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PubMed2006

Number and type of substances in alcohol and drug-related completed suicides in an Australian sample.

BACKGROUND: The association between substance use and suicide is well-established, but evidence is scant regarding the relationship between the number, type, and level of substances and other risk factors in completed suicide across the lifespan. AIMS: To examine the relationship between social/demographic characteristics and the number, type, and level of drugs present in an unrestricted age sample of completed suicides in Australia. METHOD: An analysis was undertaken of 893 substance-related suicides using data from the Government Statistician's Office for the years 1989-1992. RESULTS: The number and type of substances present in suicide victims was related to the individuals' gender, age, marital status, employment status, and method of suicide. Blood alcohol level was significantly different between the methods of suicide, but was unrelated to demographic characteristics of the individual. The level of antidepressants and minor tranquilizers in the individuals was also unrelated to demographic characteristics. CONCLUSION: Examination of the type and number of substances present in completed suicides is an important component in creating profiles of potential suicide victims.

Adult↗
PubMed1984

Drug use among young adults: the impacts of role status and social environment.

In this article we report findings from panel analyses in which we examined drug use during the first three years following high school, a period during which many young people make important transitions in social environments, primary activity, and marital status. Post-high-school drug use is highly predictable from senior year drug use; however, usage rates for alcohol, marijuana, and other illicit drugs (but not cigarettes) seem also to be influence by post-high-school living arrangements. More specifically, those who continued to live with their parents showed little or no change in their drug use; but among those who moved out of the parental home, those who married showed a decrease in use, those living with a partner of the opposite sex showed some increase in drug use, and those who entered other living arrangements (which include dormitories) also showed an increase in use. These relations were largely unaffected by the inclusion of student status, employment status, and other predictor dimensions.

Adolescent↗
PubMed2002

Personal dimensions of identity and empirical research in APA journals.

This study reviewed 402 empirical research papers published during 1999 in 9 American Psychological Association journals from the perspective of the Personal Dimensions of Identity (PDI) model. Descriptions of participants were reviewed to determine whether researchers reported information concerning Dimensions A, B, and C of the PDI model. PDI A and B Dimensions of age, gender, education, and geographic location were reported with the highest frequency: 88.56%, 89.30%, 78.50%, and 73.88%, respectively, whereas race/ethnicity was reported with moderate frequency, 60.70%. The remaining PDI A Dimensions of language, physical disability, sexual orientation, and social class, and the remaining B Dimensions of citizenship status, employment status, income, marital status, military experience, occupation, and religion, were reported in relatively low percentages of studies.

Ethics, Research↗
PubMed2000

Perceived inability to cope and care-seeking in patients with toothache: a qualitative study.

AIMS: To explore the subjective experience of a sample of patients attending a dental teaching hospital emergency clinic with toothache. MATERIALS AND METHODS: Subjects 21 female and 14 male dental patients, of different ages, marital status, employment status and levels of education, presenting with toothache at a dental teaching hospital emergency clinic. Data collection Unstructured in-depth interviews, following a topic guide. Analysis Transcribing, sifting, indexing and charting data according to key issues and themes. FINDINGS: A dimension of toothache pain that emerged was the perceived inability to cope. Patients reported a dependency on a dentist or other person to alleviate their pain, suggesting connotations of helplessness, disempowerment and incapacitation. The perceived inability to cope was also expressed in terms of loss of control, despair and isolation. A number of care-seeking patterns for toothache was identified: repeated visits to the same dentist for emergency care, repeated visits to different dentists, attendance at the dental hospital emergency clinic and consulting non-dental health workers such as doctors and pharmacists. CONCLUSIONS: The perceived inability to cope and care-seeking patterns are two unexplored dimensions of the toothache pain experience. Both dimensions may be associated with pain intensity, the clinical conditions that manifest as toothache, quality of treatment provided and management of demand for emergency dental care. A conceptual framework is proposed for future research to investigate these relationships.

Adolescent↗
PubMed2006

Depressive mood and obesity in US adults: comparison and moderation by sex, age, and race.

