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PubMed2001

Alcohol abuse and economic conditions: evidence from repeated cross-sections of individual-level data.

This study presents novel evidence on the relationship between macroeconomic conditions and patterns of alcohol consumption. Prior research has suggested that alcohol abuse varies procyclically, implying that income effects dominate any drinking patterns related to the opportunity cost of time or the psychological stress of recessions. However, those inferences have been based either on aggregate measures of consumption volume or possibly confounded cross-sectional identification strategies. This study examines these issues by evaluating detailed consumption data from the more than 700 000 respondents who participated in the Center for Disease Control and Prevention's Behavioral Risk Factor Surveillance System (BRFSS) surveys over the 1984-1995 period. The results provide robust evidence that the prevalence of binge drinking is strongly countercyclical. Furthermore, even among those who remain employed, binge drinking increased substantially during economic downturns. This combination of results suggests that recession-induced increases in the prevalence of binge drinking do not simply reflect an increased availability of leisure and may instead reflect the influence of economic stress.

Adolescent↗
PubMed1991

TRSA's (Textile Rental Association of America) strategic analysis of the industry for 1992.

Growth exceeding Gross National Product (GNP), strong competition, ongoing consolidation, and improving profitability--trends that have characterized the textile rental industry throughout the 1980s--continued in 1990. And despite a recession in the latter part of the year, the trends appear to be indicative of the decade ahead. The compelling question for the industry and the country is whether or not the recession is over, also unclear is the rate of recovery that can be anticipated. Economic assumptions, developed jointly by the Council of Economic Advisers, the U.S. Treasury, and Office of Management and Budget, show a resumption of economic growth in the latter half of 1991 with the pace accelerating into 1992. Real GNP growth is predicted to become about three percent annually by 1995-96, and to be accompanied by gradual declines in inflation and interest rates. This annual strategic analysis by TRSA officers and staff offers insights into industry trends as well as the issues affecting customers and the market place.

Bedding and Linens↗
PubMed2000

Effect of change in the psychosocial work environment on sickness absence: a seven year follow up of initially healthy employees.

STUDY OBJECTIVE: To investigate the impact of changes in psychosocial work environment on subsequent sickness absence. DESIGN: Analysis of questionnaire and sickness absence data collected in three time periods: 1990-1991, before the recession; 1993, worst slump during the recession; and 1993-1997, a period after changes. SETTING: Raisio, a town in south western Finland, during and after a period of economic decline. PARTICIPANTS: 530 municipal employees (138 men, 392 women) working during 1990-1997 who had no medically certified sick leaves in 1991. Mean length of follow up was 6.7 years. MAIN RESULTS: After adjustment for the pre-recession levels, the changes in the job characteristics of the workers during the recession predicted their subsequent sick leaves. Lowered job control caused a 1.30 (95% CI = 1.19, 1.41) times higher risk of sick leave than an increase in job control. The corresponding figures in relation to decreased social support and increased job demands were 1.30 (95% CI = 1.20, 1.41) and 1.10 (95% CI = 1.03, 1.17), respectively. In some cases there was an interaction with socioeconomic status, changes in the job characteristics being stronger predictors of sick leaves for employees with a high income than for the others. The highest risks of sick leave (ranging from 1.40 to 1.90) were associated with combined effects related to poor levels of and negative changes in job control, job demands and social support. CONCLUSION: Negative changes in psychosocial work environment have adverse effects on the health of employees. Those working in an unfavourable psychosocial environment before changes are at greatest risk.

Adolescent↗
PubMed1979

[Inside the labyrinth of feminine delirium.].

In order to understand the problem of the relationship between woman and madness, it is important to take history into account. Mental illness consists in the difficulty to express one's sexual difference in a wide sense (economic, political, ideological, imaginary and symbolical), this is where history comes into consideration. Woman, relegated in the far recess of history, deprived of the possibility to express herself, is today searching for her true expression. As far as the man's confusion of ideas is concerned, because of his denial of woman, all he had left was to differentiate himself from himself and therefore creates symbolic social classes ; this thesis is not an idealistic one - it goes without saying that this symbolical evolution develops itself in interrelation with economic and material development of society. The masculine confusion of ideas (délire) is historical while the feminine one is hysterical. This view of mental illness has political and ideological consequences. The annihilation of the roots of mental illness will come about only through the elimination of social classes and the real liberation of woman. This does not mean the rejection of therapeutic work, revolutions never cured anybody, but the extension of the clinical world to politics, the breaking down of established practices and interdisciplinarity. In short term, we have to deal with individuals who feel in themselves the after effects of an aged social structure, therefore not strictly individual but collective behaviors. In the long term, only a profound social transformation can limit the number of victims of the situation. One day maybe every one will be able to express and achieve themselves in a fully realised communism. This text wanted to be a locus of information on the historical and political basis of mental illness and the interconnected role played by the feminine 'délire' (madness).

English Abstract↗
PubMed2004

Morbidity and economic complications following mucogingival surgery in a hemophiliac HIV-infected patient: a case report.

