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PubMed2002

Health-related quality of life for nasopharyngeal carcinoma patients with cancer-free survival after treatment.

PURPOSE: To evaluate the health-related quality of life (HR-QOL) of nasopharyngeal cancer (NPC) patients with cancer-free survival after treatment and to investigate the factors correlated with their HR-QOL. METHODS AND MATERIALS: One hundred eighty-two NPC patients with cancer-free survival of more than 2 years after treatment were enrolled in the study. Data from the same number of people without a history of cancer, who had come to the hospital for health checkups, were also collected for comparison. The Chinese SF-36 questionnaire and nine items about head-and-neck functional impairments (HNFI) were self-reported by all participants at the clinics. Data relating to sociodemographic factors, cancer stage, and treatment of NPC survivors were analyzed. RESULTS: Psychometric tests revealed the excellent internal reliability (Cronbach's alpha: 0.87-0.96) and discriminative validity of the Chinese SF-36 used in Taiwan. Most functional domains of the Chinese SF-36 and all nine HNFI items were significantly worse in NPC survivors than in control subjects. No cancer or treatment-related variables significantly correlated with any functional domains of SF-36 or any items of HNFI for NPC survivors. Economic status, educational level, occupational status, and the number of comorbidities were the variables that significantly correlated with most functional domains of SF-36 for NPC survivors. Patients with more sufficient economic status, higher educational levels, with employment, or without comorbidity tended to enjoy better HR-QOL as detected by the SF-36. Salivation, hearing, and swallowing dysfunctions were the top three HNFI that disturbed NPC survivors. Economic status remained the most significant variable correlated with HNFI, including salivation, swallowing, neck stiffness, taste, and phonation. Survivors with better economic status reported less severe HNFI. CONCLUSIONS: NPC survivors had worse HR-QOL than healthy control subjects in the study. Socioeconomic status was the most significant variable that correlated with the HR-QOL of NPC survivors. This result might indicate that patients' superior individual characteristics and financial resources are important variables determining their ability to cope with cancer and treatment complications affecting their HR-QOL.

Adult↗
PubMed1982

The sex differential in mortality rates: demographic and behavioral factors.

By using the 1965 Human Population Laboratory Survey of a random sample of 6928 adults in Alameda County, California, and a nine-year follow-up, mortality risk is examined by sex, while simultaneously controlling for 16 demographic and behavioral risk factors by a multiple logistic analysis. Risk factors include age, race, socioeconomic status, occupation, physical health status, use of health services, smoking, alcohol consumption, physical activity, weight, sleeping patterns, marital status, social contacts, church and group membership and life satisfaction. The prevalence and relative mortality risk of each factor combine to influence the sex differential. The unadjusted relative mortality risk for men compared to women is 1.5 (p less than or equal to 0.001). Adjustment for some factors (e.g., smoking and alcohol) decreases this difference, while other adjustments (e.g., for physical activity, physical health status and marital status) increase the difference. Adjustment for all 16 factors slightly increases the relative risk to 1.7 (p less than or equal to 0.001). These demographic and behavioral risk factors do not account for the overall sex difference in mortality rates. Examination of the interaction of biologic and behavioral risk factors may more fully explain the sex differential in mortality.

Adult↗
PubMed2003

Social relations in women with coronary heart disease: the effects of work and marital stress.

BACKGROUND: Studies have previously shown that psychosocial stress, related to both work and family, is associated with the increased risk of coronary heart disease (CHD) morbidity and mortality. The objective of this study was to examine how social relations are affected by marital stress and work stress in a population-based sample of Swedish women with CHD. METHOD: Data was obtained from the Stockholm Female Coronary Risk Study, comprising 292 women aged 65 years or younger, with a mean age of 56 (SD=7) years admitted for an acute event of CHD and examined 3-6 months after hospitalization. Marital and work stress was assessed using the Stockholm Marital Stress Scale and the Swedish version of the Karasek demand-control questionnaire, respectively. Condensed versions of the Interview Schedule for Social Interaction (ISSI) and of Interpersonal Support Evaluation List (ISEL) were used to assess social relations and social support. RESULTS: Marital stress was associated with less social integration (P<0.001), less appraisal support (P<0.001), a lower sense of belonging (P<0.01) and less tangible support (P<0.01) even after controlling for work stress. Adjustment for age, socioeconomic status (education and occupational status) did not alter these results significantly. Work stress did not show statistically significant effects on any of the measured social relations. CONCLUSION: The present study showed that marital stress influenced women's social relations. These results suggest that marital stress needs to be further investigated not only as an independent but also as an interactive risk factor for women with CHD.