OBJECTIVE: Sustained depressive mood is a gateway symptom for a major depressive disorder. This paper investigated whether the association between depressive mood and obesity differs as function of sex, age, and race in US adults after controlling for socio-economic variables of martial status, employment status, income level and education level. METHODS: A total of 44,800 nationally representative respondents from the 2001 Behavioral Risk Factor Surveillance Survey were studied. Respondents were classified as having experienced a depressive mood if they felt sad, blue, or depressed at least for 1 week in the previous month. The depressive mood was operationalized in terms of duration and sustenance, both defined based on number of days with depressive mood: 7+ and 14+ days. Age groups were classified as young (18-64 years) and old (65+ years). Obesity status was classified as: not overweight/obese (BMI<25); overweight (25 or=30). RESULTS: Prevalence of prior-month depressive mood was 14.3 and 7.8% for 7+ and 14+ days, respectively. Controlling for race and socio-economic variables, both young overweight and obese women were significantly more likely to have experienced depressive mood than nonoverweight/nonobese women. Young overweight, but not obese, men were significantly more likely to have experienced depressive mood than nonoverweight/nonobese men. Young obese women were also significantly more likely to have a sustained depressive mood than nonoverweight/nonobese women. For old respondents, depressive mood and its sustenance were not associated with obesity in either sex. DISCUSSION: The relationship between the depressive mood and obesity is dependent upon gender, age, and race. Young obese women, Hispanics in particular, are much more prone to depressive mood than nonobese women. Future studies testing associations between depression and obesity should be sensitive to the influence of these demographic and socio-economic variables.

Adolescent↗
PubMed2006

Indoor time-microenvironment-activity patterns in seven regions of Europe.

Personal exposure to environmental substances is largely determined by time-microenvironment-activity patterns while moving across locations or microenvironments. Therefore, time-microenvironment-activity data are particularly useful in modeling exposure. We investigated determinants of workday time-microenvironment-activity patterns of the adult urban population in seven European cities. The EXPOLIS study assessed workday time-microenvironment-activity patterns among a total of 1427 subjects (age 19-60 years) in Helsinki (Finland), Athens (Greece), Basel (Switzerland), Grenoble (France), Milan (Italy), Prague (Czech Republic), and Oxford (UK). Subjects completed time-microenvironment-activity diaries during two working days. We present time spent indoors--at home, at work, and elsewhere, and time exposed to tobacco smoke indoors for all cities. The contribution of sociodemographic factors has been assessed using regression models. More than 90% of the variance in indoor time-microenvironment-activity patterns originated from differences between and within subjects rather than between cities. The most common factors that were associated with indoor time-microenvironment-activity patterns, with similar contributions in all cities, were the specific work status, employment status, whether the participants were living alone, and whether the participants had children at home. Gender and season were associated with indoor time-microenvironment-activity patterns as well but the effects were rather heterogeneous across the seven cities. Exposure to second-hand tobacco smoke differed substantially across these cities. The heterogeneity of these factors across cities may reflect city-specific characteristics but selection biases in the sampled local populations may also explain part of the findings. Determinants of time-microenvironment-activity patterns need to be taken into account in exposure assessment, epidemiological analyses, exposure simulations, as well as in the development of preventive strategies that focus on time-microenvironment-activity patterns that ultimately determine exposures.

Activities of Daily Living↗
PubMed1997

Depression in female health visitor consulters: social and demographic facets.

The primary health care setting has been established as a key venue for identifying and working with depression. Despite this, and the high risk of depression experienced by women in the postnatal period, maternal depression has been little examined in the work of health visitors. Furthermore, although research has been undertaken on social factors related to depression in the general population, there is nothing specifically on the population of health visitor clients. This study focuses on social and demographic factors related to maternal depression amongst users of health visitor services. In a study of 701 women in rural and urban areas, maternal depression was found to be significantly associated with the absence of receipt of further or higher education, housing status, employment status, reliance on state benefit, family size, family breakdown (reconstituted families and single divorced or separated women), perceptions of support and difficulty in getting children off to sleep, particularly after the first year of the child's life. Loglinear analysis was used to identify the most parsimonious model of these relationships, and three key areas emerged: social and economic disadvantage, family size and history of family disruption. The model suggested that 'behind' these data may have been poor life chances, as evidenced by data on further and higher education. These data identify elements of objective life circumstances important for depression in this group. They have considerable significance for the organization of health service resources and these are discussed.

Adult↗
PubMed1984

Professional burnout and its relation to job characteristics, satisfaction, and control.

Burnout scores for 104 professionals in the fields of college student personnel, health and mental health, administration and miscellaneous other professionals were correlated with ratings on 13 job characteristics, and ratings of satisfaction with, and control over, these characteristics. Results indicate significant positive correlations between the burnout scores and 10 of the 13 job characteristics. Significant positive correlations were found for burnout and all 13 items of job satisfaction. Significant negative correlations were found for 6 of the items where control was rated. Demographic variables of age, sex, marital status, employment status of spouse, dependents, number of hours worked, and being on call showed no significant correlations with burnout. Recommendations are made for continued research and theory building which take into account the concept of control over one's work environment.

