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.

Do obesity and sleep problems cluster in the workplace?:A multivariate, multilevel study

OBJECTIVES: The aim of this study was to examine the co-occurrence of obesity and sleep problems among employees and workplaces. METHODS: We obtained data from 39 873 men and women working in 3040 workplaces in 2000-2002 (the Finnish Public Sector Study). Individual- and workplace-level characteristics were considered as correlates of obesity and sleep problems, which were modelled simultaneously using a multivariate, multilevel approach. RESULTS: Of the participants, 11% were obese and 23% reported sleep problems. We found a correlation between obesity and sleep problems at both the individual [correlation coefficient 0.048, covariance 0.047, standard error (SE) 0.005) and workplace (correlation coefficient 0.619, covariance 0.068, SE 0.011) level. The latter, but not the former, correlation remained after adjustment for individual- and workplace-level confounders, such as age, sex, socioeconomic status, shift work, alcohol consumption, job strain, and proportion of temporary employees and manual workers at the workplace. CONCLUSIONS: Obese employees and those with sleep problems tend to cluster in the same workplaces, suggesting that, in addition to targeting individuals at risk, interventions to reduce obesity and sleep problems might benefit from identifying "risky" workplaces.

Present orientation, future orientation and alcohol use in Northern Irish adolescents

Earlier initiation into more problematic drinking behaviour has been found to be associated with more problematic drinking later in life. Research has suggested that a lower future time perspective (and higher present time perspective) is associated with health-compromising behaviours such as problematic alcohol use in college student, University undergraduate and general population samples. This study used a cross-sectional design to examine whether consideration of future consequences (CFC), assessed by the Consideration of Future Consequences Scale, was significantly related to drinking behaviour in a large sample (n=707) of Northern Irish adolescents. Alcohol use was self-reported by means of a composite measure of drinking behaviour. Demographic data were also gathered. After controlling for year in school (proxy for age), sex and for clustering at school level, lower future orientation and higher present orientation were found to be significantly associated with more problematic self-reported drinking behaviour. These results extend recent findings of a significant relationship between a foreshortened future time perspective and more problematic self-reported drinking behaviour in a UK sample of University undergraduates, to a large UK sample of adolescents. Given the relationship between early-onset drinking and more problematic use in later life, health promotion interventions might explore using the CFC construct in targeting adolescent drinkers.

Cognitive and task-related EEG correlates of arithmetic performance in adolescents

Cognitive and neurophysiological correlates of arithmetic calculation, concepts, and applications were examined in 41 adolescents, ages 12-15 years. Psychological and task-related EEG measures which correctly distinguished children who scored low vs. high (using a median split) in each arithmetic subarea were interpreted as indicative of processes involved. Calculation was related to visual-motor sequencing, spatial visualization, theta activity measured during visual-perceptual and verbal tasks at right- and left-hemisphere locations, and right-hemisphere alpha activity measured during a verbal task. Performance on arithmetic word problems was related to spatial visualization and perception, vocabulary, and right-hemisphere alpha activity measured during a verbal task. Results suggest a complex interplay of spatial and sequential operations in arithmetic performance, consistent with processing model concepts of lateralized brain function.

The Temporal Focus Scale:Factor structure and association with alcohol use in a sample of Northern Irish school children

The Temporal Focus Scale (TFS) is a 12-item self-report measure of cognitive engagement with the temporal domains of past, present and future. Developed in college student samples, a three-factor structure with adequate reliability and validity was documented in a series of independent studies. We tested the factor structure of the scale in a sample of Northern Irish adolescents and found that our data supported a three factor structure, although there were problems with item 10. Because time perspective measures have been found to relate differentially to various health behaviours, we tested the relations between scores on the TFS and self-reported alcohol use. Results showed that scores on the TFS were not consistent statistical predictors of drinking category in a logistic regression. Results are discussed in terms of scale development, future scale use and the assessment of health-compromising behaviours such as adolescent alcohol consumption. © 2012 The Foundation for Professionals in Services for Adolescents.

Foveal relocation surgery:Is it a reasonable option for patients with age-related macular degeneration?

Foveal relocation (or translocation) has been reintroduced recently as a possible treatment for patients with subfoveal choroidal neovascular membranes secondary to age-related macular degeneration and degenerative myopia. Different surgical techniques have been proposed and the results, although encouraging, are not completely satisfactory yet. Most surgical procedures described are technically difficult and require special vitreo-retinal expertise. Furthermore, although marked improvements in visual acuity have been observed in some patients, others do not experience visual improvement, even after a successful surgery. Additionally, devastating complications, such as proliferative vitreo-retinopathy (PVR) can occur, impairing the final visual outcome. Although foveal relocation surgery may be a promising direction in research and development, as yet, there is no randomised controlled trial to show that it is more effective than any other forms of treatment for macular degeneration. The validity of this surgical approach needs to be evaluated by the results of longer-term follow-up. This article reviews the current surgical techniques for foveal relocation, their outcomes and complications, and discusses the surgical problems that vitreo-retinal surgeons face when performing foveal relocation surgery.

