Non-specific psychological distress, smoking status and smoking cessation: United States National Health Interview Survey 2005

<p>Abstract</p> <p>Background</p> <p>It is well established that smoking rates in people with common mental disorders such as anxiety or depressive disorders are much higher than in people without mental disorders. It is less clear whether people with these mental disorders want to quit smoking, attempt to quit smoking or successfully quit smoking at the same rate as people without such disorders.</p> <p>Methods</p> <p>We used data from the 2005 Cancer Control Supplement to the United States National Health Interview Survey to explore the relationship between psychological distress as measured using the K6 scale and smoking cessation, by comparing current smokers who had tried unsuccessfully to quit in the previous 12 months to people able to quit for at least 7 to 24 months prior to the survey. We also used data from the 2007 Australian National Survey of Mental Health and Wellbeing to examine the relationship between psychological distress (K6) scores and duration of mental illness.</p> <p>Results</p> <p>The majority of people with high K6 psychological distress scores also meet diagnostic criteria for mental disorders, and over 90% of these people had first onset of mental disorder more than 2 years prior to the survey. We found that people with high levels of non-specific psychological distress were more likely to be current smokers. They were as likely as people with low levels of psychological distress to report wanting to quit smoking, trying to quit smoking, and to have used smoking cessation aids. However, they were significantly less likely to have quit smoking.</p> <p>Conclusions</p> <p>The strong association between K6 psychological distress scores and mental disorders of long duration suggests that the K6 measure is a useful proxy for ongoing mental health problems. As people with anxiety and depressive disorders make up a large proportion of adult smokers in the US, attention to the role of these disorders in smoking behaviours may be a useful area of further investigation for tobacco control.</p

Democracia vs. eficiência: como alcançar equilíbrio em tempo de crise financeira

Resumo A administração pública é forçada a encontrar um equilíbrio entre eficiência e democracia na definição da sua agenda e curso de ação. Uma das características da administração pública é que todas as decisões devem refletir valores democráticos, para além de serem eficientes. No entanto, a reforma administrativa, motivada por dificuldades financeiras, tende a destacar a importância do desempenho financeiro, em detrimento dos aspetos democráticos nas políticas de gestão pública. Esta pesquisa visa analisar a relação e tensão entre a eficiência e a democracia à luz da mais recente crise financeira global. O trabalho utiliza uma abordagem quantitativa e recolhe dados de governos locais portugueses para testar o argumento de uma relação linear inversa de desempenho financeiro e procedimentos democráticos. Os resultados confirmam o argumento de uma relação inversa, definida por Waldo (1948). Adicionalmente, os resultados também permitem concluir que a crise financeira evidenciou o efeito negativo dos procedimentos democráticos no desempenho financeiro

The Anxious and the Climbers: Ambivalent Attitudes Towards Democracy Among South Africa's Middle Class

Beyond the hopes placed in Africa's emergent middle class as an engine of economic growth, some analysts see this group as a bastion of political stability and enduring democratisation across the continent. This paper's approach differs from that of most studies, which treat the middle class as a homogeneous group, through two key contributions. First, using cluster analysis, I propose a novel way of conceptualising social class that broadly draws on the Weberian idea of shared life chances. I apply this method to South Africa and identify five social classes characterised by their members' living standards, overall life satisfaction, and self-perceived upward mobility. Second, the empirical analysis reveals significant discrepancies in attitudes towards democracy between the downwardly and upwardly mobile strata of the middle class, which I term the "anxious" and the "climbers", respectively. On the one hand, the "climbers" show the highest generic support for democracy as a form of government, whereas the "anxious" middle class displays feelings of resignation. On the other hand, I find indicative evidence of a status-quo bias among the "climbers". Rather than assuming a more demanding or critical stance in politics, they allow their political priorities to be at least partly shaped by an interest in securing and expanding attained living standards; being upwardly mobile is even associated with a higher tolerance for government attempts to constrain freedom of information, opinion, or expression