were more likely to be responsible for childcare or schooling (24.6% [95% CI, 19.0%-30.2%] vs 0.8% [95% CI, 0.01%-2.1%]; P < .001) and household tasks (31.4% [95% CI, 25.4%-37.4%] vs 7.2% [95% CI, 3.5%-10.9%]; P < .001) during the pandemic compared with men. Women were also more likely than men to work primarily from home (40.9% [95% CI, 35.1%-46.8%] vs 22.0% [95% CI, 17.2%-26.8%]; P < .001) and reduce their work hours (19.4% [95% CI, 14.7%-24.1%] vs 9.4% [95% CI, 6.0%-12.8%]; P = .007). Women experienced greater work-to-family conflict (ß = 2.79; 95% CI, 1.00 to 4.59; P = .03), family-to-work conflict (ß = 3.09; 95% CI, 1.18-4.99; P = .02), and depressive (ß = 1.76; 95% CI, 0.56-2.95; P = .046) and anxiety (ß = 2.87; 95% CI, 1.49-4.26; P < .001) symptoms compared with men. We observed a difference between women and men in depressive symptoms during the COVID-19 pandemic (mean [SD] PHQ-9 score: 5.05 [6.64] vs 3.52 [5.75]; P = .009) that was not present before the pandemic (mean [SD] PHQ-9 score: 3.69 [5.26] vs 3.60 [6.30]; P = .86). Conclusions and Relevance: This study found significant gender disparities in work and family experiences and mental health symptoms among physician parents during the COVID-19 pandemic, which may translate to increased risk for suicide, medical errors, and lower quality of patient care for physician mothers. Institutional and public policy solutions are needed to mitigate the potential adverse consequences for women's careers and well-being.

Work-life balance: a comparison of women in cardiology and other specialties.

OBJECTIVE: Significant gender disparities exist in some medical specialties, particularly cardiology. We assessed work, personal life and work-life balance in women in cardiology in Australia and New Zealand (NZ), compared with other specialties, to determine factors that may contribute to the lack of women in the specialty. METHODS: This study is a prospective survey-based cohort study comparing cardiology and non-cardiology specialties. An online survey was completed by female doctors in Australia and NZ, recruited via email lists and relevant social media groups. The survey included demographics, specialty, stage of training, work hours/setting, children and relationships, career satisfaction, income and perceptions of specialty. RESULTS: 452 participants completed the survey (median age 36 years), of which 57 (13%) worked in cardiology. Of all respondents, 84% were partnered and 75% had children, with no difference between cardiology and non-cardiology specialties. Compared with non-cardiology specialties, women in cardiology worked more hours per week (median 50 hours vs 40 hours, p<0.001), were more likely to be on call more than once per week (33% vs 12%, p<0.001) and were more likely to earn an annual income >$3 00 000 (35% vs 10%, p<0.001). Women in cardiology were less likely to agree that they led a balanced life (33% vs 51%, p=0.03) or that their specialty was female friendly (19% vs 75%, p<0.001) or family friendly (20% vs 63%, p<0.001). CONCLUSIONS: Compared with other specialties, women in cardiology reported poorer work-life balance, greater hours worked and on-call commitments and were less likely to perceive their specialty as female friendly or family friendly. Addressing work-life balance may attract and retain more women in cardiology.

Academic Medicine Faculty Perceptions of Work-Life Balance Before and Since the COVID-19 Pandemic.

