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Job Stress Blamed for Sizeable Proportion of Depression by Caroline Cassels

Negative working conditions, including low job satisfaction, little control, and a lack of appreciation by employers, are responsible for a sizeable proportion of depression in middle-aged adults, new research suggests.

Investigators at the University of Michigan Institute for Social Research in Ann Arbor found that workers with a higher total “negative working conditions” score also had higher scores for depressive symptoms.

In workers with the total highest scores, negative working conditions accounted for about one third of the standard deviation in depressive symptoms, a “substantial difference,” according to investigators.

“These findings add to the growing body of evidence that employment is an important source of divergence in mental health across midlife,” the researchers, led by Sarah A. Burgard, PhD, write.

The study is published in the September issue of the Journal of Occupational and Environmental Medicine.

Novel Methodology

Previous longitudinal studies of negative working conditions have tended to use a single exposure indicator, such as job strain. However, the investigators note that although this methodology has predicted health outcomes in a large number of populations, it may not capture the full range of negative conditions individuals experience on the job.

For the study, the researchers analyzed the relationship between a large number of working conditions and depressive symptoms on the basis of 4 waves of data collection during a period of 15 years in 1889 US workers aged 25 years and older.

The workers were asked about all working conditions, including job satisfaction, work/life balance, conflicting demands, and whether they felt appreciated for their work.

Researchers created a “novel” summary score of negative working conditions that encompassed all available working condition measures and examined the link between this score and depressive symptoms.

“Our measurement strategy can capture a wider range of experiences that workers face on the job, while not requiring the same set of items to be fielded in each wave of a survey,” the authors write.

The investigators found that workers with higher total negative working conditions scores also had the highest scores for depressive symptoms, as measured by the Center of Epidemiological Studies–Depression scale (CES-D).

For workers with the highest total scores, negative working conditions accounted for about one third of the standard deviation in depressive symptoms, “a substantial difference,” according to the authors.

These findings, the investigators note, underscore the importance of the “role of good jobs in enhancing worker productivity and reducing the costs of depression for workers, their families, and healthcare systems.”

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Connie’s comments:

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The Great Stagnation of the American Education by Robert Gordon

For most of American history, parents could expect that their children would, on average, be much better educated than they were. But that is no longer true. This development has serious consequences for the economy.

The epochal achievements of American economic growth have gone hand in hand with rising educational attainment, as the economists Claudia Goldin and Lawrence F. Katz have shown. From 1891 to 2007, real economic output per person grew at an average rate of 2 percent per year — enough to double every 35 years. The average American was twice as well off in 2007 as in 1972, four times as well off as in 1937, and eight times as well off as in 1902. It’s no coincidence that for eight decades, from 1890 to 1970, educational attainment grew swiftly. But since 1990, that improvement has slowed to a crawl.

Companies pay better-educated people higher wages because they are more productive. The premium that employers pay to a college graduate compared with that to a high school graduate has soared since 1970, because of higher demand for technical and communication skills at the top of the scale and a collapse in demand for unskilled and semiskilled workers at the bottom.

As the current recovery continues at a snail’s pace, concerns about America’s future growth potential are warranted. Growth in annual average economic output per capita has slowed from the century-long average of 2 percent, to 1.3 percent over the past 25 years, to a mere 0.7 percent over the past decade. As of this summer, per-person output was still lower than it was in late 2007. The gains in income since the 2007-9 Great Recession have flowed overwhelmingly to those at the top, as has been widely noted. Real median family income was lower last year than in 1998.

There are numerous causes of the less-than-satisfying economic growth in America: the retirement of the baby boomers, the withdrawal of working-age men from the labor force, the relentless rise in the inequality of the income distribution and, as I have written about elsewhere, a slowdown in technological innovation.

Education deserves particular focus because its effects are so long-lasting. Every high school dropout becomes a worker who likely won’t earn much more than minimum wage, at best, for the rest of his or her life. And the problems in our educational system pervade all levels.

The surge in high school graduation rates — from less than 10 percent of youth in 1900 to 80 percent by 1970 — was a central driver of 20th-century economic growth. But the percentage of 18-year-olds receiving bona fide high school diplomas fell to 74 percent in 2000, according to the University of Chicago economist James J. Heckman. He found that the holders of G.E.D.’s performed no better economically than high school dropouts and that the rising share of young people who are in prison rather than in school plays a small but important role in the drop in graduation rates.

Then there is the poor quality of our schools. The Program for International Student Assessment tests have consistently rated American high schoolers as middling at best in reading, math and science skills, compared with their peers in other advanced economies.

At the college level, longstanding problems of quality are joined with the issues of affordability. For most of the postwar period, the G.I. Bill, public and land-grant universities and junior colleges made a low-cost education more accessible in the United States than anywhere in the world. But after leading the world in college completion, America has dropped to 16th. The percentage of 25- to 29-year-olds who hold a four-year bachelor’s degree has inched up in the past 15 years, to 33.5 percent, but that is still lower than in many other nations.

