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PubMed1992

[Evaluation of subjective happiness in the elderly using a visual analogue scale of happiness to analyze the effect of life style and neurobehavioral function on subjective happiness].

The effects of activity of daily living (ADL), physical conditions, social environmental factors and neurobehavioral functions on subjective happiness were investigated in 313 elderly subjects. The degree of subjective happiness was measured using visual analogue scale of happiness (VAS-H). There was significant relationship between VAS-H and ADL. The VAS-H score had weak but significant correlation with physical conditions and neurobehavioral functions. The social environmental factors, especially economical conditions, family relationships and group behavior had a significant correlation with VAS-H. In conclusion, in apparent healthy elderly people, the subjective degree of happiness was not related to ADLs, but to social environment and information physical conditions.

Activities of Daily Living↗
PubMedDate not supplied

[Children's health under the conditions of social differentiation].

Results of social-and-hygienic research of the health condition of children belonging to different social-and-economic population categories are under discussion. The material family status is shown to directly affect the child's life quality, i.e. family life mode, psychological climate, scope and variety of food-stuffs, the possibility to have a regular and valuable recreation, educational regime, and the possibility to satisfy the spiritual demands of a child etc. The morbidity goes up among children as the family income decreases. The social-and-economic conditions are the uttermost and often decisive risk factor that provokes the development of deviations in children's health. The material stratification of society conditions, for children, differing degrees of access to public benefits that are involved in shaping the children's health, thus, entailing the disequilibrium in their health. A realistic pattern of children's health is needed as a data base to define an objective necessity of children in medical care of different types as well as their necessity in medical drugs and equipment.

Adolescent↗
PubMed2002

Evolving concepts of management of febrile neutropenia in children with cancer.

BACKGROUND: Recent investigations of febrile neutropenia in pediatric cancer patients have identified subsets of low-risk patients who can be managed with less antibiotic therapy than previously recommended standards. METHODS AND MATERIALS: PubMed and Medline were searched for prospective trials and reviews of febrile neutropenia in children. Magnitude and duration of fever and neutropenia, comorbidities, and therapeutic strategies were examined. RESULTS: Twenty-seven prospective trials and five reviews were identified. The child with cancer and low-risk febrile neutropenia is clinically well and afebrile within 24-96 hr of antibiotic therapy and has evidence of marrow recovery with a rising phagocyte count. Disqualifying comorbidities include leukemia at diagnosis or in relapse, uncontrolled cancer, age under 1 year, medical condition(s) that would otherwise require hospitalization and social or economic conditions that may potentially compromise access to care or compliance. Therapeutic strategies include parenteral or oral antibiotics in the hospital with early discharge or parenteral antibiotics in the outpatient setting followed by oral or parenteral therapy and daily reassessment. Although as many as 25% of low-risk patients require modification of therapy and/or hospitalization, life-threatening or fatal infection is exceptional. CONCLUSION: One-third to one-half the children with febrile neutropenia are at low-risk of serious infection. In the context of clinic trials, they can be safely managed with inpatient or outpatient strategies that maintain close follow-up and reduce the burden of antibiotic therapy. Adoption of these alternative strategies as the standard of care should proceed with caution guided by written protocols.

Algorithms↗
PubMed1989

[Seroepidemiologic study of hepatitis A virus among children of Maracaibo, Venezuela].

With the purpose of determining the incidence of Hepatitis A virus infection, we determined the presence of antibodies against this virus (anti-VHA) with the ELISA technique in 209 children from Maracaibo city of different socioeconomic levels, ages ranging from 6 months to 12 years. At the same time, we investigated the incidence of a recent infection through IgM antibodies for Hepatitis A (anti-VHA IgM) using the same ELISA technique. We found a global positive incidence of 46.4% for all ages. Individual ages studied showed 31% seropositivity in children less than one year old and a higher seropositivity in children between 9 and 11 years old (50-76.4%). There were noticeable differences in seropositivity in relation to social economic condition observing a higher percentage in children of low social economic level. A recent infection was demonstrated after the second year of life (60%) and a variable percentage through all pediatric ages studied. There was no recent infection detected in children under one year of age which suggests that antibodies anti-VHA obtained transplacentally can last at least for the first year of life as it does with other virus.

Child↗
PubMed1989

[Computerized obstetrical record of the North Pas-de-Calais region].