Adult↗
PubMed1993

Some factors that influence dropping out from outpatient alcoholism treatment facilities.

Even though clients treated in an outpatient setting have been documented to have very high dropout rates, evidences of the factors that influence dropping out are fragmentary and are based on small-scale studies. In our attempt to distinguish such factors, outpatient and intensive outpatient alcoholism admissions for the State of New Jersey were analyzed. Our findings indicated that females, the young and the unskilled are at a higher risk of dropping out. We also documented that drinking status of patients, occupational status, health insurance coverage, educational status, living arrangement, duration of stay in treatment and the number of sessions of service were important factors that influenced the likelihood of dropping out. Controlling for the number of sessions revealed that the relationship between the odds of dropping out and duration in treatment was mixed. Primary drug abusers in our cohort had the highest likelihood of dropping out followed by the dually addicted. It is argued that dropping out is likely to be complicated by the inability of alcoholism treatment facilities to cope with multiple addiction problems.

Adolescent↗
PubMedDate not supplied

Motives for smoking cessation are associated with stage of readiness to quit smoking and sociodemographics among German industrial employees.

PURPOSE: To test the relationships among particular motives for smoking cessation, stage of readiness to quit (preparation or contemplation), and sociodemographic characteristics. DESIGN: A cross-sectional study to examine attitudes toward and use of health promotion at the worksite, using a self-administered questionnaire. SETTING: Two German metal companies. SUBJECTS: Of 1641 responding employees (response rate 65% in company A and 44% in company B), 360 smokers who intended to quit immediately (n = 105) or in the near future (n = 255) were analyzed. MEASURES: The questionnaire comprised of sociodemographic characteristics, smoking behavior, smoking history, readiness to quit smoking, motives to quit, such as coworkers' complaints and health-related or financial concerns. Chi-squared tests and multiple logistic regression analyses were performed. RESULTS: Health-related reasons (94%) predominated financial (27%) or image-related (14%) reasons for smoking cessation. Participants in the cessation preparation group were more likely to report an awareness of being addicted (79.6% vs. 58.2%; p < .001) and the negative public image (22.5% vs. 11.6%; p < .01) as reasons for quitting compared with those in the contemplation group. In multivariable regression models, the motives for smoking cessation, including reduced performance, family's and coworkers' complaints, pregnancy/children, and negative public image, but not health-related and financial concerns, differed significantly by gender, age, marital status, education, and occupational status. CONCLUSIONS: Motives for smoking cessation vary according to the individual's level of readiness to quit and sociodemographic background.

Cross-Sectional Studies↗
PubMed2001

[An analysis on the forearm bone mass density of rural female and the environmental risk factors].

The distribution of distal and proximal forearm bone mass densities (BMD) with age was discribed and the environmental risk factors of rural female analyzed. A group of 1432 rural female aged 15 and over were sellected. Their demographic characteristics, living and eating habit were obtained by standardized questionnaire. The distal and proximal forearm bone mass density were measured by peripheral dual-energy X ray absorptionmetry (pDEXA). The results showed that the distal and proximal forearm BMDs were increased with age before age 25 and 30 respectively, and reached the peak value at age 30-35. The distal forearm bone density decreased significantly at age 40 while the proximal forearm BMD decreased at age 45. Bone loss rate of the two bone sites was increased significantly at age 50 and reached the peak value at age 55-60. Only the the density of proximal forearm bone, and the year of menopause was the main cause of low bone density. Body weight was the positive factor for bone density at age less than 60. Height only positively affected the proximal forearm bone of those at age 30-45. More ever, drinking tea, parity and educational status may affect distal forearm bone in certain age group while parity, educational status, occupation and marital status were possible risk factors of proximal forearm BMD. It is concluded that environmental risk factors of BMD varied with bone site and age. The prevention of low BMD must rely on subject's age and bone site. The surveillance of low bone density must put the emphasis on spony bone.

Adult↗
PubMed1995

A study of absence rates in male and female employees working in occupations of equal status.

