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1.
  • de Smet, P., et al. (author)
  • Gender and regional differences in perceived job stress across Europe
  • 2005
  • In: Eur J Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 15:5, s. 536-45
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: Over the last 20 years stress at work has been found to be predictive of several conditions such as coronary heart disease, high blood pressure and non-specific sick leave. The Karasek demand/control/strain concept has been the most widely used in prospective epidemiological studies. OBJECTIVES: To describe distribution in Karasek's demand/control (DC) dimensions as well as prevalence of strain in samples from different parts of Europe grouped into three regions (South, Middle, Sweden), adjusting for occupation. To describe gender differences in Karasek's DC dimensions along with strain prevalence and assess the regional stability of those differences in different occupational groups. DESIGN: The Job stress, Absenteeism and Coronary heart disease in Europe (JACE) study, a Concerted Action (Biomed I) of the European Union, is a multicentre prospective cohort epidemiological study: 38,019 subjects at work aged 35-59 years were surveyed at baseline. Standardised techniques were used for occupation coding (International Standardised Classification of Occupations) and for the DC model (Karasek scale): five items for the psychological demand and nine items for the control or decision latitude dimensions, respectively. RESULTS: A total of 34,972 subjects had a complete data set. There were important regional differences in the Karasek scales and in prevalence of strain even after adjustment for occupational class. Mean demand and control were higher in the Swedish centres when compared to two centres in Milano and Barcelona (Southern region) and values observed in four centres (Ghent, Brussels, Lille and Hoofddorp) in Middle Europe were closer to those observed in the Southern cities than to those obtained in the Swedish cities. Clerks (ISCO 4) and, more specifically, office clerks (ISCO 41) exhibited the smallest regional variation. In a multivariate model, the factor 'region' explained a small fraction of total variance. In the two Southern centres as well as in the four Middle European centres, men perceived marginally less job-demand as compared to women whereas the reverse was observed in the two Swedish centres. Differences were larger for control: men appeared to perceive more control at work than did women. In a multivariate model, gender explained a small fraction whereas occupational level explained a large fraction of the variance. CONCLUSIONS: In this standardised multicentre European study Karasek's DC model showed large gender and occupational differences whereas geographic region explained a small fraction of the total DC variance, notwithstanding large differences in labour market and working conditions as pointed out by the European Commission as recently as 2000.
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2.
  • Kornitzer, M., et al. (author)
  • Job stress and major coronary events: results from the Job Stress, Absenteeism and Coronary Heart Disease in Europe study
  • 2006
  • In: Eur J Cardiovasc Prev Rehabil. - : Oxford University Press (OUP). - 1741-8267 .- 1741-8275. ; 13:5, s. 695-704
  • Journal article (peer-reviewed)abstract
    • AIMS: The intention of this study is to investigate the relationship of the demands/control/strain model with hard coronary events in an epidemiological, prospective, multicenter, European study. METHODS AND RESULTS: Six cohorts (Brussels, Ghent, Lille, Barcelona, Goteborg and Malmo) from four European countries (Belgium, France, Spain and Sweden) consisting of 21 111 middle-aged male subjects participated between 1993 and 1996 in the baseline survey of the Job Stress, Absenteeism and Coronary Heart Disease in Europe (JACE) study. The Karasek strain model of psychological demands (five items)/control (nine items) was used. During a mean follow-up of 40 months 185 acute coronary events or coronary deaths were observed. Age-adjusted hazard ratios (HRs) for developing an acute coronary event were 1.46 [CI 95% confidence interval (1.08-1.97)] for high against low psychological demands and 1.53 (95% CI 1.0-2.35) for strained (high demands plus low control) against relaxed (low demands plus high control) groups. After adjustment for standard cardiovascular risk factors the HR for developing a coronary event for those above or equal to the median against those below the median of psychological demands was 1.46 (95% CI 1.08-1.97) whereas the HR for strained against relaxed groups is 1.46 (95% CI 0.96-2.25). Sensitivity analyses confirmed the robustness of the results. CONCLUSION: In this European, multicenter, prospective, epidemiological study the Karasek job strain model was an independent predictor of acute coronary events, with the psychological demands scale emerging as the important component.
