Inequality and identity in contemporary processes of labour market restructuring

Contemporary processes of labour market restructuring have resulted in increasing social and spacial inequalities in the United Kingdom. While the well discussed-issues of class, race and gender continue to be correlated to inequality, the decline in manufacturing jobs and rise in low-level service work has brought a new reality of identity-correlation. To remain employed, workers must increasingly transcend their geography and current job role; presenting an identity that is appealing to employers. Thus, in today's labour market with its increasing economic polarisation, previously strong social and work identities are now challenged by the logic of capital

'Cease and desist?' The persistence of Marlboro brand imagery in racing video games

Since 1972, Philip Morris (PM) has sponsored motorsports. Racing video games are a popular genre among youth and often emulate the branding of their real-life counterparts, potentially exposing youth to tobacco imagery. We examined racing video games for the presence of Marlboro imagery and explored the history of efforts to remove or regulate such imagery.We searched the Truth Tobacco Industry documents for relevant documents and used information from video game-related websites and game play videos to identify racing video games that contained Marlboro trademarks and imagery. We also collected information on the Entertainment Software Ratings Board's (ESRB) tobacco-specific and overall game ratings.In 1989, negative publicity surrounding the presence of Marlboro logos in racing games led PM to threaten legal action against two game makers for copyright infringement. PM also launched a media campaign promoting this intervention as evidence of its commitment to youth smoking prevention. Nonetheless, we identified 219 video games from 1979 to 2018 that contained Marlboro trademarks and/or Marlboro-sponsored drivers and livery. Among the games in our sample with an ESRB game rating, all but one received an 'E,' indicating appropriateness for everyone, and all but three lacked tobacco content descriptors.Racing video games have been and continue to be a vehicle for exposing adolescents to the Marlboro brand. Because voluntary efforts by PM and the video game industry to prevent youth exposure to tobacco brands in video games have been ineffective, USA and international policy-makers should prohibit tobacco content in video games

Older and wiser? Men’s and women’s accounts of drinking in early mid-life

Most qualitative research on alcohol focuses on younger rather than older adults. To explore older people’s relationship with alcohol, we conducted eight focus groups with 36 men and women aged 35 to 50 years in Scotland, UK. Initially, respondents suggested that older drinkers consume less alcohol, no longer drink to become drunk and are sociable drinkers more interested in the taste than the effects of alcohol. However, as discussions progressed, respondents collectively recounted recent drunken escapades, challenged accounts of moderate drinking, and suggested there was still peer pressure to drink. Some described how their drinking had increased in mid-life but worked hard discursively to emphasise that it was age and stage appropriate (i.e. they still met their responsibilities as workers and parents). Women presented themselves as staying in control of their drinking while men described going out with the intention of getting drunk (although still claiming to meet their responsibilities). While women experienced peer pressure to drink, they seemed to have more options for socialising without alcohol than did men. Choosing not to drink alcohol is a behaviour that still requires explanation in early mid-life. Harm reduction strategies should pay more attention to drinking in this age group

Relation of modifiable neighborhood attributes to walking

Abstract Background There is a paucity of research examining associations between walking and environmental attributes that are more modifiable in the short term, such as car parking availability, access to transit, neighborhood traffic, walkways and trails, and sidewalks. Methods Adults were recruited between April 2004 and September 2006 in the Minneapolis-St Paul metropolitan area and in Montgomery County, Maryland using similar research designs in the two locations. Self-reported and objective environmental measures were calculated for participants\u27 neighborhoods. Self-reported physical activity was collected through the long form of the International Physical Activity Questionnaire (IPAQ-LF). Generalized estimating equations were used to examine adjusted associations between environmental measures and transport and overall walking. Results Participants (n = 887) averaged 47 years of age (SD = 13.65) and reported 67 min/week (SD = 121.21) of transport walking and 159 min/week (SD = 187.85) of non-occupational walking. Perceived car parking difficulty was positively related to higher levels of transport walking (OR 1.41, 95%CI: 1.18, 1.69) and overall walking (OR 1.18, 95%CI: 1.02, 1.37). Self-reported ease of walking to a transit stop was negatively associated with transport walking (OR 0.86, 95%CI: 0.76, 0.97), but this relationship was moderated by perceived access to destinations. Walking to transit also was related to non-occupational walking (OR 0.85, 95%CI: 0.73, 0.99). Conclusions Parking difficulty and perceived ease of access to transit are modifiable neighborhood characteristics associated with self-reported walking

Pharmacist intervention in primary care to improve outcomes in patients with left ventricular systolic dysfunction

<b>Background</b> Meta-analysis of small trials suggests that pharmacist-led collaborative review and revision of medical treatment may improve outcomes in heart failure.<p></p> <b>Methods and results</b> We studied patients with left ventricular systolic dysfunction in a cluster-randomized controlled, event driven, trial in primary care. We allocated 87 practices (1090 patients) to pharmacist intervention and 87 practices (1074 patients) to usual care. The intervention was delivered by non-specialist pharmacists working with family doctors to optimize medical treatment. The primary outcome was a composite of death or hospital admission for worsening heart failure. This trial is registered, number ISRCTN70118765. The median follow-up was 4.7 years. At baseline, 86% of patients in both groups were treated with an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. In patients not receiving one or other of these medications, or receiving less than the recommended dose, treatment was started, or the dose increased, in 33.1% of patients in the intervention group and in 18.5% of the usual care group [odds ratio (OR) 2.26, 95% CI 1.64–3.10; P< 0.001]. At baseline, 62% of each group were treated with a β-blocker and the proportions starting or having an increase in the dose were 17.9% in the intervention group and 11.1% in the usual care group (OR 1.76, 95% CI 1.31–2.35; P< 0.001). The primary outcome occurred in 35.8% of patients in the intervention group and 35.4% in the usual care group (hazard ratio 0.97, 95% CI 0.83–1.14; P = 0.72). There was no difference in any secondary outcome.<p></p> <b>Conclusion</b> A low-intensity, pharmacist-led collaborative intervention in primary care resulted in modest improvements in prescribing of disease-modifying medications but did not improve clinical outcomes in a population that was relatively well treated at baseline