Employers Should Owe a Duty of Loyalty to Their Workers

An employee’s overarching legal commitment to his or her employer is commonly known as the “duty of loyalty.” This lopsided duty of loyalty exacerbates the inordinate power that employers possess over their workers. We propose that the duty of loyalty owed by workers to their employers be made reciprocal: employers should also owe a general duty of loyalty and care towards their employees

The distribution of the common mental disorders: social inequalities in Europe

BACKGROUND: The social class distribution of the common mental disorders (mostly anxiety and/or depression) has been in doubt until recently. This paper reviews the evidence of associations between the prevalence of the common mental disorders in adults of working age and markers of socio-economic disadvantage. METHODS: Work is reviewed which brings together major population surveys from the last 25 years, together with work trawling for all European population studies. Data from more recent studies is examined, analysed and discussed. Because of differences in methods, instruments and analyses, little can be compared precsiely, but internal associations can be examined. FINDINGS: People of lower socio-economic status, however measured, are disadvantaged, and this includes higher frequencies of the conditions now called the 'common mental disorders' (mostly non-psychotic depression and anxiety, either separately or together). In European and similar developed populations, relatively high frequencies are associated with poor education, material disadvantage and unemployment. CONCLUSION: The large contribution of the common mental disorders to morbidity and disability, and the social consequences in working age adults would justify substantial priority being given to addressing mental health inequalities, and deprivation in general, within national and European social and economic policy

Framingham Stroke Risk Profile and poor cognitive function: a population-based study.

BACKGROUND: The relationship between stroke risk and cognitive function has not previously been examined in a large community living sample other than the Framingham cohort. The objective of this study was to examine the relationship between 10-year risk for incident stroke and cognitive function in a large population-based sample. METHODS: Participants were 7377 adults aged 50 years and over of the 2002 wave of the English Longitudinal Study of Ageing, a prospective cohort study. A modified version of the Framingham Stroke Risk Profile (incorporating age, sex, systolic blood pressure, antihypertensive medication, diabetes, smoking status, cardiovascular disease, and atrial fibrillation) was used to assess 10-year risk of stroke. Linear regression models were used to determine the cross-sectional relationship of stroke risk to global cognitive function and performance in multiple cognitive domains. RESULTS: In unadjusted models 10 percentage point increments of 10-year stroke risk were associated with poor global cognitive function (-0.40 SD units, 95% CI -0.43 - -0.38), and lowered performance in all cognitive domains. After statistical adjustment for age, sex, testing interval and other correlates of cognitive function the association with stroke risk was attenuated though remained significant for global cognitive function (-0.06 SD units, 95% CI -0.09 - -0.03), immediate and delayed verbal memory, semantic verbal fluency and processing speed. CONCLUSION: In individuals free from a history of stroke or dementia, high subclinical cerebrovascular disease burden was associated with worse cognitive function in multiple domains.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Trendanalyse der KMK-Statistiken zur sonderpädagogischen Förderung 1994 bis 2019

Die Ständige Konferenz der Kultusminister der Länder (KMK) gibt alle zwei Jahre eine Statistik zur sonderpädagogischen Förderung in Deutschland heraus. Der vorliegende Beitrag stellt eine erstmals durchgeführte Trendanalyse über den gesamten Berichtszeitraum seit dem Schuljahr 1994/95 vor. Insgesamt lässt sich festhalten, dass nur die Förderquote im sonderpädagogischen Schwerpunkt Lernen sinkt, alle anderen Schwerpunkte einen bisweilen sehr deutlichen Zuwachs aufweisen. Zudem zeigt sich, dass sich die Entwicklungstrends (Steigungskoeffizienten) von Förder-, Separations- und Integrationsquote mit dem Zeitpunkt des Inkrafttretens der UN-BRK signifikant ändern: Während Förder- und Integrationsquote nach 2009 steiler ansteigen als vorher, zeigt sich bei der Separationsquote eine Trendwende hin zu einer leicht abnehmenden Tendenz. (DIPF/Orig.)The standing conference of the state ministers of education (Kultusministerkonferenz [KMK]) publishes statistics on special needs education in Germany every two years. The present article presents a trend analysis carried out for the first time over the entire reporting period since the school year 1994/95. Overall, it can be said that only the rate of diagnoses in the special educational focus on learning is falling, all other focus areas show an increase. In addition, it can be seen that the trends (regression coefficients) of the rate of diagnoses, the exclusion rate and the inclusion rate change significantly with the UN CRPD being ratified: While rate of diagnoses and the inclusion rate increase more steeply after 2009 than before, there is a trend reversal in the exclusion rate towards a slightly decreasing trend. (Authors

