Psychosocial Working Conditions Research Articles

Understanding Australia’s teacher shortage: the importance of psychosocial working conditions to turnover intentions

AbstractAustralian policymakers are currently attempting to address an ‘unprecedented teacher shortage’. Through a survey of 905 teachers in Australian government schools, this paper examines some of the key factors influencing the career intentions of teachers in Australian government schools. Drawing upon the concept of the psychosocial work environment from the field of occupational health, this analysis examines the relationship between key workplace demands, workplace resources, teachers’ experiences and attitudes towards work, teachers’ mental health outcomes, and their intentions to either remain in or leave their roles. The results reveal significant relationships between teachers’ intentions to leave their roles and challenging working conditions, adverse work experiences, as well as heightened levels of stress, burnout, and depressive symptoms. In contrast, remaining in their role was associated with factors indicative of a supportive psychosocial work environment, such as job recognition, trust in management, organisational justice, positive work experiences, and lower levels of mental health difficulties. The study underscores the urgent need to understand and assess the psychosocial work environments of teachers, and for multi-level strategies that address both protective and risk factors.

Psychosocial working conditions as determinants of slips and lapses, and poor social interactions with patients among medical assistants in Germany: A cohort study.

We sought to examine the relationship of unfavorable psychosocial working conditions with slips and lapses and poor patient interaction as well as potential intermediate factors among medical assistants (MAs) in Germany based on prospective data. We used data from 408 MAs from a 4-year cohort study (follow-up: 2021). At baseline, psychosocial working conditions were assessed by the established effort-reward-imbalance questionnaire and a MA-specific questionnaire with 7 subscales. Frequency of slips and lapses (e.g., pertaining to measurements and documentation) and the quality of patient interactions (e.g., unfriendliness or impatience) due to work stress were assessed at follow-up with three items each (potential score ranges = 3-15). Potential intermediate factors at baseline included work engagement (i.e., vitality and dedication (UWES)), work satisfaction (COPSOQ), anxiety (GAD-2), depressiveness (PHQ-2), and self-reported health. We ran multivariable linear regression using z-standardized exposures to estimate unstandardized coefficients (B) and 95% confidence intervals (CI). Potential intermediate factors were added separately to the regression models. Attenuation of the association between exposure and outcome toward the null value (B = 0) was interpreted as mediation. High reward and lack of resources were weakly associated with the frequency of slips and lapses (the Bs were -0.18 and 0.23, respectively; p<0.05), with little evidence of mediation. With the exception of low recognition, all unfavorable psychosocial working conditions predicted a higher frequency of poor interactions with patients (p-values<0.01). These associations were attenuated by work engagement, work satisfaction, and health outcomes. We found mostly non-significant associations between adverse psychosocial working conditions and the frequency of slips and lapses. However, unfavorable psychosocial working conditions among MAs predicted a higher frequency of poor interaction with patients due to stress.

Psychosocial working conditions, perceived patient safety and their association in emergency medical services workers in Germany - a cross-sectional study.

Emergency medical service (EMS) workers face challenging working conditions that are characterized by high stress and a susceptibility to making errors. The objectives of the present study were (a) to characterize the psychosocial working conditions of EMS workers, (b) to describe the perceived quality of patient care they provide and patient safety, and (c) to investigate for the first time among EMS workers associations of psychosocial working conditions with the quality of patient care and patient safety. For this cross-sectional study, we carried out an online survey among 393 EMS workers who were members of a professional organization. Working conditions were measured by the Demand-Control-SupportQuestionnaire (DCSQ) and seven self-devised items covering key stressors. Participants reported how often they perceived work stress to affect the patient care they provided and we inquired to what extent they are concerned to have made a major medical error in the last three months. Additionally, we used parts of the Emergency Medical Services - Safety Inventory (EMS-SI) to assess various specific errors and adverse events. We ran descriptive analyses (objective a and b) and multivariable logistic regression (objective c). The most common stressors identified were communication problems (reported by 76.3%), legal insecurity (69.5%), and switching of colleagues (48.9%) or workplaces (44.5%). Overall, 74.0% reported at least one negative safety outcome based on the EMS-SI. Concerns to have made an important error and the perception that patient care is impaired by work stress and were also frequent (17.8% and 12.7%, respectively). Most psychosocial working conditions were associated with the perception that patient care is impaired due to work stress. Work stress in EMS staff is pronounced and negative safety outcomes or potential errors are perceived to occur frequently. Poor psychosocial working conditions were only consistently associated with perceived impairment of patient care due to work stress. It seems necessary to reduce communication problems and to optimize working processes especially at interfaces between emergency services and other institutions. Legal insecurity could be reduced by clarifying and defining responsibilities. Communication and familiarity between team colleagues could be fostered by more consistent composition of squads.

