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At least 487 records · Page 27Linked to original sources
PubMed1976

Vigorous exercise in leisure time, coronary risk-factors, and resting electrocardiogram in middle-aged male civil servants.

During 1968 to 1970, approximately 17 000 middle-aged male executive grade civil service officers, all of them engaged in sedentary or very light work, recorded on a Monday morning their leisure time activities over the previous Friday and Saturday. In 1971 a sample of 509 of these men completed further questionnaires for medical, social, and smoking history; these men had a resting electrocardiogram, and height, weight, skinfold thickness, blood pressure, and plasma total cholesterol were measured. Vigorous exercise in leisure time had previously been reported by 125 (25%) of the men, and these as a group had significantly fewer electrocardiographic abnormalities (changes compatible with myocardial ischaemia, ectopic beats, and sinus tachycardia) than the men not reporting vigorous exercise (P less than 0-02). This difference remained when all men with any history suggestive of cardiovascular disease were excluded from the analysis. Blood pressure, plasma total cholesterol, and smoking habits were examined with respect both to vigorous exercise and to the electrocardiogram, but the only relation found was that electrocardiographic abnormality increased with increasing blood pressure. Even among men with higher pressures, however, those reporting vigorous exercise had fewer electrographic abnormalities than the others. The results provide further support for the association of habitual physical activity with coronary health.

Adult↗
PubMed2004

Involvement in civil society groups: Is it good for your health?

STUDY OBJECTIVE: To determine the involvement in civil society groups (CSGs) and the impact of this on health. DESIGN: Case study, cross sectional, self completion questionnaire, and semi-structured interviews. SETTING: Residents in two suburbs in Adelaide, South Australia. PARTICIPANTS: Every household (1038) received a questionnaire asking the adult with the next birthday to complete it. A total of 530 questionnaires were returned. Sixteen questionnaire respondents were also interviewed. MAIN RESULTS: 279 (53%) questionnaire respondents had been involved in a CSG in the past 12 months, 190 (36%) in locally based CSGs, and 188 (35%) in CSGs outside the area. Eleven of the 16 interviewees had been involved in a CSG. A path analysis examined the relation between demographic variables, CSG involvement, and mental and physical health, as measured by the SF-12. Physical health was negatively associated with CSG involvement and older age, and positively associated with working full time or part time and higher education level. Mental health was positively associated with older age, working full time or part time, and higher income but negatively associated with having a child under 18, speaking a language other than English and higher education level. Very few interviewees made a direct link between CSGs and positive individual health outcomes, though some positive community level outcomes were noted. More consistent were reports of the detrimental effects of CSG involvement on mental and physical health. CONCLUSIONS: Involvement in CSGs was significant but not always positive for health. It is possible that CSG involvement is good for a community but not necessarily for the individual.

Adolescent↗
PubMed1978

Vigorous exercise in leisure time and the death rate: a study of male civil servants.

In 1968-70, 17,944 middle-aged male executive grade civil servants in Great Britain provided a record of their leisure-time activities for two sample days and they have been followed until the end of 1977. In a 20% sample (3591 men), 268 have died. Men who had reported "vigorous exercise" (VE) during the two days suffered fewer deaths from coronary heart disease throughout the years 1968-77; there was no significant difference in mortality from other causes. VE men recorded more physical activity in general, and they saw themselves as physically more active than the rest. Total physical activity scores, however, were weakly related to coronary mortality. Men reporting vigorous exercise smoked somewhat less than other men, but the two factors were independently associated with mortality from coronary heart disease.

Aged↗
PubMed1978

Employment grade and coronary heart disease in British civil servants.

The relationship between grade of employment, coronary risk factors, and coronary heart disease (CHD) mortality has been investigated in a longitudinal study of 17 530 civil servants working in London. After seven and a half years of follow-up there was a clear inverse relationship between grade of employment and CHD mortality. Men in the lowest grade (messengers) had 3.6 times the CHD mortality of men in the highest employment grade (administrators). Men in the lower employment grades were shorter, heavier for their height, had higher blood pressure, higher plasma glucose, smoked more, and reported less leisure-time physical activity than men in the higher grades. Yet when allowance was made for the influence on mortality of all of these factors plus plasma cholesterol, the inverse association between grade of employment and CHD mortality was still strong. It is concluded that the higher CHD mortality experienced by working class men, which is present also in national statistics, can be only partly explained by the established coronary risk factors.

Adult↗
PubMed1998

Design, objectives, and lessons from a pilot 25 year follow up re-survey of survivors in the Whitehall study of London Civil Servants.