Importance: How the COVID-19 pandemic has affected academic medicine faculty's work-life balance is unknown. Objective: To assess the association of perceived work-life conflict with academic medicine faculty intention to leave, reducing employment to part time, or declining leadership opportunities before and since the COVID-19 pandemic. Design, Settings, and Participants: An anonymous online survey of medical, graduate, and health professions school faculty was conducted at a single large, urban academic medical center between September 1 and September 25, 2020. Main Outcomes and Measures: Self-assessed intention to leave, reducing employment to part time, or turning down leadership opportunities because of work-life conflict before and since the COVID-19 pandemic. Results: Of the 1186 of 3088 (38%) of faculty members who answered the survey, 649 (55%) were women and 682 (58%) were White individuals. Respondents were representative of the overall faculty demographic characteristics except for an overrepresentation of female faculty respondents and underrepresentation of Asian faculty respondents compared with all faculty (female faculty: 649 [55%] vs 1368 [44%]; Asian faculty: 259 [22%] vs 963 [31%]). After the start of the COVID-19 pandemic, faculty were more likely to consider leaving or reducing employment to part time compared with before the pandemic (leaving: 225 [23%] vs 133 [14%]; P < .001; reduce hours: 281 [29%] vs 206 [22%]; P < .001). Women were more likely than men to reduce employment to part time before the COVID-19 pandemic (153 [28%] vs 44 [12%]; P < .001) and to consider both leaving or reducing employment to part time since the COVID-19 pandemic (leaving: 154 [28%] vs 56 [15%]; P < .001; reduce employment: 215 [40%] vs 49 [13%]; P < .001). Faculty with children were more likely to consider leaving and reducing employment since the COVID-19 pandemic compared with before the pandemic (leaving: 159 [29%] vs 93 [17%]; P < .001; reduce employment: 213 [40%] vs 130 [24%]; P < .001). Women with children compared with women without children were also more likely to consider leaving since the COVID-19 pandemic than before (113 [35%] vs 39 [17%]; P < .001). Working parent faculty and women were more likely to decline leadership opportunities both before (faculty with children vs without children: 297 [32%] vs 84 [9%]; P < .001; women vs men: 206 [29%] vs 47 [13%]; P < .001) and since the COVID-19 pandemic (faculty with children vs faculty without children: 316 [34%] vs 93 [10 %]; P < .001; women vs men: 148 [28%] vs 51 [14%]; P < .001). Conclusions and Relevance: In this survey study, the perceived stressors associated with work-life integration were higher in women than men, were highest in women with children, and have been exacerbated by the COVID-19 pandemic. The association of both gender and parenting with increased perceived work-life stress may disproportionately decrease the long-term retention and promotion of junior and midcareer women faculty.

Clinician Burnout Associated With Sex, Clinician Type, Work Culture, and Use of Electronic Health Records.

Importance: Electronic health records (EHRs) are considered a potentially significant contributor to clinician burnout. Objective: To describe the association of EHR usage, sex, and work culture with burnout for 3 types of clinicians at an academic medical institution. Design, Setting, and Participants: This cross-sectional study of 1310 clinicians at a large tertiary care academic medical center analyzed EHR usage metrics for the month of April 2019 with results from a well-being survey from May 2019. Participants included attending physicians, advanced practice providers (APPs), and house staff from various specialties. Data were analyzed between March 2020 and February 2021. Exposures: Clinician demographic characteristics, EHR metadata, and an institution-wide survey. Main Outcomes and Measures: Study metrics included clinician demographic data, burnout score, well-being measures, and EHR usage metadata. Results: Of the 1310 clinicians analyzed, 542 (41.4%) were men (mean [SD] age, 47.3 [11.6] years; 448 [82.7%] White clinicians, 52 [9.6%] Asian clinicians, and 21 [3.9%] Black clinicians) and 768 (58.6%) were women (mean [SD] age, 42.6 [10.3] years; 573 [74.6%] White clinicians, 105 [13.7%] Asian clinicians, and 50 [6.5%] Black clinicians). Women reported more burnout (survey score ≥50: women, 423 [52.0%] vs men, 258 [47.6%]; P = .008) overall. No significant differences in EHR usage were found by sex for multiple metrics of time in the EHR, metrics of volume of clinical encounters, or differences in products of clinical care. Multivariate analysis of burnout revealed that work culture domains were significantly associated with self-reported results for commitment (odds ratio [OR], 0.542; 95% CI, 0.427-0.688; P < .001) and work-life balance (OR, 0.643; 95% CI, 0.559-0.739; P < .001). Clinician sex significantly contributed to burnout, with women having a greater likelihood of burnout compared with men (OR, 1.33; 95% CI, 1.01-1.75; P = .04). An increased number of days spent using the EHR system was associated with less likelihood of burnout (OR, 0.966; 95% CI, 0.937-0.996; P = .03). Overall, EHR metrics accounted for 1.3% of model variance (P = .001) compared with work culture accounting for 17.6% of variance (P < .001). Conclusions and Relevance: In this cross-sectional study, sex-based differences in EHR usage and burnout were found in clinicians. These results also suggest that local work culture factors may contribute more to burnout than metrics of EHR usage.