Nurses' organizational climate of perceived organizational support and its relationships with psychosocial working conditions and psychological contracts: A longitudinal questionnaire study.

The aim of the present study was to investigate the longitudinal relationships between nurses' organizational climate of perceived organizational support (POS-climate) and their psychosocial working conditions and psychological contracts. A two-wave longitudinal cohort questionnaire study was carried out among registered nurses employed within six hospitals in two regions in Sweden (n = 711). Two cross-lagged panel models were tested after ensuring scalar factorial invariance of the measurement models. The first model investigated longitudinal relationships between psychosocial working conditions and the POS-climate, while the second model investigated such relationships between the psychological contracts and the POS-climate. The results indicated that influence at work and an ideology-infused psychological contract had positive effects on the nurses' POS-climate. These results highlight the importance of providing nurses with such influence, and of a shared ideology within the entire health-care organization, centered on the ethical values of the health-care professions.

Psychosocial working conditions and mental health among medical assistants in Germany: a scoping review

BackgroundMedical assistants (MA) constitute one of the largest professions in outpatient health care in Germany. The psychosocial working conditions of health care staff are generally believed to be challenging and to thereby increase the risk of poor mental health. A review of MA’s psychosocial working conditions and mental health is lacking, however. We aimed to systematically identify and summarize existing research on psychosocial working conditions and mental health of MA by addressing (1) Which methods, concepts, and instruments have been used to capture the psychosocial working conditions and mental health among MA in Germany? (2) What findings are available? and (3) What are the research gaps?MethodsWe systematically searched Medline, Scopus, CCMed and Google Scholar. Using the Population Concept Context (PCC)-framework, we applied the following eligibility criteria: (a) Language: English or German, (b) publication between 2002-2022, (c) original study, (d) study population: mainly MA (i.e., ≥ 50% of the study population), (e) concept: psychosocial working conditions and/or mental health, and (f) context: Germany. Two reviewers extracted data independently, results were compared for accuracy and completeness.ResultsEight hundred twenty-seven sources were identified. We included 30 publications (19 quantitative, 10 qualitative, and one mixed methods study). Quantitative studies consistently reported high job satisfaction among MA. Quantitative and mixed methods studies frequently reported aspects related to job control as favorable working conditions, and aspects related to job rewards as moderate to unfavorable. Qualitative studies reported low job control in specific work areas, high demands in terms of workload, time pressure and job intensity, and a desire for greater recognition. Social interactions seemed to be important resources for MA. Few studies (n = 8) captured mental health, these reported inconspicuous mean values but high prevalences of anxiety, burnout, depression, and stress among MA. Studies suggested poorer psychosocial working conditions and mental health among MA during the COVID-19 pandemic.ConclusionsQuantitative studies tend to suggest more favorable psychosocial working conditions among MA than qualitative studies. We suggest mixed methods to reconcile this alleged inconsistency. Future research should examine discrepancies between job satisfaction and unfavorable working conditions and if psychosocial working conditions and mental health remain changed after the COVID-19 pandemic.

The Influence of Workplace Violence, Psychosocial Working Conditions on Depressive Symptoms Among Female Workers in South Korea.

Workers' depression is an important issue, with the prevalence higher in women than in men. This study aimed to identify the effects of workplace violence exposure and psychosocial working conditions on depressive symptoms in female workers in South Korea. This study included 15 605 female wageworkers who participated in the fifth Korean Working Conditions Survey. Logistic regression analyses were implemented to identify the factors that affected their depression. The female workers reported increased frequency of symptoms of depression when there was humiliating behavior from co-workers (adjusted odds ratio [aOR] = 1.999) or physical violence from clients (aOR = 1.609). In psychosocial working environments, they reported a greater frequency of depressive symptoms with high quantitative demands (aOR = 1.498), high emotional demands (aOR = 1.085), lower colleague's support (aOR = 1.566), or lack of support from supervisors at the workplace (aOR = 1.707). An emphasis should be put on preventing humiliating behaviors from co-workers as well as violence from clients in the workplace.