The objective of this study was to investigate the extent to which occupational status and age influence absence rates in male and female employees. This involved collection of data for absences of one or more calendar days, including the length of absence and the location, age, occupational status and gender of the worker. This information was supplied by personnel departments on standardized forms. The study took place in three occupational groups in two organizations with equal work status for men and women, located in England, Scotland and Northern Ireland. In total, we studied 2561 workers (77.8% male, 22.2% female) in employment during the three months between April and July 1992. More women than men took time off work in the study period. Female absence exceeded male absence for spells of absence in ratios between 1.3:1 and 1.5:1, and for days in ratios between 1.2:1 and 1.9:1; age standardization removed the differences in spell rates (in all but one group) and total absence (days). Both men and women took fewer but longer spells of absence with increasing age. Men were more likely to take spells lasting more than one day, but women took more multiple single-day spells. Relative job status affected absence rates, with professional staff taking less absence than support staff. In this workforce controlled for occupation, significant differences in crude absence rates were observed between males and females. Age standardization explained the difference in spell rates in most groups. This suggests that there is little true difference in absence rates and highlights the importance of age standardization in such studies.

Absenteeism↗
PubMed2003

The demand-control-support model and health among women and men in similar occupations.

The aim of the study was to investigate the main and the interaction effects of the demand-control-support (DCS) model on women's and men's health in a Swedish telecom company. According to the DCS model, work that is characterized by high demands, low decision latitude, and low support decreases health and well-being. Furthermore, control and support are assumed to interact in protecting against adverse health effects of stress. Earlier studies have failed to consider occupational status and gender simultaneously. Questionnaire data from 134 female and 145 male employees in similar occupations were collected. Correlational analysis supported the main effect hypotheses irrespective of gender. Hierarchical multiple regression analyses indicated that only demands predicted women's health, whereas both demands and lack of social support predicted men's health. However, no interaction effects were found for either women or men. Further studies should probe the relevance of the model while considering gender and occupational status.

Adult↗
PubMed2002

Economic status, smoking, occupational exposure to rubber, and lung cancer: a case-cohort study.

Recent studies tend consistently to confirm the presence of a moderate excess risk of lung cancer in the rubber industry. However, the agent responsible for the excess of lung cancer is still obscure. Also, analyses without regard to the modifying effects of sex, economic status, and smoking habit are less than satisfactory. To explore these questions, we have conducted a case-cohort study using the data of 51 lung cancer deaths in 1973-1997 and a random sample (sub-cohort) of 188 from among 1598 subjects in a rubber factory in Shanghai, China. We computed the risks of lung cancer by economic status, smoking habit, coal fumes in home, and year of first employment. We assessed lung cancer risks for occupational exposures, unadjusted and adjusted for economic status and smoking. After confounding effects of smoking and economic status were controlled, we found that rate ratios were 1.43 (95% confidence interval (CI) 0.43-4.69), 1.79 (95% CI 0.64-5.03), and 3.76 (95% CI 1.44-9.86) for 1-14, 15-29, and 30-45 exposure-years in curing department, respectively. The data showed significant trends in increased risk of lung cancer with duration of exposure in tire-curing department (score test for trend:, P = 0.004). However, in front rubber processing (weighing and mixing, calendering, extruding, and milling), no significant excess risk of lung cancer was found. If it can be confirmed that nitrosamines are mainly generated in back rubber processing (curing and vulcanizing), it would be reasonable to conclude that excess risk of lung cancer in rubber industry is attributable, at least partially, to exposure to nitrosamines.

Aged↗
PubMed2002

Household economic strategies and nutritional anthropometry of women in American Samoa and highland Bolivia.

This study compares findings from research projects involving different genetic, environmental, and cultural contexts: a study of lifestyle and health from American Samoa (ASLS) and the Bolivian project. Reproduction and Ecology in Provincia Aroma (REPA). This paper presents analyses of varying economic strategies and their association with nutritional status indicators in each population. The ASLS sample includes 66 Samoan women and the REPA sample includes 210 Aymara women. Principle components analysis of household economic resources within each sample extracted two significant factors: one represents modernizing influences including education and occupational status, and the other represents ethnographically salient traditional economic behavior. The traditional pattern includes adding household members in Samoa and selling agricultural products in Bolivia. This analysis places each woman along two continua, traditional and modern, based on her household mobilization of economic resources, permitting an understanding of the patterns underlying household economic behavior that is not possible in univariate analyses of socioeconomic variables. For the Bolivian women the strategy involving more education and higher occupational status was associated with higher measures of several nutritional status indicators, including body mass index, arm muscle area, and peripheral skinfolds. But among the Samoan women, where substantial obesity was the norm, there were no significant differences in anthropometric measurements based on economic strategies. These data argue for the importance of directly measuring the potential consequences of variation in household economic strategies rather than merely inferring such, and of assessing ethnographically relevant aspects of household economic production rather than limiting analyses to non-context-specific economic indicators such as income. This focus on household strategy is likely to be fruitful especially where economic and nutritional conditions are marginal. The findings from Bolivia also support efforts in developing countries to improve girls' education, and thereby occupational prospects, as a means to improve their health status as women.