The computerized obstetrical record of the North-Pas-de-Calais region proceeds from the desire of a number of people from the Regional Health Observatory, to dispose of a prospective epidemiologic tool in the field of perinatology. The objective is a better knowledge of the cause of perinatal death, analyzing the modalities of prenatal monitoring, delivery conditions, transfer of the newborns, as well as socio-economical conditions. The program manages the computerization of a usual obstetrical file, in the region, including approximately 200 items and allowing every possible comparison with the well-known CCIM record. The program permits local treatment of the data (statistical calculations) in each maternity hospital: rapid transmission of information between maternity and correspondents (computerized personalized mail), a base of agreement between the different protagonists: midwives, pediatricians, specialists, an easier collaboration with the protection agencies and, especially, the Regional Direction of Sanitary and Social Affairs, with automatic response to hundreds of questions of the yearly questionnaire, which saves a great deal of time and an extreme reliability of the information. This program is compatible with any IBM PC microcomputer and includes a hard disk of 10 or 20 mega-octets. The current price (microcomputer with hard disk, monitor, keyboard, letter-quality printer, management program) make all these performances available at a relatively low expense, under 25,000 francs (not including the tax).

Female↗
PubMed2004

[Causes of death among HIV infected adults in French Guyana and the French West Indies in the era of highly active antiretroviral therapy (HAART)].

OBJECTIVE: The survey "Mortality 2000" had for aim to describe the distribution of causes of death in HIV-infected adults in France. METHOD: Hospital wards involved in the management of HIV infection prospectively reported deaths occurring in 2000. The causes of death were documented using a standardized questionnaire. RESULTS: In French Guyana and the French West Indies the five referent wards reported 81 deaths. The main underlying causes of death were AIDS-related (67%), non-AIDS and non-hepatitis related cancer (9%), cardiovascular disease (7%), bacterial infections (5%), and end stage liver disease (4%). Among AIDS-related deaths, the more frequent diseases were histoplasmosis and toxoplasmosis in Guyana and atypical mycobacterial infection, tuberculosis, and cytomegalovirus disease in the West Indies. Median age was 43 years, transmission of HIV infection was heterosexual in 79%; 56% lived in poor socio-economic conditions, and 30% were born abroad. One out of five had been recently diagnosed with HIV infection and one out of three had never received antiretroviral treatment. CONCLUSION: In 2000, two in three death cases in HIV-infected adults were AIDS-related in French Guyana and the French West Indies. Improved strategies for screening HIV infection before the occurrence of AIDS are still needed taking into consideration poor socio-economic and migrant conditions.

Adult↗
PubMed1994

A Head Start for the 21st century.

Social and economic conditions since the creation of Head Start in 1965 have worsened. The stresses of economic restructuring in America and the pervasiveness of violence have severely eroded the capacity of many families to provide safe and caring homes in strong communities. The necessary adaptation of Head Start to these new conditions involves the essential linkage of early childhood and family support approaches with community economic development. This strategy must include a reappraisal of mental health paradigms that will enable children, youth, and families to be healthy and productive members of their neighborhoods and country. Although public support for Head Start remains strong, considerable rethinking about a Head Start for the 21st century is now occurring; results will affect the quality of life for the entire society.

Adolescent↗
PubMed1997

Mental illness in late life: socioeconomic conditions, psychiatric symptoms, and adjustment of long-term sufferers.

The relationships between social and economic conditions and psychiatric disorder among 346 older adults with severe mental illness living in the community are examined in this article. Measures included socioeconomic indexes, symptoms, diagnoses, and adjustment. As expected, socioeconomic and illness factors were interrelated in this sample. Diagnosis was related to both functioning and socioeconomic factors. As a rule, participants were financially impoverished but socially integrated into social networks consisting largely of kin. In spite of impoverishment and presence of significant symptoms, most were maintaining themselves in the community with at least marginal functioning, though they received very little support from the mental health system beyond medication. Compared with the younger cohort, the older cohort was functioning better, had fewer symptoms, and had better global adjustment. Those with coexisting psychotic and affective syndromes were most at risk. Future analyses with this data set will need to develop complex multivariate models to predict the primary influences on functioning and short-term stability.

Adult↗
PubMedDate not supplied

[Displaced women's opinion of the impact of forced displacement on their health].

OBJECTIVE: To analyze the adaptation process of women internally displaced to the city and the relationship between displacement and their self-perceived main health problems. METHODS: A qualitative, exploratory, descriptive study was carried out by means of semi-structured individual interviews with a maximum variation sample of 25 internally displaced women. A narrative content analysis was conducted with mixed generation of categories and data segmentation by age and themes. The area under study consisted of five localities in the city of Bogotá (Colombia). RESULTS: According to the interviewed women's discourses, their adaptation to city life depended on the new socioeconomic and environmental conditions and the psychosocial impact of displacement on the family. Precarious economic conditions forced them to live in an unhealthy environment and, occasionally, to adopt the role of head of household. In this role, many of these women, particularly young women, faced great difficulties in ensuring that the family's needs were met. Young women and teenagers reported behavioral changes due to displacement, including reproduction of violence in the home. The main self-perceived health problems among displaced women were mental health, access to food, infections and gynecological alterations. Displaced women identified the main factors hindering their access to health services as their economic situation and home responsibilities. CONCLUSIONS: Displaced women face new environmental and family challenges that negatively affect their health and access to healthcare. Specific interventions aimed at displaced women are required to foster better health through access to work and long -term socioeconomic stability.

