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(2) TREATMENT
WITH BACTERIA CAN PROTECT
CHILDREN FROM
RECURRENT EAR INFECTIONS
(3) NATIONAL
SCREENING PROGRAMME SHOULD
ADDRESS THE
PSYCHOSOCIAL IMPACT OF
CHLAMYDIAL
INFECTION
(4) SUPPORTED
EMPLOYMENT HELPS PEOPLE WITH
SEVERE MENTAL
ILLNESS OBTAIN WORK
(1) BIRTH WEIGHT
RELATED TO MENTAL ABILITY
AND EDUCATIONAL PERFORMANCE
(Birth weight and cognitive function
in the British 1946 birth
cohort: longitudinal population
based study)
http://bmj.com/cgi/content/full/322/7280/199
Birth weight is significantly associated
with cognitive (mental)
ability at age 8 years, through adolescence,
and into early
adulthood, independent of social background.
Furthermore,
birth weight is also associated with educational
performance,
finds a study in this week's BMJ.
Researchers at the MRC National Survey
of Health and
Development (the British 1946 birth cohort),
based at
University College London, examined the
association
between birth weight and cognitive ability
in 3,900 males and
females born in 1946, who had had cognitive
assessments
from childhood to middle life (measured
at ages 8, 11, 15, 26
and 43). They also examined the association
between birth
weight and educational attainment in this
group.
Birth weight was significantly and positively
associated with
cognitive ability at age 8 across the
full birth weight range in
the normal population, even after factors
such as sex, father's
social class, and mother's education and
age were taken into
account. This association was also seen
at ages 11, 15 and
26, but at age 43, birth weight had no
significant effect on any
of the test scores. Birth weight was also
associated with
education, with those of higher birth
weight more likely to
have achieved higher qualifications.
Despite some inevitable limitations, these
results support the
view that birth weight is related to cognitive
performance
independently of social background, conclude
the authors.
Contact:
Marcus Richards, MRC National Survey of
Health and
Development, University College London,
UK
Email: m.richards@ucl.ac.uk
(2) TREATMENT
WITH BACTERIA CAN PROTECT
CHILDREN FROM RECURRENT EAR INFECTIONS
(Effect of recolonisation with "interfering"
alpha-streptococci
on recurrences of acute and secretory
otitis media in children:
randomised placebo controlled trial)
http://bmj.com/cgi/content/full/322/7280/210
Selected bacteria with the ability to inhibit
the growth of
common pathogens can be used to protect
children who are
prone to acute otitis media (ear infection)
and could also help
reduce antibiotic use, finds a study in
this week's BMJ.
Researchers in Sweden identified 108 children
prone to acute
otitis media aged between 6 months and
6 years. Children
were given antibiotic treatment twice
daily for 10 days. This
was followed by either alpha-streptococcal
or placebo
solution sprayed into the nose for a further
10 days. After 60
days, the same spray was started for another
10 days. At 3
months, 22 children (42%) given the streptococcal
spray
were healthy and free of infection compared
with only 12
(22%) of those given placebo. This difference
was also
shown for recurrences of secretory otitis
media, often seen as
a complication of acute otitis media,
add the authors.
Ironically, repeated courses of antibiotics
may be contributing
to recurrent infections in these children,
as most antibiotics
affect the normal bacteria that form part
of the body's natural
defence, explain the authors. Treatment
with streptococcal
bacteria could help reduce antibiotic
consumption in
susceptible children, they conclude.
Contact:
Kristian Roos, Associate Professor, Ear,
Nose and Throat
Department, Lundby Hospital, Gothenburg,
Sweden
Email: kristian.roos@lundbysjukhus.se
(3) NATIONAL SCREENING
PROGRAMME SHOULD
ADDRESS THE PSYCHOSOCIAL IMPACT OF
CHLAMYDIAL INFECTION
(Qualitative analysis of psychosocial
impact of diagnosis of
Chlamydia trachomatis: implications
for screening)
http://bmj.com/cgi/content/full/322/7280/195
A diagnosis of chlamydia triggers women's
concern about the
perceived stigma of sexually transmitted
infections, future
reproductive health, and notifying partners,
according to a
study in this week's BMJ. These findings
have important
implications for a proposed national screening
programme in
the UK.
Duncan and colleagues surveyed 17 women,
aged between
18 and 29 years, attending either a genitourinary
medicine
clinic or a family planning clinic in
Glasgow about their
experiences and concerns of being diagnosed
with chlamydia.
Three themes were identified: perceptions
of stigma
associated with sexually transmitted infection,
uncertainty
about future reproductive health and anxieties
regarding
partner's reaction to diagnosis.
These areas of concern need to be examined
before the
implementation of any new screening programme,
say the
authors. For example, information given
to women before
screening should seek to normalise and
destigmatise
chlamydial infection to reduce the negative
psychosocial
impact of a positive diagnosis. Furthermore,
messages
accompanying screening should not imply
that diagnosis and
treatment will prevent infertility, and
support services should
be available because notification of partner
can cause anxiety,
they conclude.
Contact:
Barbara Duncan, Centre for Applied Social
Psychology,
University of Strathclyde, UK
Email: barbara.duncan@strath.ac.uk
(4) SUPPORTED
EMPLOYMENT HELPS PEOPLE WITH
SEVERE MENTAL ILLNESS OBTAIN WORK
(Helping people with severe mental
illness to obtain work:
systematic review)
http://bmj.com/cgi/content/full/322/7280/204
Supported employment is more effective
than prevocational
training at helping people with severe
mental illness to obtain
and keep competitive employment (a job
paid at the market
rate, and for which anyone can apply),
finds a study in this
week's BMJ.
Crowther and colleagues analysed 11 trials
comparing
prevocational training (a period of preparation
before entering
competitive employment) or supported employment
(placement in competitive employment while
offering on the
job support) with each other, or with
standard community
care, for people with severe mental illness.
They found that
supported employment was more effective
than prevocational
training at helping people to obtain competitive
employment.
This effect was still present, although
at a reduced level, when
all but the two highest quality trials
were excluded from the
analysis.
There are compelling ethical, social and
clinical reasons for
helping people with mental illness to
work, say the authors. In
light of the UK government's commitment
to helping disabled
people return to the workplace, it should
encourage agencies
concerned with vocational rehabilitation
to develop and
evaluate supported employment schemes
similar to those in
the United States, they conclude.
Contact:
Ruth Crowther, Research Fellow, School
of Psychiatry and
Behavioural Sciences, University of Manchester,
UK
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