Psychosocial work stressors and risk of type 2 diabetes: effect, impact and mechanisms

BACKGROUND: As early as the 17th century diabetes was linked to psychosocial stressors, yet this association still remains elusive. The impact of psychosocial work stressors on diabetes is also unknown, as are the pathways involved. AIM: To investigate the prospective effect and impact of psychosocial work stressors on incident T2DM and elucidate direct and indirect pathways in this association. METHODS: Prospective analysis (1991-2004) among 5895 Caucasian middle-aged civil servants free from baseline diabetes in the Whitehall II cohort study. T2DM was ascertained by an oral glucose tolerance test supplemented by self-reports over four consecutive waves of data collection. The demand/control/support and effort-reward imbalance models were used to assess psychosocial work stressors. RESULTS: Job strain (high job demands/low job control), iso-strain (high demands/low control/low work social support) and effort-reward imbalance (high efforts/low rewards at work) are associated with 60% to 2-fold higher risk of T2DM among women but not men. This effect is higher among obese and lower socioeconomic position individuals. An estimated 35-44% of T2DM cases are attributed to psychosocial work stressors among exposed women, while 10-15% of all cases in the study population are estimated to result from exposure to work stressors, assuming a causal association. Biological factors (obesity, HDL-cholesterol and markers of inflammation) explain 1/3 of the effect of psychosocial work stressors on T2DM. CONCLUSIONS: The observed association between psychosocial work stressors and T2DM is internally valid, temporal and biologically plausible, thus most likely causal. The external validity is questionable however as the effect was observed among a very specific sample of white-collar, Caucasian female civil servants. Given the interaction with body weight status, reduction of psychosocial work stressors would offer some benefits in light of the huge impact of the growing obesity epidemic on T2DM. Even though cardiometabolic and inflammatory factors explain a substantial part of the psychosocial effect on T2DM, other novel mediating factors should be identified. These results should be confirmed by other studies, preferably experimental, with special attention on gender differences. Policies for reduction of psychosocial work stressors should be informed by findings from such studies

Agropastoral Systems an Alternative to Revert Pasture Degradation in the Cerrados of Brazil: Preliminary Results

A long term experiment was set to test the hypothesis that agropastoral systems could improve crop and animal production, being more profitable and sustainable relative to economical, biological and environmental aspects, than continuous and traditional crop and grazing pasture systems. Five farming systems are being tested: two traditional (continuous soybean annual cropping and continuous pasture cropping) and three agropastoral systems (two combinations of four by four years of rotational crop-pasture systems and one by three years of crop-pasture rotation). Animal production in continuous pasture cropping measured as liveweight gain/ha (LWG) are declining along the years in the sub-treatment without fertilizer maintenance. After five cycles of animal performance evaluation, average yields were 397 as compared to 444 kg of LWG/ha, in fertilized pasture. Agropastoral systems, in the other hand, have shown promising results of LWG, either in the one by three or in the four by four cropping combination, with animal production ranking from 547 to 789 kg of LWG/ha/year. Soil fertility in agropastoral systems increased substantially

Dietary glycaemic index and cognitive function: prospective associations in adults of the 1946 British birth cohort

OBJECTIVE: Evidence suggests that the rate of glucose release following consumption of carbohydrate-containing foods, defined as the glycaemic index (GI), is inversely associated with cognitive function. To date, most of the evidence stems from either single-meal studies or highly heterogeneous cohort studies. We aimed to study the prospective associations of diet GI at age 53 years with outcomes of verbal memory and letter search tests at age 69 years and rate of decline between 53 and 69 years. DESING: Longitudinal population-based birth cohort study. SETTING: MRC National Survey for Health and Development. PARTICIPANTS: Cohort members (n 1252). RESULTS: Using multivariable linear and logistic regression, adjusted for potential confounders, associations of higher-GI diet with lower verbal memory, lower letter search speed and lower number of hits in a letter search test were attenuated after adjustments for cognitive ability at age 15 years, educational attainment, further training and occupational social class. No association was observed between diet GI at 53 years and letter search accuracy or speed–accuracy trade-off at 69 years, or between diet GI at 53 years and rate of decline between 53 and 69 years in any cognitive measure. CONCLUSIONS: Diet GI does not appear to predict cognitive function or decline, which was mainly explained by childhood cognitive ability, education and occupational social class. Our findings confirm the need for further research on the association between diet and cognition from a life-course perspective

