Releases Saturday 27 January 2001
No 7280 Volume 322

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(1) BIRTH WEIGHT RELATED TO MENTAL ABILITY
AND EDUCATIONAL PERFORMANCE

(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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