Colombia↗
PubMed2000

[Using the excimer laser in refractive eye surgery. Results of a survey of German ophthalmologists].

BACKGROUND: Little information about the cost-effectiveness of excimer laser operations is available. As the number and structure of providers of these services in Germany are relatively unknown, only rough estimations can be made about the number of operations. PURPOSE: In this study the market for excimer laser operations is defined, structured from an economic view and examined according to medium-term demand and supply trends. The aim of the study is an applicable estimation of the current level of dissemination and of existing economic conditions for providers of excimer laser operations. METHODS: In a postal survey 219 ophthalmologists in Germany were asked to provide the number of excimer laser operations they had carried out and the organizational and financial details of these services. The questionnaire was answered anonymously. RESULTS: One can conclude that the annual number of interventions is increasing, although less significantly than in the United States. In most cases, providers of German health insurance have rejected inclusion of this service in their reimbursement catalogue. CONCLUSIONS: As of yet, excimer-laser-related turnover has frequently not met expectations. However, because of modifications of technological, health-economic and demand conditions an increase in the number of operations within this area is expected in the future.

Cost Control↗
PubMed2005

Associations of poverty, substance use, and HIV transmission risk behaviors in three South African communities.

The majority of the world's HIV infections occur in communities ravished by poverty. Although HIV/AIDS and poverty are inextricably linked, there are few studies of how poverty-related stressors contribute to HIV risk behavior practices. In this study, surveys were conducted in three South African communities that varied by race and socio-economic conditions: people living in an impoverished African township (N = 499); an economically impoverished but well infrastructured racially integrating township (N = 995); and urban non-impoverished neighborhoods (N = 678). Results showed that HIV/AIDS risks were closely related to experiences of poor education, unemployment, discrimination, violence, and crime. Although poverty-related stressors were associated with a history of alcohol and drug use, substance use did not moderate the association between poverty-related stressors and HIV risk behaviors. The findings suggest that HIV prevention strategies should not treat AIDS as a singled out social problem independent of other social ills.

Adult↗
PubMed2001

Hospitalization rates as indicators of access to primary care.

Variations in hospitalization rates for selected conditions are being used as indicators of the effectiveness of primary care in small areas. Are these rates actually sensitive to problems in local primary care systems? This study examines the relationship between ambulatory care sensitive condition (ACSC) hospital admission rates and primary care resources and the economic conditions in primary care market areas in North Carolina in 1994. The data show a high degree of correlation between the rates and income but not primary care resources. The distribution of rates did agree with expert assessments of the location of places with poor access to health services. The data confirm that access to effective primary care reflected in lower rates of ACSC admissions is a function of more than the professional resources available in a market area. The solution to reducing disparities in health status may not lie within the health system.

Health Services Accessibility↗
PubMed2001

The erosion of citizenship.

The Marshallian paradigm of social citizenship has been eroded because the social and economic conditions that supported postwar British welfare consensus have been transformed by economic and technological change. This article argues that effective entitlement was based on participation in work, war and reproduction, resulting in three types of social identity: worker-citizens, warrior-citizens and parent-citizens. The casualization of labour and the technological development of war have eroded work and war as routes to active citizenship. Social participation through reproduction remains important, despite massive changes to marriage and family as institutions. In fact the growth of new reproductive technologies have reinforced the normative dominance of marriage as a social relation. These rights of reproduction are described as 'reproductive citizenship'. The article also considers the role of voluntary associations in Third-Way strategies as sources of social cohesion in societies where social capital is in decline, and argues that the voluntary sector is increasingly driven by an economic logic of accumulation. With the erosion of national citizenship, Marshall's three forms of rights (legal, political and social) have been augmented by rights that are global, namely environmental, aboriginal and cultural rights. These are driven by global concerns about the relationship between environment, community and body such that the quest for social security has been replaced by concerns for ontological security.

Employment↗
PubMed1990

International comparative analysis: main findings and conclusions.

This paper compares the experience of health and inequality reviewed in the Bulgarian, Hungarian, Polish and Soviet profiles. With health systems very similar in formal organization and stated aims, health status based on death rates has followed very similar tendencies in each country. Sharp post-war falls in infant death slowed down from the 60s onwards, but continued to fall. Life expectancy also increased but again from the late 60s began to fall, particularly for middle-aged men. Inequalities in health-care provision and access have been paralleled by inequalities in health outcome between areas and socio-economic groups. Comparative analysis, however, suggests that the dysfunctions of the health system have only been contributing factors to more fundamental causes stemming from socio-economic conditions, cultural and collective behaviour and the priorities of the political and economic system. Written before the transforming political events of late 1989, the reviews emphasise the need for change and a search for more effective and equitable systems and policies.

