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PubMed1994

Neck strain in car occupants: injury status after 6 months and crash-related factors.

In this study, 29 individuals who sustained a neck strain as a result of a car crash were drawn from a group of physiotherapy and general practices and were followed up after 6 months. The aim was to examine relationships between the state of the neck injury at the time of follow up and crash-related factors, notably crash severity and occupant awareness. Crash severity was assessed by measurement of damage to the involved vehicles, while 6-month injury status was established through physical examinations and interviews. No statistically significant associations between crash severity and 6-month injury status were found, but subjects who were unaware of the impending collision had a greatly increased likelihood of experiencing persisting symptoms of and/or signs of neck strain, compared with those who were aware (odds ratio = 15.0; 95 per cent confidence limits: 1.8, 178). While the role of crash severity in the production and duration of neck strains remains unclear, awareness appears to have a strong protective influence and may prove to be a useful prognostic indicator in clinical settings.

Accidents, Traffic↗
PubMed1978

Factors influencing readmission to hospital: II. Paraplegia.

This study of 200 paraplegics shows that occupational status at the time of becoming paralysed exerts as great an influence upon readmission to hospital as does the level or the extent of the lesion and that the effect of the level of the lesion on readmission to hospital increases with lower occupational status.

Adolescent↗
PubMedDate not supplied

The occupational health status of hired farm workers.

The U.S. hired farm work force presently is two-thirds foreign-born: mostly young Mexican men with low educational attainment who neither read nor write English. Sixty percent earn so little that they and their families live in poverty. Four of ten migrate to find work, 33% are not authorized to work in the U.S., and 25% work for a labor market intermediary, usually a labor contractor. Few hired farm workers have health insurance of any kind and, despite low incomes, relatively few seek or receive government benefits. Government regulation of the workplace exempts agricultural employers from numerous provisions that apply to other industries; for example, agriculture is exempt from portions of the Fair Labor Standards Act, allowing children as young as age 12 to work in the fields, and employers with 10 or fewer employees are exempt from OSHA regulation. Only 12 states require farm employers to carry workers' compensation insurance. While hired farm workers face significant safety and health risks, there are major gaps in existing research covering this occupational group. An ad hoc task force convened by NIOSH developed a prioritized agenda for occupational safety research in this population: musculoskeletal disorders, pesticide-related conditions, traumatic injuries, respiratory conditions, dermatitis, infectious diseases, cancer, eye conditions, and mental health.

Adolescent↗
PubMed1989

Psychotropic drug prescription in Italy. A survey in general practice.

A survey of psychotropic drug prescription was conducted in Verona using information obtained from 92 GPs. A total of 2559 patients consulted their GPs on the day of the study and 14.2% of them received a prescription for a psychotropic drug. Benzodiazepines were the most frequently prescribed: 72.8% and 70.4% of all psychotropic prescriptions in women and men respectively. The prevalence of prescription was higher in women than in men (15.8% vs 11.2%) and the difference was statistically significant (P less than 0.001). Subjects aged 45-64 had the highest chance of receiving prescriptions for psychotropics. Occupational status seems related to psychotropic drug prescription only in women. A strong association was found between psychotropic drug prescription and conspicuous psychiatric morbidity. This association was independent of sex, age, and occupational status. An interactive effect between social problems and sex on psychotropic drug prescription was found. The perception by the GP of a social problem increases the risk that a psychotropic will be prescribed about twice in women, but not in men.

Adolescent↗
PubMed1992

Job strain and ambulatory work blood pressure in healthy young men and women.

The effect of high job strain (defined as high psychological demands plus low decision latitude at work) on blood pressure was determined in 129 healthy, nonhypertensive men (n = 65) and women (n = 64). Blood pressure measures included mean screening levels obtained in a clinical environment, mean ambulatory levels from one 8-hour workday, and the change in levels from screening to mean work levels. In male workers, men with high and low job strain showed similar blood pressures at screening, but men with high job strain showed greater increases from screening to work, resulting in higher mean work blood pressure. Occupational status was unrelated to job strain or blood pressure in men. In female workers, women with high and low job strain did not differ in any measure of blood pressure; however, there were trends for higher occupational status and greater skill discretion to be associated with higher blood pressure responses at work in women.