Factors That Influence Millennial Generation Nurses' Intention to Stay: An Integrated Literature Review.

OBJECTIVE: To synthesize literature exploring the expectations of millennial nurses and factors that influence their retention. BACKGROUND: Long-anticipated nursing shortages are happening nationwide in part from boomer retirements. These supply issues are expected to worsen because of an aging population who will require complex healthcare going forward. Millennial nurse turnovers, however, represent the biggest threat to supply. METHODS: This extensive literature review was conducted following published guidelines. Thirteen publications regarding millennials' expectations of work were analyzed. RESULTS: Millennials expect strong leadership, advancement opportunities, alignment of organizational and personal values, good coworker relationships, healthy work-life balance, recognition, and cutting-edge technology. CONCLUSIONS: Millennials have specific expectations for work, and they will leave if these go unmet. Findings from this review provide valuable insight into this generation of nurses to help leaders create appropriate retention strategies. The limited literature on this topic highlights the need for more research.

Changes in work and life patterns associated with depressive symptoms during the COVID-19 pandemic: an observational study of health app (CALO mama) users.

BACKGROUND: During the COVID-19 pandemic, many people refrained from going out, started working from home (WFH), and suspended work or lost their jobs. This study examines how such pandemic-related changes in work and life patterns were associated with depressive symptoms. METHODS: An online survey among participants who use a health app called CALO mama was conducted from 30 April to 8 May 2020 in Japan. Participants consisted of 2846 users (1150 men (mean age=50.3) and 1696 women (mean age=43.0)) who were working prior to the government declaration of a state of emergency (7 April 2020). Their daily steps from 1 January to 13 May 2020 recorded by an accelerometer in their mobile devices were linked to their responses. Depressive symptoms were assessed using the Two-Question Screen. RESULTS: On average, participants took 1143.8 (95% CI -1557.3 to -730.2) fewer weekday steps during the declaration period (from 7 April to 13 May). Depressive symptoms were positively associated with female gender (OR=1.58, 95% CI 1.34 to 1.87), decreased weekday steps (OR=1.22, 95% CI 1.03 to 1.45) and increased working hours (OR=1.73, 95% CI 1.32 to 2.26). Conversely, starting WFH was negatively associated with depressive symptoms (OR=0.83, 95% CI 0.69 to 0.99). CONCLUSIONS: Decreased weekday steps during the declaration period were associated with increased odds of depressive symptoms, but WFH may mitigate the risk in the short term. Further studies on the longitudinal effects of WFH on health are needed.

What Factors Influence the Sleep of On-call Workers?

Objective: On-call work is becoming increasingly common in response to service demands. This study had two aims; 1) describe the demographic profile of on-call workers in Australia, and 2) establish the impacts of on-call work on workers' sleep. Methods: A cross-sectional study was conducted using an online questionnaire completed by Australian on-call workers (n = 228) from various professions. The questionnaire included items on i) demographic and work characteristics, ii) rumination about on-call factors, iii) sleep quantity and quality. Analyses were conducted using mixed effects ordinal regression and multivariable logistic regression. Results: Workers slept <7 hours per night when on-call (80%), and reported sleep was impacted on-call even when no-calls were received (56%). On-call workers rated interruptions to family/leisure time (70%), missing a call (69%), preplanning in case of a call (69%), and not able to make plans (67%) as the main factors they ruminated about. Female on-call workers were more likely to think about the likelihood of being called, report frequent thoughts about what they would need to do if called, and think about interruptions to family/leisure time as a result of a call. Younger workers were more likely to think about the likelihood of being called compared to older adults, however middle-aged workers were less likely to plan for a call compared to younger workers. Conclusions: This study is the first to describe Australia's on-call population, including factors that specifically impact sleep. Future studies should implement tailored education and support strategies to address the unique challenges facing on-call workers.

Women in Otolaryngology: Experiences of Being Female in the Specialty.

