Job Strain and its Associated Factors among Lecturers in the School of Medical Sciences, Universiti Sains Malaysia and Faculty of Medicine, Universiti Kebangsaan Malaysia

The aim of this study was to investigate whether job strain, psychological demands, and decision latitude are independent determinants of disability pension rates over a 12-year follow-up period. We studied 3,181 men and 3,359 women, all middle-aged and working at least 30 h per week, recruited from the general population of Malmö, Sweden, in 1992. The participation rate was 41 %. Baseline data include sociodemographics, the Job Content Questionnaire, lifestyle, and health-related variables. Disability pension information was obtained through record linkage from the National Health Insurance Register. Nearly 20 % of the women and 15 % of the men were granted a disability pension during the follow-up period. The highest quartile of psychological job demands and the lowest quartile of decision latitude were associated with disability pensions when controlling for age, socioeconomic position, and health risk behaviours. In the final model, with adjustment also for health indicators and stress from outside the workplace, the hazard ratios for high strain jobs (i.e. high psychological demands in combination with low decision latitude) were 1.5 in men (95 % CI, 1.04-2.0) and 1.7 in women (95 % CI, 1.3-2.2). Stratifying for health at baseline showed that high strain tended to affect healthy but not unhealthy men, while this pattern was reversed in women. High psychological demands, low decision latitude, and job strain were all confirmed as independent risk factors for subsequent disability pensions. In order to increase chances of individuals remaining in the work force, interventions against these adverse psychosocial factors appear worthwhile.

Event Abstract Back to Event Acute stress induces voluntary alcohol intake in mice through anxiety mitigated by toll-like receptor 4 antagonist Huei G. Chuang1, Sangu Muthuraju1*, Nur Naznee H. Abd Aziz2, Mustapha Muzaimi2, Jafri M. Abdullah1, 2 and Zamzuri Idris1, 2 1 Hospital Universiti Sains Malaysia, Health Campus, Universiti Sains Malaysia, Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Malaysia 2 Universiti Sains Malaysia Health Campus, Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Malaysia Background Evidences previously supporting the functional involvement of toll-like receptor 4 (TLR4) in the mediation of neuroimmune system, further promoting the emergence of alcohol drinking behaviour following stress exposure. Thus, this study focused to investigate the effect of TLR4 antagonist Lipopolysaccharide-Rhodobacter Sphaeroides(LPS-RS) on the stress-induced voluntary alcohol drinking behaviour, neuronal component, and genes expression associating with stress and addiction. Methods This study involved the exposure of restraint and social isolation stress using Swiss Albino mice. Two-bottle choice ethanol exposure method was used in the evaluation of voluntary ethanol drinking behaviour. Several behavioural assessments including elevated plus-maze, light-dark box exploration, open field maze, beam walking test, and wire hanging test were carried out to assess the fear and anxiety-like behaviour, locomotion, motor coordination, and neuromuscular