Showing papers by "University of London published in 2003"
University of Cambridge1, University of Toronto2, Yale University3, University of Iceland4, University of Melbourne5, Lund University6, National Institutes of Health7, Princess Anne Hospital8, The Chinese University of Hong Kong9, University of California, Irvine10, Pomeranian Medical University11, Helsinki University Central Hospital12, Institute of Cancer Research13, University of London14, St Mary's Hospital15
TL;DR: Risks in carriers were higher when based on index breast cancer cases diagnosed at <35 years of age and for variation in risk by mutation position for both genes, and some evidence for a reduction in risk in women from earlier birth cohorts is found.
Abstract: Germline mutations in BRCA1 and BRCA2 confer high risks of breast and ovarian cancer, but the average magnitude of these risks is uncertain and may depend on the context. Estimates based on multiple-case families may be enriched for mutations of higher risk and/or other familial risk factors, whereas risk estimates from studies based on cases unselected for family history have been imprecise. We pooled pedigree data from 22 studies involving 8,139 index case patients unselected for family history with female (86%) or male (2%) breast cancer or epithelial ovarian cancer (12%), 500 of whom had been found to carry a germline mutation in BRCA1 or BRCA2. Breast and ovarian cancer incidence rates for mutation carriers were estimated using a modified segregation analysis, based on the occurrence of these cancers in the relatives of mutation-carrying index case patients. The average cumulative risks in BRCA1-mutation carriers by age 70 years were 65% (95% confidence interval 44%-78%) for breast cancer and 39% (18%-54%) for ovarian cancer. The corresponding estimates for BRCA2 were 45% (31%-56%) and 11% (2.4%-19%). Relative risks of breast cancer declined significantly with age for BRCA1-mutation carriers (P trend.0012) but not for BRCA2-mutation carriers. Risks in carriers were higher when based on index breast cancer cases diagnosed at <35 years of age. We found some evidence for a reduction in risk in women from earlier birth cohorts and for variation in risk by mutation position for both genes. The pattern of cancer risks was similar to those found in multiple-case families, but their absolute magnitudes were lower, particularly for BRCA2. The variation in risk by age at diagnosis of index case is consistent with the effects of other genes modifying cancer risk in carriers.
3,384 citations
TL;DR: The prevention of HIV and TB, the extension of WHO DOTS programs, and a focused effort to control HIV-related TB in areas of high HIV prevalence are matters of great urgency.
Abstract: BACKGROUND: The increasing global burden of tuberculosis (TB) is linked to human immunodeficiency virus (HIV) infection. METHODS: We reviewed data from notifications of TB cases, cohort treatment outcomes, surveys of Mycobacterium tuberculosis infection, and HIV prevalence in patients with TB and other subgroups. Information was collated from published literature and databases held by the World Health Organization (WHO), the Joint United Nations Programme on HIV/Acquired Immunodeficiency Syndrome (UNAIDS), the US Census Bureau, and the US Centers for Disease Control and Prevention. RESULTS: There were an estimated 8.3 million (5th-95th centiles, 7.3-9.2 million) new TB cases in 2000 (137/100,000 population; range, 121/100,000-151/100,000). Tuberculosis incidence rates were highest in the WHO African Region (290/100,000 per year; range, 265/100,000-331/100,000), as was the annual rate of increase in the number of cases (6%). Nine percent (7%-12%) of all new TB cases in adults (aged 15-49 years) were attributable to HIV infection, but the proportion was much greater in the WHO African Region (31%) and some industrialized countries, notably the United States (26%). There were an estimated 1.8 million (5th-95th centiles, 1.6-2.2 million) deaths from TB, of which 12% (226 000) were attributable to HIV. Tuberculosis was the cause of 11% of all adult AIDS deaths. The prevalence of M tuberculosis-HIV coinfection in adults was 0.36% (11 million people). Coinfection prevalence rates equaled or exceeded 5% in 8 African countries. In South Africa alone there were 2 million coinfected adults. CONCLUSIONS: The HIV pandemic presents a massive challenge to global TB control. The prevention of HIV and TB, the extension of WHO DOTS programs, and a focused effort to control HIV-related TB in areas of high HIV prevalence are matters of great urgency.