OBJECTIVES: A broad survey of women otolaryngologists on the current state of the field, including opportunities for advancement, support of family leave, and prevalence of harassment, has not been performed since 1998. An update on the experiences of female otolaryngologists is vital to continue to advance the specialty. STUDY DESIGN: Anonymous web-based survey. METHODS: Survey of members of the Women in Otolaryngology (WIO) section of the American Academy of Otolaryngology-Head and Neck Surgery (all members of the AAO-HNS that identify as female are automatically members of this section). Distributed via AAO-HNS. RESULTS: Five hundred thirty-five responses out of 2303 total WIO members (response rate of 23.2%). Respondents ranged in age from 25 to >65 years. Respondents reported that in the residency programs they attended, 29% of residents, 13% of faculty, and 7% of department leaders were women. Forty-four percent disagreed that their department leaders and 39% disagreed that their male co-residents were supportive of women starting families in training. Younger respondents were more likely to feel that their department leaders were supportive of female residents, maternity leave, etc. Harassment in the current work environment did not differ by age; 53% reported harassment-free, 31% subtle undertones, 8% noticeable tones, 2% significant harassment. Harassment in the workplace varied by region; the greatest level of harassment was in the Midwest. CONCLUSIONS: Women otolaryngologists continue to experience harassment in the workplace. It is encouraging that younger otolaryngologists feel more supported by their departments in both their careers and their personal lives. This survey highlights critical areas for continued growth within our specialty. LEVEL OF EVIDENCE: IV Laryngoscope, 131:E380-E387, 2021.

Managing Diabetes in the Workplace.

BACKGROUND: Although many adults with diabetes are productive members of the workforce, loss of work productivity has been associated with diabetes. The purpose of this study was to explore the interrelationship between work-related factors and current work ability in adults with type 1 diabetes (T1D) and type 2 diabetes (T2D). METHODS: This study used a convergent mixed-method design. We assessed the relationship between work-related factors and work ability using bivariate statistics and logistic regression. Work ability was measured using the Work Ability Index and Karasek's Job Content Questionnaire (JCQ) was employed to measure job demands. Qualitative interviews (n = 30) explored the relationship between diabetes and work. FINDINGS: The sample (n =101) was mostly female (65%) and White (74%). Most worked full-time (65%), had T2D (87%), an elevated glycated hemoglobin A1c ≥ 7% (56%), and were overweight (22%) or obese (68%). Only 33% of subjects self-reported their work ability as excellent. Four of the JCQ subscales (skill discretion, psychological demands, supervisor support, and coworker support), and work-life balance were significantly associated with work ability (all p < .05). In adjusted models, better coworker support (OR = 1.4; 95% CI = [1.04, 1.9]) and better work-life balance (OR = 1.3; 95% CI = [1.1, 1.5]) were associated with excellent work ability. Many stated their diabetes impacted them at work and spoke of the effects of stress. Few engaged in workplace wellness programs. CONCLUSION/APPLICATION TO PRACTICE: Social support and work-life balance were associated with excellent work ability. Engaging workers with diabetes in workplace educational programs may take strategic efforts by occupational health staff.

Gender Differences in Compensation, Mentorship, and Work-Life Balance within Facial Plastic Surgery.

OBJECTIVES: Our objective was to identify gender differences in work-life balance, professional advancement, workload, salary, and career satisfaction among facial plastic and reconstructive surgeons. STUDY DESIGN: Cross-Sectional Survey. METHODS: American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) members were invited by email to respond to a confidential 25-question online survey. The survey had a response rate of 12%. There were a total of 139 participants; 23 participants were in training and 116 were either board-eligible or board-certified facial plastic surgeons. Collected variables included general demographics, personal life, academic involvement, career development, workload, and career satisfaction. RESULTS: Forty percent of participants were female. Fifty-nine percent of female participants were 25-35 years old compared with 15% of male participants. The majority of male participants were over 45 years old (63%) while only 19% of female participants fell into this age category (P < .0001). Women were more likely to be in a relationship with a physician (35% vs. 19%) or non-physician full-time professional (55% vs. 31%). The vast majority of men had children (89%) while only half of women (52%) had children. On average, women with children had fewer children than men (P < .0001). No gender difference was seen with respect to working full versus part-time (P = .81). Participants were equally satisfied with a surgical career regardless of gender. CONCLUSION: Although significant progress has already been made towards closing the gender gap, gender disparities remain both professionally and personally for facial plastic surgeons. With an increasing number of women in medicine, we should continue to strive to close the gender gap. LEVEL OF EVIDENCE: 4 Laryngoscope, 131:E787-E791, 2021.

The Roles of Work-Life Conflict and Gender in the Relationship between Workplace Bullying and Personal Burnout. A Study on Italian School Principals.