DESIGN: To assess the feasibility of conducting a re-survey of men who are resident in the United Kingdom 25 years after enrollment in the Whitehall study of London Civil Servants. METHODS: A random sample of 401 study survivors resident in three health authority areas was selected for this pilot study. They were mailed a request to complete a self administered questionnaire, and then asked to attend their general practice to have their blood pressure, weight, and height measured and a blood sample collected into a supplied vacutainer, and mailed to a central laboratory. Using a 2 x 2 factorial design, the impact of including additional questions on income and of an informant questionnaire on cognitive function was assessed. RESULTS: Accurate addresses were obtained from the health authorities for 96% of the sample. Questionnaires were received from 73% and blood samples from 61% of the sample. Questions on income had no adverse effect on the response rate, but inclusion of the informant questionnaire did. Between 1970 and 1995 there were substantial changes within men in the mean blood pressure and blood total cholesterol recorded, as reflected by correlation coefficients between 1970 and 1995 values of 0.26, and 0.30 for systolic and diastolic blood pressure and 0.38 for total cholesterol. CONCLUSION: This pilot study demonstrated the feasibility of conducting a re-survey using postal questionnaires and mailed whole blood samples. The magnitude of change in blood pressure and blood total cholesterol concentrations within individuals was greater than anticipated, suggesting that such remeasurements may be required at different intervals in prospective studies to help interpret risks associations properly. These issues will be considered in a re-survey of the remaining survivors of the Whitehall study.

Aged↗
PubMed2002

Effects of chronic job insecurity and change in job security on self reported health, minor psychiatric morbidity, physiological measures, and health related behaviours in British civil servants: the Whitehall II study.

STUDY OBJECTIVE: To determine the effect of chronic job insecurity and changes in job security on self reported health, minor psychiatric morbidity, physiological measures, and health related behaviours. DESIGN: Self reported health, minor psychiatric morbidity, physiological measures, and health related behaviours were determined in 931 women and 2429 men who responded to a question on job insecurity in 1995/96 and again in 1997/99. Self reported health status, clinical screening measures, and health related behaviours for participants whose job security had changed or who remained insecure were compared with those whose jobs had remained secure. SETTING: Prospective cohort study, Whitehall II, all participants were white collar office workers in the British Civil Service on entry to the study. MAIN RESULTS: Self reported morbidity was higher among participants who lost job security. Among those who gained job security residual negative effects, particularly in the psychological sphere were observed. Those exposed to chronic job insecurity had the highest self reported morbidity. Changes in the physiological measures were limited to an increase in blood pressure among women who lost job security and a decrease in body mass index among women reporting chronic job insecurity. There were no significant differences between any of the groups for alcohol over the recommended limits or smoking. CONCLUSION: Loss of job security has adverse effects on self reported health and minor psychiatric morbidity, which are not completely reversed by removal of the threat and which tend to increase with chronic exposure to the stressor.

Adult↗
PubMed1990

Blood lead concentration, renal function, and blood pressure in London civil servants.

Blood lead concentration was measured in 398 male and 133 female London civil servants not subject to industrial exposure to heavy metals. The relation between blood lead and serum creatinine concentrations and blood pressure were examined. Blood lead concentration ranged from 0.20 to 1.70 mumol/l with a geometric mean concentrations of 0.58 mumol/l in men and 0.46 mumol/l in women (p less than 0.001). In women blood lead concentration increased with age (r = +0.27; p = 0.002). In the two sexes blood lead concentration was positively correlated with the number of cigarettes smoked a day (men r = +0.17 and women r = +0.22; p less than or equal to 0.01), with the reported number of alcoholic beverages consumed a day (men r = +0.34 and women r = 0.23; p less than 0.01), and with serum gamma-glutamyltranspeptidase (men r = +0.23 and women r = +0.14; for men p less than 0.01). Blood lead concentration was not correlated with body weight, body mass index, and employment grade. In men 14% of the variance of blood lead concentration was explained by the significant and independent contributions of smoking and alcohol intake and in women 16% by age, smoking, and alcohol consumption. In men serum creatinine concentration tended to rise by 0.6 mumol/l (95% confidence interval from -0.2 to +1.36 mumol/l) for each 25% increment in blood lead concentration. In men and women the correlations between blood lead concentration and systolic and diastolic blood did not approach statistical significance. In conclusion, in subjects not exposed to heavy metals at work gender, age, smoking, and alcohol intake are determinants of blood lead concentration. At a low level of exposure, lead accumulation may slightly impair renal function, whereas blood pressure does not seem to be importantly influenced. Alternatively, a slight impairment of renal function may give rise to an increase in blood lead concentration.

Alcohol Drinking↗
PubMed2003

Effects of the civil procedure rules on clinical negligence claims.

The frequency with which clinicians can expect to face allegations of clinical negligence and court proceedings related to those allegations is likely to increase in coming years. The processes of investigation and defence have been modified by the introduction of the Civil Procedure Rules in 1999. This review outlines these developments and emphasises the need for speedy and comprehensive responses by doctors involved in such procedures.

Expert Testimony↗
PubMed1993

Factors predictive of long-term coronary heart disease mortality among 10,059 male Israeli civil servants and municipal employees. A 23-year mortality follow-up in the Israeli Ischemic Heart Disease Study.