2,762 citations
TL;DR: The importance of undernutrition as an underlying cause of child deaths associated with infectious diseases, the effects of multiple concurrent illnesses, and recognition that pneumonia and diarrhoea remain the diseases that are most often associated with child deaths as mentioned in this paper.
2,680 citations
TL;DR: The findings show that the interventions needed to achieve the millennium development goal of reducing child mortality by two-thirds by 2015 are available, but that they are not being delivered to the mothers and children who need them.
2,430 citations
Book•
27 Oct 2003TL;DR: This second edition is completely revised to include up-to-date work on automated feedback, plagiarism, social media, Virtual Learning Environments and teacher workload issues.
Abstract: Authoritative and accessible, this book introduces the theory and practice of teaching writing to students of EFL/ESL learners While assuming no specialist knowledge, Ken Hyland systematically sets out the key issues of course design, lesson planning, texts and materials, tasks, feedback and assessment and how current research can inform classroom practice This second edition is completely revised to include up-to-date work on automated feedback, plagiarism, social media, Virtual Learning Environments and teacher workload issues It takes the clear stance that student writers not only need realistic strategies for drafting and revising, but also a clear understanding of genre to structure their writing experiences according to the expectations of particular communities of readers and the constraints of particular contexts Review exercises, reflection questions, plentiful examples and a new extensive glossary make the book invaluable to both prospective and practicing teachers alike
1,343 citations
TL;DR: It is suggested that the most important factors underlying inability to replicate these associations are publication bias, failure to attribute results to chance, and inadequate sample sizes, problems that are all rectifiable.
1,224 citations
TL;DR: On current evidence, washing hands with soap can reduce the risk of diarrhoeal diseases by 42-47% and interventions to promote handwashing might save a million lives and more and better-designed trials are needed.
Abstract: We set out to determine the impact of washing hands with soap on the risk of diarrhoeal diseases in the community with a systematic review with random effects meta-analysis Our data sources were studies linking handwashing with diarrhoeal diseases Seven intervention studies, six case-control, two cross-sectional, and two cohort studies were located from electronic databases, hand searching, and the authors' collections The pooled relative risk of diarrhoeal disease associated with not washing hands from the intervention trials was 188 (95% CI 131-268), implying that handwashing could reduce diarrhoea risk by 47% When all studies, when only those of high quality, and when only those studies specifically mentioning soap were pooled, risk reduction ranged from 42-44% The risks of severe intestinal infections and of shigellosis were associated with reductions of 48% and 59%, respectively In the absence of adequate mortality studies, we extrapolate the potential number of diarrhoea deaths that could be averted by handwashing at about a million (11 million, lower estimate 05 million, upper estimate 14 million) Results may be affected by the poor quality of many of the studies and may be inflated by publication bias On current evidence, washing hands with soap can reduce the risk of diarrhoeal diseases by 42-47% and interventions to promote handwashing might save a million lives More and better-designed trials are needed to measure the impact of washing hands on diarrhoea and acute respiratory infections in developing countries
1,223 citations
TL;DR: Global estimates of soil-transmitted helminth infections are brought up to date, some interesting new trends are revealed and the future for control is discussed.
1,139 citations
TL;DR: A review of English-language journals published since 1990 and three global mental health reports identified 11 community studies on the association between poverty and common mental disorders in six low- and middle-income countries that showed an association between indicators of poverty and the risk of mental disorders.
