An essay on 'health capital' and the Faustian bargains struck by workers in the globalised shipping industry.

It has long been understood that work directly generates ill health and disability through injuries and occupational exposure to toxic and carcinogenic materials, but the more complex relationship between work and ill health that is seemingly mediated through psychological distress is more controversial. For example, the 'Karasek model', whereby high job demands coupled with limited latitude in decision making were thought to generate ill health, has not been supported in large-scale surveys. This paper postulates an alternative linking mechanism between work and health, namely Mildred Blaxter's concept of 'health capital', and specifically explores the value of the concept in understanding lay theorising about the links between labour intensification and self-perceived health: workers' perceptions that their work has become more effortful may be bracketed with their belief that their continuing employment is demanding accelerating expenditure of their health capital.

Conflict and user involvement in drug misuse treatment decision-making: a qualitative study.

Background: This paper examines client/staff conflict and user involvement in drug misuse treatment decision-making.

Methods: Seventy-nine in-depth interviews were conducted with new treatment clients in two residential and two community drug treatment agencies. Fifty-nine of these clients were interviewed again after twelve weeks.

Contribution of problem drug users' deaths to excess mortality in Scotland: secondary analysis of cohort study.

Objectives: To examine the "Scottish effect"-namely, the growing divergence between mortality in Scotland and England that is not explained by national differences in levels of deprivation-and, more specifically, to examine the extent to which the Scottish effect is explained by cross national differences in the prevalence of problem drug use.

Design: Secondary analysis of cohort study (the DORIS study).

Participants: 1033 Scottish drug users recruited to the cohort study in 33 drug treatment facilities across Scotland in 2001-2 and followed up 33 months later in 2004-5.

'Treatment experienced' and 'treatment naïve' drug agency clients compared.

Background: Research on the prevalence and significance of previous treatment is limited, but indicates that many drug agency clients have had prior drug treatment experiences. Furthermore, treatment experienced drug users have different characteristics from treatment novices at treatment entry and poorer outcomes at follow up.

Methods: Data from a national longitudinal study of drug users entering treatment in Scotland were analysed using univariate and multivariate techniques to provide the first systematic comparison of treatment experienced and treatment naïve drug users in the UK.

Borna disease virus: the generation and review of a scientific study.

The paper uses interviews and observational data gathered among a group of UK scientists and civil servants responsible for managing a study examining the possible transmission to humans of Borna disease virus (BDV), a disease primarily of farm animals. From a science and technology studies perspective, the paper examines the social processes whereby this scientific problem (possible human transmission) was constituted as a worthy topic of scientific investigation, came to receive funding, and was subjected to independent review. It appears that BDV research displays only some of the characteristics of 'post-normal science' with little participation by extended peer communities.

Observations of shipboard illness behavior: work discipline and the sick role in a residential work setting.

In this article, the author reports on a small-scale ethnographic study of illness behavior in a residential work setting, a large merchant cargo ship with a multinational crew. Although parallels with previous observational work on illness behavior in residential settings (where illnesses result in treatment only if there is a break in accommodation to symptoms) exist, it is clear that type of setting is pivotal in shaping illness careers. Here, accommodation to symptoms was overlain by the economic imperative to keep the ship functioning: Management feared that the right to the sick role would allow "malingering," whereas workers feared adoption of the sick role would exclude them from employment.

Rationale, design and conduct of a comprehensive evaluation of a school-based peer-led anti-smoking intervention in the UK: the ASSIST cluster randomised trial [ISRCTN55572965].

Background: To date, no school-based intervention has been proven to be effective in preventing adolescent smoking, despite continuing concern about smoking levels amongst young people in the United Kingdom. Although formal teacher-led smoking prevention interventions are considered unlikely to be effective, peer-led approaches to reducing smoking have been proposed as potentially valuable.

Methods/design: ASSIST (A Stop Smoking in Schools Trial) is a comprehensive, large-scale evaluation to rigorously test whether peer supporters in Year 8 (age 11-12) can be recruited and trained to effect a reduction in smoking uptake among their fellow students.