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.

Job strain as a risk factor for coronary heart disease:a collaborative meta-analysis of individual participant data

BACKGROUND: Published work assessing psychosocial stress (job strain) as a risk factor for coronary heart disease is inconsistent and subject to publication bias and reverse causation bias. We analysed the relation between job strain and coronary heart disease with a meta-analysis of published and unpublished studies. METHODS: We used individual records from 13 European cohort studies (1985-2006) of men and women without coronary heart disease who were employed at time of baseline assessment. We measured job strain with questions from validated job-content and demand-control questionnaires. We extracted data in two stages such that acquisition and harmonisation of job strain measure and covariables occurred before linkage to records for coronary heart disease. We defined incident coronary heart disease as the first non-fatal myocardial infarction or coronary death. FINDINGS: 30?214 (15%) of 197?473 participants reported job strain. In 1·49 million person-years at risk (mean follow-up 7·5 years [SD 1·7]), we recorded 2358 events of incident coronary heart disease. After adjustment for sex and age, the hazard ratio for job strain versus no job strain was 1·23 (95% CI 1·10-1·37). This effect estimate was higher in published (1·43, 1·15-1·77) than unpublished (1·16, 1·02-1·32) studies. Hazard ratios were likewise raised in analyses addressing reverse causality by exclusion of events of coronary heart disease that occurred in the first 3 years (1·31, 1·15-1·48) and 5 years (1·30, 1·13-1·50) of follow-up. We noted an association between job strain and coronary heart disease for sex, age groups, socioeconomic strata, and region, and after adjustments for socioeconomic status, and lifestyle and conventional risk factors. The population attributable risk for job strain was 3·4%. INTERPRETATION: Our findings suggest that prevention of workplace stress might decrease disease incidence; however, this strategy would have a much smaller effect than would tackling of standard risk factors, such as smoking. FUNDING: Finnish Work Environment Fund, the Academy of Finland, the Swedish Research Council for Working Life and Social Research, the German Social Accident Insurance, the Danish National Research Centre for the Working Environment, the BUPA Foundation, the Ministry of Social Affairs and Employment, the Medical Research Council, the Wellcome Trust, and the US National Institutes of Health.

Trades Unions and the Transition away from 'actually existing unsustainability':From economic crisis to a new political economy beyond growth

Traditionally trades unions have accepted and promoted orthodox economic growth as a policy imperative. In recent years there has been a noticeable ‘greening’ of trade unions in relation to initiatives such as the ‘Green new deal’ and the creation of ‘green collar’ employment and the focus on a ‘just transition’ to a low carbon economy. Yet given the growing evidence of the negative impacts of economic growth in terms of environmental, resource and pollution impacts as well as the inability of economic growth to tackle (as opposed to managed) socio-economic inequality, it is timely to review the case for trades unions to fundamentally rethink the commitment to orthodox economic growth. That is, for trades unions to consider going beyond their current ‘green/sustainability’ strategies to consider more radical ‘post-growth’ policy positions. This chapter will explore some of the dimensions of a ‘post-growth’ trade union agenda by considering the evidence for going beyond growth from within the trade union movement (specifically looking at the International Labor Organization’s 2004 report on Economic Security, to internal union discussions around trades unionism and climate change) and external evidence ranging from Wilkinson and Pickett’s The Spirit Level (which suggests amongst other things that in the developed world what is needed is not economic growth but greater redistribution and lowering inequality – issues also of traditional interest to the Trades Union movement) to Tim Jackson’s Prosperity without Growth (which suggests that economic growth is ecologically unsustainable as well having passed a threshold beyond which it is contributing to human well-being in the developed world). As well as discussing the relationship between trades unionism and what may be called ‘green political economy’ (such as the ‘degrowth’ and ‘limits to growth’ perspectives) this chapter will also discuss the practical/policy implications of this ‘post-growth’ perspective in relation to trades unionism’s analysis of capitalism and its transformation in the context of a climate changed, carbon constrained world, including implications for ideas such as basic income, a shorter working week and what a trades unionism focused on how to achieve high quality of life within a low carbon context might look like.

Collaborative practice:a strategy to improve the relevance of health services research.

Health services research has emerged as a tool for decision makers to make services more effective and efficient. While its value as a basis for decision making is well established, the incorporation of such evidence into decision making remains inconsistent. To this end, strengthening collaborative relationships between researchers and healthcare decision makers has been identified as a significant strategy for putting research evidence into practice.

Understanding the collaborative experience between researchers and health care practitioners:Implications for gerontological nursing practice

The health care field is a new arena for collaborative research carried out by practitioner-researcher teams. Although the current literature discusses factors supportive of such teams, most evidence is anecdotal or descriptive of pilot projects. In this article, the authors use survey and interview data to document health care practitioners' views on collaborative research with an experienced researcher/ mentor. Topics covered include a description of the research project and process, positive and negative aspects of doing research, expectations, recommendations to colleagues starting research, and desirable characteristics in practitioners and researchers on collaborative research teams. Of all attributes mentioned, personal traits and skills were among the most frequently mentioned for both practitioners and researchers, followed by research knowledge and attitudes for practitioners, and teaching skills for researchers. The article also addresses factors important to the success of collaborative research: how to develop a project, characteristics of collaborative team members, team functioning, and institutional support. Copyright © 2000 Taylor & Francis.

The Terror that Underpins the “Peace”: The Political Economy of Colombia's Paramilitary Demobilization Process

Studies on terrorism have traditionally focused on non-state actors who direct violence against liberal states. These studies also tend to focus on political motivations and, therefore, have neglected the economic functions of terrorism. This article challenges the divorce of the political and economic spheres by highlighting how states can use terrorism to realise interconnected political and economic goals. To demonstrate this, we take the case of the paramilitary demobilisation process in Colombia and show how it relates to the US-Colombian free trade agreement. We argue that the demobilisation process fulfils a dual role. First, the process aims to improve the image of the Colombian government required to pass the controversial free trade agreement through US Congress to protect large amounts of US investment in the country. Second, the demobilisation process serves to mask clear continuities in paramilitary terror that serve mutually supportive political and economic functions for US investment in Colombia.