Adolescent↗
PubMed2003

Work-parenting linkages among dual-earner couples at the transition to parenthood.

This study evaluates the impact of work experiences on parenting quality during the transition to parenthood. Dual-earner parents (n = 83) completed measures of work experiences (autonomy and interpersonal atmosphere). Parenting was observed twice, 3 months apart. Hierarchical regression analyses showed that mothers who reported a more negative interpersonal atmosphere at work showed decreases in positive parenting and increases in negative parenting over time, after controlling for their occupational status and general well-being. Mothers' work experiences also predicted changes in fathers' observed parenting. In contrast, fathers' work experiences were largely unrelated to fathers' or mothers' parenting. With one exception, parents' occupational status did not moderate work-parenting relationships, and feelings of role overload did not mediate these relationships.

Adult↗
PubMed1993

Current transition of the physician's professionalism and doctor-patient relationship.

In recent years, the physician's professionalism seemed to be facing or experiencing a phase of change. To investigate this phenomenon, social perception and attitude toward physicians were surveyed and analyzed. The subjects consisted of three types of sample group, namely, the general public, physicians, and medical students. Data were collected through interviews, mailing, and self-administered questionnaire surveys to each sample, respectively. The results of analysis showed us that social evaluation of physicians in Korean society exhibited ambivalent perceptions toward physicians. The physician's occupational status was generally evaluated by the three samples as being in a higher stratum in the social structure. But there were great gaps between their perceptions of the change in the physician's occupational status. While the general public perceived that the physician's status might improve in the future, physicians and medical students predicted an absolute declination of the status. Although the general public sympathized with the physician's characteristics as a professional group, an apparent tendency to assume the attitude of a fairly equal relationship toward physicians has increased. The transitional change in the physician's professionalism could be observed through the ubiquity in the perception of the patient's rights in doctor-patient relationships. Such phenomena are believed to have caused physicians to think that not only has their status declined in recent years but also that this declination of social status would continue in the future.

Attitude↗
PubMed1996

Perceived workplace harassment experiences and problem drinking among physicians: broadening the stress/alienation paradigm.

Sociologists who embrace the stress or alienation paradigms generally focus on explaining problem drinking in low status occupations. By contrast, this paper argues that a broadened conceptualization of stress and alienation which incorporates abusive work relationships has utility for explaining male and female drinking outcomes in both high and low status occupations. We provide empirical data on the relationship between perceived abusive experiences and drinking outcomes in a cohort of male and female physicians in their internship year of training. The data show that perceived sexual harassment, discriminatory treatment and psychological humiliation relate to various drinking outcomes in men and women, controlling for drinking prior to the internship year. While females were more likely to report experiencing abuse, these perceived experiences had deleterious effects on drinking outcomes for both genders. Personal vulnerability (narcissism) brought into the training environment somewhat influenced the later reporting of abusive experiences by males but not by females. Regression analyses showed that, for both males and females, work-place abusive experiences in interaction with personality vulnerability best explained drinking outcomes. The implications of these results for the design of future alcohol-related work-place studies are discussed.

Adult↗
PubMed2001

Does socioeconomic status predict course and outcome in patients with psychosis?

