***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Studies on the direct and buffering effects of social support have not examined psychiatric sickness absence and few studies have considered support both at home and at work . This study addresses prospect ively the effects of chronic stressors and social supports , at home and at work , on psychiatric sickness absence rates . METHODS  Sociodemographic factors , health and social support were measured at baseline , and short and long spells of sickness absence were measured prospect ively over a 5-year period . The participants were a sub sample of 4202 male and female civil servants , aged 35 - 55 years at baseline , from an occupational cohort , the Whitehall II Study , who completed detailed social support questions .  RESULTS Support from colleagues and supervisors at work is related to lower risk of short spells of psychiatric sickness absence , particularly for those also receiving high levels of negative aspects of close relationships from their closest person outside work . Negative aspects of close relationships from the closest person increase the risk of taking long spells of psychiatric sickness absence in men . High levels of material problems increase the risk of short spells of sickness absence . CONCLUSIONS Negative aspects of close relationships may have an aetiological role in non-psychotic psychiatric disorder . Social support at work appears to protect against short spells of psychiatric sickness absence . This potentially implies that levels of short spells of absence might be reduced by increasing support at work . Conversely , emotional support at home may influenced absence-related behaviour and encourage a person to take absence at a time of illness Study objectives : To investigate the association between job strain and components of the job strain model and  coronary heart disease ( CHD ) risk . Design : Prospect i ve cohort study ( Whitehall II study ) . At the first phase of the study ( 1985–1988 ) , data on self reported psychosocial work characteristics were collected from all participants . Participants were followed up until the end of phase 5 ( 1997–2000 ) , with mean length of follow up of 11 years . Setting : London based office staff in 20 civil service departments . Participants : 6895 male and 3413 female civil servants aged 35–55 . Outcome measures : Incident vali date d CHD . Main results : People with concurrent low decision latitude and high dem and s ( job strain ) were at the highest risk for CHD . High job dem and s , and , less consistently , low decision latitude , predicted CHD incidence . The effect of job strain on CHD incidence was strongest among younger workers , but there was no effect modification by social support at work , or employment grade . Conclusions : Job strain , high job dem and s , and , to some extent , low decision latitude , are associated with an increased risk of CHD among British civil servants This cross-sectional study investigates the relationship between the psychosocial work environment and  cardiovascular disease ( CVD ) prevalence in a r and omly selected , representative sample of 13,779 Swedish male and female workers . It was found that self-reported psychological job dem and s , work control , and co-worker social support combined greater then multiplicatively in relation to CVD prevalence . An age-adjusted prevalence ratio ( PR ) of 2.17 ( 95 % CI-1.32 , 3.56 ) was observed among workers with high dem and s , low control , and low social support compared to a low dem and , high control , and high social support reference group . PRs of approximately 2.00 were observed in this group after consecutively controlling for the effects of age together with 11 other potential confounding factors . The magnitude of the age-adjusted PRs was greatest for blue collar males . Due to the cross-sectional nature of the study design , causal inferences can not be made . The limitations of design and measurement are discussed in the context of the method ological weaknesses of the work stress field OBJECTIVES : The impact of work on the risk of future  psychiatric disorder has been examined in few longitudinal studies . This was examined prospect ively in a large epidemiological study of civil servants . METHODS : In the Whitehall II study , a longitudinal , prospect i ve cohort study of 6895 male and 3413 female London based civil servants , work characteristics measured at baseline ( phase 1 : 1985 - 8 ) and first follow up ( phase 2 : 1989 ) were used to predict psychiatric disorder measured by a 30 item  general health question naire ( GHQ )  at phase 2 and phase 3 follow up ( phase 3 : 1991 - 3 ) .  