Adult↗
PubMed1989

Psychosocial status of young adult survivors of childhood cancer: a survey.

The majority of childhood cancer patients now can expect to survive into early adulthood, cured of their cancer. Current adult survivors are a diverse group in terms of diagnosis, age at diagnosis, and types of treatment. It is estimated that by 1990, 1 in every 1,000 twenty-year-olds will have had cancer, making it important to describe the long-term psychosocial adjustment of this population. Patients who were diagnosed between 1948 and 1975 while less than 16 years of age, who were currently 18 years or older, had been off therapy for at least 5 years, and had no known brain damage were eligible for this survey and were identified through the tumor registry at the Children's Hospital of Philadelphia (CHP). Initially, the parents were contacted by letter. Ninety-five (57%) of the 167 eligible patients participated in a telephone interview, which covered educational achievement, occupational status, interpersonal relationships, marital status, pregnancies, employee benefits and insurance, and medical and health behaviors. Respondents were not different from nonrespondents in terms of sex, year of diagnosis, age at diagnosis, diagnoses, stage of illness, or type of treatments. There were no differences in terms of education, marital status, fertility issues, or occupational status by diagnosis group, age at diagnosis, or treatments. The patients were compared to siblings over 18 years of age in terms of education and marital status. No significant differences in sex distribution or years of education between patients and siblings were found. The siblings were, as a group, older than the patients and were more likely to be married. In general, these patients were functioning normally, but there are many unexplored areas of interpersonal relationships and productivity that need further study before conclusions regarding psychosocial adjustment of childhood cancer survivors can be drawn.

Adolescent↗
PubMed2001

Social inequality in the utilization of in- and outpatient treatment of non-psychotic/non-organic disorders: a study with health insurance data.

BACKGROUND: This study deals with the utilization of in- and outpatient care due to non-psychotic/non-organic disorders (ICD-9 300-307: neuroses, personality disorders, sexual disturbances, alcohol and substance dependencies, drug abuse and functional disorders). Specifically, it examines whether social gradients to the detriment of individuals from lower social positions appear. This is dealt with both in terms of in- and outpatient treatment. Secondly, it examines whether the likelihood of being treated as an inpatient rather than an outpatient differs between occupational status positions. Finally, the study considers whether the hospital department a given patient is most likely to be assigned to differs between occupational status positions. METHOD: Analyses were performed with records from a statutory health insurance in West Germany. The database consists of 124,917 men and women between 20 and 60 years of age. We included only subjects with employment periods, as otherwise outpatient treatment could not be assessed completely. The data had been recorded between 1987 and 1996. In total, 9129 persons had one of the above mentioned diagnoses, 6115 of them received outpatient treatment and 3014 were inpatients only. RESULTS: The relative risk (RR) for outpatient diagnoses was RR=4.41 for the male unskilled/semi-skilled insured in comparison with men in the highest occupational position, the equivalent RR for women was 2.1. The respective results for inpatient treatment were RR=7.3 for men and RR=2.3 for women. In men, the relative risks were considerably reduced after cases with alcohol- and substance-related diagnoses had been excluded. For the assignment to in- and outpatient treatment, no consistent differences between individuals with different occupational positions emerged. Once diagnosed, higher-status individuals had the longest treatment periods as in- and outpatients. Only a small proportion of diagnosed subjects received medical care in psychiatric wards; this held especially for the group with higher occupational positions. CONCLUSIONS: Social inequalities in the treatment of psychogenic disorders emerged for outpatients as well as for inpatients. Inpatients tended to avoid treatment in psychiatric departments, and it can be concluded that individuals holding higher positions may be more successful in their attempts to avoid stigmatization.