PSYCHOSOCIAL WORKING CONDITIONS OF TEACHERS IN PRIMARY SCHOOLS (CASE STUDY)

PSYCHOSOCIAL WORKING CONDITIONS OF TEACHERS IN PRIMARY SCHOOLS (CASE STUDY)

Psychosocial factors, psychological well-being and safety incidents among long-distance bus drivers in Ghana: A cross-sectional survey

BackgroundCommercial bus drivers account for most road traffic crashes and related mortality. The psychosocial working conditions of these drivers have been found precarious. However, road safety initiatives in Ghana still focus on correcting risky driving behaviours, ignoring the conditions under which these drivers operate. Hence, the purpose of this study was to examine whether psychosocial work factors can predict the psychological well-being and risky driving behaviours of long-distance bus drivers in Ghana. MethodsThis quantitative cross-sectional survey recruited 7315 long-distance bus drivers that operate from Accra to other parts of Ghana and cities in other West African countries. Hypotheses were tested using Partial Least Squares Structural Equation Modelling (PLS-SEM). ResultsWe found that job demands and job resources are direct and significant predictors of psychological well-being and safety incidents among these drivers. Moreover, psychological well-being of the drivers had a significant inverse relationship with their safety incidents. Psychosocial safety climate (PSC) had a negative association with safety incidents, and a positive but non-significant association with psychological well-being. PSC had a negative and significant association with job resources contrary to the notion of the PSC theory. ConclusionPsychosocial work factors are predictors of psychological well-being and safety incidents of long-distance bus drivers. Owners and managers of bus transport businesses in Ghana, driver unions and station masters need to highly prioritise psychological health and safety of this bus drivers by providing suitable job resources and adopting bottom-up communication that might help the drivers effectively cope with their job demands.

The Relationship between Patients' Demands and Workplace Violence among Healthcare Workers: A Multilevel Look Focusing on the Moderating Role of Psychosocial Working Conditions.

Workplace violence against healthcare workers is a widespread phenomenon with very severe consequences for the individuals affected and their organizations. The role played by psychosocial working conditions in healthcare workers' experiences of violence from patients and their family members has received relatively scant attention. In the present study, we investigated the idea that psychosocial working conditions (workload, job control, supervisor support, and team integration), by affecting the well-being and job performance of healthcare workers, play a critical role in the relationship between patients' demands and the escalation of workplace violence. Specifically, we tested the hypothesis that psychosocial working conditions moderate the relationship between patients' demands and workplace violence. Participants were 681 healthcare workers distributed in 55 work groups of three public healthcare facilities in Italy. Multilevel analysis showed significant interactions between patients' demands and each of the investigated psychosocial factors on workplace violence, which in all the cases were in the expected direction. The results suggest that improving the quality of the psychosocial work environment in which healthcare workers operate may be a critical aspect in the prevention of workplace violence.

Can an educational intervention in the context of inpatient pulmonary rehabilitation improve asthma self-management at work? A study protocol of a randomized controlled trial

BackgroundAsthma self-management (e.g., trigger avoidance or correct medication use) is a cornerstone of therapy. Its successful implementation in everyday working life is determined by psychosocial working conditions, in particular by support from superiors and colleagues and the job decision latitude (i.e., when and how to carry out which tasks). To empower individuals with asthma to modify their working conditions, employees need to use certain communication skills and acquire specific knowledge. Both could be taught as part of patient education during pulmonary rehabilitation. Therefore, the aim of the planned study is the development and multicentre implementation of an education module for individuals with asthma during their rehabilitation and to generate evidence on its effectiveness.MethodsParticipants (n ≥ 180) will be recruited, randomized into an intervention and a control group, trained and surveyed in two rehabilitation clinics. The intervention group will receive the supplementary patient education module “Asthma and Work” while the control group will participate in a program on " Eating behaviour” (both 2 × 50 min). The effectiveness of the intervention will be examined based on pre-post measurements (T1 and T2) and a 3-month follow-up (T3). We will consider behavioural intention (T2) and asthma self-management at work (T3) as primary outcomes. Secondary outcomes will include self-management-related knowledge, self-efficacy, number of sick days, number of exacerbations, asthma control (Asthma Control Test), asthma-related quality of life (Marks Asthma Quality of Life Questionnaire), and subjective employment prognosis (Brief Scale Measuring the Subjective Prognosis of Gainful Employment). The pre-post comparisons are to be evaluated using univariate analyses of covariance.DiscussionImproving asthma self-management at work could increase the work ability and social participation of employees with asthma. This could reduce costs, e.g. in terms of asthma-related sick leave.Trial registrationGerman Clinical Trials Register (ID: DRKS00031843)