Abstract: A review of English-language journals published since 1990 and three global mental health reports identified 11 community studies on the association between poverty and common mental disorders in six low- and middle-income countries. Most studies showed an association between indicators of poverty and the risk of mental disorders, the most consistent association being with low levels of education. A review of articles exploring the mechanism of the relationship suggested weak evidence to support a specific association with income levels. Factors such as the experience of insecurity and hopelessness, rapid social change and the risks of violence and physical ill-health may explain the greater vulnerability of the poor to common mental disorders. The direct and indirect costs of mental ill-health worsen the economic condition, setting up a vicious cycle of poverty and mental disorder. Common mental disorders need to be placed alongside other diseases associated with poverty by policy-makers and donors. Programmes such as investment in education and provision of microcredit may have unanticipated benefits in reducing the risk of mental disorders. Secondary prevention must focus on strengthening the ability of primary care services to provide effective treatment.
1,047 citations
TL;DR: The application of the 'precautionary principle' is a non-scientific approach that assumes that risk assessments will be carried out, and anti-Gram-positive growth promoters would be expected to have little effect on most Gram-negative organisms.
Abstract: The use of antibiotics in food animals selects for bacteria resistant to antibiotics used in humans, and these might spread via the food to humans and cause human infection, hence the banning of growth-promoters. The actual danger seems small, and there might be disadvantages to human and to animal health. The low dosages used for growth promotion are an unquantified hazard. Although some antibiotics are used both in animals and humans, most of the resistance problem in humans has arisen from human use. Resistance can be selected in food animals, and resistant bacteria can contaminate animal-derived food, but adequate cooking destroys them. How often they colonize the human gut, and transfer resistance genes is not known. In zoonotic salmonellosis, resistance may arise in animals or humans, but human cross-infection is common. The case of campylobacter infection is less clear. The normal human faecal flora can contain resistant enterococci, but indistinguishable strains in animals and man are uncommon, possibly because most animal enterococci do not establish themselves in the human intestine. There is no correlation between the carriage of resistant enterococci of possible animal origin and human infection with resistant strains. Commensal Escherichia coli also exhibits host-animal preferences. Anti-Gram-positive growth promoters would be expected to have little effect on most Gram-negative organisms. Even if resistant pathogens do reach man, the clinical consequences of resistance may be small. The application of the 'precautionary principle' is a non-scientific approach that assumes that risk assessments will be carried out.
1,039 citations
TL;DR: Community epidemiological surveys using the World Health Organization Composite International Diagnostic Interview administered face‐to‐face were carried out in 10 countries in North America, Latin America, Europe, and Asia.
Abstract: Absence of a common diagnostic interview has hampered cross-national syntheses of epidemiological evidence on major depressive episodes (MDE). Community epidemiological surveys using the World Health Organization Composite International Diagnostic Interview administered face-to-face were carried out in 10 countries in North America (Canada and the US), Latin America (Brazil, Chile, and Mexico), Europe (Czech Republic, Germany, the Netherlands, and Turkey), and Asia (Japan). The total sample size was more than 37,000. Lifetime prevalence estimates of hierarchy-free DSM-III-R/DSM-IV MDE varied widely, from 3% in Japan to 16.9% in the US, with the majority in the range of 8% to 12%. The 12-month/lifetime prevalence ratio was in the range 40% to 55%, the 30-day/12-month prevalence ratio in the range 45% to 65%, and median age of onset in the range 20 to 25 in most countries. Consistent socio-demographic correlates included being female and unmarried. Respondents in recent cohorts reported higher lifetime prevalence, but lower persistence than those in earlier cohorts. Major depressive episodes were found to be strongly co-morbid with, and temporally secondary to, anxiety disorders in all countries, with primary panic and generalized anxiety disorders the most powerful predictors of the first onset of secondary MDE. Major depressive episodes are a commonly occurring disorder that usually has a chronic-intermittent course. Effectiveness trials are needed to evaluate the impact of early detection and treatment on the course of MDE as well as to evaluate whether timely treatment of primary anxiety disorders would reduce the subsequent onset, persistence, and severity of secondary MDE.
TL;DR: This paper considers what the debates on trust have to offer health policy analysis by exploring the meaning, bases and outcomes of trust, and its relevance to health systems, and presents a synthesis of theoretical perspectives on the notion of trust.
TL;DR: The immunomodulator imiquimod has proved to be an adjunct for CL therapy and the search for new drugs continues, with bisphosphonates, for example, risedronate and pamidronate, and plant derivatives being reported to have activity against experimental animal infections.