Self-reported quality of care for older adults from 2004 to 2011: a cohort study

Background: little is known about changes in the quality of medical care for older adults over time. Objective: to assess changes in technical quality of care over 6 years, and associations with participants' characteristics. Design: a national cohort survey covering RAND Corporation-derived quality indicators (QIs) in face-to-face structured interviews in participants' households. Participants: a total of 5,114 people aged 50 or more in four waves of the English Longitudinal Study of Ageing. Methods: the percentage achievement of 24 QIs in 10 general medical and geriatric clinical conditions was calculated for each time point, and associations with participants' characteristics were estimated using logistic regression. Results: participants were eligible for 21,220 QIs. QI achievement for geriatric conditions (cataract, falls, osteoarthritis and osteoporosis) was 41% [95% confidence interval (CI): 38–44] in 2004–05 and 38% (36–39) in 2010–11. Achievement for general medical conditions (depression, diabetes mellitus, hypertension, ischaemic heart disease, pain and cerebrovascular disease) improved from 75% (73–77) in 2004–05 to 80% (79–82) in 2010–11. Achievement ranged from 89% for cerebrovascular disease to 34% for osteoarthritis. Overall achievement was lower for participants who were men, wealthier, infrequent alcohol drinkers, not obese and living alone. Conclusion: substantial system-level shortfalls in quality of care for geriatric conditions persisted over 6 years, with relatively small and inconsistent variations in quality by participants' characteristics. The relative lack of variation by participants' characteristics suggests that quality improvement interventions may be more effective when directed at healthcare delivery systems rather than individuals

Neighborhood Deprivation, Individual Socioeconomic Status, and Cognitive Function in Older People: Analyses from the English Longitudinal Study of Ageing

To assess the relationship between cognitive function, socioeconomic status, and neighborhood deprivation (lack of local resources of all types, financial and otherwise). DESIGN : Nationally representative cross-section. SETTING : The English Longitudinal Study of Ageing (ELSA). PARTICIPANTS : Seven thousand one hundred twenty-six community-dwelling individuals aged 52 and older and resident in urban areas. MEASUREMENTS : Individual cognitive function score and index of multiple deprivation (IMD) at the Super Output Area level, adjusting for health, lifestyle, and sociodemographic confounders. Analyses were conducted separately according to sex and age group (52–69 and ≥70). RESULTS : IMD affected cognitive function independent of the effects of education and socioeconomic status. For example, in fully adjusted models, women aged 70 and older had a standardized cognitive function score ( z -score) that was 0.20 points (95% confidence interval (CI)=0.01–0.39) lower in the bottom 20% of wealth than the top 20%, 0.44 points (95% CI=0.20–0.69) lower in the least-educated group than in the most educated, and 0.31 points (95% CI 0.15–0.48) lower if resident lived in an area in the bottom 20% of IMD than in the top 20%. CONCLUSION : In community-based older people in urban neighborhoods, neighborhood deprivation—living in a neighborhood with high levels of deprivation, compared with national levels—is associated with cognitive function independent of individual socioeconomic circumstances. The mechanisms underlying this relationship are unclear and warrant further investigation.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66217/1/j.1532-5415.2007.01557.x.pd

APOE e4 genotype predicts severe COVID-19 in the UK Biobank community cohort

This article is freely available via Open Access. Click on the Publisher URL to access it via the publisher's site.C.L.K., L.C.P., G.A.K., and D.M. are supported in part by an R21 grant (R21AG060018) funded by National Institute on Aging, National Instute of Health, USA, UK Medical Research Council award MR/S009892/1 (PI Melzer) supports J.L.A. J.A.H.M. is supported by National Institute for Health Research, UK Doctoral Research Fellowship DRF-2014-07-177.published version, accepted version (12 month embargo), submitted versio

Events in Early Life are Associated with Female Reproductive Ageing: A UK Biobank Study.