Adult↗
PubMed2004

Employment, employment-related problems, and drug use at drug court entry.

The literature indicates that employment may be an important factor for retaining substance misusing clients in treatment. Given the link between employment problems and treatment retention for Drug Court clients, the current project builds upon the existing services provided by Drug Courts in order to develop and implement an innovative model that focuses on obtaining, maintaining, and upgrading employment for Drug Court participants. The purpose of this article is to (1) describe the employment intervention used in Kentucky Drug Courts, which is grounded in established job readiness and life skill training approaches; and (2) profile those participants who were employed full-time prior to Drug Court and those who were not. Findings suggest that those employed full-time were more likely to have higher incomes and more earned income from legitimate job sources, although there were no differences in the types of employment (major jobs included food service and construction). In addition, study findings suggest that full-time employment was not "protective" since there were few differences in drug use and criminal activity by employment status. Employment interventions need to be examined to determine their utility for enhancing employment and keeping drug users in treatment. This article focuses on the initial 400 participants, who began entering the study in March, 2000.

Adult↗
PubMedDate not supplied

Demographic characteristics and perceived health status of users of folk therapies in Taiwan.

OBJECTIVES: This study examined the prevalence of folk therapy use among Taiwanese adults and factors associated with such use. SUBJECTS AND METHODS: The data used in this study were from the 2001 National Health Interview Survey in Taiwan, which utilized a multistaged stratified systematic sampling scheme. Included in the current analysis were 11,290 individuals from 20 to 65 years. RESULTS: Only 1.3% of those surveyed were classified as users of folk therapy. Users of folk therapies were older (p = 0.002), had higher annual incomes (p < 0.001), and experienced more health problems (p = 0.006) than nonusers. The two groups were comparable in the areas of marital status, employment status, gender, and educational level. Users had lower scores in the physical functioning (p < 0.001), role physical (p = 0.041), general health perception (p = 0.002), and bodily pain (p < 0.001) domains of the Medical Outcome Studies 36-Item Short-Form Health Survey. The two groups were not significantly different regarding the utilization and satisfaction with conventional medical resources and the domain scores of the brief version of the World Health Organization Quality of Life (QOL) questionnaire. CONCLUSIONS: Less than 2% of adult Taiwanese population reported relying primarily on folk therapies for their common physical discomfort. Users of folk therapies are older, have higher incomes, and have more health problems and poorer health-related QOL, but they neither make more frequent use of conventional medical services nor are they dissatisfied with the available services.

Adult↗
PubMed2006

Heavy drinking occasions and depression.

AIMS: To assess the risk of depression for subjects with or without heavy drinking occasions after adjusting for the average long-term alcohol consumption, age, gender, marital status, employment status, and chronic diseases. METHODS: In a cross-sectional population survey (N = 3124) carried out in Finland in 1997, long-term average alcohol consumption was assessed by a self-administered quantity-frequency questionnaire. A heavy drinking occasion was defined as six or more drinks for men and four or more drinks for women consumed at one session. The self-administered 21-item Beck Depression Inventory score of > or = 10 was classified as clinically significant depression. RESULTS: Ex-drinkers and subjects with heavy drinking occasions had more often clinically significant depression compared with lifelong abstainers and individuals without heavy drinking occasions. In addition to the drinking habit, the risk for clinically significant depression increased also with age. Men aged 45-64 years with heavy drinking occasions had 2.3 times higher risk for depression compared with young men (aged 25-34 years) without heavy drinking occasions. The respective risk for old women was 2.2 times higher. CONCLUSIONS: Drinking pattern with heavy drinking occasions is independently associated with clinically significant depression irrespective of average long-term alcohol consumption.

Adult↗
PubMed2005

Smoking practices in New York City: the use of a population-based survey to guide policy-making and programming.

To inform New York City's (NYC's) tobacco control program, we identified the neighborhoods with the highest smoking rates, estimated the burden of second-hand smoke exposure, assessed the early response to state taxation, and examined cessation practices. We used a stratified random design to conduct a digit-dialed telephone survey in 2002 among 9,674 New York City adults. Our main outcome measures included prevalence of cigarette smoking, exposure to second-hand smoke, the response of smokers to state tax increases, and cessation practices. Even after controlling for sociodemographic factors (age, race/ethnicity, income, education, marital status, employment status, and foreign-born status) smoking rates were highest in Central Harlem and in the South Bronx. Sixteen percent of nonsmokers reported frequent exposure to second-hand smoke at home or in a workplace. Among smokers with a child with asthma, only 33% reported having a no-smoking policy in their homes. More than one fifth of smokers reported reducing the number of cigarettes they smoked in response to the state tax increase. Of current smokers who tried to quit, 65% used no cessation aid. These data were used to inform New York City's smoke-free legislation, taxation, public education, and a free nicotine patch give-away program. In conclusion, large, local surveys can provide essential data to effectively advocate for, plan, implement, and evaluate a comprehensive tobacco control program.

