Coronary artery calcium: a multi-institutional, multimanufacturer international standard for quantification at cardiac CT. Slote L.

DEFINING THE SOCIAL AND CULTURAL ENVIRONMENT

Rubino, C. Schyns, B. Contemporary Educational Psychology , 25, 82— Cardiol Rev. Marmot M, Ryff CD, Bumpass LL, Shipley M, Marks NF.

In the fields of occupational health psychology and social epidemiology, have focused on characterizing the psychosocial work environment, including measures of job security, psychological job demands and stress, and decision latitude (control over the work process) (Karasek and Theorell, ).

• Downsizing and social cohesion: the case of downsizing survivors.
• Additionally, how the accumulation of stressful experiences over a lifetime impacts the relationship between stress, SES, and drug abuse would provide important additional information about how genetic mechanisms work.

Psychosocial job exposure and risk of coronary artery ...

25/05/2021 · Karasek RA. Job demands, job decision latitude, and mental strain: Implications for job redesign. Adm Sci Q. 1979;24:285–308. View Article Google Scholar 6. Karasek R, Theorell T. Healthy work: stress, productivity, and the reconstruction of working life: Basic books; 1992. View Article

The Job-Demand-Control-Support Model: What it is and why ...

09/12/2020 · The Job-Demand-Control-Support model is a well-known theory that explains how job characteristics influence employees’ psychological well-being (Karasek & Theorell, 1990). The model illustrates how job demands can cause stress for employees, such as heavy workload, role ambiguity, and job-related strain.

Dean and Pollard () adapted the demand control concept from occupational conducted by Robert Karasek () and Törres Theorell (Karasek & Theorell, ). Karasek and Theorell recognized that occupational stress and illness, or work satisfaction and effectiveness, arise from an interactive dynamic between the challenges (demands.

Karasek Theorell 1990. Genes, Behavior, and the Social Environment: Moving Beyond the Nature/Nurture Debate.

Finally, intrapersonal demands are interpreting challenges or success requirements that pertain to the internal physiological or psychological state of the interpreter e. In Dean and Pollard's D-C schema, controls are skills, decisions, or other resources that an interpreter may bring to bear in response to the demands presented by a given work assignment.

Controls for interpreters may include education, experience, preparation for an assignment, behavioral actions or interventions, particular translation decisions, e.

As adapted from Karasek's D-C theory, the term controls refers to a broad array of worker characteristics, abilities, judgments, and actions that contribute to effective work. As we use the term, it is a noun, not a verb, and is preferably stated as control options. Dean and Pollard define three temporal opportunities where controls may be employed: pre-assignment controls e. When engaging in a D-C work analysis, recognition of a given demand sparks consideration and critique of control options that might be employed during each of these three time periods.

See our publications page for a complete listing of our DC-S and other publications, many of which are available free of charge by request. Together, education, income, and occupation mutually influence and interact with one another over the life course to shape the health outcomes of individuals at multiple levels of social organization the family, neighborhoods, and beyond.

An independent social determinant of health is the extent, strength, and quality of our social connections with others. Recognition of the importance of social connections for health dates back as far as the work of Emile Durkheim.

Certain periods during the life course may be critical for the development of bonds and attachment Fonagy, According to attachment theory, secure attachments during infancy satisfy a universal human need to form close affective bonds Bowlby, Two social variables are of particular interest in characterizing social relationships: social networks and social support.

Social networks are defined as the web of person-centered social ties Berkman and Glass, Social support refers to the various types of assistance that people receive from their social networks and can be further differentiated into three types: instrumental, emotional, and informational support. Instrumental support refers to the tangible resources such as cash loans, labor in kind that people receive from their social networks, while emotional support includes less tangible but equally important forms of assistance that make people feel cared for and loved such as sharing confidences, talking over problems.

Informational support refers to the social support that people receive in the form of valuable information, such as advice about healthy diets or tips about a new cancer screening test. A variety of pencil-and-paper instruments exist to measure both social networks and social support; for a detailed guide, see Cohen et al.