Hospital antibiotic use and its relationship to age-adjusted comorbidity and alcohol-based hand rub consumption

SUMMARY The objective of this study was to evaluate the effect of age-adjusted comorbidity and alcohol-based hand rub on monthly hospital antibiotic usage, retrospectively. A multivariate autoregressive integrated moving average (ARIMA) model was built to relate the monthly use of all antibiotics grouped together with age-adjusted comorbidity and alcohol-based hand rub over a 5-year period (April 2005-March 2010). The results showed that monthly antibiotic use was positively related to the age-adjusted comorbidity index (concomitant effect, coefficient 1·103, P = 0·0002), and negatively related to the use of alcohol-based hand rub (2-month delay, coefficient -0·069, P = 0·0533). Alcohol-based hand rub is considered a modifiable factor and as such can be identified as a target for quality improvement programmes. Time-series analysis may provide a suitable methodology for identifying possible predictive variables that explain antibiotic use in healthcare settings. Future research should examine the relationship between infection control practices and antibiotic use, identify other infection control predictive factors for hospital antibiotic use, and evaluate the impact of enhancing different infection control practices on antibiotic use in a healthcare setting.

Consideration of future consequences and alcohol use among Northern Irish adolescents

This study investigated the relationship between consideration of future consequences and alcohol use among adolescents. A cross-sectional design was used and a large sample of 12-to 16-year-old schoolchildren (n = 806) in Northern Ireland were recruited for this study. Alcohol use was assessed using a composite measure of drinking behaviour, the Adolescent Alcohol Involvement Scale. Time perspective was measured using the Consideration of Future Consequences Scale (CFCS). Data were also gathered on self-esteem, three domains of self-efficacy and aggression, all of which have been found to be related to both drinking behaviour and time perspective. Factor analysis of the CFCS revealed support for a two-factor solution, with CFC-I representing present orientation and CFC-F representing future orientation. After controlling for year in school (proxy for age) and gender and for clustering at school level, scores on both subscales were significantly associated with alcohol use. Only CFC-F score remained significant with the addition of psychosocial variables. These results support recent findings of a significant relationship between CFCS score and alcohol use in UK adolescents and University undergraduates, and suggest that in more fully controlled analyses, future orientation, rather than present, is related to adolescent drinking. Results are discussed in relation to health promotion. © 2013 Informa UK Ltd.

Patterns of Presentation for Attempted Suicide: Analysis of a Cohort of Individuals Who Subsequently Died by Suicide

All suicides and related prior attempts occurring in Northern Ireland over two years were analyzed, focusing on number and timing of attempts, method, and mental health diagnoses. Cases were derived from coroner's records, with 90% subsequently linked to associated general practice records. Of those included, 45% recorded at least one prior attempt (with 59% switching from less to more lethal methods between attempt and suicide). Compared with those recording one attempt, those with 2+ attempts were more likely to have used less lethal methods at the suicide (OR = 2.77: 95% CI = 1.06, 7.23); and those using less lethal methods at the attempts were more likely to persist with these into the suicide (OR = 3.21: 0.79, 13.07). Finally, those with preexisting mental problems were more likely to use less lethal methods in the suicide: severe mental illness (OR = 7.88: 1.58, 39.43); common mental problems (OR = 3.68: 0.83, 16.30); and alcohol/drugs related (OR = 2.02: 0.41, 9.95). This analysis uses readily available data to highlight the persisting use of less lethal methods by visible and vulnerable attempters who eventually complete their suicide. Further analysis of such conditions could allow more effective prevention strategies to be developed.

Self-reported psychosocial needs and health-related quality of life of colorectal cancer survivors

Purpose of the research
To investigate the prevalence and nature of unmet needs among colorectal cancer (CRC) survivors and the relationship between needs and quality of life (QoL).

Methods and sample
Using the Northern Ireland Cancer Registry (NICR) as a sampling frame and working in collaboration with primary care physicians or GPs, the Cancer Survivors Unmet Needs (CaSUN) questionnaire and the Quality of Life in Adult Cancer Survivors Scale (QLACS) were posted to a randomly selected sample of 600 CRC survivors.