ability. Morphological and immunoreactivity analysis and genes expression analysis were done after the completion of behavioural assessments. Results TLR4 antagonist LPS-RS treated stressed-mice showed a significant decrease in the ethanol intake compared to stressed mice. Behaviourally, acute stress did not cause any significant deficits on the motor coordination, neuromuscular ability, locomotion, exploratory behaviour and risk-assessment behaviour. Behavioural results proved that acute stress exposure causing the emergence of fear and anxiety-like behaviour in the stressed mice. Morphological analysis showed no significant changes in prefrontal cortex and hippocampus among all groups, while in immunoreactivity analysis, stressed-mice showed a significant increase immunoreactivity of c-FOS in both prefrontal cortex and hippocampus, significant increase immunoreactivity of TLR4 in prefrontal cortex and GFAP in hippocampus. Stressed-mice too showed significant increase in the TLR4, NF-Kappa, iNOS, DRD2, CREB-1, and OPRM-1 genes expression compared to control and LPS-RS treated mice. Conclusion TLR4 suppression using antagonist LPS-RS could be effective in reducing the ethanol intake among stress-exposed mice suggested that TLR4 suppression might provide a therapeutic value in the treatment of stress-induced alcohol addiction. Acknowledgements We thank the School of Medical Sciences, Pusat Pengajian Sains Perubatan (PPSP), Universiti Sains Malaysia. This work has been supported by project number 304/PPSP/61313158 from the Short-term Grant received by Dr. Sangu Muthuraju. Keywords: Toll-like recepter 4 (TLR4), acute stress, Addiction, Alcohol drinking behavior, Lipopolysaccharide-Rhodobacter Sphaeroides(LPS-RS) Conference: International Conference on Drug Discovery and Translational Medicine 2018 (ICDDTM '18) “Seizing Opportunities and Addressing Challenges of Precision Medicine”, Putrajaya, Malaysia, 3 Dec - 5 Feb, 2019. Presentation Type: Oral Presentation Topic: Miscellaneous Citation: Chuang HG, Muthuraju S, Abd Aziz NH, Muzaimi M, Abdullah JM and Idris Z (2019). Acute stress induces voluntary alcohol intake in mice through anxiety mitigated by toll-like receptor 4 antagonist. Front. Pharmacol. Conference Abstract: International Conference on Drug Discovery and Translational Medicine 2018 (ICDDTM '18) “Seizing Opportunities and Addressing Challenges of Precision Medicine”. doi: 10.3389/conf.fphar.2018.63.00073 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 30 Sep 2018; Published Online: 17 Jan 2019. * Correspondence: Dr. Sangu Muthuraju, Hospital Universiti Sains Malaysia, Health Campus, Universiti Sains Malaysia, Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan Darul Naim, 16150, Malaysia, muthuraju67@gmail.com Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Huei G Chuang Sangu Muthuraju Nur Naznee H Abd Aziz Mustapha Muzaimi Jafri M Abdullah Zamzuri Idris Google Huei G Chuang Sangu Muthuraju Nur Naznee H Abd Aziz Mustapha Muzaimi Jafri M Abdullah Zamzuri Idris Google Scholar Huei G Chuang Sangu Muthuraju Nur Naznee H Abd Aziz Mustapha Muzaimi Jafri M Abdullah Zamzuri Idris PubMed Huei G Chuang Sangu Muthuraju Nur Naznee H Abd Aziz Mustapha Muzaimi Jafri M Abdullah Zamzuri Idris Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