Adolescent↗
PubMed1996

Characteristics of leisure time physical activity associated with decreased risk of premature all-cause and cardiovascular disease mortality in middle-aged men.

The association between leisure time physical activity and the risk of all-cause and cardiovascular disease mortality was analyzed in a Finnish cohort of 1,072 men age 35-63 years who were followed up for 10 years and 10 months. During the period, 168 deaths were recorded, 93 of which were the result of cardiovascular diseases. Leisure time physical activity was assessed by several measures: 1) a single question combining an estimate of the frequency and intensity of the total amount of leisure time physical activity, 2) a compiled measure of leisure time physical activity derived from three separate questions concerning the intensity and frequency of activity, 3) a physical energy expenditure index computed as an estimate of weekly energy expenditure for leisure time activity and commuting to work, 4) 16 separate specified activities of daily living and domestic chores included in the leisure time physical activity index. The association between baseline leisure time physical activity and the risk of death was assessed using the Cox proportional hazards model. After adjustment for potential confounders, the leisure time physical activity energy expenditure index and participation in several specific activities of daily living and domestic chores showed that the mortality risk for all causes and cardiovascular diseases was highest in the most sedentary men. With respect to the leisure time physical activity energy expenditure index, sedentary men ( those with an estimated weekly energy expenditure in leisure time physical activity of < 800 kcal) had an increased risk of 2.74 (95% confidence interval 1.46-5.14) for all-cause mortality and a risk of 3.58 (95% confidence interval 1.45-8.85) for cardiovascular disease mortality compared with the most active persons (those with an estimated weekly energy expenditure in leisure time physical activity of at least 2,100 kcal) when age, initial health status, marital status, employment status, and smoking were controlled.

Adult↗
PubMedDate not supplied

Maternal employment and parent-child relationships in single-parent families of low-birth-weight preschoolers.

BACKGROUND: The influence of premature birth of an infant in female-headed, single-parent families together or in conjunction with family environment factors, such as employment of the mother, on the mother-premature child relationship has not been considered in past studies. OBJECTIVES: To explore differences in parent-child and family relationships for employed and nonemployed single mothers of low-birth-weight (LBW) and full-term preschool children and to describe the relationships of the mother's employment status, employment history, and employment attitude-behavior consistency to parent-child and family relationships. METHODS: Single mothers with LBW (n = 60) and full-term (n = 61) preschool children provided data on their employment situation, the Parenting Stress Index, the Feetham Family Functioning Survey, and the Home Observation for Measurement of the Environment. RESULTS: Employed mothers had more positive perceptions and provided more enriching home environments for their children. Greater attitude-behavior consistency was associated with more positive perceptions of the parental role. CONCLUSION: Thus, in single-parent families, employment and consistency are positive influences on the mother-child relationship.

Adaptation, Psychological↗
PubMedDate not supplied

Mortality and quality of life 12 months after myocardial infarction: effects of depression and anxiety.

OBJECTIVE: The purpose of this study was to determine the impact of symptoms of depression and anxiety on mortality and quality of life in patients hospitalized for acute myocardial infarction (MI). METHODS: The Beck Depression Inventory and the State-Trait Anxiety Inventory were completed by 288 patients hospitalized for MI. Twelve-month survival status was ascertained, and quality of life among survivors was assessed at 12 months using the Dartmouth COOP charts. RESULTS: Thirty-one (10.8%) patients died, 27 of cardiac causes, during the 12-month follow-up. Symptoms of depression and anxiety predicted neither cardiac nor all-cause mortality. Severity of infarction and evidence of heart failure predicted both cardiac and all-cause mortality. The same findings emerged from supplementary analyses of data from patients who died after discharge from the hospital. Symptoms of depression and anxiety, measured at entry, predicted 12-month quality of life among survivors, as did gender, partner status, employment status, living alone, previous frequency of exercise, and indices of disease severity (Killip class and Peel Index). In a multiple regression model in which all of these variables were entered, initial depression scores provided the best independent prediction of quality of life, although living alone, severity of infarction, and state anxiety also entered the model. CONCLUSIONS: Symptoms of depression and anxiety did not predict either cardiac or all-cause mortality after MI, but they did predict quality of life among those who lived to 12 months.

Adult↗
PubMedDate not supplied

Correlates of attitudes toward a smoking ban in vehicles.