Comprehensive evaluation of the impact of workplace exposures on physician-certified sick leave in the general working population

BackgroundOur objective was to quantify the prospective associations between work factors across chemical, physical, mechanical, and psychosocial domains and the onset of medically certified sick leave.MethodsEligible respondents were interviewed in 2009, 2013, or 2016 and were registered in the national sick leave register with an employee relationship lasting more than 50 working days during the year of the survey interviews and the following year (n = 15,294 observations). To focus on the onset of high-level sick leave (HLSL; >16 days a year), we excluded individuals with HLSL during the survey year (baseline). We then used mixed-effect logistic regression models to assess prospective associations between self-reported work conditions and the occurrence of doctor-certified HLSL in the following year.ResultsThe average occurrence of HLSL was 13.1%. After adjusting for sex, age, level of education, chronic health problems, and smoking, we observed an exposure-response relationship between cumulative exposure to work factors within all domains and the occurrence of HLSL. When evaluating the impact of combined exposures, predicted odds ratios (OR) for employees exposed to 1, 2, and 3 or more work factors within all domains were 1.60 (95%CI 1.32 − 1.94), 2.56 (95%CI 1.73 − 3.74) and 4.09 (95%CI 2.28 − 7.25), compared to those not exposed.ConclusionsThe results support the notion that exposure to multiple work factors in various domains, including psychosocial, mechanical, chemical, and physical work conditions, is associated with an increased risk of high-level sick leave. Employers and occupational health professionals should consider the joint impact of these domains when designing interventions.

Psychosocial work conditions and traffic safety among minibus and long-bus drivers.

This study sought to examine the association between psychosocial work factors and road traffic crashes (RTCs), and test the differences in psychosocial work factors between minibus and long-bus drivers. This cross-sectional survey employed a convenient sampling method to collect data from 7315 long-distance minibus and long-bus drivers who operate between the Ghanaian cities, Accra and Tema and other parts of the country. The drivers answered a job content questionnaire, psychosocial safety climate scale (PSC-12), work-family conflict scale, and demographic questions on age, education, driving hours, and RTC history. The correlational analysis showed a significant association between psychosocial work factors and RTCs for the previous 2 years. Hierarchical multiple linear regression found that supervisor support, skill discretion, decision autonomy, psychological demands, PSC, and work-family conflict significantly contributed to explaining RTC rates among the drivers. Also, significant differences were found between minibus and long-bus drivers in driving hours, occurrence of near misses, RTCs, and all psychosocial work factors explored in this study except work-family conflict. Psychosocial work factors directly predict RTCs among minibus and long-bus drivers. Policymakers, driver unions, and owners and managers of bus transport businesses should prioritize integrating occupational health and safety into road transport activities. Furthermore, managers and bus owners should use bottom-up communication, provide access to support services and work-family balance initiatives, flexible work schedules, and a supportive work environment to improve road safety.

Psychosocial Work Conditions as Determinants of Well-Being in Jamaican Police Officers: The Mediating Role of Perceived Job Stress and Job Satisfaction.

Policing is considered a high-stress occupation due to the demanding nature of the job. Addressing police stress requires a detailed understanding of how psychosocial risk factors influence various aspects of their well-being. Moreover, an analysis of the direct effects of work conditions and the mediating effects of cognitive appraisals is also warranted. Using the Demands-Resources-Individual Effects (DRIVE) model of work-related stress this study investigated the direct effects of work conditions on well-being and also examined the intermediate role of perceived job stress and job satisfaction in the relationship between work conditions and well-being. Five hundred and seventy-eight police officers from the Jamaica Constabulary Force (J.C.F.) completed the questionnaire. Data were analyzed using hierarchical regressions and the Hayes Process tool for mediation analysis. Both perceived job stress and satisfaction mediated the relationship between work conditions and general physical health. Perceived job stress was an indirect pathway through which work conditions influenced psychological distress, whereas job satisfaction was not a significant mediator. In contrast, job satisfaction mediated the relationship between work conditions and positive well-being, but perceived job stress did not. These findings provide significant evidence for periodically monitoring and auditing perceptions of stress and job satisfaction, as they are likely precursors to subsequent health problems.

