Job Strain and Alcohol Intake:A Collaborative Meta-Analysis of Individual-Participant Data from 140 000 Men and Women

BACKGROUND: The relationship between work-related stress and alcohol intake is uncertain. In order to add to the thus far inconsistent evidence from relatively small studies, we conducted individual-participant meta-analyses of the association between work-related stress (operationalised as self-reported job strain) and alcohol intake. METHODOLOGY AND PRINCIPAL FINDINGS: We analysed cross-sectional data from 12 European studies (n?=?142 140) and longitudinal data from four studies (n?=?48 646). Job strain and alcohol intake were self-reported. Job strain was analysed as a binary variable (strain vs. no strain). Alcohol intake was harmonised into the following categories: none, moderate (women: 1-14, men: 1-21 drinks/week), intermediate (women: 15-20, men: 22-27 drinks/week) and heavy (women: >20, men: >27 drinks/week). Cross-sectional associations were modelled using logistic regression and the results pooled in random effects meta-analyses. Longitudinal associations were examined using mixed effects logistic and modified Poisson regression. Compared to moderate drinkers, non-drinkers and (random effects odds ratio (OR): 1.10, 95% CI: 1.05, 1.14) and heavy drinkers (OR: 1.12, 95% CI: 1.00, 1.26) had higher odds of job strain. Intermediate drinkers, on the other hand, had lower odds of job strain (OR: 0.92, 95% CI: 0.86, 0.99). We found no clear evidence for longitudinal associations between job strain and alcohol intake. CONCLUSIONS: Our findings suggest that compared to moderate drinkers, non-drinkers and heavy drinkers are more likely and intermediate drinkers less likely to report work-related stress.

Oesophageal cancer survival in Europe:A EUROCARE-4 study

Oesophageal cancer survival is poor with variation across Europe. No pan-European studies of survival differences by oesophageal cancer subtype exist. This study investigates rates and trends in oesophageal cancer survival across Europe. Data for primary malignant oesophageal cancer diagnosed in 1995-1999 and followed up to the end of 2003 was obtained from 66 cancer registries in 24 European countries. Relative survival was calculated using the Hakulinen approach. Staging data were available from 19 registries. Survival by region, gender, age, morphology and stage was investigated. Cohort analysis and the period approach were applied to investigate survival trends from 1988 to 2002 for 31 registries in 17 countries. In total 51,499 cases of oesophageal cancer diagnosed 1995-1999 were analysed. Overall, European 1- and 5-year survival rates were 33.4% (95% CI 32.9-33.9%) and 9.8% (95% CI 9.4-10.1%), respectively. Males, older patients and patients with late stage disease had poorer 1- and 5-year relative survival. Patients with squamous cell carcinoma had poorer 1-year relative survival. Regional variation in survival was observed with Central Europe above and Eastern Europe below the European pool. Survival for distant stage disease was similar across Europe while survival rates for localised disease were below the European pool in Eastern and Southern Europe. Improvement in European 1-year relative survival was reported (p=0.016). Oesophageal cancer survival was poor across Europe. Persistent regional variations in 1-year survival point to a need for a high resolution study of diagnostic and treatment practices of oesophageal cancer.

Hypermobility and musculoskeletal pain in children:a systematic review

Objective: To examine the evidence of an association between hypermobility and musculoskeletal pain in children. Methods: A systematic review of the literature was performed using the databases PubMed, EMBASE, NHS Evidence, and Medline. Inclusion criteria were observational studies investigating hypermobility and musculoskeletal pain in children. Exclusion criteria were studies conducted on specialist groups (i.e. dancers) or hospital referrals. Pooled odds ratios (ORs) were calculated using random effects models and heterogeneity was tested using ?(2)-tests. Study quality was assessed using the Newcastle-Ottawa Scale for case-control studies. Results: Of the 80 studies identified, 15 met the inclusion criteria and were included in the review. Of these, 13 were included in the statistical analyses. Analysing the data showed that the heterogeneity was too high to allow for interpretation of the meta-analysis (I(2) = 72%). Heterogeneity was much lower when the studies were divided into European (I(2) = 8%) and Afro-Asian subgroups (I(2) = 65%). Sensitivity analysis based on data from studies reporting from European and Afro-Asian regions showed no association in the European studies [OR 1.00, 95% confidence interval (CI) 0.79-1.26] but a marked relationship between hypermobility and joint pain in the Afro-Asian group (OR 2.01, 95% CI 1.45-2.77). Meta-regression showed a highly significant difference between subgroups in both meta-analyses (p <0.001). Conclusion: There seems to be no association between hypermobility and joint pain in Europeans. There does seem to be an association in Afro-Asians; however, there was a high heterogeneity. It is unclear whether this is due to differences in ethnicity, nourishment, climate or study design.