BACKGROUND: We examined the relationship between socioeconomic status (SES) and course and outcome of patients with psychosis. Two hypotheses were examined: a) patients with higher best-ever SES will have better course and outcome than those with lower best-ever SES, and b) patients with greater downward drift in SES will have poorer course and outcome than those with less downward drift. METHOD: Data were drawn from the baseline and 2-year follow-up assessments of the UK700 Case Management Trial of 708 patients with severe psychosis. The indicators of SES used were occupational status and educational achievement. Drift in SES was defined as change from best-ever occupation to occupation at baseline. RESULTS: For the baseline data highly significant differences were found between best-ever groups and negative symptoms (non-manual vs. unemployed--coef -10.5, p=0.000, 95% CIs 5.1-15.8), functioning (non-manual vs. unemployed--coef -0.6, p=0.000, 95% CIs 0.3 to -0.8) and unmet needs (manual vs. unemployed - coef 0.5, p=0.004, 95% CIs 0.2-0.9). No significant differences between best-ever groups were found for days in hospital, symptoms, perceived quality of life and dissatisfaction with services. Significant differences for clinical and social variables were found between drift and non-drift SES groups. There were no significant findings between educational groups and clinical and social variables. CONCLUSIONS: Best-ever occupation, but not educational qualifications, appeared to predict prognosis in patients with severe psychosis. Downward drift in occupational status did not result in poorer illness course and outcome.

Adult↗
PubMed2000

Eating habits, health status, and concern about health: a study among 1641 employees in the German metal industry.

BACKGROUND: Nutrition has been found to be associated with sociodemographic characteristics and concern about health. There is limited knowledge, however, of associations between blue-collar worker's diet, morbidity, and health care utilization. METHODS: We conducted a survey on eating habits, physical symptoms, health care utilization, health status, and concern about health in two German metal companies. A self-administered questionnaire was mailed to employees of whom 1641 participated in the study (response rate 54. 7%). RESULTS: Most employees were characterized by a combination of healthy and unhealthy eating elements. Using linear regression analyses adjusted for age, gender, and occupational status, healthy eating was negatively associated with stomach aches and headaches, but not with cardiovascular disease. Restricted activity days and days in hospital were associated with healthy eating, but self-assessed health status and physician consultations were not. Using stepwise multiple regression analysis, age, gender, and concern about health were strongly and morbidity was weakly related to diet. Occupational status, marital status, and number of children were not associated with nutrition. CONCLUSIONS: Health promotion programs should motivate younger and male employees to participate in and aim toward increasing concern about health.

Adult↗
PubMed2005

Relation between early life socioeconomic position and all cause mortality in two generations. A longitudinal study of Danish men born in 1953 and their parents.

OBJECTIVE: To examine (1) the relation between parental socioeconomic position and all cause mortality in two generations, (2) the relative importance of mother's educational status and father's occupational status on offspring mortality, and (3) the effect of factors in the family environment on these relations. DESIGN: A longitudinal study with record linkage to the Civil Registration System. The data were analysed using Cox regression models. SETTING: Copenhagen, Denmark. SUBJECTS: 2890 men born in 1953, whose mothers were interviewed regarding family social background in 1968. The vital status of this population and their parents was ascertained from April 1968 to January 2002. MAIN OUTCOME MEASURES: All cause mortality in study participants, their mothers, and fathers. RESULTS: A similar pattern of relations was found between parental social position and all cause mortality in adult life in the three triads of father, mother, and offspring constituted of the cohort of men born in 1953, their parents, and grandparents. The educational status of mothers showed no independent effect on total mortality when father's occupational social class was included in the model in either of the triads. Low material wealth was the indicator that remained significantly associated with adult all cause mortality in a model also including parental social position and the intellectual climate of the family in 1968. In the men born in 1953 the influence of material wealth was strongest for deaths later in adult life. CONCLUSION: Father's occupational social class is associated with adult mortality in all members of the mother-father-offspring triad. Material wealth seems to be an explanatory factor for this association.

Adult↗
PubMed1998

Socio-economic differences in health risk behavior in adolescence: do they exist?