TL;DR: A significant age-associated decrease in global and regional brain volumes is found and some evidence indicates that this decline in brain volumes may be due to a nonlinear acceleration in rates of atrophy with increasing age.
Abstract: pare directly results based on cross-sectional and longitudinal data. Methods: Thirty-nine healthy control subjects (age range, 31-84 years) underwent serial magnetic resonance imaging assessments. Measurements included the whole-brain, temporal lobe, hippocampal, and ventricular volumes at baseline and for repeat scans. Results: We found significant decreases in crosssectionalwhole-brain(P.001),temporallobe(P.001), andhippocampal(P=.003)volumesandasignificantincrease in ventricular volume (P.001) with increasing age. Cross-sectional and longitudinal estimates of atrophy rates were similar. We also found directional evidenceofaccelerationinatrophyrateswithincreasingage in all analyses, with the most marked changes occurring after 70 years of age. This increase in rates after 70 years ofagewasparticularlymarkedintheventricles(P.001) and the hippocampi (P=.01). Conclusions:We found a significant age-associated decrease in global and regional brain volumes. Some evidence indicates that this decline in brain volumes may beduetoanonlinearaccelerationinratesofatrophywith increasingage.Abetterunderstandingofthisprocessmay helptodiscriminatenormalage-relatedchangesfromneurodegenerative diseases. Arch Neurol. 2003;60:989-994
TL;DR: Equity must be a priority in the design of child survival interventions and delivery strategies, and mechanisms to ensure accountability at national and international levels must be developed.
TL;DR: The theoretical and political benefit of the widespread ban of growth promoters needs to be more carefully weighed against the increasingly apparent adverse consequences.
Abstract: Following the ban of all food animal growth-promoting antibiotics by Sweden in 1986, the European Union banned avoparcin in 1997 and bacitracin, spiramycin, tylosin and virginiamycin in 1999. Three years later, the only attributable effect in humans has been a diminution in acquired resistance in enterococci isolated from human faecal carriers. There has been an increase in human infection from vancomycin-resistant enterococci in Europe, probably related to the increased in usage of vancomycin for the treatment of methicillin-resistant staphylococci. The ban of growth promoters has, however, revealed that these agents had important prophylactic activity and their withdrawal is now associated with a deterioration in animal health, including increased diarrhoea, weight loss and mortality due to Escherichia coli and Lawsonia intra- cellularis in early post-weaning pigs, and clostridial necrotic enteritis in broilers. A directly attributable effect of these infections is the increase in usage of therapeutic antibiotics in food animals, including that of tetracycline, aminoglycosides, trimethoprim/sulphonamide, macrolides and lincosamides, all of which are of direct importance in human medicine. The theoretical and political benefit of the widespread ban of growth promoters needs to be more carefully weighed against the increasingly apparent adverse conse- quences.
TL;DR: The basis for a sociology of expectations is developed, drawing on recent writing within Science and Technology Studies and case studies of biotechnology innovation, and a model for understanding how expectations will predictably vary according to some key parameters is offered.
Abstract: Future expectations and promise are crucial to providing the dynamism and momentum upon which so many ventures in science and technology depend. This is especially the case for pre-market applications where practical utility and value has yet to be demonstrated and where investment must sustained. For instance, clinical biotechnology (including a wide range of genetic therapeutic and engineering applications) has been at the centre of ferocious debates about whether or not promises and expectations will be realised. In some cases, the failure of expectations has severely damaged the reputation and credibility of professions, institutions and industry. The need for a better analytical understanding of the dynamics of expectations in innovation is both necessary and timely.
TL;DR: Results indicated that acceptance predicted mental health and an objective measure of performance over and above job control, negative affectivity, and locus of control over and over.