In line with Karasek's job strain model, the objective of the study was to determine whether workers submitted to high job strain, a combination of high psychological demand and low decision latitude, develop more psychological distress than workers not submitted to high job strain. A second objective was to determine whether social support at work modifies the association between job strain and psychological distress. The design was cross-sectional and included white-collar workers in the Québec city area. A self-administered 26-item questionnaire (the Job Content Questionnaire) measured psychological demand, decision latitude, and social support at work. Psychological distress was measured by the Psychiatric Symptom Index, a 14-item self-administered instrument. Among the 2889 participants, the prevalence of psychological distress was 27.8%. High job strain was present in 20.5% of the subjects. The crude odds ratio (OR) of high job strain with psychological distress was 3.52 [95% confidence interval (95% CI) 2.54-4.88]. The OR adjusted for age, gender, employment status, occupation, social support at work, nonwork social support, cynicism, hostility, domestic load, and stressful life events during the last 12 months was still significant (OR 2.45, 95% CI 1.66-3.62). Our results support the association between job strain and psychological distress. Social support at work, although significantly associated with psychological distress, did not modify the association between job strain and psychological distress.

Mika Kivimaki initiated the Individual Participant Data (IPD) Meta-Analysis Consortium, which currently has 50 members. The Consortium recently published several research reports on the relationship between job strain (high psychological demands and low decision latitude at work), on the one hand, and cardiovascular disease and its risk factors, on the other hand. Since IPD repre- sents a novel way to conduct epidemiological research collaboration and as some of the findings from the IPD Consortium have been criticized, this commentary aims to address the rationales behind the approach and discuss some of the main criticisms of the Consortium.Researchers must tackle many problems when inter- preting associations between a psychosocial work envi- ronment factor and a health outcome. First of all, work environment factors belong to a "distal" rather than a "proximal" group. In other words, the closer one gets to a biological mechanism relevant for disease development, the more likely it is that a relevant association will be strong. For instance, small samples are needed to establish an individual "brain" factor associated with depression or emotional exhaustion - simply because the brain factor is more or less depression. Factors related to work orga- nization, on the other hand, are more "distal" since there are many factors that influence the relationship between the environment and the body's organs. Accordingly, it is sometimes difficult to obtain sufficient statistical power for the establishment of an undisputable association. For instance, the long "distance" between job strain and the outcome, myocardial infarction (MI), explains why we should expect a weaker association than in the study of "proximal" factors, for instance myocardial metabolism in relation to MI. Nevertheless, on a societal level, job strain is very important since it affects many working people, with a prevalence in the working population (in the IPD Consortium study's operational definition) of around 15%. Accordingly, if an unequivocal association is established, it is of major importance to those respon- sible for work organization and interventions designed to improve working conditions. However, large samples are needed to establish unequivocal proof.Since Karasek introduced his demand-control model (1), there have been many studies of the association between job strain and risk of MI. These studies have become increasingly sophisticated over the years. In addi- tion, there is accumulated indirect evidence from longitu- dinal studies of the relationship between job strain, on the one hand, and blood pressure variations and endocrine, metabolic, and immunological parameters, on the other hand. The results from these studies give us a plausible physiological explanation of the assumed relationship between job strain and MI risk.A reason why this research field has attracted strong attention is that MI is an undisputable illness outcome. The study of MI risk, therefore, serves as a good scientific model for studying the relationship between job strain and adverse health outcomes in general.Establishment of and rationale behind the IPD ConsortiumThere have been divided opinions about the relationship between job strain and risk of MI. The main reason for the controversy has been that, despite the relatively large size of several of the published cohort studies with number of observation years often in the range of 50 000, the statistical power has been too small for an unequivocal establishment of an association. As a result, Mika Kivimaki invited a number researchers, who had included psychosocial job factors in their study protocols and had or had not published results on the relationship between job strain and MI risk, to establish the IPD Consortium. Including unpublished cohorts was important as this provided a possibility to address the problem of publication bias - the tendency of research- ers and journals to publish only positive findings that can lead to inflated associations. …

Introduction Work-related stress is a significant risk factor contributing to burnout, especially in professions characterized by elevated mental demands such as front-line occupational physicians. The aim of our study was to assess the extent of psychosocial risk (PSR) factors among occupational physicians. Methods A descriptive cross-sectional survey was conducted among physicians working in occupational medicine groups in Tunisia in November 2022. The Karasek questionnaire and Siegrist’s effort/reward imbalance model were utilized to assess PSR factors among the participants. Results The participation rate was 46%. The mean age was 41± 6 years. The sex ratio was 0.2. A high psychological demand and a low level of social support were found in 79% and 75% of the cases respectively. The prevalence of job strain was 60% and iso strain 75%. Effort/reward imbalance was noted in 30% of cases. High psychological demand and low social support were significantly associated with the number of patients per day and per year. Low decision latitude was significantly associated with the number of patients per year, the scarcity of participation in medical training and the presence of third-party constraints whose purpose is to interfere with the medical decision. The main source of work-related stress was poor administrative management for 38% of cases. Discussion These findings highlight the prevalence of PSR among occupational physicians. We recommend considering a legislative reform to improve the overall well-being of these healthcare professionals. Conclusion One out of two occupational physicians is experiencing job strain. A specific preventive strategy is suggested, as well as a legislative reform.