Psychosocial safety climate (PSC) and working conditions, predictors of mental health and antidepressant and opioid use in Australia: a study protocol for longitudinal data linkage

IntroductionWork-related stress is a social determinant of global health that represents a huge cost to workers’ health and reduces work performance. In Australia, mental well-being is a pressing national issue—with...

Assessment of Noise and Vibration Annoyance and Other Physical Factors of Working Conditions on Vessels by Means Surveys - a Research Method

Factors related to the working environment (e.g. excessive noise and vibration, inadequate lighting, excessive non-ionizing radiation) contribute to neglect in the work of vessel crew, while also causing health effects in their body. Fishing and shipping are among the sectors of the economy that are characterized by particularly adverse working conditions. According to data published in 2021, among fishermen, of whom there are a total of about 28 million worldwide, about 24,000 of them lose their lives in the course of their profession every year. Many of marine accidents on ships are caused by crew errors due to inadequate working conditions. Therefore, an comprehensive assessment of factors occurring in this specific working environment will be carried out. This assessment will include both those physical factors whose impact is generally considered to be of great concern, such as noise, mechanical vibration or lighting, but also others, such as changing climatic conditions or psychosocial working conditions, which also have a significant impact on the well-being and ability to work and the safety and health of workers, including their quality of life. The assessment will be based on surveys. The paper presents the description of the elaborated questionnaire due to noise and vibration.

“Always Look at the Clock”: Psychosocial Working Conditions in Outpatient Care—A Qualitative Study

Background: In view of demographic change, there is a growing need for qualified nursing professionals. More and more people in need of care prefer to be cared for at home. A shortage of skilled workers and constantly changing and increasing professional requirements are some of the consequences. The aim of this study is to generate further insights into work-related psychosocial stress factors and the resources of outpatient caregivers in their subjective perceptions to derive approaches for possible health-promoting interventions for practice and research that promote healthier and more sustainable work. In addition, coping strategies and needs should be inquired about in order to determine support offers. Methods: Using a semi-structured interview guide, thirty outpatient nursing professionals in Germany were interviewed in 2022. The subject of this interview was the psychosocial working conditions and resources in outpatient care. The collected data were evaluated by means of the Kuckartz qualitative content analysis. Results: This qualitative study identified work-related job demands and resources in outpatient care. The way nurses are treated in the companies they work for and the appreciation of patients were explored as important resources. Physical demands, the time factor, and dealing with personal fates are primarily mentioned as stress factors. The learning effect plays an important role in dealing with these. Conclusion: This study contributes to a better understanding of current job strain and resources as well as job satisfaction in outpatient care. In any case, it became clear that the nursing staff love their profession, which they see more as a vocation. Future quantitative studies are necessary to build on these findings. First ideas of implications for health promotion measures in research and practice have already been derived.

Workplace bullying in a group context: are victim reports of working conditions representative for others at the workplace?

ABSTRACT Previous research on psychosocial working conditions as risk factors of workplace bullying builds on the underlying assumption that targets’ subjective reports of their psychosocial working conditions are shared by their non-bullied colleagues. This study investigates differences in perceptions of such conditions by comparing the ratings from targets of bullying, witnesses, and non-witnesses in groups with at least one target, and groups free from bullying. We also examine if known work-related risk factors predict a group level estimate of bullying with the targets excluded from the analyses. Data included 2215 employees in 195 work groups from Sweden. Targets of bullying perceived the psychosocial working conditions more negatively compared to non-exposed colleagues. In addition, non-exposed in work groups with at least one target reported their working conditions more negatively than those working in groups free from bullying. Associations between examined working conditions and group levels of bullying were significant even when the targets were excluded from the analyses, albeit less strong. The results show that working conditions are risk factors of bullying, but also indicate that previous studies may have overestimated the associations. Future research should consider differences in perceptions of targets and non-targets when investigating work-related risk factors of bullying.