Abstract: Acceptance, the willingness to experience thoughts, feelings and physiological sensations without having to control them or let them determine one's actions, is a major individual determinant of mental health and behavioral effectiveness in a more recent theory of psychopathology. This 2-wave panel study examined the ability of acceptance also to explain mental health, job satisfaction, and performance in the work domain. The authors hypothesized that acceptance would predict these 3 outcomes 1 year later in a sample of customer service center workers in the United Kingdom (N = 412). Results indicated that acceptance predicted mental health and an objective measure of performance over and above job control, negative affectivity, and locus of control. These beneficial effects of having more job control were enhanced when people had higher levels of acceptance. The authors discuss the theoretical and practical relevance of this individual characteristic to occupational health and performance.
TL;DR: The high energy densities of many fast foods challenge human appetite control systems with conditions for which they were never designed and are likely to result in the accidental consumption of excess energy and hence to promote weight gain and obesity.
Abstract: Fast foods are frequently linked to the epidemic of obesity, but there has been very little scientific appraisal of a possible causal role Here we review a series of studies demonstrating that the energy density of foods is a key determinant of energy intake These studies show that humans have a weak innate ability to recognise foods with a high energy density and to appropriately down-regulate the bulk of food eaten in order to maintain energy balance This induces so called 'passive over-consumption' Composition data from leading fast food company websites are then used to illustrate that most fast foods have an extremely high energy density At some typical outlets the average energy density of the entire menus is approximately 1100 kJ 100 g(-1) This is 65% higher than the average British diet (approximately 670 kJ 100 g(-1)) and more than twice the energy density of recommended healthy diets (approximately 525 kJ 100 g(-1)) It is 145% higher than traditional African diets (approximately 450 kJ 100 g(-1)) that probably represent the levels against which human weight regulatory mechanisms have evolved We conclude that the high energy densities of many fast foods challenge human appetite control systems with conditions for which they were never designed Among regular consumers they are likely to result in the accidental consumption of excess energy and hence to promote weight gain and obesity
TL;DR: The DALY estimates highlight the fact that mortality alone underestimates the burden of disease, especially with regard to unintentional injuries, respiratory disease, and nervous system, mental and sense organ disorders, and the impact of HIV/AIDS can be expected to grow very rapidly in the next few years.
Abstract: BACKGROUND: This paper describes the first national burden of disease study for South Africa The main focus is the burden due to premature mortality, ie years of life lost (YLLs) In addition, estimates of the burden contributed by morbidity, ie the years lived with disability (YLDs), are obtained to calculate disability-adjusted life years (DALYs); and the impact of AIDS on premature mortality in the year 2010 is assessed METHOD: Owing to the rapid mortality transition and the lack of timely data, a modelling approach has been adopted The total mortality for the year 2000 is estimated using a demographic and AIDS model The non-AIDS cause-of-death profile is estimated using three sources of data: Statistics South Africa, the National Department of Home Affairs, and the National Injury Mortality Surveillance System A ratio method is used to estimate the YLDs from the YLL estimates RESULTS: The top single cause of mortality burden was HIV/AIDS followed by homicide, tuberculosis, road traffic accidents and diarrhoea HIV/AIDS accounted for 38% of total YLLs, which is proportionately higher for females (47%) than for males (33%) Pre-transitional diseases, usually associated with poverty and underdevelopment, accounted for 25%, non-communicable diseases 21% and injuries 16% of YLLs The DALY estimates highlight the fact that mortality alone underestimates the burden of disease, especially with regard to unintentional injuries, respiratory disease, and nervous system, mental and sense organ disorders The impact of HIV/AIDS is expected to more than double the burden of premature mortality by the year 2010 CONCLUSION: This study has drawn together data from a range of sources to develop coherent estimates of premature mortality by cause South Africa is experiencing a quadruple burden of disease comprising the pre-transitional diseases, the emerging chronic diseases, injuries, and HIV/AIDS Unless interventions that reduce morbidity and delay morbidity become widely available, the burden due to HIV/AIDS can be expected to grow very rapidly in the next few years An improved base of information is needed to assess the morbidity impact more accurately
TL;DR: The results suggest that multiple dendritic cell types, not just plasmacytoid cells, can act as specialized interferon-producing cells in certain viral infections, and reveal the existence of a TLR-independent pathway for d endritic cell activation that can be the target of viral interference.