Several of these instruments have been psychometrically validated and indicate good internal consistency and test-retest reliability. A substantial body of epidemiological evidence has linked social networks and social support to positive physical and mental health outcomes throughout the life course Stansfeld, Social connectedness is be lieved to confer generalized host resistance to a broad range of health outcomes, ranging from morbidity and mortality to functional outcomes Cassel, Prospective epidemiological studies in adult populations have found consistently that social networks predict the risk of all-cause and cause-specific mortality including cardiovascular disease, cancer, and traumatic causes of death Berkman and Glass, For mental health outcomes, a wealth of evidence indicates that social support buffers the effects of stressful life events and helps to prevent the onset of psychiatric disorders, particularly depression Kawachi and Berkman, Both social networks and social support have been linked to better prognoses and survival following major illnesses, such as myocardial infarction, stroke, and certain types of cancer, including melanoma Berkman and Glass, Some experimental evidence in the field of psychoneuroimmunology has suggested that social connectedness may confer host resistance against the development of infections Cohen et al.

For example, the presence of a supportive caregiver among children has been shown to lower hypothalamic-pituitary-adrenal HPA reactivity as measured by salivary cortisol levels to maternal separation Gunnar et al. Among adults, social support predicts lower levels of HPA axis and sympathetic nervous system reactivity in laboratory-based challenge paradigms Seeman and McEwen, First, major illnesses such as a diagnosis of depression or HIV can be a potent trigger of changes in social networks and social support.

Similarly, abusive partners or abusive parents are sources of negative social support. See Chapter 4 for a detailed discussion of personality and temperament. For example, recent large-scale randomized trials following major illnesses, such as myocardial infarction Writing Committee for the ENRICHD Investigators, , stroke Glass et al. However, it is premature to conclude on the basis of these intervention trials that social support has no causal effect on health.

The bottom line seems to be that effective interventions to strengthen social support to affect clinical outcomes have yet to be devised Cohen et al. Animal models point to the role of the neuropeptide oxytocin in facilitating various social behaviors such as maternal attachment and pair bonding Zak et al. Social support and the administration of oxytocin have been shown to reduce stress responses during a public speaking task Heinrichs et al.

In the emerging field of neuroeconomics, it was recently demonstrated that the intranasal administration of oxytocin causes a substantial increase in trust among humans, thereby greatly increasing the benefits from social interactions Kosfeld et al.

If oxytocin is indeed the biological substrate for prosocial behavior, these preliminary findings suggest promising experimental and laboratory-based approaches for investigating gene-environment interactions in the association of social support and health.

Measures of social capital typically emphasize two components, both measured or aggregated to the community level. The structural component of social capital includes the extent and intensity of associational links and activity in society e. A growing number of multilevel studies have found an association between community stocks of social capital and individual health outcomes e.

For example, higher stocks of social capital are associated with the improved ability of communities to exercise informal social control over deviant behaviors such as smoking and drinking by minors , as well as to undertake collective action for mutual benefit e.

The psychosocial work environment—particularly exposure to job stress—has been linked to the onset of several conditions, including cardiovascular disease, musculoskeletal disorders, and mental illness Marmot and Wilkinson, Two models of job stress have received particular attention in the literature: the job demand-control model Karasek and Theorell, and the effort-reward imbalance model Siegrist et al. The demand-control model posits that it is the combination of high psychological demands and low level of control low decision authority and skill utilization that leads to high physiological strain among workers and hence to the onset of disease such as hypertension and cardiovascular disease Marmot and Wilkinson, A pencil-and-paper questionnaire to measure job demands and job control has been developed and validated for use in population-based studies and can be accessed at www.

In contrast to the demand-control model of job stress, the effort-reward imbalance model developed by Siegrist maintains that working conditions produce adverse health outcomes when the costs associated with the job e. As with the demand-control model, a self-administered questionnaire has been developed and validated. Both the demand-control model and the effort-reward imbalance model have been shown to predict the incidence of cardiovascular disease and other health outcomes in longitudinal observational studies Marmot and Wilkinson, The relationship between job stress and health is likely to be reciprocal, however.

