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Arble, E. & Arnetz, B. (2017). A Model of First-responder Coping: An Approach/Avoidance Bifurcation. Stress and Health, 33(3), 223-232
Open this publication in new window or tab >>A Model of First-responder Coping: An Approach/Avoidance Bifurcation
2017 (English)In: Stress and Health, ISSN 1532-3005, E-ISSN 1532-2998, Vol. 33, no 3, p. 223-232Article in journal (Refereed) Published
Abstract [en]

The work of first responders is fraught with numerous stressors, ranging from potentially traumatic critical incidents to institutional strains. The severity and pervasiveness of these difficulties prompt a necessary consideration of the coping methods employed by first responders. The present study developed an empirical model of first-responder coping strategies, based upon a nationally representative survey sample of 6240 first responders. Participants were drawn from Swedish first responders in the following occupations: coast guard, customs control, military, emergency medical services, fire department and police services. In the final model, exposure to stress related to well-being through several indirect paths that in sum accounted for the original direct relationship between these constructs. These several indirect paths were classified theoretically as either approach or avoidance coping behaviours or subsequent health outcomes. In general, approach coping behaviours were related to better well-being; and avoidance was related to a decrease in the outcome. The size of the present sample, as well as the diverse nature of the included first responders, suggests that the resulting model may offer a unique insight into potentially adaptive pathways for first-responder coping.

Place, publisher, year, edition, pages
WILEY, 2017
Keyword
first responder, coping strategies, job stress, health promotion
National Category
Psychology
Identifiers
urn:nbn:se:uu:diva-333702 (URN)10.1002/smi.2692 (DOI)000407283500005 ()27500991 (PubMedID)
Available from: 2017-11-16 Created: 2017-11-16 Last updated: 2017-11-16Bibliographically approved
Arnetz, B. B., Lewalski, P., Arnetz, J., Breejen, K. & Przyklenk, K. (2017). Examining self-reported and biological stress and near misses among Emergency Medicine residents: a single-centre cross-sectional assessment in the USA. BMJ Open, 7(8), Article ID e016479.
Open this publication in new window or tab >>Examining self-reported and biological stress and near misses among Emergency Medicine residents: a single-centre cross-sectional assessment in the USA
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2017 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 7, no 8, article id e016479Article in journal (Refereed) Published
Abstract [en]

Objectives To examine the relationship between perceived and biological stress and near misses among Emergency Medicine residents. Design Self-rated stress and stress biomarkers were assessed in residents in Emergency Medicine before and after a day shift. The supervising physicians and residents reported numbers of near misses. Setting The study took place in the Emergency Department of a large trauma 1 centre, located in Detroit, USA. Participants Residents in Emergency Medicine volunteered to participate. The sample consisted of 32 residents, with complete data on 28 subjects. Residents' supervising physicians assessed the clinical performance of each resident. Primary and secondary outcome measures Participants' preshift and postshift stress, biological stress (salivary cortisol, plasma interleukin-6, tumour necrosis factor-alpha (TNF-alpha) and high-sensitivity C-reactive protein), residents' and supervisors' reports of near misses, number of critically ill and patients with trauma seen during the shift. Results Residents' self-reported stress increased from an average preshift level of 2.79 of 10 (SD 1.81) to a postshift level of 5.82 (2.13) (p<0.001). Residents cared for an average of 2.32 (1.52) critically ill patients and 0.68 (1.06) patients with trauma. Residents reported a total of 7 near misses, compared with 11 reported by the supervising physicians. After controlling for baseline work-related exhaustion, residents that cared for more patients with trauma and had higher levels of TNF-a reported a higher frequency of near misses (R-2=0.72; p=0.001). Residents' preshift ratings of how stressful they expected the shift to be were related to the supervising physicians' ratings of residents' near misses during the shift. Conclusion Residents' own ratings of near misses were associated with residents' TNF-alpha, a biomarker of systemic inflammation and the number of patients with trauma seen during the shift. In contrast, supervisor reports on residents' near misses were related only to the residents' preshift expectations of how stressful the shift would be.