Context: Community-based medical education (CBME) has become widely accepted as an important innovation in undergraduate medical education. In curriculum featuring CBE, students are acquainted with the community early in their studies however; the impact of this training can be judged best to see them practice the required aspects of CBME. Malaysia is a multiracial country with a very strong community dependant life style. Main national health problems have called for a change in health profession education from traditional hospital based health care to community-based delivery system. There are three major university medical schools that practice either community oriented or community based medical education in undergraduate medical curriculum. Universiti Sains Malaysia (USM) has a community based medical education (CBME) curriculum as compared to a community oriented education curriculum (COE) adopted by Universiti Malaya (UM) and a more traditional curriculum practiced by Universiti Kebangsaan Malaysia (UKM) Objective: To determine whether medical graduates from USM with a community-based medical education in its curriculum for more than 25 years are inspired to have stronger commitment towards community health as shown during their on-job practice of medicine compared to other graduates from UM and UKM, who have adopted community-oriented medical education. Methods: A questionnaire-based pilot study with 12 items (variables) was designed to obtain supervisor’s opinion on commitment of interns towards the health of community they serve. The questionnaire was administered to a randomized group of 85 specialists supervising the internship training program in five major disciplines including internal medicine, surgery, orthopedic, gynecology and obstetrics and pediatric medicine. The data received from 62 respondents from four major disciplines was analyzed utilizing SPSS version 12.0.1. Result: The responses received from 62 supervisors on 9 out of 12 variables were directly related to community commitments of interns. It was shown that the USM graduates who were taught through a CBME curriculum have performed better than the graduates from UM and UKM who followed a COE curriculum. p-value (< 0.001) was highly significant and consistent with higher mean score in those variables. Conclusion: The graduates taught through a CBME curriculum (USM) performed better in community commitments towards patients care compared to graduates from COE curriculum (UM) and a traditional curriculum (UKM).

The objectives of this study were to determine whether job strain is more strongly associated with higher ambulatory blood pressure (ABP) among blue-collar workers compared with white-collar workers, to examine whether this pattern generalizes across working and nonworking days and across sex, and to examine whether this pattern is accounted for by psychosocial factors or health behaviors during daily life. A total of 480 healthy workers (mean age = 43 years, 53% female) in the Adult Health and Behavior Project-Phase 2 completed ABP monitoring during 3 working days and 1 nonworking day. Job strain was operationalized as high psychological demand (> sample median) combined with low decision latitude (<sample median; Karasek model; Job Content Questionnaire). Covariate-adjusted multilevel random coefficient regressions demonstrated that associations between job strain and systolic and diastolic ABP were stronger among blue-collar workers compared with white-collar workers (b = 6.53 [F(1,464) = 3.89, p = .049] and b = 5.25 [F(1,464) = 6.09, p = .014], respectively). This pattern did not vary by sex, but diastolic ABP findings were stronger when participants were at work. The stronger association between job strain and ABP among blue-collar workers was not accounted for by education, momentary physical activity, or substance use, but was partially accounted for by covariation between higher hostility and blue-collar status. Job strain is associated with ABP among blue-collar workers. These results extend previous findings to a mixed-sex sample and nonworking days and provide, for the first time, comprehensive exploration of several behavioral and psychosocial explanations for this finding.

The aim of this cross-sectional study was to explore the association of worker characteristics and work organization factors with prevalence of patient-handling injury among nursing personnel in an acute-care inpatient setting. Self-administered questionnaires (n = 585) captured worker characteristics and patient-handling injuries within the previous 6 months. Karasek's Job Content Questionnaire measured work organization factors, including job strain (high psychological demand, low decision latitude). We created a novel measure (job strain(PHYSICAL)) reflecting high physical demand and low decision latitude, providing a more direct physiologic link to our outcome. Log-binomial regression was used to calculate prevalence ratios (PR) and 95% confidence intervals (CI). Patient-handling injuries were prevalent (35%), and incident reports were filed infrequently for injuries receiving medical care. Prevalence of injury was higher among aides compared to nurses [adjusted PR 1.4, 95%CI (1.1-1.8)] as well as among those with high [adjusted PR 1.6, 95%CI (1.2-2.4)] or mid [adjusted PR 1.9, 95%CI (1.4-2.7)] levels of job dissatisfaction. The novel definition of job strain (job strain(PHYSICAL): high physical demand, low decision latitude) was more strongly associated with patient-handling injury than the traditional definition of job strain (high psychological demand, low decision latitude). These findings add to a growing body of literature on the highly contextual nature of work organization factors.