For example, the onset of subtle illness symptoms may result in the worker switching to a less demanding job. On the other hand, other problems, such as omitted variable bias, can present formidable challenges to causal inference in this field.

If these third variables temperament, hardiness remain unmeasured, their omission may result in biased estimates of the effect of psychosocial working conditions on health outcomes. Social variables potentially affect health outcomes throughout the entire spectrum of etiology: from disease onset beginning prenatally and accumulating in their effects throughout the life course to disease progression and survival. Prior to the onset of disease, social variables might influence the risk of prenatal infections, the adoption of risky or health-promoting behaviors, or the ability to cope with adverse circumstances.

It is important to note, however, that the relevance and magnitude of the associations between social-environmental variables and health outcomes can vary at different points of the disease process.

For breast cancer, the increased incidence among higher SES women is in part explained by reproductive factors, including earlier age at menarche, later age at first birth, and lower fertility.

Likewise, observational evidence suggests the strong role of social support in improving survival and functional recovery following major diseases such as stroke or heart attack , but the evidence is less consistent for preventing the incidence of disease where social networks appear to have a stronger role Seeman, For example, the Barker hypothesis implicates the prenatal period as being particularly relevant for the later development of coronary heart disease and some cancers Barker and Bagby, Childhood illness can in turn truncate the educational and occupational mobility of the affected individuals.

This constitutes a social mechanism—separate from a genetic mechanism—for the inheritance or transmission of disease risk. There may, of course, be gene-environment interactions involved in the ways in which these two separate influences shape the patterns of health across the life course.

Specifically, benefits may result from the increased interest in understanding gene-environment interactions that may include insights into the social variables that represent important sources of variance and increased understanding about how physiological pathways for some disease processes might be modified, constrained, or moderated by environmental influences.

For example, if one were interested in how stress is related to drug abuse, given the higher levels of chronic social stress, an ethnically diverse sample would be of great benefit to drawing conclusions about extremes of the stress continuum by studying African Americans who have experienced psychosocial sources such as racism and discrimination e.

Additionally, how the accumulation of stressful experiences over a lifetime impacts the relationship between stress, SES, and drug abuse would provide important additional information about how genetic mechanisms work. There remain important unanswered questions in understanding the contribution of the social and cultural environment to health.

Significant opportunities are at hand to bridge the gaps in our understanding of how social and genetic factors interact and mutually influence health outcomes. The next chapter discusses the relationship of genetics and health. It should be noted that genetic factors also may apparently vary by socioeconomic group. For example, the prevalence of the BRCA1 gene mutations is higher among women of Ashkenazi Jewish descent than among other women. In turn, Americans of Ashkenazi Jewish origin tend to have a higher than average socioeconomic position than the average.

Disentangling the various contributions of genes and social factors is therefore challenging McClain et al. Turn recording back on. National Center for Biotechnology Information , U. National Library of Medicine Rockville Pike , Bethesda MD , USA. NCBI Skip to main content Skip to navigation Resources How To About NCBI Accesskeys My NCBI Sign in to NCBI Sign Out. Show details Institute of Medicine US Committee on Assessing Interactions Among Social, Behavioral, and Genetic Factors in Health; Hernandez LM, Blazer DG, editors.

Contents Hardcopy Version at National Academies Press. SES and Health An association between SES and health has been recognized for centuries Antonovsky, Educational Attainment Education is usually assessed by the use of two standard questions that ask about the number of years of schooling completed and the educational credentials gained.

Occupational Status The third standard component of SES that typically is measured by social scientists is occupational status, which summarizes the levels of prestige, authority, power, and other resources that are associated with differ ent positions in the labor market. Social Networks, Social Support, and Health An independent social determinant of health is the extent, strength, and quality of our social connections with others.