The cost of a university education has risen faster than the rate of inflation for decades. Between 2008 and 2012 state financing for higher education declined by 28 percent. Presidents of Ivy League and other elite schools point to the lavish subsidies they give low- and middle-income students, but this leaves behind the vast majority of American college students who are not lucky or smart enough to attend them.

While a four-year college degree still pays off, about one-quarter of recent college graduates are currently unemployed or underemployed. Meanwhile, total student debt now exceeds $1 trillion.

Heavily indebted students face two kinds of risks. One is that they fall short of their income potential, through some combination of unemployment and inability to find a job in their chosen fields. Research has shown that on average a college student taking on $100,000 in student debt will still come out ahead by age 34. But that break-even age goes up if future income falls short of the average.

There is also completion risk. A student who takes out half as much debt but drops out after two years never breaks even because wages of college dropouts are little better than those of high school graduates. These risks are acute for high-achieving students from low-income families: Caroline M. Hoxby, a Stanford economist, found that they often don’t apply to elite colleges and wind up at subpar ones, deeply in debt.

Two-year community colleges enroll 37 percent of American undergraduates. The Center on International Education Benchmarking reports that only 13 percent of students in two-year colleges graduate in two years; that figure rises to a still-dismal 28 percent after four years. These students are often working while taking classes and are often poorly prepared for college and required to take remedial courses.

Our subpar performance in schooling our kids hurts our economy’s capacity to grow.

Federal programs like No Child Left Behind and Race to the Top have gone too far in using test scores to evaluate teachers. Many children are culturally disadvantaged, even if one or both parents have jobs, have no books at home, do not read to them, and park them in front of a TV set or a video game in lieu of active in-home learning. Compared with other nations where students learn several languages and have math homework in elementary school, the American system expects too little. Parental expectations also matter: homework should be emphasized more, and sports less.

Poor academic achievement has long been a problem for African-Americans and Hispanics, but now the achievement divide has extended further. Isabel V. Sawhill, an economist at the Brookings Institution, has argued that “family breakdown is now biracial.” Among lower-income whites, the proportion of children living with both parents has plummeted over the past half-century, as Charles Murray has noted.

Are there solutions? The appeal of American education as a destination for the world’s best and brightest suggests the most obvious policy solution. Shortly before his death, Steve Jobs told President Obama that a green card conferring permanent residency status should be automatically granted to any foreign student with a degree in engineering, a field in which skills are in short supply..

Richard J. Murnane, an educational economist at Harvard, has found evidence that high school and college completion rates have begun to rise again, although part of this may be a result of weak labor markets that induce students to stay in school rather than face unemployment. Other research has shown that high-discipline, “no-excuses” charter schools, like those run by the Knowledge Is Power Program and the Harlem Children’s Zone, have erased racial achievement gaps. This model suggests that a complete departure from the traditional public school model, rather than pouring in more money per se, is needed.

Early childhood education is needed to counteract the negative consequences of growing up in disadvantaged households, especially for children who grow up with only one parent. Only one in four American 4-year-olds participate in preschool education programs, but that’s already too late. In a remarkable program, Reach Out and Read, 12,000 doctors, nurses and other providers have volunteered to include instruction on the importance of in-home reading to low-income mothers during pediatric checkups.

Even in today’s lackluster labor market, employers still complain that they cannot find workers with the needed skills to operate complex modern computer-driven machinery. Lacking in the American system is a well-organized funnel between community colleges and potential blue-collar employers, as in the renowned apprenticeship system in Germany.

How we pay for education shows, in the end, how much we value it. In Canada, each province manages and finances education at the elementary, secondary and college levels, thus avoiding the inequality inherent in America’s system of local property-tax financing for public schools. Tuition at the University of Toronto was a mere $5,695 for Canadian arts and science undergraduates last year, compared with $37,576 at Harvard. It should not be surprising that the Canadian college completion rate is about 15 percentage points above the American rate. As daunting as the problems are, we can overcome them. Our economic growth is at stake.

Connie’s comments: More vocational schools and city colleges. More economics, finance and money management subjects. Let’s raise the financial IQ of our youth. Our future should be  filled with middle class who can transition to the wealthy bracket.

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Fat Cells in Breast Tissue: Link Between Social Stress and Breast Cancer by Lilie Shockney RN

Yes, you read that correctly. Researchers have discovered that exposure to severe social stressors during a girl’s early life may be linked by local chemical signals released by fat cells in the girl’s breast tissue may provide an important link to her eventual development of breast cancer years later. This research was conducted at the University of Chicago and published in the May issue of Cancer Prevention Research.

This is incredible, and disturbing, news

To think that some forms of stress in our youth can trigger the development of breast cancer in our adulthood—WOW!

Something that was of particular interest to me in this study was the finding that the social isolation experienced by many young girls can lead—and has apparently been found to lead—to the reprogramming of certain genes in fat cells in the mammary glands. In-depth tests were focused on triple-negative breast cancers (i.e., those not stimulated to grow by female hormones or by a HER2 protein) as a way to help ensure the purity of the data results.

A young girl’s attachments and bonds to others

This news is hard to read, given that many of us are mothers and grandmothers and feel at times that we have no control over our youngsters’ health. Now we must also keep in mind that getting young girls involved socially is clearly more important that we realized.