Key results
Approximately 69% (413/600) met eligibility criteria for participating in the study; and 30% (124/413) responded to the survey. A comparative analysis of NICR data between respondents and non-respondents did not indicate any systematic bias except that respondents appeared to be younger (65 years vs. 67 years). Approximately 60% of respondents reported having no unmet needs, with 40% reporting one or more unmet health and social care needs such as fear of recurrence, information needs, difficulty obtaining travel insurance and car parking problems. QoL was significantly lower for CRC survivors who reported an unmet need. Highest scores (poorer QoL) were reported for fatigue, welfare benefits and distress recurrence.

Conclusions
Overall, the majority of CRC survivors who had care needs appeared to have needs that were mainly psychosocial in nature and these unmet needs were related to poorer QoL.

Alcohol use and positive screening results for depression and anxiety are highly prevalent among chinese children with strabismus

Purpose: To study associations between strabismus and alcohol use, anxiety, and depression among 10- to 17-year-old children in Guangdong, southern China. Design: Cross-sectional, population-based study. Methods: Among 7537 children aged 6-17 years from 9 randomly selected primary and middle schools, ocular alignment was assessed with the Hirschberg light reflex, cover-uncover testing, and alternate cover testing at distance (6 m) and near (40 cm). Additionally, 4000 children (53.1%) aged 10+ years received self-administered questionnaires containing screening questions on alcohol use, anxiety, and depression. Results: Examinations were completed on 7464 of 7537 subjects (99.0%), including 3928 boys (52.6%), with a mean age of 11.1 ± 1.8 years. The prevalence of any strabismus, including exotropia (2.7%), esotropia (0.2%), and intermittent exotropia (3.9%), was 6.8%. Strabismus was more prevalent in urban students (7.3%) and female subjects (7.4%) compared to rural students (6.0%) and male subjects (6.2%) (all P <.05). In multivariate regression models, any strabismus was associated with older age and rural vs urban residence. Among 3903 children (97.6%) answering questionnaires, history of alcohol use (62.3% vs 36.3%) and positive screening responses for depression (26.0% vs 11.6%) and anxiety (10.3% vs 4.9%) were significantly (P <.01 for all) more common among children with strabismus. Conclusion: These Chinese children with strabismus had a significantly higher prevalence of alcohol use and possible markers of emotional problems than children without strabismus. Further research should focus on the appropriateness of classifying surgical treatment for strabismus as "cosmetic" (ineligible for reimbursement) under China's rural health insurance.

A prospective comparative evaluation of a Criminal Justice Liaison and Diversion Service in Belfast

There is continued interest in the planning, development and implementation of services designed to identify, detainees with mental illness and connect them to health and social services. However, currently little is known about how best to configure, organise and deliver these services. The study employed a prospective follow-up design with a comparator group to describe and evaluate a police mental health liaison service based in Belfast. Participants were recruited from two neighbouring police stations, only one of which provided a mental health liaison service. Outcomes including mental health status, drug and alcohol misuse, risk-related behaviour and ‘administrative’ outcomes were assessed at the time of arrest and six months later. The service was successful in identifying and assessing detainees though there appeared to be similar between-group levels of mental health problems over time. Results highlight a need to develop firmer linkages and pathways between criminal justice liaison / diversion services and routine health and social services. 

Limited range coverage problems

Tal como o título indica, esta tese estuda problemas de cobertura com alcance limitado. Dado um conjunto de antenas (ou qualquer outro dispositivo sem fios capaz de receber ou transmitir sinais), o objectivo deste trabalho é calcular o alcance mínimo das antenas de modo a que estas cubram completamente um caminho entre dois pontos numa região. Um caminho que apresente estas características é um itinerário seguro. A definição de cobertura é variável e depende da aplicação a que se destina. No caso de situações críticas como o controlo de fogos ou cenários militares, a definição de cobertura recorre à utilização de mais do que uma antena para aumentar a eficácia deste tipo de vigilância. No entanto, o alcance das antenas deverá ser minimizado de modo a manter a vigilância activa o maior tempo possível. Consequentemente, esta tese está centrada na resolução deste problema de optimização e na obtenção de uma solução particular para cada caso. Embora este problema de optimização tenha sido investigado como um problema de cobertura, é possível estabelecer um paralelismo entre problemas de cobertura e problemas de iluminação e vigilância, que são habitualmente designados como problemas da Galeria de Arte. Para converter um problema de cobertura num de iluminação basta considerar um conjunto de luzes em vez de um conjunto de antenas e submetê-lo a restrições idênticas. O principal tema do conjunto de problemas da Galeria de Arte abordado nesta tese é a 1-boa iluminação. Diz-se que um objecto está 1-bem iluminado por um conjunto de luzes se o invólucro convexo destas contém o objecto, tornando assim este conceito num tipo de iluminação de qualidade. O objectivo desta parte do trabalho é então minimizar o alcance das luzes de modo a manter uma iluminação de qualidade. São também apresentadas duas variantes da 1-boa iluminação: a iluminação ortogonal e a boa !-iluminação. Esta última tem aplicações em problemas de profundidade e visualização de dados, temas que são frequentemente abordados em estatística. A resolução destes problemas usando o diagrama de Voronoi Envolvente (uma variante do diagrama de Voronoi adaptada a problemas de boa iluminação) é também proposta nesta tese.