National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:uu:diva-340106 (URN)10.1136/bmjopen-2017-016479 (DOI)000411802700163 ()
Available from: 2018-01-31 Created: 2018-01-31 Last updated: 2018-04-05Bibliographically approved
Wright, A. M., Aldhalimi, A., Lumley, M. A., Jamil, H., Pole, N., Arnetz, J. E. & Arnetz, B. B. (2016). Determinants of resource needs and utilization among refugees over time. Social Psychiatry and Psychiatric Epidemiology, 51(4), 539-549
Open this publication in new window or tab >>Determinants of resource needs and utilization among refugees over time
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2016 (English)In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 51, no 4, p. 539-549Article in journal (Refereed) Published
Abstract [en]

This study examined refugees' resource needs and utilization over time, investigated the relationships between pre-displacement/socio-demographic variables and resource needs and utilization, and explored the role of resource needs and utilization on psychiatric symptom trajectories. Iraqi refugees to the United States (N = 298) were assessed upon arrival and at 1-year intervals for 2 years for socio-demographic variables and pre-displacement trauma experiences, their need for and utilization of 14 different resources, and PTSD and depressive symptoms. Although refugees reported reduction of some needs over time (e.g., need for cash assistance declined from 99 to 71 %), other needs remained high (e.g., 99 % of refugees reported a need for health care at the 2-year interview). Generally, the lowest needs were reported after 2 years, and the highest utilization occurred during the first year post-arrival. Pre-displacement trauma exposure predicted high health care needs but not high health care utilization. Both high need for and use of health care predicted increasing PTSD and depressive symptoms. Specifically, increased use of psychological care across the three measurement waves predicted more PTSD and depression symptoms at the 2-year interview. Differences emerged between need for and actual use of resources, especially for highly trauma-exposed refugees. Resettlement agencies and assistance programs should consider the complex relationships between resource needs, resource utilization, and mental health during the early resettlement period.

Keyword
Refugees, Resource need, Resource utilization, PTSD, Depression
National Category
Psychiatry
Identifiers
urn:nbn:se:uu:diva-295561 (URN)10.1007/s00127-015-1121-3 (DOI)000373707600008 ()26370213 (PubMedID)
Available from: 2016-06-08 Created: 2016-06-08 Last updated: 2017-11-30Bibliographically approved
Ramji, R., Arnetz, J., Nilsson, M., Jamil, H., Norstrom, F., Maziak, W., . . . Arnetz, B. (2015). Determinants of waterpipe use amongst adolescents in Northern Sweden: a survey of use pattern, risk perception, and environmental factors. BMC Research Notes, 8, Article ID 441.
Open this publication in new window or tab >>Determinants of waterpipe use amongst adolescents in Northern Sweden: a survey of use pattern, risk perception, and environmental factors
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2015 (English)In: BMC Research Notes, ISSN 1756-0500, E-ISSN 1756-0500, Vol. 8, article id 441Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Determinants of waterpipe use in adolescents are believed to differ from those for other tobacco products, but there is a lack of studies of possible social, cultural, or psychological aspects of waterpipe use in this population. This study applied a socioecological model to explore waterpipe use, and its relationship to other tobacco use in Swedish adolescents.

METHODS: A total of 106 adolescents who attended an urban high-school in northern Sweden responded to an anonymous questionnaire. Prevalence rates for waterpipe use were examined in relation to socio-demographics, peer pressure, sensation seeking behavior, harm perception, environmental factors, and depression.