Adult↗
PubMed1990

Discriminant function analysis: a case study of some socioeconomic constraints on child nutrition.

Discriminant function analysis was used to understand the combination of socioeconomic variables in various forms of malnutrition in preschool children. Data available (1976) from two sets viz., 4000 children of rural and urban areas of Hyderabad (in south India) and 215 children of urban and rural areas of Jaipur (in north India) were used for the study. The prevalence rates of various forms of malnutrition in children were different by variations in socioeconomic status and sex (P less than 0.05). Discriminant function analysis of all socioeconomic indicators showed that educational levels and occupational status of parents and percaput income were most important for differentiation of children who were normals and undernourished. Occupational status of the father and the child's calorie intake or duration of lactation improved the differentiation of normals from those who were under-nourished. Higher prevalence of malnutrition in female children than in the male children was found due to variations in per capita income and levels of maternal education. Closely associated best set of factors could be traced using the discriminant function analysis.

Child Nutrition Disorders↗
PubMed1997

Duration of general practice consultations: association with patient occupational and educational status.

Past studies have demonstrated that the majority of health care visits are made to general practitioners, and that socio-economically disadvantaged individuals are significantly more likely to use such services. Relatively little is known, however, about the quality of general practice care provided to patients of different socio-economic status. The specific aims of the study were to determine whether an association existed between consultation duration and patient educational and occupational status, and if an association was evident, to determine the extent of association after taking into account a range of identified confounding variables and the effect of a clustered sample design. Consecutive consultations from a randomly selected sample of general practitioners were audiotaped and their durations measured electronically. Patient education and occupational status were obtained by questionnaire. Information concerning a range of additional patient, practitioner and consultation variables was also assessed in order to identify possible confounders of the association between consultation duration and patient occupational and educational status. No association was evident between consultation duration and level of patient educational qualification. Independent of identified confounding variables and the effect of a clustered sample design, general practitioners spent less time with those patients employed in unskilled occupations. Unskilled patients received 2.1 min or 21% less time per consultation than patients in professional occupations. The odds of patients in unskilled occupations receiving a long consultation (> 10 min) were 26% less than the odds of patients in professional occupations. The finding of an occupational status differential in the duration of general practice consultations suggests that socio-economically disadvantaged patients may not be receiving the health care they require. Further research is required to confirm these findings and to identify whether similar differentials are evident in more specific elements of general practice care.

Adult↗
PubMed1991

[Functional liver status in occupational contact with acrylonitrile].

Experiment was performed on 133 workers engaged in the production "Acrylonitrile" by number of tests, giving information on the status of the enzyme, detoxifying and lipidic liver functions. Significant deviations are established in 22 workers, whose length of service in industry is 10 to 21 years. Most significant is the number of workers with changes from group I, where the total index of exposure surpasses 10 times the maximum admissible. The comparison of the present results with those from the performed experiments in 1971 and 1981 shows an increase in the frequency of changes, which proves the existence of real risk for the health of the workers from this production. The workers showing deviations are subject to active follow-up care and diagnostic specification.

Acrylonitrile↗
PubMed2003

[Nursing accidents at the workplace and their relation with the security and occupational health status].

The purpose of this study was to examine the accidents and incidents that take place in the workplace and their relationship with the occupational health and safety climate. The sample for this study was chosen by convenience and was composed of 154 professional nurses. The Occupational Health and Safety Climate Scale. (Roduguez et al., 2000) was used for the research. The results of the study reveal that the variables that contribute to understanding the determinants of the occupational health and safety climate are the individual's relationships with peers and supervisors, the number of trainings in the area of occupational health and safety and the number of accidents that the individual has experienced.

Accidents, Occupational↗
PubMed1993

[Growth and sex dimorphism in school children according to their father's occupation].

A cross-sectional morphometric study on 569 school children from the city of San Clemente del Tuyú (Buenos Aires, Argentina) has been performed. The sample was subdivided into 28 subgroups according to the age range (7-13 years old), sex, and occupational status -low or high- of the fathers. Body weight, height, sitting height, and head and arm circumferences were measured. Statistics of analysis of variance (ANOVA) and Tukey test for unequal sample sizes were performed at each stage of age. Both males and females belonging to the lower social status showed a general decrement in growth: shortening in leg length was evident. Since the girls from both occupational status showed -in general terms-hypothesis of "better canalization of the females" has been corroborated by the present work.

Adolescent↗