The prevalence of occupational burnout and its individual and situational predictors among addiction therapists.

This study assesses the prevalence and individual and organizational predictors of occupational burnout among addiction therapists. A total of 452 addiction therapists from a representative sample of 184 Polish alcohol treatment facilities (outpatient and inpatient) participated in the study (facility response rate = 42%). The Oldenburg Burnout Inventory was used to measure occupational burnout, and 15 subscales of the Copenhagen Psychosocial Questionnaire II were administered to assess psychosocial work conditions. In addition, the Coronavirus Anxiety Scale, the Hospital Anxiety and Depression Scale and the abbreviated six-item De Jong Gierveld Loneliness Scale measured other important dimensions of addiction therapists' psychosocial functioning. Logistic regression was used for the analysis of the data. Occupational burnout was noticeably prevalent in the study group: 62% of respondents experienced exhaustion and 50% experienced disengagement from work, both to at least a moderate degree. Situational (organizational) variables were the most important predictors, explaining much more of the variance in both dimensions of burnout than the individual factors, of which only depression was significantly related to higher levels of exhaustion. Coronavirus anxiety played a marginal role in explaining the severity of burnout. The current study is one of the first attempts to assess the level of occupational burnout among addiction therapists and to comprehensively investigate the factors contributing to it. The findings provide useful information for the development of interventions aimed at preventing or reducing burnout in this professional group.

Association between psychosocial working conditions and well-being before retirement: a community-based study

ABSTRACT Psychosocial working conditions have been linked to mental health outcomes, but their association with well-being is poorly studied. We aimed to investigate the association between psychosocial working conditions and well-being before retirement, and to explore the role of gender and leisure activities in the association. From the Swedish National Study on Aging and Care in Kungsholmen, 598 community dwellers aged 60–65 years were included in the cross-sectional study. Lifelong occupational history was obtained through an interview. Job demands and job control in the longest-held occupation were graded with job exposure matrices. Psychosocial working conditions were classified into high strain (high demands, low control), low strain (low demands, high control), passive job (low demands, low control), and active job (high demands, high control). Well-being was assessed with the 10-item version of positive and negative affect schedule, and scored using confirmatory factor analysis. Engagement in leisure activities was categorized as low, moderate, and high. Data were analyzed using linear regression. Both high job control and high job demands were dose-dependently associated with higher well-being. Overall, compared to active jobs, passive jobs were associated with lower well-being (β −0.19, 95% CI −0.35 to −0.02, P = 0.028). Passive (β −0.28, 95% CI −0.51 to −0.04, P = 0.020) and high strain (β −0.31, 95% CI −0.52 to −0.10, P = 0.004) jobs were associated with lower well-being in men, but not in women. The association between passive jobs and well-being was attenuated by high leisure activities, while the association between high strain and well-being was magnified by low leisure activities. In conclusion, negative psychosocial working conditions are associated with poor well-being, especially in men. Leisure activities may modulate the association. Our study highlights that promoting favorable working conditions can be a target to improve well-being among employees and active participation in leisure activities is encouraged to cope with work-related stress for better well-being.

Gender- and age-specific associations between psychosocial work conditions and perceived work sustainability in the general working population in Taiwan.

One aspect of work sustainability pertains to workers' intention to remain in their current job until reaching retirement age. Various adverse working conditions are expected to diminish work sustainability among different social groups. This study aims to examine these associations across gender and age groups. The study participants were 19,152 economically-active adults in a national survey conducted in Taiwan. Information concerning psychosocial working conditions were obtained through interviews, using the Job Content Questionnaire. Work sustainability was evaluated by one question that asked whether the participants felt they would be able to do their current job until the age of 60. The association between psychosocial work conditions and work sustainability was examined by logistic regression analysis. We further performed stratified analysis to explore age and gender-specific associations. We observed that 14.2% and 17.1% of male and female workers reported low work sustainability. Workers in the electronics industries and female workers in the healthcare and education sectors reported low work sustainability. Gender-specific analyses showed that low job control among men and shift work among women were significantly associated with low work sustainability. Age-specific analyses indicated that having poor health, shift work, and long working hours in younger workers, and having low job control in older workers were associated with low work sustainability. To retain older workers in the labor market, policies should aim at the improvement of psychosocial work conditions, and gender- and age-specific issues should be taken into consideration.