RESULTS: Thirty-three percent reported ever having smoked waterpipe (ever use), with 30 % having done so during the last 30 days (current use). Among waterpipe ever users, 60 % had ever smoked cigarettes in comparison to 32 % of non-waterpipe smokers (95 % confidence interval 1.4-7.9). The odds of having ever smoked waterpipe were three times higher among male high school seniors as well as students with lower grades. Waterpipe ever users had three times higher odds of having higher levels of sensation-seeking (95 % confidence interval 1.2-9.5) and scored high on the depression scales (95 % confidence interval 1.6-6.8) than non-users. The odds of waterpipe ever use were four times higher for those who perceived waterpipe products to have pleasant smell compared to cigarettes (95 % confidence interval 1.7-9.8). Waterpipe ever users were twice as likely to have seen waterpipe use on television compared to non-users (95 % confidence interval 1.1-5.7). The odds of having friends who smoked regularly was eight times higher for waterpipe ever users than non-users (95 % confidence interval 2.1-31.2).

CONCLUSION: The current study reports a high use of waterpipe in a select group of students in northern Sweden. The study adds the importance of looking at socioecological determinants of use, including peer pressure and exposure to media marketing, as well as mental health among users.

National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-262891 (URN)10.1186/s13104-015-1413-4 (DOI)1756-0500 (Electronic) 1756-0500 (Linking) (ISBN)
Funder
Swedish National Institute of Public Health, 1059/2014-6.2
Available from: 2015-09-22 Created: 2015-09-22 Last updated: 2017-12-05Bibliographically approved
Elsouhag, D., Arnetz, B., Jamil, H., Lumley, M. A., Broadbridge, C. L. & Arnetz, J. (2015). Factors Associated with Healthcare Utilization Among Arab Immigrants and Iraqi Refugees. Journal of Immigrant and Minority Health, 17(5), 1305-1312
Open this publication in new window or tab >>Factors Associated with Healthcare Utilization Among Arab Immigrants and Iraqi Refugees
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2015 (English)In: Journal of Immigrant and Minority Health, ISSN 1557-1912, E-ISSN 1557-1920, Vol. 17, no 5, p. 1305-1312Article in journal (Refereed) Published
Abstract [en]

Arab migrants-both immigrants and refugees-are exposed to pre- and post- migration stressors increasing their risk for health problems. Little is known, however, about rates of, or factors associated with, healthcare utilization among these two groups. A sample of 590 participants were interviewed approximately 1 year post-migration to the United States. Factors associated with healthcare utilization, including active and passive coping strategies, were examined using logistic regressions. Compared to national healthcare utilization data, immigrants had significantly lower, and refugees had significantly higher rates of healthcare utilization. Being a refugee, being married, and having health insurance were significantly associated with medical service utilization. Among refugees, less use of psychological services was associated with the use of medications and having problem-focused (active) strategies for dealing with stress. Healthcare utilization was significantly higher among refugees, who also reported a greater need for services than did immigrants.

Keyword
Immigrants, Refugees, Healthcare, Stress
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-264034 (URN)10.1007/s10903-014-0119-3 (DOI)000360911300003 ()25331684 (PubMedID)
Available from: 2015-10-06 Created: 2015-10-05 Last updated: 2017-12-01Bibliographically approved
Jen, K.-L. -., Zhou, K., Arnetz, B. & Jamil, H. (2015). Pre- and Post-displacement Stressors and Body Weight Development in Iraqi Refugees in Michigan. Journal of Immigrant and Minority Health, 17(5), 1468-1475
Open this publication in new window or tab >>Pre- and Post-displacement Stressors and Body Weight Development in Iraqi Refugees in Michigan
2015 (English)In: Journal of Immigrant and Minority Health, ISSN 1557-1912, E-ISSN 1557-1920, Vol. 17, no 5, p. 1468-1475Article in journal (Refereed) Published
Abstract [en]

Refugees have typically experienced stress and trauma before entering the US. Stressors and mental health disorders may contribute to obesity. The aim of this study was to investigate changes in the body mass index (BMI) in Iraqi refugees settled in Michigan in relationship to pre- and post-migration stressors and mental health. Anthropometric and demographic data were collected from 290 Iraqi refugees immediately after they arrived in Michigan and one year after settlement. Significant increases were observed in BMI (+0.46 +/- A 0.09 kg/m(2), p < 0.0001) and the percentage of refugees suffering from hypertension (from 9.6 to 13.1 %, p < 0.05). Significant increases in stress, depression and acculturation, as well as decreases in post-migration trauma and social support, were also observed. Linear regression analyses failed to link stressors, well-being, and mental health to changes in BMI. It is likely that acculturation to a new lifestyle, including dietary patterns and physical activity levels, may have contributed to these changes.