And we must guard against pushing too hard

Also, we must be sure that we have appropriate expectations of them, so that we don’t over-stress them by pushing them to achieve the unachievable. It’s always been important at so many levels that we caregivers be very watchful of issues like sexual abuse, physical abuse, bullying, and a young girl‘s attempts to measure up to other people’s unrealistic expectations. Now we have another reason to help: to prevent the development of breast cancer in her adulthood. 

©1996-2013, Johns Hopkins University. All rights reserved.

 

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Oral infections causing more hospitalizations by Catherine St Louis

Left untreated, a serious tooth abscess can eventually kill.

In 2007, Deamonte Driver, a 12-year-old boy in Maryland, died after bacteria from an abscessed tooth spread to his brain. The case drew widespread media attention, and his is the cautionary tale cited whenever politicians and advocates discuss access to oral health care.

But a new study suggests that deaths from these preventable infections may not be as rare as once thought and that the number of Americans hospitalized with them may be on the rise.

Studies have shown that dental problems account for hundreds of thousands of emergency room visits each year. The new analysis, published in the September issue of the Journal of Endodontics, focused on patients who had to be hospitalized because of an infection of the tip of the tooth’s root, called a periapical abscess. It is a common consequence of untreated tooth decay, and it can be dangerous if it spreads.

After reviewing national patient data from 2000 to 2008, researchers in Boston found that the people hospitalized for dental abscesses increased by more than 40 percent, to 8,141 in 2008 from 5,757 in 2000. Some 66 patients died after they were hospitalized, according to the new analysis.

“We have not had verification before of the number of deaths,” said Dr. Frank Catalanotto, chairman of the department of community dentistry and behavioral science at the University of Florida College of Dentistry, who was not involved in the report. “The seriousness of dental infections that go untreated or are treated too late is a bigger problem than we had estimated.”

When money and access are not problems, an abscessed tooth can easily be treated with a root canal or an extraction. But increasingly, Americans rely on hospital emergency rooms for dental care, instead of regular dentist visits — a trend exacerbated by a lack of insurance coverage and trouble paying out of pocket.

Last year, a Pew Charitable Trusts report estimated that preventable dental conditions, including abscessed teeth, were the primary reason for 830,590 emergency room visits in 2009 — a 16 percent increase from 2006.

Until now, it has been unclear just how many patients end up hospitalized specifically for abscessed teeth or how much they cost the health care system. According to the new analysis, that figure was $858.9 million, after adjustment for inflation, from 2000 to 2008.

“That’s what we are paying instead of paying up front, and it’s such a waste, one with a high human cost,” said Shelly Gehshan, the director of the Pew Children’s Dental Campaign. “Dental insurance is eroding little by little, and affordability of dental care is something the industry has not addressed.”

A periapical abscess is a “rare event, and to have significant morbidity is even rarer,” said Dr. Bruce Dye, a dental epidemiologist at the Centers for Disease Control and Prevention. Still, the number of patients hospitalized for them is “creeping up.”

But Dr. Dye cautioned that the analysis did not address whether patients were able to afford dental care; some may have ended up at the emergency room for a complication after receiving a root canal from a dentist. “You can’t make the statement that this is a sign of increased problem of access to care,” he said.

Medicaid coverage for routine dental services for adults varies widely by state; Medicare does not cover routine dental care. The programs do pay for hospital stays, however, and the new study found that Medicare paid for roughly 19 percent of hospitalizations for dental abscesses, while Medicaid shouldered 25 percent and private insurance plans paid for 33 percent.

In recent years, Dr. Samuel Dorn, a chairman of endodontics at the University of Texas Health Science Center at Houston, said he had seen an increase in hospitalizations for dental abscesses.

“People put it off until they find their face all swollen or they can’t breathe, and they run to the hospital,” he said. “And that’s when we have these emergent conditions.”

His colleague Dr. Mark Wong, the chairman of oral surgery at the university, said residents’ logs showed that in 2008, 273 “incision and drainage” procedures because of abscessed teeth were done in local hospitals. Last year, the number was 488; 248 patients were hospitalized.

“To call this an epidemic of dental infections we are seeing in major hospital environments and in our emergency rooms — it’s not an overstatement,” Dr. Wong said.

An acute abscess of an upper tooth can cause cheek swelling and, untreated, lead to a brain abscess or a sinus infection. If bacteria spread from an abscess in a lower tooth, the swelling can constrict the airway. Some patients underestimate how serious the condition can be.

“It’s better to have it treated when it’s treatable than to wait until it gets out of hand and is possibly life-threatening,” said Dr. Gary R. Hartwell, the president of the American Association of Endodontists. The increase in hospitalizations is part of a sea change in dental care, he said: “Now it’s reached a point unless something’s bothering them or they’ve got pain, people say, ‘I’m just not going to go to the dentist.’ ”

 

Connie’s comments: Do a regular dental hygiene and check up. Drink tea. Gargle with salt water and add tea tree oil or peppermint essential oil in your mouth wash.

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