One size doesn't fit all: PBL tutor training and development

PBL tutors in medical schools worldwide are a diverse population of faculty (subject-expertise, employment status and tutoring experience). Tutors often receive a common initial training program followed by structured support. This study aims to understand tutor motivation, challenges and support needed, the relationship between them and whether a common training and support program is understood as effective. Tutor data (n =50) were analyzed based on age, gender, background, experience, employment status and campus location. Interestingly, the study revealed some evidence that a challenge for tutors is what disrupts their motivation and thus a relevant support mechanism is needed in order to re-establish or maintain this motivation. Specifically, the motivator “interaction with students” correlated with challenges “management of group dynamics”, “student adherence with PBL rules” and “professional behavior of students” whilst motivator “educational value of PBL” correlated with “student adherence with PBL rules”, “professional behavior of students” and “student information and expectations of PBL”. Further, tutors benefited from peer-reviews and opportunities to provide feedback whilst, their needs diverged in terms of content and assessment-related support, motivation and management of group dynamics. Thus, implementation of a framework for restructuring the tutor support system is necessary paving the way for an individualized support system

Y-chromosomal analysis of Greek Cypriots reveals a primarily common pre-Ottoman paternal ancestry with Turkish Cypriots

Genetics can provide invaluable information on the ancestry of the current inhabitants of Cyprus. A Y-chromosome analysis was performed to (i) determine paternal ancestry among the Greek Cypriot (GCy) community in the context of the Central and Eastern Mediterranean and the Near East; and (ii) identify genetic similarities and differences between Greek Cypriots (GCy) and Turkish Cypriots (TCy). Our haplotype-based analysis has revealed that GCy and TCy patrilineages derive primarily from a single gene pool and show very close genetic affinity (low genetic differentiation) to Calabrian Italian and Lebanese patrilineages. In terms of more recent (past millennium) ancestry, as indicated by Y-haplotype sharing, GCy and TCy share much more haplotypes between them than with any surrounding population (7–8% of total haplotypes shared), while TCy also share around 3% of haplotypes with mainland Turks, and to a lesser extent with North Africans. In terms of Y-haplogroup frequencies, again GCy and TCy show very similar distributions, with the predominant haplogroups in both being J2a-M410, E-M78, and G2-P287. Overall, GCy also have a similar Y-haplogroup distribution to non-Turkic Anatolian and Southwest Caucasian populations, as well as Cretan Greeks. TCy show a slight shift towards Turkish populations, due to the presence of Eastern Eurasian (some of which of possible Ottoman origin) Y-haplogroups. Overall, the Y-chromosome analysis performed, using both Y-STR haplotype and binary Y-haplogroup data puts Cypriot in the middle of a genetic continuum stretching from the Levant to Southeast Europe and reveals that despite some differences in haplotype sharing and haplogroup structure, Greek Cypriots and Turkish Cypriots share primarily a common pre-Ottoman paternal ancestry

Kinstate intervention in ethnic conflicts : Albania and Turkey compared

Albania and Turkey did not act in overtly irredentist ways towards their ethnic brethren in neighboring states after the end of communism. Why, nonetheless, did Albania facilitate the increase of ethnic conflict in Kosovo and Macedonia, while Turkey did not, with respect to the Turks of Bulgaria? I argue that kin-states undergoing transition are more prone to intervene in external conflicts than states that are not, regardless of the salience of minority demands in the host-state. The transition weakens the institutions of the kin-state. Experiencing limited institutional constraints, self-seeking state officials create alliances with secessionist and autonomist movements across borders alongside their own ideological, clan-based and particularistic interests. Such alliances are often utilized to advance radical domestic agendas. Unlike in Albania's transition environment, in Turkey there were no emerging elites that could potentially form alliances and use external movements to legitimize their own domestic existence or claims

Constructing identity through symbols by groups demanding self-determination: Bosnian Serbs and Iraqi Kurds