Work characteristics and GHQ  were measured at all three phases . RESULTS : Low social support at work and low decision authority , high job dem and s and effort-reward imbalance were associated with increased risk of psychiatric disorder as assessed by the GHQ at follow up adjusting for age , employment grade , and baseline GHQ score . CONCLUSIONS : Social support and control at work protect mental health while high job dem and s and effort-reward imbalance are risk factors for future psychiatric disorder . Intervention at the level of work design , organisation , and management might have positive effects on mental health in working population OBJECTIVES There is considerable evidence documenting the association between psychosocial risk factors and  work disability due to musculoskeletal disorders , and this has prompted suggestions that psychosocial screening should be administered in the workplace in order to identify individuals at risk of prolonged absence . However , the predictive value of psychosocial risk factors on return-to-work is largely unknown . The present study aim ed to explore the predictive relationship between psychosocial risk factors and absence due to musculoskeletal disorders of the lower back and upper limbs . METHODS A prospect i ve study of 4637 workers from a large , multi-site company in the UK was conducted in which a wide range of established question naires were used to collect baseline psychosocial data . Respondents were then followed over the ensuing 15 months , and absence due to musculoskeletal disorders was recorded . RESULTS 219 workers took absence due to musculoskeletal disorders . Detrimental cut-off scores ( risks ) on the psychosocial instruments were established , and it was found that work-related psychosocial risk factors predicted the likelihood of a future spell of absence ( odds ratios ranging between 1.6 and 3.2 ) , but not the duration of that absence . CONCLUSIONS Although work-related psychosocial factors were associated with the occurrence of absence due to musculoskeletal disorders , these findings do not lend support to the use of routine occupational psychosocial screening in order to predict prolonged absence Objectives : To study the influence of change in self perceived psychosocial work characteristics on subsequent rates of sickness absence . Methods : Prospect i ve cohort study of British civil service employees .  Job control , job dem and s , and work social supports were measured in 1985/88 and in 1991/93 . Analyses included 3817 British civil servants with sickness absence records at baseline ( 1985–89 ) and for two follow up periods , early ( 1994–95 ) and later follow up ( 1996–98 ) . Results : Change in work characteristics predicted subsequent incidence of long spells of sickness absence ( > 7 days ) in the early follow up period after adjustment for covariates including baseline work characteristics , health status , and sickness absence . Adjusted rate ratios were 1.23 ( 95 % CI 1.03 to 1.46 ) for decreased compared with stable decision latitude ; 1.17 ( 95 % CI 1.01 to 1.36 ) for increased compared with stable job dem and s and 0.79 ( 95 % CI 0.67 to 0.93 ) for increased compared with stable work social support . These associations were also seen in a sub- sample who did not change employment grade . In the later follow up period , associations between work change and long spells of sickness absence were similar for decision latitude , less pronounced for job dem and s , and no longer apparent for social supports . Changes in work characteristics were not associated with subsequent short spells of sickness absence ( ⩽7 days ) . Conclusions : Adverse changes in the psychosocial work environment may lead to increased rates of sickness absence . These findings suggest that workplace interventions to improve psychosocial working conditions may reduce levels of sickness absence Abstract Objective : To determine the association between adverse psychosocial characteristics at work and risk of coronary heart disease among male and female civil servants . Design : Prospect i ve cohort study ( Whitehall II study ) . At the baseline examination ( 1985 - 8 ) and twice during follow up a self report question naire provided information on psychosocial factors of the work environment and coronary heart disease . Independent assessment s of the work environment were obtained from personnel managers at baseline . Mean length of follow up was 5.3 years . Setting : London based office staff in 20 civil service departments . Subjects : 10 308 civil servants aged 35 - 55 were examined-6895 men ( 67 % ) and 3413 women ( 33 % ) . Main outcome measures : New cases of angina ( Rose question naire ) , severe pain across the chest , diagnosed ischaemic heart disease , and any coronary event . Results : Men and women with low job control , either self reported or independently assessed , had a higher risk of newly reported coronary heart disease during follow up . Job control assessed on two occasions three years apart , although intercorrelated , had cumulative effects on newly reported disease . Subjects with low job control on both occasions had an odds ratio for any subsequent coronary event of 1.93 ( 95 % confidence interval 1.34 to 2.77 ) compared with subjects with high job control at both occasions . This association could not be explained by employment grade , negative affectivity , or classic coronary risk factors . Job dem and s and social support at work were not related to the risk of coronary heart disease . Conclusions : Low control in the work environment is associated with an increased risk of future coronary heart disease  among men and women employed