Bulgaria↗
PubMed1999

The effect of increased consumer demand on fees for aesthetic surgery: an economic analysis.

Economic theory dictates that changes in consumer demand have predictable effects on prices. Demographics represents an important component of demand for aesthetic surgery. Between the years of 1997 and 2010, the U.S. population is projected to increase by 12 percent. The population increase will be skewed such that those groups undergoing the most aesthetic surgery will see the largest increase. Accounting for the age-specific frequencies of aesthetic surgery and the population increase yields an estimate that the overall market for aesthetic surgery will increase by 19 percent. Barring unforeseen changes in general economic conditions or consumer tastes, demand should increase by an analogous amount. An economic demonstration shows the effects of increasing demand for aesthetic surgery on its fees. Between the years of 1992 and 1997, there was an increase in demand for breast augmentation as fears of associated autoimmune disorders subsided. Similarly, there was increased male acceptance of aesthetic surgery. The number of breast augmentations and procedures to treat male pattern baldness, plastic surgeons, and fees for the procedures were tracked. During the study period, the supply of surgeons and consumer demand increased for both of these procedures. Volume of breast augmentation increased by 275 percent, whereas real fees remained stable. Volume of treatment for male pattern baldness increased by 107 percent, and the fees increased by 29 percent. Ordinarily, an increase in supply leads to a decrease in prices. This did not occur during the study period. Economic analysis demonstrates that the increased supply of surgeons performing breast augmentation was offset by increased consumer demand for the procedure. For this reason, fees were not lowered. Similarly, increased demand for treatment of male pattern baldness more than offset the increased supply of surgeons performing it. The result was higher fees. Emphasis should be placed on using these economic relationships to expand the demand for aesthetic surgery.

Fees, Medical↗
PubMed1994

Migration and unemployment duration among young adults.

"The relationship between migration and unemployment duration is examined. Standard job search predictors of spell length (replacement income, labor force experience, personal characteristics and economic conditions) are included as control variables alongside measures of migration in a Weibull hazard model. The model is estimated using data from the [U.S.] National Longitudinal Survey of Youth. Young adults who migrated while unemployed had longer durations of unemployment than those who did not migrate. The rate at which they found jobs was also linked to how long they had been unemployed, to being laid off, being African American, to going to college, having a mortgage and to national unemployment conditions."

Americas↗
PubMed2005

[Violence clusters in Pernambuco, Brazil].

OBJECTIVES: To analyze the spatial distribution of homicide mortality rates among males 15 to 49 years old in the state of Pernambuco, Brazil, for the periods of 1980 to 1984 and 1995 to 1998, and to identify violence clusters. METHODS: Mortality data were obtained from the Brazilian Ministry of Health's Mortality Information System. The mean homicide mortality rate was estimated for each municipality in the state for the two periods. The Moran coefficient was calculated to determine spatial autocorrelation. (The Moran coefficient ranges from -1 to +1, with a positive coefficient indicating a cluster of similar values, and a negative coefficient indicating adjacent dissimilar values.) To identify clusters of municipalities with either high or low homicide mortality rates, the local indicator of spatial association (LISA) was used. Finally, a Moran map was constructed to identify municipalities with statistically significant LISA values and to identify clusters of municipalities with either high or low homicide mortality rates. RESULTS: The Moran coefficient for 1980-1984 was 0.392, and for 1995-1998 it was 0.291 (P < 0.001). In the 1980-1984 period, one cluster of high homicide mortality rates was found in the Mata Sul region of the state, close to the metropolitan region of the state capital, Recife. In the 1995-1998 period, two violence clusters were identified: a predominantly urban one in the Recife metropolitan region, and the other in the state interior, in an area known as the "Marijuana Polygon" (Polígono da Maconha). CONCLUSION: This study suggests that the violence clusters are not the result of the socioeconomic conditions per se, but rather the consequence of the interaction between poor economic conditions and drug trafficking.

Adolescent↗
PubMed1991

The determinants of interdistrict labour in-migration in Pakistan, 1971-1980.

"This article begins by reviewing the previous literature pertinent to labour migration within Pakistan. Next, a migration equation at the aggregate level is specified, based on the expected socio-economic determinants of labour migration and data availability. Regression analysis was used to identify and quantify the determinants of interdistrict migration in Pakistan during the period 1971-1980. The results demonstrate that one of the major determinants of migration into a district was the percent of previous migrants in a district's population. Interdistrict migration was also significantly associated with the socio-economic variables of urbanization, population density, and literacy rates. The research presented here provides evidence that the movement of labour between districts in Pakistan is towards locations of superior socio-economic conditions."

Asia↗