Keyword
Iraqi refugees, Body mass index, Lifestyle, Acculturation, Nutrition, Mental health
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-264035 (URN)10.1007/s10903-014-0127-3 (DOI)000360911300022 ()25376128 (PubMedID)
Available from: 2015-10-06 Created: 2015-10-05 Last updated: 2017-12-01Bibliographically approved
Arnetz, B. B., Broadbridge, C. L. & Ghosh, S. (2014). Longitudinal determinants of energy levels in knowledge workers. Journal of Occupational and Environmental Medicine, 56(1), 79-85
Open this publication in new window or tab >>Longitudinal determinants of energy levels in knowledge workers
2014 (English)In: Journal of Occupational and Environmental Medicine, ISSN 1076-2752, E-ISSN 1536-5948, Vol. 56, no 1, p. 79-85Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Increasingly, workers in the service, welfare, and health care sectors suffer adverse effects (ie, depression, burnout, etc) of "low-energy syndromes." Less is known about energy-based outcomes among knowledge workers. This study aimed to identify determinants of self-rated energy in knowledge workers and examine how these determinants change over time.

METHODS: In collaboration with a large union and employer federation, 317 knowledge workers in Sweden responded to the health and productivity survey three times.

RESULTS: At each assessment, worry, satisfaction with eating habits, and work-effectiveness were predictive of energy levels; however, only work-effectiveness covaried with energy over time.

CONCLUSIONS: This study suggests that perceived work-effectiveness is an important factor in preventing knowledge workers from experiencing "low-energy syndromes." Lifestyle factors also play a role. Therefore, multifaceted interventions for increasing energy are needed.

National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-221575 (URN)10.1097/JOM.0000000000000029 (DOI)000336246200011 ()24351892 (PubMedID)
Available from: 2014-04-02 Created: 2014-04-02 Last updated: 2017-12-05Bibliographically approved
Jamil, H. J., Kariaparambil Rajan, A., Grzybowski, M., Fakhouri, M. & Arnetz, B. (2014). Obesity and overweight in ethnic minorities of the detroit metropolitan area of michigan.. Journal of community health, 39(2), 301-9
Open this publication in new window or tab >>Obesity and overweight in ethnic minorities of the detroit metropolitan area of michigan.
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2014 (English)In: Journal of community health, ISSN 0094-5145, E-ISSN 1573-3610, Vol. 39, no 2, p. 301-9Article in journal (Refereed) Published
Abstract [en]

Race, ethnicity and socioeconomic factors influence the prevalence of obesity and overweight, which are major public health problems. Our objectives were (1) to calculate the prevalence of self-reported obesity and overweight in whites, blacks, Chaldeans, and Arabs in the Detroit metropolitan area; and (2) to examine the odds for self-reported overweight and obesity in the racial and ethnic minorities when compared to whites. The responses to a self-administered survey conducted among the adult residents (n = 2,883) of the Detroit metropolitan area of Michigan were analyzed. Prevalence of overweight and obesity were 47.4 and 34.6 % respectively for the whole sample, while it was 39.9 and 43.6 % for whites, 42.3 and 47.8 % for blacks, 46.2 and 30.3 % for Chaldeans, and 52.2 and 28.5 % for Arabs. The odds for obesity was significantly lower in Arabs [odds ratio (OR) 0.31; 95 % confidence interval (CI) 0.13-0.72] and Chaldeans (OR 0.14; 95 % CI 0.06-0.33) when compared to whites. Chaldeans (OR 0.36; 95 % CI 0.15-0.86) had significantly decreased likelihood for being overweight compared to whites. Odds for obesity and overweight can vary in the different ethnic minorities within whites. Sharing similar living conditions decreases the differences in the odds for overweight and obesity between whites and blacks. Taking into consideration the racial and ethnic differences of the target population may help in developing better programs for fighting overweight and obesity.