The Psychosocial Work Environment and Health The psychosocial work environment—particularly exposure to job stress—has been linked to the onset of several conditions, including cardiovascular disease, musculoskeletal disorders, and mental illness Marmot and Wilkinson, Exploring relative deprivation: Is social comparison a mechanism in the relation between income and health? Acheson D. Independent Inquiry into Inequalities in Health Report.

London:: The Stationery Office; Adler N, Boyce T, Chesney M, Cohen S, Folkman S, Kahn R, Syme S. Socioeconomic status and health: The challenge of the gradient. American Psychologist. Antonovsky A. Social class, life expectancy and overall mortality. Milbank Memorial Fund Quarterly. Barker DJ, Bagby SP. Developmental antecedents of cardiovascular disease: A historical perspective.

Journal of the American Society of Nephrology. Berkman L, Glass T. Social integration, social networks, social support, and health. In: Berkman L, Kawachi I, editors. Social Epidemiology. New York: Oxford University Press; Berkman L, Kawachi I, editors. Berkman L, Macintyre S. The measurement of social class in health studies: Old measures and new formulations. In: Kogevinas M, Pearce N, Susser M, Boffetta P, editors. Social Inequalities and Cancer. Lyon, France: IARC Scientific Publication Number ; Bowlby J.

London: Hogarth Press; Attachment and Loss. Burgard S, Stewart J, Schwartz J. Occupational Status. San Francisco, CA: MacArthur Network on SES and Health; Case A, Paxson C. Parental behavior and child health. Health Affairs. Case A, Lubotsky D, Paxson C. Economic status and health in childhood: The origins of the gradient. American Economic Review. Cassel J. The contribution of the social environment to host resistance: The fourth Wade Hampton Frost lecture.

American Journal of Epidemiology. Clark R, Anderson NB, Clark VR, Williams DR. Racism as a stressor for African Americans: A biopsychosocial model. Cohen S, Underwood LG, Gottlieb BH.

Social Support Measurement and Intervention. Costello EJ, Compton SN, Keeler G, Angold A. Relationships between poverty and psychopathology: A natural experiment. Journal of the American Medical Association. Cutler D, Lleras-Muney A. Education and Health: Evaluating Theories and Evidence. Ann Arbor, MI: National Poverty Center; Duncan GJ, Daly MC, McDonough P, Williams DR. American Journal of Public Health.

Duncan OD. A socioeconomic index for all occupation. In: Reiss A Jr, editor. Occupations and Social Status. New York: Free Press; Eibner C, Sturn R, Gresenz CR. Does relative deprivation predict the need for mental health services?

Journal of Mental Health Policy and Economics. Ettner SL. New evidence on the relationship between income and health. Journal of Health Economics. Fonagy P. Patterns of attachment, interpersonal relationships and health.

In: Blane D, Brunner E, Wilkinson R, editors. Health and Social Organization: Towards Health Policy for the Twenty-First Century. London: Routledge Press; Glass TA, Berkman LF, Hiltunen EF, Furie K, Glymour MM, Fay ME, Ware J. Psychosomatic Medicine. Gliksman MD, Kawachi I, Hunter D, Colditz GA, Manson JE, Stampfer MJ, Speizer FE, Willett WC, Hennekens CH.

Childhood socioeconomic status and risk of cardiovascular disease in middle aged U. Journal of Epidemiology and Community Health. Goodwin PJ, Leszcz M, Ennis M, Koopmans J, Vincent L, Guther H, Drysdale E, Hundleby M, Chochinov HM, Navarro M, Speca M, Hunter J. The effect of group psychosocial support on survival in metastatic breast cancer. New England Journal of Medicine. Gunnar MR, Larson MC, Hertsgaard L, Harris ML, Brodersen L. The stressfulness of separation among nine-month-old infants: Effects of social context variables and infant temperament.

Child Development. Harpham T, Grant E, Thomas E. Measuring social capital within health surveys: Key issues. Health Policy and Planning. Heinrichs M, Baumgartner T, Kirschbaum C, Ehlert U.