This contribution revisits the question over which much ink has been spilled in the study of national self-determination; who are the people? More specifically, the authors ask how national identity in self-determination claims is constructed. Drawing on observations from two case studies, they submit that cultural/ethnic definitions of national identity continue to underwrite self-determination claims. The authors argue that these practices have been central to the process of defining and reproducing the group identity on behalf of which the claim to political autonomy is made. The use of symbols and practices referring to territorially bound distinct nations with different linguistic and cultural features compared with other groups inhabiting the state reinforces the assertiveness of self-determination claims. Despite their differences, Bosnian Serbs and Iraqi Kurds typically follow similar trajectories in their use of ethnic, cultural and territorial symbols to reinstate the validity of their demands

Stres na radu i zdravlje medicinskih sestara u jedinicama intenzivne njege u Srbiji

The aim of this study was to identify and analyse professional stressors, evaluate the level of stress in nurses in Intensive Care Units (ICU), and assess the correlation between the perception of stress and psychological and somatic symptoms or diseases shown by nurses. The research, designed as a crosssectional study, was carried out in the Intensive Care Units (ICU), in health centres in Serbia. The sample population encompassed 1000 nurses. Expanded Nursing Stress Scale (ENSS) was used as the research instrument. ENSS revealed a valid metric characteristic within our sample population. Nurses from ICUs rated situations involving physical and psychological working environments as the most stressful ones, whereas situations related to social working environment were described as less stressful; however, the differences in the perception of stressfulness of these environments were minor. Socio-demographic determinants of the participants (age, marital status and education level) significantly affected the perception of stress at work. Significant differences in the perception of stressfulness of particular stress factors were observed among nurses with respect to psychological and somatic symptoms (such as headache, insomnia, fatigue, despair, lower back pain, mood swings etc.) and certain diseases (such as hypertension, myocardial infarction, stroke, diabetes mellitus etc). In view of permanent escalation of professional stressors, creating a supportive working environment is essential for positive health outcomes, prevention of job-related diseases and better protection of already ill nurses.Cilj je ovoga rada bio identifi cirati i analizirati profesionalne stresore, procijeniti razinu stresa kod medicinskih sestara u jedinicama intenzivne njege te procijeniti korelaciju između percepcije stresa i prisutnosti psiholoških i somatskih simptoma ili bolesti kod medicinskih sestara. Istraživanje je provedeno u obliku studije presjeka u Jedinicama intenzivne njege u zdravstvenim centrima u Srbiji. Uzorak se sastojao od 1000 medicinskih sestara-tehničara. Za procjenu i analizu profesionalnih stresora korišten je upitnik Expanded Nursing Stress Scale (ENSS), koji je pokazao validne metrijske karakteristike na našoj ispitanoj populaciji. Medicinske sestre u Jedinicama intenzivne njege ocijenile su situacije iz fizičkoga i psihološkoga radnog okruženja kao izrazito opterećujuće, a situacije iz socijalnoga radnog okruženja kao manje opterećujuće. Razlika u percepciji stresogenosti navedenih radnih okruženja nije bila statistički značajna. Sociodemografske determinante ispitanika (dob, bračno stanje i stupanj obrazovanja) značajno utječu na percepciju stresa na radnom mjestu. Utvrđena je statistički značajna razlika u opažanju stresogenosti pojedinih stresnih situacija na radnom mjestu između medicinskih sestara u odnosu na postojanje psihosomatskih simptoma (kao što su glavobolja, nesanica, umor, očaj, bol u leđima, česte promjene raspoloženja) ili određenih bolesti (kao što su povišena hipertenzija, infarkt miokarda, cerebrovaskularni inzult, šećerna bolest). Zbog sve izraženije prisutnosti profesionalnih stresora nužno je poduzeti određene strateške mjere kod medicinskih sestara u Jedinicama intenzivne njege. Strateške mjere podrazumijevaju unaprjeđenje psihosocijalne radne klime, što bi unaprijedilo njihovo zdravlje i spriječilo nastanak bolesti u svezi s radom, ali i omogućilo bolju zaštitu već oboljelim medicinskim sestrama