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3.
  • de Lauzon, Blandine, et al. (author)
  • The Three-Factor Eating Questionnaire-R18 is able to distinguish among different eating patterns in a general population.
  • 2004
  • In: The Journal of nutrition. - 0022-3166. ; 134:9, s. 2372-80
  • Journal article (peer-reviewed)abstract
    • A revised version of the Three-Factor Eating Questionnaire (TFEQ) was developed in an obese population, but its applicability to the general population was not assessed. We aimed to define the relationship between eating behavior and reported food intake. This was a cross-sectional study of 529 middle-aged adults and 358 teenagers and young adults recruited on a geographical basis. The TFEQ-R18 measures 3 aspects of eating behavior: cognitive restraint (CR), uncontrolled eating (UE), and emotional eating. Reported food intake was calculated from a food frequency questionnaire. Girls who scored higher on restrained eating had a lower energy intake than the other girls (9164 kJ vs. 13,163 kJ, P < 0.001). In adult men, energy intake increased with UE (9663 kJ vs. 11,029 kJ in the lower and higher UE tertiles, respectively, P < 0.05). When specific food groups were analyzed, higher CR was positively associated in adults with healthy food groups like green vegetables [OR = 1.92 (0.68-2.44)] and negatively associated with French fries [OR = 0.35 (0.22-0.57)] and sugar [OR = 0.38 (0.23-0.61)]. Energy-dense foods, such as fat, were positively associated with UE [OR = 2.28 (1.46-3.57) for dietary fat]. Finally, emotional eaters had a higher snacking food intake. In teenagers and young adults, most associations were seen with CR. Converse to observations in adults, teenagers and young adults who exhibited a high cognitive restraint reported consumption of fewer energy-dense foods rather than more "healthy foods." The TFEQ-R18 was therefore able to distinguish among different eating patterns in our sample of a French general population.
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4.
  • de Lauzon-Guillain, Blandine, et al. (author)
  • Is restrained eating a risk factor for weight gain in a general population?
  • 2006
  • In: The American journal of clinical nutrition. - 0002-9165. ; 83:1, s. 132-8
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: In modern societies characterized by abundant and accessible foods, restrained eating may become an adaptive behavior to limit weight gain. OBJECTIVE: We assessed the relations between eating behavior (EB) and adiposity in a general population over a 2-y period. DESIGN: We recruited 466 adults and 271 adolescents in 1999 on a geographical basis to participate in a longitudinal study. At the initial examination and 2 y later, they answered an EB questionnaire, the Three-Factor Eating Questionnaire-R18, which measured cognitive restraint (CR), uncontrolled eating, and emotional eating. On the same occasions, several measures of adiposity were also obtained: body mass index (BMI; in kg/m2), waist circumference, the sum of 4 skinfold thicknesses, and percentage body fat. Relations between EB and adiposity were tested separately in adults and adolescents by using mixed linear regressions after adjustment for age, sex, and (in adolescents) Tanner pubertal stage. RESULTS: At baseline, CR was positively associated with BMI in normal-weight subjects (mean BMI: 21.4 in the lowest to 23.3 in the highest CR quintile; P < 0.001) but not in overweight adults (P = 0.25). Initial CR did not predict change in adiposity variables (BMI change: P = 0.79 in adults, P = 0.57 in adolescents and young adults). Conversely, a high initial BMI was associated with a larger increase in CR (beta = 20.1, P < 0.0001 in adults; beta = 21.7, P = 0.003 in adolescents and young adults). CONCLUSIONS: Restrained eating is strongly associated with adiposity in normal-weight subjects but not in overweight subjects. However, restrained eating does not promote weight gain.
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