National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-221576 (URN)10.1007/s10900-013-9760-3 (DOI)000332484600012 ()23990337 (PubMedID)
Available from: 2014-04-02 Created: 2014-04-02 Last updated: 2017-12-05Bibliographically approved
Jamil, H., Geeso, S. G., Arnetz, B. B. & Arnetz, J. E. (2014). Risk Factors for Hookah Smoking Among Arabs and Chaldeans. Journal of Immigrant and Minority Health, 16(3), 501-507
Open this publication in new window or tab >>Risk Factors for Hookah Smoking Among Arabs and Chaldeans
2014 (English)In: Journal of Immigrant and Minority Health, ISSN 1557-1912, E-ISSN 1557-1920, Vol. 16, no 3, p. 501-507Article in journal (Refereed) Published
Abstract [en]

Hookah smoking is more prevalent among individuals of Middle Eastern descent. This study examined general and ethnic-specific risk factors for hookah smoking among Arabs and Chaldeans. A self-administered anonymous questionnaire was conducted among 801 adults residing in Southeast Michigan. Binary logistic regression modeling was used to predict risk factors for hookah smoking. Hookah smoking was significantly more prevalent among Arabs (32 %) than Chaldeans (26 %, p < 0.01) and being Arab was a risk factor for lifetime hookah use. Younger age (<25 years), being male, higher annual income, and having health insurance were significant risk factors for hookah use. Chaldeans believed to a greater extent than Arabs that smoking hookah is less harmful than cigarette smoking (75 vs. 52 %, p < 0.001). Hookah smoking is prevalent in both ethnic groups, but significantly higher among Arabs. Results indicate that prevention efforts should target younger males with higher incomes.

National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-221574 (URN)10.1007/s10903-013-9772-1 (DOI)000335771700022 ()23579963 (PubMedID)
Available from: 2014-04-02 Created: 2014-04-02 Last updated: 2017-12-05Bibliographically approved
Arnetz, B. B., Broadbridge, C. L., Jamil, H., Lumley, M. A., Pole, N., Barkho, E., . . . Arnetz, J. E. (2014). Specific Trauma Subtypes Improve the Predictive Validity of the Harvard Trauma Questionnaire in Iraqi Refugees. Journal of Immigrant and Minority Health, 16(6), 1055-1061
Open this publication in new window or tab >>Specific Trauma Subtypes Improve the Predictive Validity of the Harvard Trauma Questionnaire in Iraqi Refugees
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2014 (English)In: Journal of Immigrant and Minority Health, ISSN 1557-1912, E-ISSN 1557-1920, Vol. 16, no 6, p. 1055-1061Article in journal (Refereed) Published
Abstract [en]

Trauma exposure contributes to poor mental health among refugees, and exposure often is measured using a cumulative index of items from the Harvard Trauma Questionnaire (HTQ). Few studies, however, have asked whether trauma subtypes derived from the HTQ could be superior to this cumulative index in predicting mental health outcomes. A community sample of recently arrived Iraqi refugees (N = 298) completed the HTQ and measures of posttraumatic stress disorder (PTSD) and depression symptoms. Principal components analysis of HTQ items revealed a 5-component subtype model of trauma that accounted for more item variance than a 1-component solution. These trauma subtypes also accounted for more variance in PTSD and depression symptoms (12 and 10 %, respectively) than did the cumulative trauma index (7 and 3 %, respectively). Trauma subtypes provided more information than cumulative trauma in the prediction of negative mental health outcomes. Therefore, use of these subtypes may enhance the utility of the HTQ when assessing at-risk populations.

National Category
Medical and Health Sciences Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-221572 (URN)10.1007/s10903-014-9995-9 (DOI)000344549800004 ()24549491 (PubMedID)
Available from: 2014-04-02 Created: 2014-04-02 Last updated: 2017-12-05Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0001-7173-4333

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