Psychosocial factors at work from the job strain model and preventable mortality in France: The STRESSJEM prospective study

Extensively Drug-Resistant Mycobacterium tuberculosis in Kelantan East Coast of Malaysia: First Two Cases

Event Abstract Back to Event A study on optimal concentrations of isodiospyrin putative inhibitory actions against exonic splicing enhancers of Dystrophin gene exon 53 skipping in Duchenne Muscular Dystrophy Hussain S. Alzahrani1*, Roslina Rashid2, Muzaimi Mustapha1 and Teguh H. Sasongko2 1 Universiti Sains Malaysia, Department of Neuroscience, School of Medical Sciences, Health Campus, Malaysia 2 Universiti Sains Malaysia, Human Genome Center, School of Medical Sciences, Health Campus, Malaysia Duchene muscular dystrophy (DMD) is an X-linked recessive disorder. It is characterized by rapid loss of muscular tissues due lacking gene of muscle replacement. The DMD gene is responsible for Dystrophin protein expression, which exists within a complex called Dystrophin glycol-protein complex (DGC). Exon mutations within DMD gene cause defective expression of Dystrophin. This study aimed to determine the inhibitory actions of Isodiospyrin targeting splicing factors and SR protein (Serine-arginine rich amino acids) a known topoisomerase inhibitor, which plays a critical role in splice site selection. previous studies demonstrated that Isodiospyrin has antitumor activity and inhibits topoisomerase enzyme from phosphorylating SF2/ASF splicing factor. In the current study we used plasmid of non-mutated exon 53 minigenes, transfected into non-mutated HEK-293 cell lines. Then, observed its actions on cells viability and exon splicing modification. The later was confirmed using RT-PCR, followed by exon 53 sequence software analysis. In consistence with previous studies, concentration of half maximal inhibitory effect (IC50) was 3.58µM, and the optimal inhibitory concentrations were: 1.79, 0.90, and 0.60µM. However, there was no detection of exon 53 skipping when exposing non-mutated HEK-293 cells to the optimal concentrations of Isodiospyrin compound. The results suggest that exon 53 splicing may occur without phosphorylation of SR proteins targeted by Isodiospyrin, which indicated that the splicing of exon 53 occurred independently of SR proteins targeted by the splicing inhibitor Isodiospyrin ,in non-mutated HEK-293 cells. Keywords: Gene Expression, inhibition, in vitro, Exon splicing, Duchenne muscular dystrophy Conference: 14th Meeting of the Asian-Pacific Society for Neurochemistry, Kuala Lumpur, Malaysia, 27 Aug - 30 Aug, 2016. Presentation Type: Poster Presentation Session Topic: 14th Meeting of the Asian-Pacific Society for Neurochemistry Citation: Alzahrani HS, Rashid R, Mustapha M and Sasongko TH (2016). A study on optimal concentrations of isodiospyrin putative inhibitory actions against exonic splicing enhancers of Dystrophin gene exon 53 skipping in Duchenne Muscular Dystrophy. Conference Abstract: 14th Meeting of the Asian-Pacific Society for Neurochemistry. doi: 10.3389/conf.fncel.2016.36.00120 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 04 Aug 2016; Published Online: 11 Aug 2016. * Correspondence: Mr. Hussain S Alzahrani, Universiti Sains Malaysia, Department of Neuroscience, School of Medical Sciences, Health Campus, Kota Bharu, Kelantan, 16150, Malaysia, hssz_23@hotmail.com Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Hussain S Alzahrani Roslina Rashid Muzaimi Mustapha Teguh H Sasongko Google Hussain S Alzahrani Roslina Rashid Muzaimi Mustapha Teguh H Sasongko Google Scholar Hussain S Alzahrani Roslina Rashid Muzaimi Mustapha Teguh H Sasongko PubMed Hussain S Alzahrani Roslina Rashid Muzaimi Mustapha Teguh H Sasongko Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

Journal Article Pneumonia, Pericarditis, and Endocarditis in a Child with Corynebacterium xerosis Septicemia Get access A. S. Malik, A. S. Malik Department of Paediatrics and Microbiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia Reprints or correspondence: Dr. Alam Sher Malik, Department of Paediatrics, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, 16150 Kelantan, Malaysia. Search for other works by this author on: Oxford Academic PubMed Google Scholar M. R. Johari M. R. Johari Department of Paediatrics and Microbiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia Search for other works by this author on: Oxford Academic PubMed Google Scholar Clinical Infectious Diseases, Volume 20, Issue 1, January 1995, Pages 191–192, https://doi.org/10.1093/clinids/20.1.191-a Published: 01 January 1995