Socio-economic differences in risk behaviors in adolescence can be seen as a prelude to the re-emergence of socio economic health differences in adulthood. We studied whether or not socio-economic differences in health risk behaviors are present in male and female adolescents in The Netherlands. The relation between socio-economic status (SES) and health risk behaviors was examined, by testing both the main and interaction effects of SES and gender on separate health risk behaviors on one hand, and on the behaviors cumulatively on the other. The data were derived from 1984 adolescents in the four northern provinces of The Netherlands. SES was measured by means of the educational level and the occupational status of both parents. Four health risk behaviors were included in this study: smoking, alcohol consumption, soft drug use, and (no) physical exercise. We found that the relationships between SES and health risk behaviors are not as linear as is often found in adulthood. Our findings can be characterised overall by an absence of relationship between SES and health risk behaviors. The only exception applies to sport, which is linearly related to SES. Adolescents in the lower SES groups engage in sport less than adolescents in the higher SES groups. There was an irregular relationship between the father's occupational status and the adolescents' smoking and drinking. Adolescents in the highest, lowest and middle of the six SES groups have the highest rates of health risk behaviors. All observed relationships are similar for both male and female adolescents. A relationship between gender and the separate health risk behaviors was found only for alcohol consumption and drug use. For both male adolescents showed higher rates of risk behavior. Males also scored higher on the cumulative health risk behaviors than their female counterparts. The findings of this study do not support the hypothesis of latent differences in adolescence.

Adolescent↗
PubMed1992

[Family development conditions of autistic children before foster home care: a comparison with families of hyperkinetic, emotionally disturbed and antisocial children].

With reference to psychogenetic autism models a retrospective study investigates, if autistic children more frequently than children with other disturbances grow up in a family-environment, which is characterized (a) by deficits in emotional warmth and (b) by a relatively high educational and occupational status of parents. The parallel group study is based upon a sample of 112 children, who had been referred to a residential facility for psychiatric care. The hypothesis concerning deficits in emotional warmth is not confirmed. As to occupational status of parents however, comparative findings meet hypothetical expectations. Supplementary comparisons show, that autistic children had been exposed to parental overprotection more often and also not infrequently to ineffective behavior control.

Affective Symptoms↗
PubMed1996

Occupational health status of sawmill workers in Nigeria.

The health impact of exposure to sawdusts on 59 sawmill workers from southwest Nigeria was studied. Workers were chosen by a two-stage random sampling method from 15 privately owned sawmills. Peak flow and spirometric measurements were obtained from all workers. They also underwent a structured questionnaire which elicited occupationally related symptoms. Age and sex matched controls consisting of 199 workers from similar socio-economic backgrounds as the subjects underwent similar questionnaire and lung function tests. Results showed a high prevalence of respiratory symptoms, principally cough, chest pain and sputum production, among the workers. Most of the workers also had high prevalence of conjunctivitis, skin irritation and hearing difficulties when compared with controls. Pulmonary function parameters were also significantly lower (p < 0.05 in sawmill workers than controls). Although a large number (94.9%) of the workers were aware of the potential hazards of exposure to sawdusts, less than 20% wore protective masks. Our study highlights the need for health and safety regulation in the workplace. There is also a need for improved methods of dust control in factories with high levels of dust particulates, particularly in the developing world.

Adult↗
PubMed2005

The social patterning of relative body weight and obesity in Denmark and Finland.

BACKGROUND: Relative body weight is typically inversely associated with social status in affluent societies but studies comparing the social patterning of relative body weight and obesity in different countries have only seldom been conducted. The aim of this study was to analyse and compare the social patterning of relative weight and obesity by occupational status, educational attainment and marital status between Danish and Finnish women and men. METHODS: Data from the Finnish Survey on Living Conditions and the Danish Health and Morbidity Survey, both collected in 1994, were compared. Relative weight was studied by using body mass index (BMI), and those with BMI > or =30 kg/m(2) were regarded as obese. Logistic regression analysis was used to examine the social patterning of obesity in the pooled dataset. Two-variable interaction effects were tested separately. RESULTS: Compared with their Danish counterparts, Finnish women and men had higher average relative weight and they were more often obese. There were no country differences in the socio-economic patterning of obesity by educational attainment, but a stronger patterning of obesity by occupational status was found among Danish women. Moreover, non-married women in Denmark were more likely to be obese than their married counterparts. CONCLUSIONS: Finns have higher relative weight and they are more often obese than Danes. The social patterning of obesity was similar in both studied countries but stronger in Denmark.