Social support and oxytocin interact to suppress cortisol and subjective responses to psychosocial stress. Biological Psychiatry. Karasek RA, Theorell T. Healthy Work: Stress, Productivity, and the Reconstruction of Working Life. New York: Basic Books; Kasl S, Jones B. The impact of job loss and retirement on health. Kawachi I, Berkman L.

The Impact of Social and Cultural Environment on Health ...

In the fields of occupational health psychology and social epidemiology, researchers have focused on characterizing the psychosocial work environment, including measures of job security, psychological job demands and stress, and decision latitude (control over the work process) (Karasek and Theorell, 1990).

Dean and Pollard () adapted the demand control concept from occupational conducted by Robert Karasek () and Törres Theorell (Karasek & Theorell, ). Karasek and Theorell recognized that occupational stress and illness, or work satisfaction and effectiveness, arise from an interactive dynamic between the challenges (demands. 30/08/ · There is a great deal of demonstrating that occupational stress often from work with the following characteristics (Karasek & Theorell, ): It is very demanding. It has few opportunities for decision making. Workers have little control over how the work must be performed. The Job Demand-Control (-Support) Model (JDCS) (Karasek and Theorell, ; Luchman and González-Morales, ) posits that the combination of high demands, low control and lack of support constitutes a high strain work environment, which may influence various employee outcomes, such as mental and somatic health, job satisfaction, turnover.

Information

Purpose: The present study aimed to clarify the prospective effects of various types and frequencies of Karasek Theorell 1990 changes on aspects in the psychosocial work environment.

Methods: The study had a prospective, full-panel, repeated measures design. Data were collected by self-administered, online questionnaires, with a 2-year interval between measurement occasions.

Five types of organizational change were assessed — company restructuring, downsizing, layoffs, partial closure, and partial outsourcing. The effects of change on eleven, specific work factors were measured utilizing QPS Nordic. At baseline, employees participated, while responded at follow-up.

In the prospective analyses, i. Following repeated organizational changes, statistically significant associations were shown for all 11 work factors coefficients ranging from 0. Organizational change has repeatedly been associated with adverse effects on employee health Oreg et al.

Large-scale organizational changes, such as company restructuring, downsizing and outsourcing have been linked to somatic and mental health complaints, presenteeism and long-term sick leave Kivimäki et al. However, a thorough understanding of why organizational changes are associated with adverse health effects is still pending.

Clarifying the repercussions of organizational change for workplaces and employees is an essential first step to preventing adverse health effects of and facilitating healthy, successful change. Prior meta-analytic Karasek Theorell 1990 have shown a wide range of psychological and social work factors, such as leadership, role conflict and ambiguity, job demands, control and job insecurity to Gangbang My Wife Tube employee well-being, health and sick leave Viswesvaran et al.

In order to elucidate whether extensive company change influence central aspects of the psychosocial work environment the present study aimed to clarify the effects of various types of organizational Karasek Theorell 1990, separately and co-occurring as well as repeated over time, on 11 specific psychological and social work factors.

The term encompasses both the process by which this happens i. By definition, change implies a shift in the organization from one state to another. This shift may be deliberate, with the aim of gaining or losing specific features of the organization to attain a defined goal, or it may be less deliberate, perhaps occurring as a consequence of developments outside the control of the organization. Thus, Karasek Theorell 1990 change can be experienced both as an opportunity to gain and as a risk of losing and may involve Karasek Theorell 1990 of tasks and responsibilities that alter existing work content and —environment in various foreseen and unforeseen ways.

Nevertheless, while prior studies have linked organizational change to somatic and mental health Vahtera et al. A psychosocial work environment consists of organizational- social- and psychological factors which govern and define the content and quality of various aspects of work Nieuwenhuijsen et al.