The Copenhagen Psychosocial Questionnaire (COPSOQ) comprises dimensions (emotional demands, demands of hiding emotions, meaning of work, quality of leadership, and predictability) that are not in the job strain or the effort-reward imbalance (ERI) models. The study aim was to investigate whether these dimensions explain changes in vitality and mental health over and above the job strain and ERI models. A cohort of 3552 employees in 2000 were followed up in 2005 (cohort participation of 51%). Regression analyses were carried out with mental health and vitality as dependent variables. A significance level of 0.01 was applied when comparing regression models. Regarding mental health, both the full COPSOQ-ERI model (p = 0.005) and the full job strain-COPSOQ model (p = 0.01) were significantly better than the ERI and the job strain models. Regarding vitality, none of the full COPSOQ models (i.e. with new COPSOQ dimensions together with job strain or ERI respectively) was significantly better than the ERI (p = 0.03) or the job strain (p = 0.04) models. Emotional demands and low meaning of work predicted poor mental health and low vitality. In relation to mental health, new psychosocial risk factors have the potential to add to the predictive power of the job strain and ERI models. The current practice of including only items from the ERI and job strain models in public health studies should be reconsidered. Theories regarding the status of, for example, emotional demands and meaning of work should be developed and tested.

At the end of 2009, the number of medical schools in Malaysia had exceeded 20 and there is every indication that this number, although large for a country of 28 million people, is likely to go up. However, very few medical schools engage in postgraduate programs due to lack of qualified staff and training facilities. Only 4 medical schools have a Master of Public Health (MPH) program. These medical schools are located in the University of Malaya (UM), Universiti Kebangsaan Malaysia (UKM), Universiti Sains Malaysia (USM), and Universiti Malaysia Sarawak (UNIMAS). Of these 4, only 2 (UM and UKM) have a Doctor of Public Health Program and take in international students for their postgraduate degrees. The oldest and most established public health postgraduate degree program in Malaysia is run by the Department of Social and Preventive Medicine (popularly known as the SPM Department), University of Malaya, which is also the oldest academic public health department in Malaysia. Relative to public health departments in other universities in the Southeast Asian region, the SPM Department is small, with only 12 active academic staff and a further 9 staff who were still on study leave at the end of 2009. This small department delivers 2 general public health master’s programs, 4 specialty master’s in public health, a doctor of public health (DrPH), and PhD program and is the only department in UM’s medical faculty to maintain its own department Web site (http://spm.um.edu.my) since 1999. Since 1974, the SPM Department has produced 612 Master of Public Health and 106 Master in Medical Science (Public Health) graduates, in addition to a number of PhD graduates. Many of these graduates are international and increasingly international students make up a significant number of student intake. Currently half of its master’s and a quarter of its doctoral student intake every year are of international origin.

To test the relationship between job strain and the incidence of ischaemic heart disease (IHD) prospectively in the Danish working population. In 1986, a clinical examination was undertaken of 659 men, all employed and without known IHD, together with a questionnaire-based evaluation of living conditions and psychosocial factors at work, including items identified in the job strain model. This study was part of the World Health Organization-initiated MONICA II study. In the job strain model, job strain is defined as the combination of high psychological demands and a low degree of control in the work situation. An objective classification of the components in the job strain model was made by imputation by utilizing the participants' job title and the principles guiding the payment of their salaries/wages. In addition, a questionnaire-based subjective classification was undertaken. All participants were followed until the end of 1999 with regard to hospitalization and death as a result of IHD. Stepwise analyses were made, adjusting for age, social class, social network and established behavioural and physiological coronary risk factors. Self-reported job strain was significantly associated with IHD independently of standard coronary risk factors. Of the two components in the job strain model only high demands contributed significantly to this result. The study did not support the job strain hypothesis when an imputed, objective classification of the components in the job strain model was applied. This is in accordance with the majority of other studies in this area. An unexpected finding was that the incidence of IHD was highest among employers and managers. High psychological demands at work are a risk factor for IHD, a fact that should affect the primary and secondary prevention of IHD.