Adult↗
PubMed2005

Socioeconomic differences in the progression of carotid atherosclerosis in middle-aged men and women with subclinical atherosclerosis in Sweden.

While the persistence of socioeconomic differences in cardiovascular disease (CVD) has been recognized for many years, less is known about whether socioeconomic factors are of importance to CVD before symptoms of the disease appear. In this study the associations among educational level, occupational status and progression of atherosclerosis were investigated in 1016 Swedish middle-aged men and women with signs of subclinical atherosclerosis, i.e., carotid plaque (defined as focal intima-media thickness (IMT) > 1.2 mm). IMT in the common carotid artery (CCA) and in the carotid bifurcation area, as well as carotid plaque score, was determined by B-mode ultrasound. Results showed only weak associations between educational level, occupational status and age-, sex- and baseline IMT-adjusted progression of IMT in the CCA. However, in the age, sex- and baseline IMT-adjusted analyses, those in unskilled manual occupations showed a significantly higher yearly progression of carotid IMT in the bifurcation area compared to those in high- or medium-level non-manual occupations. Those with primary education tended to show a higher yearly progression of carotid IMT in the bifurcation area compared to those with completed secondary education. After adjustment for risk factors, the magnitude of these associations were somewhat attenuated. Similar patterns of associations were seen for the change of carotid plaque score. We conclude that low socioeconomic status (SES) is associated with progression of atherosclerosis in a middle-aged population with signs of subclinical atherosclerosis. Even though socioeconomic differences in cardiovascular risk factor levels could explain part of the found differences in progression rate in women, the mechanisms involved remain to be further established.

Aged↗
PubMed1984

Client characteristics at Kissy Mental Hospital, Freetown, Sierra Leone.

In- and out-patient data from the only Western mental health institution in Sierra Leone, Kissy Mental Hospital in Freetown , were analyzed using basic epidemiological techniques. Although it could not be proved conclusively with the available data, the educational and occupational levels of the patients appear to be far above that of the general population. Very possibly females are also underserved by the hospital. Contrasts between the two patient populations show that in-patients were more seriously ill, older, more likely to be male, more likely to be single, less educated, less likely to have social support, more likely to express Western ideas about the causes of mental illness and have more previous Western treatment, than out-patients. The literature on mental illness suggested the examination of possible associations among diagnosis, illness beliefs and types of previous treatment as response variables and several patient characteristics as explanatory variables. Out-patients who were older and those with lower status occupations had more severe illnesses. Married in-patients and out-patients with higher educational and occupational status had more Western as opposed to native beliefs about the cause of mental illness than their counterparts. More previous Western rather than native treatment was reported by in-patients who were older, from certain tribes, or had Western beliefs and by younger out-patients. Points of agreement and disagreement of study results with findings from Africa and the United States are discussed.

Adult↗
PubMedDate not supplied

Effects of mild, moderate and severe closed head injury on long-term vocational status.

Survival from significant closed head injury (CHI) is frequently associated with cognitive defects, physical impairment, personality change, interpersonal difficulty and, in general, some degree of social dependence. Here we report a multidimensional assessment of quality of life of a sample of 131 male head-injury patients suffering a range of severities of insult with specific emphasis on vocational outcome. Of those patients who sustained a severe injury and were employed full-time prior to the CHI, only 55% were able to return to this level of employment. No differences were found between the moderate and severe groups in pre- or post-CHI occupational status, as measured by the Blishen (1967) quantitative social economic index, although both groups declined from pre- to post-CHI. Lower post-CHI occupational status was associated with lower GCS on admission and longer lengths of post-traumatic amnesia, with patient self-report of physical, cognitive and psychosocial difficulties, including spousal reports of confusion, belligerance, verbal expansiveness and the decreased ability to perform socially-expected activities. Stepwise multiple regression analysis accounted for 38% of variance in post-injury vocational status, with lower pre-injury vocational status, greater age, high physical and psychological difficulties and lower admission Glasgow Coma Scale score variables forming the regression equation. Implications are discussed in terms of rehabilitation issues, including vocational programming and planning.

Adult↗