in government offices . The cumulative effect of low job control assessed on two occasions indicates that giving employees more variety in tasks and a stronger say in decisions about work may decrease the risk of coronary heart disease . Key messages Low job control in the work environment contributes to the development of coronary heart disease among British male and female civil servants The risk of heart disease is associated with both objective low job control and perceived low job control . Increase in job control over time decreases the risk of coronary heart disease . This suggests that policies giving people a stronger say in decisions about their work or providing them with more variety in work tasks may contribute to better cardiovascular OBJECTIVE --To compare measures of job stress , job satisfaction , and mental health among general practitioners before and after the introduction of the new contract in April 1990 . DESIGN --Cross sectional postal question naire survey in July 1990 . Comparison of results with those obtained in previous survey in November 1987 . SETTING --General practice in United Kingdom . SUBJECTS--1500 general practitioners r and omly selected from general medical services lists , 917 of whom ( 61 % ) returned question naires usable for statistical analysis . MAIN OUTCOME MEASURES --Aspects of job causing stress , job satisfaction ( Warr , Cook , and Wall scale ) , and mental health ( Crown-Crisp experiential index ) . RESULTS --Compared with 1987 , in 1990 doctors experienced more stress from night calls ( mean score 3.83 in 1990 v 3.45 in 1987 ) , emergencies during surgery hours ( 3.72 v 3.48 ) , and interruption of family life by telephone ( 3.58 v 2.73 ; p less than 0.001 for all three variables ) . Scores for somatic anxiety and depression were higher in both men and women in 1990 ( men : somatic anxiety 3.12 v 2.36 ; depression 3.80 v 2.94 ; women : somatic anxiety 3.56 v 2.65 ; depression 4.02 v 3.37 ; p less than 0.001 ) . Job satisfaction had also decreased in 1990 ( 5.23 v 4.26 ; p less than 0.001 ) . CONCLUSIONS --Doctors experienced more stress , less job satisfaction , and poorer mental health in 1990 than in 1987 . These changes may have result ed from the introduction of the new contract OBJECTIVE --To identify sources of job stress associated with high levels of job dissatisfaction and negative mental wellbeing among general practitioners in Engl and . DESIGN --Multivariate analysis of large data base of general practitioners compiled from results of confidential question naire survey . Data obtained on independent variables of job stress , demographic factors , and personality . Dependent variables were mental health , job satisfaction , alcohol consumption , and smoking . SETTING --National sample of general practitioners studied by university department of organisational psychology . SUBJECTS -- One thous and eight hundred seventeen general practitioners selected at r and om by 20 family practitioner committees in Engl and . INTERVENTIONS --None . END POINT -- Determination of the combination of independent variables that were predictive of mental health and job satisfaction . MEASUREMENTS AND MAIN RESULTS --Women general practitioners both had job satisfaction and showed positive signs of mental wellbeing in contrast with other normative groups . Conversely , male doctors showed significantly higher anxiety scores than the norms , had less job satisfaction , and drank more alcohol than their women counterparts . Multivariate analysis disclosed four job stressors that were predictive of high levels of job dissatisfaction and lack of mental wellbeing ; these were dem and s of the job and patients ' expectations , interference with family life , constant interruptions at work and home , and practice administration . CONCLUSIONS --There may be substantial benefit in providing a counselling service for general practitioners and other health care workers who suffer psychological pressure from their work Objective To test the predictive utility of the Örebro Musculoskeletal Pain Screening Question naire in identifying patients at risk for developing persistent back pain problems . Design Prospect i ve , where participants completed the question naire and their cases were followed for 6 months to assess outcome with regard to pain , function , and abs 
    Output:
    
Some task-restructuring interventions failed to alter the psychosocial work environment significantly , and so could not be expected to have a measurable effect on health .
Those that increased dem and and decreased control tended to have an adverse effect on health , while those that decreased dem and and increased control result ed in improved health , although some effects were minimal .
Increases in workplace support did not appear to mediate this relationship .
This systematic review suggests that task-restructuring interventions that increase dem and or decrease control adversely affect the health of employees , in line with observational research .
It lends support to policy initiatives such as the recently enforced EU directive on participation at work , which aims to increase job control and autonomy