Organizational work factors include formal and structural conditions that regulate how work is carried out, e. Social work factors Karasek Theorell 1990 the relational aspects of a workplace, such as social climate, support from superiors and co-workers. Karasek Theorell 1990 work factors refer to individual-level aspects of work, such as perceived levels of autonomy, job demands and predictability.

Despite the aforementioned awareness of the potential of organizational change to upset various organizational systems as well as employee health, few studies seem to have assessed effects of organization change on specific factors in the psychosocial work environment that are known to be associated with health. The present study assessed the effect of various types and frequencies of organizational change on 11 distinct work factors pertaining to job tasks job control, job demandsjob roles role clarity, role conflictleadership fair- empowering- supportive leadershipsocial aspects support from co-workers, social climate and predictability job predictability, future employability.

During change implementation, the organization attends to various change-related tasks in addition to the ordinary, day-to-day activities. In sum, this may increase the total amount of work and job tasks employees are faced with Kivimäki et al. Hence, organizational change may be associated with increased job demands i. When major shifts take place within an organization, the rearrangement of employee roles and responsibilities are often a central part of the process.

The need for management to invoke tough and sometimes unpopular decisions, e. Exercising an inclusive and empowering leadership style may thus be challenging during change implementation.

Hence, organizational change may lead to a decrease in employee perception of leadership as fair i. The relational aspects of the organizational may also be affected during extensive workplace changes, as the collegial composition may be rearranged or colleagues have to compete over new or remaining positions. As a result, social cohesion within the group may deteriorate and collegial support diminishes Campbell and Pepper, Thus, organizational change may be associated with a decrease in perceived support from co-workers and social climate as inclusive and trusting.

Change naturally involves some degree of uncertainty regarding the outcome and future. As extensive organizational changes often are management-driven with little Karasek Theorell 1990 involvement, uncertainty may be extra prominent. Hence, organizational changes may be associated with a decrease in employee perception of short-term job predictability and future employability. As the rate of organizational change is increasing, a larger part of the workforce is likely to experience multiple changes or repeated organizational changes during their careers, some of which they may deem excessive.

To our knowledge, a limited number of studies have examined how exposure to repeated organizational changes influence specific factors in the work environment Moore et al. These studies have reported stronger effects following repeated change than separate change, but only on outcomes such as employee health and sick leave Isaksson et al.

Thus, one may speculate whether implementing multiple, repeated changes may also be associated with a stronger effect on psychosocial work factors than single change efforts Klarner et al. In developing targeted interventions aimed at reducing the potential adverse effects of organizational change on employee health, identifying the underlying mechanisms in this stressor-strain relationship is an imperative first step. Interventions aimed at reducing or alleviating the effect of risk factors in the work environment have Karasek Theorell 1990 the potential of such interventions to reduce depressive symptoms and absenteeism and to improve productivity both during and following organizational changes Bambra et al.

The effect of organizational change on specific factors in the work environment may represent such a mechanism in which the work factors may either moderate or mediate the relationship between change and health. In order to illuminate the effect of various specific types of organizational change as well as repeated change on central aspects of the psychosocial work environment, the current study examined both the cross-sectional and prospective associations of separate and repeated organizational change with 11 specific psychological and social work factors.

The study Karasek Theorell 1990 a prospective, full panel study design, with data collected with a 2-year interval. Baseline data collected between andwith Porno Mmf 2 years later, respectively. All data were collected by a self-administered, online questionnaire. A total of 66 Karasek Theorell 1990 organizations participated in the study, representing both public and private sector and a variety of professions, company sizes and sectors.

Upon accepting to participate, information regarding the project was initially given at the company level. All current employees were invited to Karasek Theorell 1990 in the study and received an information letter by postal mail, containing a unique ID-code for accessing the online questionnaire. Respondents were allotted time during work hours to complete the questionnaire but also had the opportunity to complete the questionnaire at home.