BACKGROUND: This report describes the surgical treatment of a gingival recession in a hemophiliac HIV-infected patient. To our knowledge, mucogingival surgery has not been described previously in these patients. METHODS: Under the supervision of the patient's hematologist, a subepithelial connective tissue graft procedure was carried out to treat the recession. The treatment was performed after substitution therapy with factor VIII concentrate, supported by local antifibrinolytic treatment with epsilonaminocaproic acid. RESULTS: One week after surgery, the grafted zone showed a normal healing, but an area of necrosis appeared at the donor palatal site with spontaneous bleeding. The administration of factor VIII concentrate had to be prolonged to arrest the hemorrhage. In total, 44,500 units of factor VIII concentrate were used, the cost of which reached around $20,000. After 1 month the donor site had re-epithelialized by secondary intention. The root coverage was around 85% successful. CONCLUSIONS: Because of the surgical risk and the high economic cost in the use of the factor VIII concentrate, we do not recommend performing mucogingival surgery in HIV-infected hemophiliacs unless it is absolutely necessary. Prevention and early treatment must be the goal in the management of these patients.

Adult↗
PubMedDate not supplied

Update on pedodontics in a period of improving dental economics.

The dental services sector of the economy is a growth industry; however, many changes have occurred since the 1979-1980 recession. The population under the age of eighteen has continued to decrease, and the number of pedodontists has increased. Major changes are occurring in the incidence and prevalence of dental diseases.

Adolescent↗
PubMed1997

Back pain claim rates and the business cycle.

The causes of reported occupational back pain are controversial. Many observers appear to believe that job insecurity increases back pain compensation claims during recessions. The purpose of this study was to formally examine the impact of macro-economic forces-the business cycle-on the incidence of lost-time back pain claim rates in order to elicit clues to both its aetiology and reporting patterns. For Ontario between 1975 and 1993, age- and sex-adjusted lost-time back pain claim rates, stratified by industry sector (construction, manufacturing and trade), were regressed on the unemployment rate of the industry sector using time series methods. As a comparison group, the association between "acute" claim (fractures, lacerations, etc.) and the business cycle was also tested. Both back pain claim rates and acute claim rates increased during boom periods and decreased during recessionary periods. Time series analyses confirmed that these associations were statistically significant. The elasticities between claim rates and the unemployment rate were similar for back pain claims and acute claims. In addition, these associations were consistent in direction across all three industrial sectors tested. These results rebut the view that back pain claims increase during recessionary times.

Absenteeism↗
PubMed2001

Estimating the efficacy and efficiency of cascade genetic screening.

Screening for genetic variants that predispose individuals or their offspring to disease may be performed at the general population level or may instead be targeted at the relatives of previously identified carriers. The latter strategy has come to be known as "cascade genetic screening." Since the carrier risk of close relatives of known carriers is generally higher than the population risk, cascade screening is more efficient than population screening, in the sense that fewer individuals have to be genotyped per detected carrier. The efficacy of cascade screening, as measured by the overall proportion of carriers detected in a given population, is, however, lower than that of population-wide screening, and the respective inclusion rates vary according to the population frequency and mode of inheritance of the predisposing variants. For dominant mutations, we have developed equations that allow the inclusion rates of cascade screening to be calculated in an iterative fashion, depending upon screening depth and penetrance. For recessive mutations, we derived only equations for the screening of siblings and the children of patients. Owing to their mathematical complexity, it was necessary to study more extended screening strategies by simulation. Cascade screening turned out to result in low inclusion rates (<1%) when aimed at the identification of heterozygous carriers of rare recessive variants. Considerably higher rates are achievable, however, when screening is performed to detect covert homozygotes for frequent recessive mutations with reduced penetrance. This situation is exemplified by hereditary hemochromatosis, for which up to 40% of at-risk individuals may be identifiable through screening of first- to third-degree relatives of overt carriers (i.e., patients); the efficiency of this screening strategy was found to be approximately 50 times higher than that of population-wide screening. For dominant mutations, inclusion rates of cascade screening were estimated to be higher than for recessive variants. Thus, some 80% of all carriers of the factor V Leiden mutation would be detected if screening were to be targeted specifically at first- to third-degree relatives of patients with venous thrombosis. The relative cost efficiency of cascade as compared with population-wide screening (i.e., the overall savings in the extra managerial cost of the condition) is also likely to be higher for dominant than for recessive mutations. This notwithstanding, once screening has become cost-effective at the population level, it can be expected that cascade screening would only transiently represent an economically viable option.

Computer Simulation↗
PubMedDate not supplied

The halothane test: a practical method of eliminating porcine stress syndrome.

Pigs that are genetically liable to porcine stress syndrome can be detected around seven weeks old by their reaction to breathing halothane. Selection trials showed that the most probable form of inheritance for the halothane reaction was a single recessive gene. This halothane gene was also found to have good and bad effects on other economically important production traits, for example, improved carcase quality but reduced reproductive performance. The highest frequencies of the halothane gene were found in the pietrain and landrace breeds.

Animals↗
PubMed2003

Equity in access to child health insurance in the United States.

In an article that appeared in the New York Times on September 10, 2000, David E. Rosenbaum explicated the paradox that continues to define US medicine.(1) "In an era of unrivalled prosperity, Americans express confidence in their ability to handle most, if not all, economic concerns." He goes on to say, "The authorities and the public have begun to doubt whether costs for medical care can ever be contained, or that a practical way exists to provide insurance for all citizens. The only economic indicator that worsened in recent years is the number of Americans without health insurance. In the United States, we can make a case that what is economically rational is politically unacceptable." As the US and global economy vacillates in and out of recession, the opportunity to alter the course of US politics to effect significant change in access to health care for all Americans seems to be sliding further and further from our grasp.

Child↗