The changing pattern of adult primary glomerular disease

Published biopsy series have shown geographical and temporal variations in the patterns of primary glomerulonephritis (GN). IgA nephropathy is the most common type of GN in most European studies, but there is evidence suggesting that focal segmental glomerulosclerosis (FSGS) is increasingly common in the USA in all ethnic groups. We report the analysis of 30 years of native renal biopsies and the temporal pattern of primary glomerular disease in a single United Kingdom (UK) region.

The Changing Worlds and Workplaces of Capitalism

How do the large scale structures of capitalism and the local social relations of workplaces and organisations shape each other? Through a series of European studies of capital and labour's shifting struggles and compromises; of the politics of welfare, industrial relations and labour markets; and the transformation of post-industrial networked workplaces, this edited collection shows how capitalist workplaces and economies are changing today. The first section explores how European capitalism developed and the different national forms of the struggle between capital and labour for a bigger share of national income. In the second part of the volume, the contributors investigate the institutions that are the building blocks of these different national forms, and how they are changing as labour markets are increasingly shaped by globalisation, feminisation and liberalisation. The final chapters examine how these institutions of capitalism play out in the contemporary workplace – where the most dynamic sectors are based on loose networks and external labour markets and a shifting, uncertain alliance between employers and workers. The authors argue for a new integration of political economy and the sociology of work and organisations.

Re-embedding economic and social constitutionalism: Normative Perspectives for the E

This chapter proposes a social re-embedding of European constitutionalism by offering a coherent interpretation of EU constitutional principles as contained in the initial articles of the Treaties and the EU’s economic and social constitution as developed by the Court of Justice. It starts from the assumption that European integration is not merely an inter-state endeavour, but also a process that affects social and economic actors, in other words societies all over Europe. It may well ultimately engender a European society – if we are prepared to conceive of a poly-centric society, consisting of diverse components from a wide range of regions, social actors and cultures. Proceeding from the assumption that constitutionalism can be a relevant notion for such a holistic approach to European integration, the chapter develops elements of European constitutionalism relating to socio-economic reality. As national constitutional law, European constitutional law is presented as necessarily incomplete. European constitutionalism will thus have to offer modes of adapting open norms to an ever changing and developing societal reality. The chapter outlines a framework for such constitutionalism which, at the same time, offers opportunities for reconciling the social and economic dimensions in the European integration project through a re-configured notion of constitutionalism.

On the Limits of Exceptionalism: Principles and Practice in the Pursuit of Alternatives to Full EU Membership

Few states have been less uncomfortable with the relationship they have with the EU than the United Kingdom as a member and Turkey as an associate and would-be member. Both states currently find themselves questioning the substance and future of these relationships with domestic actors and, notably in the Turkish case, external EU voices actively advocating alternatives. While much discussion, particularly in the UK case, has focused on the advantages and disadvantages of particular existing arrangements (e.g. European Economic Area, Swiss bilateralism), this paper considers the broader principles and practices that the EU has to date either explicitly developed or implicitly established to govern the nature and substance of alternatives to [full] EU membership. It assesses the principled, practical and political limitations that exist in establishing alternatives to full membership for states seeking – or having sought for them – the accommodation of their exceptionalism. In doing so the paper considers the potential limits to a renegotiated EU membership for the UK and to an alternative short of full membership for Turkey. It also reflects on the precedent-setting consequences of any new arrangements that the EU might reach with either state for what forms membership and a relationship short of membership might take in the future.

Holding the Door Half (?) Open: the EU and Turkey 10 years on

A decade of accession negotiations with the EU has not brought Turkey significantly closer to EU membership. In part the reasons lie with Turkey. This article, however, explores the position of the EU and the ‘supply-side’ of enlargement. It reflects on developments in how the EU has engaged with Turkey on the question of membership, situating Turkey’s candidacy and the EU’s position within the broader comparative context of how the process and politics of EU enlargement have evolved over the last ten years. It focuses on a set of supply-side variables that are key to determining the progress that applicants can make towards membership: member state preferences, the activism of supranational institutional actors, the EU’s integration capacity, public opinion in the EU towards enlargement, and the narratives deployed in justification of enlargement. The article also considers the state of Turkey’s accession negotiations and how they have been and potentially will be affected, assuming they are meaningfully revived, by the evolving nature and substance of EU accession negotiations more generally and EU’s approach to conditionality.