Respondents had the opportunity to log in an unlimited number of times to access to complete the questionnaire. Inclusion criteria for both the cross-sectional and prospective sample were completing all items for each individual work factor at both T1 and T2. We assessed the effects of five distinct types of organizational changes. These were company restructuring, downsizing, layoffs, partial closure, and partial outsourcing. QPS Nordic is a validated questionnaire designed to assess a comprehensive set of social and psychological aspects in the workplace.

The effects of organizational changes on 11, specific work factors were assessed. These were six psychological work factors job control, job demands, job predictability, perceived future employability, role clarity, and role conflict and five social work factors empowering leadership, fair leadership, social climate, support from co-worker and support from superior.

Each factor was measured by multiple items, ranging from two to five Sip Notify. exe depending on the factor. All analyses included the variables age, sex, skill level, and place of Zorya Polunochnaya private vs. The categorization was done using the Standard Classification of Occupations STYRKwhich is based on the International Standard Classification of Occupations ISCO and developed by Statistics Norway SSB.

The cross-sectional and prospective associations between the separate types and frequencies of organizational changes and the various work factors were estimated utilizing linear regression analyses by the Generalized Estimated Equations method GEE. The method is based on the generalized linear model and allows for the analyses of correlated observations, such as repeated measures or clustered data. In addition, the method allows for samples to have a non-normal error distribution on the response variable.

The GEE approach Granny Group Sex chosen as it accounts for the potential correlated responses within sample clusters, which fit the present data well as it was clustered within organizations Zorn, ; Hubbard et al.

The GEE method gives a population parameter estimate based on the average of clusters in the data Hardin and Hilbe, ; Hanley et al. Hence, the GEE method estimates the average response in a population-based on the average of clusters within a sample. The GEE analysis provides the Karasek Theorell 1990 to predefine the anticipated correlation structure in the data, for instance independent, autoregressive, compound symmetry, or unstructured.

In the present analyses, the unstructured option was chosen since no theoretical grounds were present to expect a specific correlation structure in the data. In addition, Granny Group Sex unstructured option does not impose any constraints in the correlation structure in the analyses Hardin and Hilbe, GEE has previously been widely applied in epidemiological studies where data have been correlated as the method may handle various types of prior, unidentified correlations between measurements Merlo, ; Skrondal and Rabe-Hesketh, ; Cui and Qian, All analyses were run using IBM SPSS Statistics, version In the cross-sectional analyses pertaining to specific, separate organizational changes, we ran both uni- and multi-variate regressions separately with each type of change as predictor and each type of work factor as outcome.

In the prospective analyses, both uni- and multi-variate regressions were run separately with each type of change as predictor and each type Karasek Theorell 1990 work factor as outcome. The analyses were run in two steps. In the first step, Model I, analyses were adjusted for age, sex, skill level and place of employment, while in step two, Model II, analyses were also adjusted for baseline levels of the work factor in question.

In the analyses pertaining to multiple changes, we ran simple regressions with the three-level categorical predictor variable for each work factor separately. As in the analyses pertaining to specific changes, all analyses were conducted in two steps. Lastly, in the analyses pertaining to the effects Karasek Theorell 1990 repeated change, we ran simple regressions with the aforementioned four-level categorical predictor for each work factor separately.

These Karasek Theorell 1990 were also conducted in two-steps. The mean age at baseline was Xxx Zoofil Of the included subjects Women constituted For further details, see Table 1. Women were less likely to be non-respondents OR 0.

Karasek Theorell 1990 employed in private sector companies were also less likely to be non-respondents OR 0. As for skill level, respondents employed in jobs requiring 10—12 OR 1. For further details, see Table 2. Being employed in private sector was linked to dropout at follow-up OR 1. Working in an occupation requiring 13—15 years of formal education OR 1. On the other hand, employees aged 35—55 were negatively associated with dropout OR 0.

Gender was not associated with attrition. See Table 4 for further details. The multivariate analyses showed fewer significant associations, however all work factors were significantly associated with at least one type of specific change each with B- values ranging from 0. See Table Eigene Muschi Basteln for further details. In Model II, i. For further details see Table 4.