The present study sought to investigate the associations between workplace bullying and personal burnout both directly and indirectly via work-life conflict. Furthermore, the moderating role of gender in these relations was examined. Traditional research on stress at work focuses on the role of dimensions related to job tasks, demands, and organizational support in influencing the risks for stress-related problems in employees. At the same time, other experiences at work may reduce employees' well-being, such as workplace bullying and family life. Specifically, considering the detrimental role of work-life conflict, it is possible to hypothesize that it would exacerbate workplace bullying's harmful effects on employees' health. Moreover, since previous studies have reported mixed or inconsistent results when considering gender differences with the above-mentioned dimensions, it seems worth investigating the role of employee gender in representing (and response to) the bullying experiences. Building on these considerations, this work verifies whether: (1) work-life conflict mediates the relationship between workplace bullying and burnout; (2) gender moderates all the possible relationships among the constructs. Such hypotheses are verified on a sample of school principals, in light of their peculiar job role. Overall, our findings showed that: (1) Workplace bullying and burnout are associated, both with and without the perception of a concurring work-life conflict; (2) Gender does not moderate all the possible relationships among workplace bullying, work-life conflict and burnout. Overall, being female heightens the risk to perceive work-life conflict in general, as well as to be burnt out, when bullied, with and without the presence of work-life conflict; being male heightens the risk to perceive work-life conflict when bullied. Furthermore, the current findings suggest that family demands may influence school principals' feelings of exhaustion regardless of gender. These findings confirm and expand previous literature, especially concerning a less studied occupation, namely school principals, shedding a new light on their work experiences. Furthermore, the present study offers interesting implications for trainings on principal's skills and professional identity.

Control and the Health Effects of Work-Family Conflict: A Longitudinal Test of Generalized Versus Specific Stress Buffering.

The stress associated with work-to-family conflict (WFC) and family-to-work conflict (FWC) is well documented. However, surprisingly little is known about the resources that moderate the effects of work-family conflict on health over time. Using four waves of panel data from the Canadian Work, Stress, and Health Study (2011-2017; n = 11,349 person-wave observations), we compare how a core psychosocial resource (personal mastery) and a salient organizationally based resource (schedule control) moderate the health effects of WFC and FWC. After establishing these health effects related to distress and physical symptoms, we discover that mastery has generalized stress-buffering functions whereby it alleviates the health effects of both WFC and FWC. In contrast, schedule control has asymmetrical moderating functions: It attenuates the health effects of WFC only. These findings elaborate and sharpen the scope of resources as moderators in the stress process model-and we integrate these ideas with other conceptual models like the job demands-resources model.

The mediation role of work-life balance stress and chronic fatigue in the relationship between workaholism and depression among Chinese male workers in Hong Kong.

BACKGROUND AND AIMS: Few studies have tested the underlying mechanisms in the association between workaholism and depression. This study aims to investigate the potential mediation effects of work-life balance stress and chronic fatigue and depression among Chinese male workers in Hong Kong. METHODS: A population-based study among male workers in Hong Kong (n = 1,352) was conducted. The self-reported scales of assessing workaholism, work-life balance stress, chronic fatigue and depressive symptoms were included in the questionnaire. Path analysis was conducted to test the proposed mediation model. RESULTS: Workaholism was directly and indirectly associated with depression through work-life balance stress and chronic fatigue, respectively. The association between work-life balance stress and chronic fatigue was statistically significant in the correlation analysis but not in the path analysis. As high as 30.5% of the participants were classified as having probable chronic fatigue, while 8.4% of the participants were classified as having probable depression. DISCUSSION: Workaholism is a stressor that may induce negative consequences on well-being and health among male workers in Hong Kong. Interventions to help workers with time and stress management and fatigue reduction may be beneficial for their mental health. Theoretical and practical implications are discussed.

Socioeconomic status, work-life conflict, and mental health.