To examine the predictors of attitudes toward a smoking ban in vehicles, a computer-assisted telephone interview was conducted for a representative sample of Indiana adult residents using the random-digit-dialing method. Less than one third of the total respondents favored a smoking ban for car drivers and passengers, whereas about two thirds favored the smoking ban in public places. Fifty-four percent and 63 percent of nonsmokers opposed the smoking ban for car drivers and passengers, respectively. Religiosity was a significant predictor for attitudes toward a smoking ban for both drivers and passengers when controlling for other predictors, including smoking status, employment status, and age group. Gender, income group, and race/ethnicity were insignificant.

Adolescent↗
PubMed1994

Age, race, and gender variation in the utilization of coronary artery bypass surgery and angioplasty in SHEP. SHEP Cooperative Research Group. Systolic Hypertension in the Elderly Program.

OBJECTIVE: To assess variability in the use of coronary artery bypass grafting (CABG) and percutaneous transluminal angioplasty (PTCA) in the Systolic Hypertension in the Elderly Program (SHEP) cohort with incident coronary heart disease (CHD) by age, sex, and race. DESIGN: Retrospective analysis of a multicenter prospective cohort study. SETTING: Community-based ambulatory population in academic centers. PATIENTS: Among 4736 subjects initially enrolled in SHEP, there were 432 incident cases of CHD, excluding those patients who experienced rapid or sudden cardiac death. MAIN OUTCOME MEASURE: Incident cases of CHD who underwent CABG or PTCA. RESULTS: Of those participants > or = 60 and < 75 years of age, 7.3% underwent PTCA, compared with 3.9% of those > or = 75 years (P = 0.14). 15.4% of those < 75 underwent CABG surgery, compared with 7.8% of those 75 and older (P = 0.018). When both of these endpoints, CABG and PTCA, were combined, 22.4% of those < 75 underwent a procedure, while only 11.7% of the older cohort did (P = 0.005). Twenty-six percent of men underwent either CABG or PTCA, while only 9.1% of women did (P < 0.001). Of those < 75 years of age, 31.1% of men and 12.3% of women underwent CABG or PTCA (P < 0.001). In the 75 and older age category, 19.5% of men underwent these interventions, compared with 5.9% of women (P = 0.005). Active treatment group was significantly associated with decreased use of procedures in participants < 75 year old with CHD. Race, activity limitations, number of comorbid conditions, education level, marital status, employment status, and social support were not significantly associated with CABG or PTCA use. When the variables studied were entered into a logistic regression model, increased age and female sex remained independently associated with decreased CABG and PTCA use. CONCLUSION: In the SHEP trial older patients and women, regardless of comorbid conditions, socioeconomic status, and social support, underwent less intensive cardiovascular interventions than did younger patients and men when they developed CHD.

Age Factors↗
PubMed2000

Physicians are less willing to treat suicidal ideation in older patients.

OBJECTIVE: Older adults have the highest rate of suicide of any age group, and reducing the number of late-life suicides has become a national priority. The objective of this study was to determine if an age bias exists among primary care physicians when they contemplate treating suicidal patients. DESIGN: Primary care providers were mailed one of two case vignettes of a suicidal, depressed patient. The only difference between the two vignettes was the age of the patient (38 or 78 years old) and employment status (employed vs retired as a factory worker). A questionnaire was included to determine provider recognition of suicidal ideation, and a scale was designed to detect willingness to treat the vignette patient. SETTING/PARTICIPANTS: Physicians were selected randomly from the University of California, San Francisco physician roster and invited to participate in the study. A total of 342 physicians (63% response rate), including specialists, responded to the mailings. For this study, the responses of 215 primary care physicians were analyzed. INTERVENTION: The randomly assigned experimental group received a vignette of a geriatric, retired patient who was depressed and suicidal (n = 100 participants). The control group received an identical but younger, employed patient (n = 115 participants). MEASUREMENTS: A 21-item Suicidal Patient Treatment Scale measured willingness to treat the suicidal patient. RESULTS: The physicians in this study recognized depression and suicidal risk in both the adult and the geriatric vignette, but they reported less willingness to treat the older suicidal patient compared with the younger patient. The physicians were more likely to feel that suicidal ideation on the part of the older patient was rational and normal. They were less willing to use therapeutic strategies to help the older patient, and they were not optimistic that psychiatrists or psychologists could help the suicidal patient. CONCLUSIONS: This study suggests that primary care physicians are capable of recognizing suicidal ideation but are less willing to treat it if the patient is older and retired. Future research needs to determine etiologic factors for this age bias.

Adult↗