Job control and ambulatory blood pressure

Objective: The effect of work on blood pressure (BP) in a general population with appropriate adjustment for confounders is not well defined. High job control has been found to be associated with lower BP and with nocturnal BP dipping. However, with older workers this may be compromised and has not been studied extensively. Methods: A cross-sectional study was carried out on a primary care-based sample (N=2047) aged 50–69 years. Data were collected on sociodemographic factors, medication, clinic, and ambulatory blood pressure. Job control was measured using two scales from the Copenhagen Psychosocial Questionnaire (COPSOQ) (possibility for development and influence at work). Nocturnal systolic BP (SBP) dipping was the reduction in SBP from day- to night-time using ambulatory SBP readings. Results: In general, BP increased with age, male gender, and higher body mass index. Workers with high influence at work and high possibility for development were more likely to have high asleep SBP [odds ratio (OR) 2.13, 95% confidence interval (95% CI) 1.05–4.34, P=0.04], (OR 2.27, 95% CI 1.11–4.66, P=0.03) respectively. Influence at work and awake BP were inversely associated: awake SBP (OR 2.44, 95% CI 1.35–4.41, P<0.01), awake DBP (OR 2.42, 95% CI 1.24–4.72, P=0.01). No association was seen between job control and nocturnal SBP dipping. Conclusion: Older workers with high job control may be more at risk of cardiovascular disease resulting from high day- and night-time BP with no evidence of nocturnal dipping.

Diageo's 'Stop Out of Control Drinking' campaign in Ireland: an analysis

Background: It has been argued that the alcohol industry uses corporate social responsibility activities to influence policy and undermine public health, and that every opportunity should be taken to scrutinise such activities. This study analyses a controversial Diageo-funded ‘responsible drinking’ campaign (“Stop out of Control Drinking”, or SOOCD) in Ireland. The study aims to identify how the campaign and its advisory board members frame and define (i) alcohol-related harms, and their causes, and (ii) possible solutions. Methods: Documentary analysis of SOOCD campaign material. This includes newspaper articles (n = 9), media interviews (n = 11), Facebook posts (n = 92), and Tweets (n = 340) produced by the campaign and by board members. All material was coded inductively, and a thematic analysis undertaken, with codes aggregated into sub-themes. Results: The SOOCD campaign utilises vague or self-defined concepts of ‘out of control’ and ‘moderate’ drinking, tending to present alcohol problems as behavioural rather than health issues. These are also unquantified with respect to actual drinking levels. It emphasises alcohol-related antisocial behaviour among young people, particularly young women. In discussing solutions to alcohol-related problems, it focuses on public opinion rather than on scientific evidence, and on educational approaches and information provision, misrepresenting these as effective. “Moderate drinking” is presented as a behavioural issue (“negative drinking behaviours”), rather than as a health issue. Conclusions: The ‘Stop Out of Control Drinking’ campaign frames alcohol problems and solutions in ways unfavourable to public health, and closely reflects other Diageo Corporate Social Responsibility (CSR) activity, as well as alcohol and tobacco industry strategies more generally. This framing, and in particular the framing of alcohol harms as a behavioural issue, with the implication that consumption should be guided only by self-defined limits, may not have been recognised by all board members. It suggests a need for awareness-raising efforts among the public, third sector and policymakers about alcohol industry strategies

ARIA 2016: Care pathways implementing emerging technologies for predictive medicine in rhinitis and asthma across the life cycle

The Allergic Rhinitis and its Impact on Asthma (ARIA) initiative commenced during a World Health Organization workshop in 1999. The initial goals were (1) to propose a new allergic rhinitis classification, (2) to promote the concept of multi-morbidity in asthma and rhinitis and (3) to develop guidelines with all stakeholders that could be used globally for all countries and populations. ARIA—disseminated and implemented in over 70 countries globally—is now focusing on the implementation of emerging technologies for individualized and predictive medicine. MASK [MACVIA (Contre les Maladies Chroniques pour un Vieillissement Actif)-ARIA Sentinel NetworK] uses mobile technology to develop care pathways for the management of rhinitis and asthma by a multi-disciplinary group and by patients themselves. An app (Android and iOS) is available in 20 countries and 15 languages. It uses a visual analogue scale to assess symptom control and work productivity as well as a clinical decision support system. It is associated with an inter-operable tablet for physicians and other health care professionals. The scaling up strategy uses the recommendations of the European Innovation Partnership on Active and Healthy Ageing. The aim of the novel ARIA approach is to provide an active and healthy life to rhinitis sufferers, whatever their age, sex or socio-economic status, in order to reduce health and social inequalities incurred by the disease.