BACKGROUND: Work-life conflict (WLC) has a critical effect on employee mental health. However, research on occupational health has neglected the family domain. Furthermore, although it is reasonable to assume that the effect of WLC on health may differ according to socioeconomic circumstances, there is little empirical evidence for differences in the impact of WLC by socioeconomic status (SES). The purpose of this study was to assess the role of SES as an effect modifier, while examining whether the SES level affects the relationship between WLC and mental health. METHOD: We analyzed data from the nationally representative South Korean Working Conditions Survey of 2014, including 49 401 workers. Logistic regression analyses, stratified by sexes, were performed to identify sex differences, and interaction terms including WLC and SES were also incorporated. RESULTS: WLC (men: OR = 1.24; women: OR = 1.18) and domestic demands (men: OR = 1.16; women: OR = 1.22) were significantly associated with mental health. WLC exhibited a stronger association with mental health for individuals with high SES, both in terms of education (men: OR = 1.61 vs 1.51; women: OR = 1.52 vs 1.24) and income (men: OR = 1.44 vs 1.10; women: OR = 1.48 vs 1.20). CONCLUSIONS: Our data suggest that future efforts for health promotion should consider workers' family demands and SES as important modifying factors of psychological health in the workplace.

The work and training situation for young physicians undergoing specialty training in gynecology and obstetrics in Germany: an assessment of the status quo.

PURPOSE: General conditions in the health-care system in Germany have changed dramatically in recent years. Factors affecting this include above all demographic change, rapid developments in diagnostic and therapeutic options, and the application of economic criteria to the health-care sector. This study aimed to establish the current status quo regarding conditions of work and training for young doctors in gynecology and obstetrics, analyze stress factors, and suggest potential improvements. METHODS: Between October 2015 and March 2016, a web-based survey was carried out among residents and members of the German Society for Gynecology and Obstetrics. The electronic questionnaire comprised 65 items on seven topics. Part of the survey included the short version of a validated model of professional gratification crises for analyzing psychosocial work-related stress. RESULTS: The analysis included a total of 391 complete datasets. Considerable negative findings in relation to psychosocial work pressure, time and organizational factors, quality of specialty training, and compatibility between work and family life and work and academic tasks were detected. A high level of psychosocial work pressure is associated with more frequent job changes, reduced working hours, poorer health among physicians, and a lower subjectively assessed quality of care. CONCLUSIONS: Greater efforts are needed from all the participants involved in patient care to achieve high-quality training and working conditions that allow physicians to work in a healthy and effective way. These aspects are all prerequisites for sustainably maximizing the resource "physician" and for ensuring high-quality patient care.

Occupational and Individual Determinants of Work-life Balance among Office Workers with Flexible Work Arrangements.

Flexible work arrangements permitting workers to work anytime and anywhere are increasingly common. This flexibility can introduce both challenges and opportunities for the organisation, as well as for worker work-life balance (WLB). This cross-sectional study aimed to examine the extent to which occupational factors (organizational, leadership and psychosocial) and individual work-related behaviours (over-commitment, overtime work and boundary management) are associated with WLB, and whether these associations are modified by the perceived level of flexibility at work (i.e., control over when, where, and how to do the work). In total, 2960 full-time office workers with flexible work arrangements at the Swedish Transport Administration participated. Associations were determined using linear regression analyses with adjustment for covariates. The strongest negative associations with WLB were found for over-commitment, quantitative job demands, expectations of availability, and overtime work. Strongest positive associations were found for boundary management, information about organizing work, social support, and relation-oriented leadership. Perceived flexibility was positively associated with WLB, and interacted with several of the examined factors, buffering their negative associations with WLB. Results suggest that WLB can be promoted by organizational initiatives focusing on minimizing excessive job demands, increasing psychosocial resources, supporting boundary management, and enhancing perceived flexibility.

Paid Sick Leave in Washington State: Evidence on Employee Outcomes, 2016-2018.

Objectives. To estimate if Washington State's paid sick leave law increased access to paid sick leave, reduced employees' working while sick, and relieved care burdens.Methods. I drew on new data from 12 772 service workers collected before and after the law took effect in January 2018 in Washington State and over the same time period in comparison states that did not have paid sick leave requirements. I used difference-in-difference models to estimate the effects of the law.Results. The law expanded workers' access to paid sick leave by 28 percentage points (P < .001). The law reduced the share of workers who reported working while sick by 8 percentage points (P < .05). Finally, there was little evidence that the law served to reduce work-life conflict for Washington workers.Conclusions. Mandated paid sick leave increased access to paid sick leave benefits and led to reductions in employees' working while sick. However, covered workers did not experience reductions in work-life conflict in the period immediately following passage.