Abstract: Type I interferons (IFN-I) are important cytokines linking innate and adaptive immunity. Plasmacytoid dendritic cells make high levels of IFN-I in response to viral infection and are thought to be the major source of the cytokines in vivo. Here, we show that conventional non-plasmacytoid dendritic cells taken from mice infected with a dendritic-cell-tropic strain of lymphocytic choriomeningitis virus make similarly high levels of IFN-I on subsequent culture. Similarly, non-plasmacytoid dendritic cells secrete high levels of IFN-I in response to double-stranded RNA (dsRNA), a major viral signature, when the latter is introduced into the cytoplasm to mimic direct viral infection. This response is partially dependent on the cytosolic dsRNA-binding enzyme protein kinase R and does not require signalling through toll-like receptor (TLR) 3, a surface receptor for dsRNA. Furthermore, we show that sequestration of dsRNA by viral NS1 (refs 6, 7) explains the inability of conventional dendritic cells to produce IFN-I on infection with influenza. Our results suggest that multiple dendritic cell types, not just plasmacytoid cells, can act as specialized interferon-producing cells in certain viral infections, and reveal the existence of a TLR-independent pathway for dendritic cell activation that can be the target of viral interference.
Book•
01 Jan 2003TL;DR: The relationship between language and sexual desire is explored in this article, with a broad definition of "sexuality" and a discussion of the discursive construction of sexuality and the verbal expression of erotic desire.
Abstract: This lively and accessible textbook looks at how we talk about sex and why we talk about it the way we do. Drawing on a wide range of examples, from personal ads to phone sex, from sado-masochistic scenes to sexual assault trials, the book provides a clear introduction to the relationship between language and sexuality. Using a broad definition of 'sexuality', the book encompasses not only issues surrounding sexual orientation and identity but also questions about the discursive construction of sexuality and the verbal expression of erotic desire. Cameron and Kulick contextualize their findings within current research in linguistics, anthropology and psychology, and bring together relevant theoretical debates on sexuality, gender, identity, desire, meaning and power. Topical and entertaining, this much-needed textbook will be welcomed by students and researchers in sociolinguistics, linguistic anthropology and gender/sexuality studies, as well as anyone interested in the relationship between language and sex.
TL;DR: It is suggested that relative undernutrition early in life in children born preterm may have beneficial effects on insulin resistance.
TL;DR: Electrically-responsive hydrogels, response of gels to an electric field and electrically-stimulated drug release are discussed.
TL;DR: The current status of VLPs as vaccines is reviewed, and the characteristics and problems associated with producingVLPs for different viruses are discussed, showing dramatic effectiveness as candidate vaccines.
TL;DR: Technical advances in mutation detection, and the identification of other genes that cause FH, are likely to have important implications for the cost effectiveness of genetic diagnosis of FH.
TL;DR: This work indicates that it is possible to estimate the individual ancestry of a person based on DNA analysis with a reasonable number of well-defined genetic markers, as well as applying two methods of admixture mapping to test for the effects of three candidate genes.
Abstract: Ancestry informative markers (AIMs) are genetic loci showing alleles with large frequency differences between populations. AIMs can be used to estimate biogeographical ancestry at the level of the population, subgroup (e.g. cases and controls) and individual. Ancestry estimates at both the subgroup and individual level can be directly instructive regarding the genetics of the phenotypes that differ qualitatively or in frequency between populations. These estimates can provide a compelling foundation for the use of admixture mapping (AM) methods to identify the genes underlying these traits. We present details of a panel of 34 AIMs and demonstrate how such studies can proceed, by using skin pigmentation as a model phenotype. We have genotyped these markers in two population samples with primarily African ancestry, viz. African Americans from Washington D.C. and an African Caribbean sample from Britain, and in a sample of European Americans from Pennsylvania. In the two African population samples, we observed significant correlations between estimates of individual ancestry and skin pigmentation as measured by reflectometry (R2=0.21, P<0.0001 for the African-American sample and R2=0.16, P<0.0001 for the British African-Caribbean sample). These correlations confirm the validity of the ancestry estimates and also indicate the high level of population structure related to admixture, a level that characterizes these populations and that is detectable by using other tests to identify genetic structure. We have also applied two methods of admixture mapping to test for the effects of three candidate genes (TYR, OCA2, MC1R) on pigmentation. We show that TYR and OCA2 have measurable effects on skin pigmentation differences between the west African and west European parental populations. This work indicates that it is possible to estimate the individual ancestry of a person based on DNA analysis with a reasonable number of well-defined genetic markers. The implications and applications of ancestry estimates in biomedical research are discussed.