The available oocyte pool is determined before birth, with the majority of oocytes lost before puberty. We hypothesised that events occurring before birth, in childhood or in adolescence ('early-life risk factors') could influence the size of the oocyte pool and thus the timing of menopause. We included cross-sectional data from 273,474 women from the UK Biobank, recruited in 2006-2010 from across the UK. We analysed the association of early menopause with events occurring before adulthood in 11,781 cases (menopause aged under 45) and 173,641 controls (menopause/pre-menopausal at ≥ 45 years), in models controlling for potential confounding variables. Being part of a multiple birth was strongly associated with early menopause (odds ratio = 1.42, confidence interval: 1.11, 1.82, P = 8.0 × 10(-9), fully-adjusted model). Earlier age at menarche (odds ratio = 1.03, confidence interval: 1.01, 1.06, P = 2.5 × 10(-6)) and earlier year of birth were also associated with EM (odds ratio = 1.02, confidence interval: 1.00, 1.04, P = 8.0 × 10(-6)). We also confirmed previously reported associations with smoking, drinking alcohol, educational level and number of births. We identified an association between multiple births and early menopause, which connects events pre-birth, when the oocyte pool is formed, with reproductive ageing in later life.This research has been conducted using the UK Biobank Resource. This work was generously supported by a Wellcome Trust Institutional Strategic Support Award [WT097835MF to University of Exeter].This is the final version of the article. It first appeared from Nature Publishing Group via http://dx.doi.org/10.1038/srep2471

Association of Urinary Bisphenol A Concentration with Heart Disease: Evidence from NHANES 2003/06

BACKGROUND: Bisphenol A (BPA) is a high production volume chemical widely used in food and drinks packaging. Associations have previously been reported between urinary BPA concentrations and heart disease, diabetes and liver enzymes in adult participants of the National Health and Nutrition Examination Survey (NHANES) 2003/04. We aimed to estimate associations between urinary BPA concentrations and health measures in NHANES 2005/06 and in data pooled across collection years. METHODOLOGY AND FINDINGS: A cross-sectional analysis of NHANES: subjects were n = 1455 (2003/04) and n = 1493 (2005/06) adults aged 18-74 years, representative of the general adult population of the United States. Regression models were adjusted for age, sex, race/ethnicity, education, income, smoking, BMI, waist circumference, and urinary creatinine concentration. Main outcomes were reported diagnoses of heart attack, coronary heart disease, angina and diabetes and serum liver enzyme levels. Urinary BPA concentrations in 2005/06 (geometric mean 1.79 ng/ml, 95% CI: 1.64 to 1.96) were lower than in 2003/04 (2.49 ng/ml, CI: 2.20 to 2.83, difference p-value = 0.00002). Higher BPA concentrations were associated with coronary heart disease in 2005/06 (OR per z-score increase in BPA = 1.33, 95%CI: 1.01 to 1.75, p = 0.043) and in pooled data (OR = 1.42, CI: 1.17 to 1.72, p = 0.001). Associations with diabetes did not reach significance in 2005/06, but pooled estimates remained significant (OR = 1.24, CI: 1.10 to 1.40, p = 0.001). There was no overall association with gamma glutamyl transferase concentrations, but pooled associations with alkaline phosphatase and lactate dehydrogenase remained significant. CONCLUSIONS: Higher BPA exposure, reflected in higher urinary concentrations of BPA, is consistently associated with reported heart disease in the general adult population of the USA. Studies to clarify the mechanisms of these associations are urgently needed