Phase equilibria modeling for biofuels production

Em consequência de uma série de problemas ambientais, económicos e políticos relacionados com o uso de combustíveis convencionais, vários países estão agora a focar as suas atenções em combustíveis alternativos. O biodiesel está na linha da frente das alternativas ao petróleo no sector dos transportes, sendo considerado uma opção a curto prazo visto que o seu preço é competitivo e não são necessárias mudanças nos motores para implementar o seu uso. De entres os possíveis processos de produzir biodiesel, a reacção de transesterificação com catálise básica é o método preferido. Depois da reacção são sempre necessários processos de purificação de modo ao biodiesel produzido cumprir os standards definidos para os combustíveis alternativos, reduzindo problemas de motor e consequentemente aumentando a sua aceitação por parte dos consumidores. De entre as especificações encontram-se o conteúdo em água, em álcool e em glicerol. Ser-se capaz de descrever correctamente o equilíbrio de fases de sistemas que são de interesse para os processos de purificação de biodieseis numa gama alargada de condições termodinâmicas é uma condição necessária para uma correcta simulação do processo industrial, de modo a se atingir uma elevada produtividade a baixos custos de operação. O uso de moléculas oxigenadas como combustíveis representa uma alteração significativa em termos da termodinâmica de soluções. Para combustíveis baseados em petróleo as equações de estado cúbicas e os modelos clássicos de coeficientes de actividade mostraram ser apropriados, no entanto para combustíveis novos como o biodiesel, sendo mais complexos do ponto de vista das interacções intermoleculares com formação de dipolos e pontes de hidrogénio, são necessários modelos termodinâmicos mais complexos para descrever essas interacções. Neste trabalho a CPA EoS (Cubic-Plus-Association Equation of State) será desenvolvida de modo a permitir uma descrição adequada dos equilíbrios líquido-vapor e líquido-líquido para uma serie de sistemas binários e multicomponentes contendo água, ácidos gordos, ésteres de ácidos gordos, glicerol e álcoois.

Location-routing problems of semi-obnoxious facilities: approaches and decision support

A presente tese resulta de um trabalho de investigação cujo objectivo se centrou no problema de localização-distribuição (PLD) que pretende abordar, de forma integrada, duas actividades logísticas intimamente relacionadas: a localização de equipamentos e a distribuição de produtos. O PLD, nomeadamente a sua modelação matemática, tem sido estudado na literatura, dando origem a diversas aproximações que resultam de diferentes cenários reais. Importa portanto agrupar as diferentes variantes por forma a facilitar e potenciar a sua investigação. Após fazer uma revisão e propor uma taxonomia dos modelos de localização-distribuição, este trabalho foca-se na resolução de alguns modelos considerados como mais representativos. É feita assim a análise de dois dos PLDs mais básicos (os problema capacitados com procura nos nós e nos arcos), sendo apresentadas, para ambos, propostas de resolução. Posteriormente, é abordada a localização-distribuição de serviços semiobnóxios. Este tipo de serviços, ainda que seja necessário e indispensável para o público em geral, dada a sua natureza, exerce um efeito desagradável sobre as comunidades contíguas. Assim, aos critérios tipicamente utilizados na tomada de decisão sobre a localização destes serviços (habitualmente a minimização de custo) é necessário adicionar preocupações que reflectem a manutenção da qualidade de vida das regiões que sofrem o impacto do resultado da referida decisão. A abordagem da localização-distribuição de serviços semiobnóxios requer portanto uma análise multi-objectivo. Esta análise pode ser feita com recurso a dois métodos distintos: não interactivos e interactivos. Ambos são abordados nesta tese, com novas propostas, sendo o método interactivo proposto aplicável a outros problemas de programação inteira mista multi-objectivo. Por último, é desenvolvida uma ferramenta de apoio à decisão para os problemas abordados nesta tese, sendo apresentada a metodologia adoptada e as suas principais funcionalidades. A ferramenta desenvolvida tem grandes preocupações com a interface de utilizador, visto ser direccionada para decisores que tipicamente não têm conhecimentos sobre os modelos matemáticos subjacentes a este tipo de problemas.