TL;DR: Community-based outpatient treatment of multidrug-resistant tuberculosis can yield high cure rates even in resource-poor settings and early initiation of appropriate therapy can preserve susceptibility to first-line drugs and improve treatment outcomes.
Abstract: Background Despite the prevalence of multidrug-resistant tuberculosis in nearly all low-income countries surveyed, effective therapy has been deemed too expensive and considered not to be feasible outside referral centers. We evaluated the results of community-based therapy for multidrug-resistant tuberculosis in a poor section of Lima, Peru. Methods We describe the first 75 patients to receive ambulatory treatment with individualized regimens for chronic multidrug-resistant tuberculosis in northern Lima. We conducted a retrospective review of the charts of all patients enrolled in the program between August 1, 1996, and February 1, 1999, and identified predictors of poor outcomes. Results The infecting strains of Mycobacterium tuberculosis were resistant to a median of six drugs. Among the 66 patients who completed four or more months of therapy, 83 percent (55) were probably cured at the completion of treatment. Five of these 66 patients (8 percent) died while receiving therapy. Only one patient continu...
TL;DR: More precise indicators of education, employment and material circumstances are better markers of increased rates than occupational social class, which are significantly more frequent in socially disadvantaged populations.
Abstract: Background: Of two large-scale government-commissioned studies of common mental disorders in the UK, one found occupational social class to be the strongest marker of risk while the other showed no clear relationship. This study reviews the published evidence on the links between conventional markers of social position and the common mental disorders in developed countries. Methods: Inclusion criteria covered general population based studies with broad social class variation; samples of 3,000 or more adults of working age; identification of mental illness by validated instruments; social position identified by explicit standard markers; fieldwork undertaken since 1980; published output on key areas of interest. Incompatible study methods and concepts made statistical pooling of results invalid. Results: Of nine studies, eight provide evidence of an association between one or more markers of less privileged social position and higher prevalence of common mental disorders. For some individual indicators in particular studies, no clear trend was evident, but no study showed a contrary trend for any indicator. The more consistent associations were with unemployment, less education and low income or material standard of living. Occupational social class was the least consistent marker. Conclusions: Common mental disorders are significantly more frequent in socially disadvantaged populations. More precise indicators of education, employment and material circumstances are better markers of increased rates than occupational social class.
Posted Content•
TL;DR: In this article, the authors examined the nature of employment and the conditions of work in five telephone call centres in the telecommunications industry in Australia and identified the factors that are associated with emotional exhaustion and the frequency of absence amongst the employees.
Abstract: This paper examines the nature of employment and the conditions of work in five telephone call centres in the telecommunications industry in Australia. Call centre work typically requires high levels of sustained interpersonal interaction with customers which can lead to burnout and employee withdrawal. Customer service staff can also become targets of customer hostility and abuse. In addition, this form of work tends to involve extensive employee monitoring and surveillance with little job discretion or variety of tasks. The paper draws upon survey data from 480 telephone service operators to identify the factors that are associated with emotional exhaustion and the frequency of absence amongst the employees. A modelling of the data using LISREL VIII revealed that a number of job and work-setting variables affected the level of emotional exhaustion of employees. These included interactions with the customer, a high workload and a lack of variety of work tasks. Moreover, higher rates of absence were associated with emotional exhaustion.