Over 10,000 male civil servants and municipal employees in Israel, aged 40 years and above, underwent an extensive clinical, biochemical, anthropometric, sociodemographic and psychosocial evaluation in 1963, 1965 and 1968. Follow-up for mortality was continued through 1986. Over 23 years, a number of previously established risk factors for coronary heart disease (CHD) incidence were found to predict mortality. The long-term follow-up assisted in illustrating temporal patterns. A single causal assessment of blood pressure retained high prediction for long-term mortality. Blood lipids, while significantly associated with both coronary and all-cause mortality, exhibited a small contribution to the latter, when compared to hypertension, cigarette smoking habits and diabetes. Weak associations of long-term coronary mortality with the dietary intake patterns of fatty acids, as reported at baseline, were probably fully mediated by the effect of the diet on serum cholesterol. Religious orthodoxy appeared to provide a degree of immunity, part of which was independent of life-style correlates. A number of now well-established associations in cardiovascular epidemiology were first demonstrated, or amplified, in the study. Patterns of ethnic diversity in the risk factor and prevalence rates of CHD persisted, as viewed from the angle of mortality rates, over nearly a quarter of a decade, highlighting the enigma of a migrant country as a cardiovascular melting pot.

Adult↗
PubMed1975

Dangerousness and civil commitment of the mentally ill: some public policy considerations.

The author discusses "dangerousness to others" as a ground for involuntary civil commitment of the mentally ill, suggesting that there is often a confounding of legal/public-policy concerns and mental health concerns in issues related to this concept. The questionable nature of the presumption of dangerousness in mental patients and the overprediction of dangerous behavior for this group indicate that such commitment processes may circumvent legal safeguards designed to ensure due process. The author recommends that psychiatrists and other mental health professionals assume greater responsibility for the ways in which their services are used in these proceedings.

Alcoholism↗
PubMed1979

Impact of restrictive civil commitment procedures on a prison psychiatric service.

To assess the impact of restrictive civil commitment procedures, the authors studied the population of a prison psychiatric unit before and after the procedures were implemented. Their findings suggest that when the community finds it difficult to use the alternative of involuntary hospitalization, arrest and imprisonment are used to remove mentally ill people from the community.

Commitment of Persons with Psychiatric Disorders↗
PubMed1985

Liability of the mentally ill and their insurers in negligence and other civil actions.

Although familiar with the insanity defense, psychiatrists know little about the liability of mentally ill persons in civil actions or the secondary liability of their insurers. Generally the mentally ill are responsible civilly for their actions regardless of mental state except where the law requires specific intent and the illness negates such intent. Psychiatrists and other mental health workers may thus have grounds for suit against patients who injure them. While insurance coverage may exclude intentional acts, insurers may be civilly liable, even for blatant criminal acts. The author reviews the relevant laws and presents illustrative case examples.

Criminal Law↗
PubMed1987

Predictive validity of judgments of dangerousness in emergency civil commitment.

The authors investigated the predictive validity of judgments of dangerousness made in the context of emergency civil commitment. The medical charts of 101 consecutive patients involuntarily admitted to a university-based acute inpatient unit were reviewed for evidence of violence within the first 72 hours of hospitalization. More than two-thirds of the patients committed as a danger to others engaged in some type of violence, compared with fewer than one-third of other involuntary patients. The findings suggest that the emergency commitment situation permits judgments of dangerousness with a relatively high degree of short-term predictive validity.

Adult↗
PubMed1991

Decision making in psychiatric civil commitment: an experimental analysis.

OBJECTIVE: Legislation in Canada and the United States that was intended to decrease the use of civil commitment has resulted in a paradoxical increase in involuntary hospital admissions. To elucidate the reasons for this increase, this study was designed to assess the relative importance of various factors involved in the decision to commit a patient. METHOD: All psychiatrists in Ontario were sent a questionnaire asking them to make commitment decisions based on hypothetical case vignettes. Four factors were systematically varied in the vignettes: the patients' legal commitability, clinical treatability, alternative resources, and psychotic symptoms. Completed questionnaires, with three vignettes each, were returned by 495 respondents. RESULTS: All four variables were statistically significant in the expected direction; legal commitability (i.e., dangerousness to self and/or others, inability to care for self) and presence of psychotic symptoms accounted for the majority of the variance in the final decision to commit. CONCLUSIONS: These results suggest that psychiatrists in Ontario rely primarily on legally mandated factors (i.e., psychosis and dangerousness) in making their decisions to commit, although a considerable amount of individual variation is also evident.

Adult↗
PubMed1995

Prevalence of seasonal difficulties in mood and behavior among Japanese civil servants.

OBJECTIVE: Most prevalence studies of seasonal changes in mood and behavior have come from Western countries. The authors' goal was to determine the prevalence of seasonal changes in mood and behavior in a randomly selected group of Japanese workers. METHOD: They administered a Japanese translation of the Seasonal Pattern Assessment Questionnaire to 1,276 civil servants in Nagoya, Japan. RESULTS: The estimated prevalence of winter seasonal affective disorder was 0.86%, the estimated prevalence of winter subsyndromal seasonal affective disorder was 0.86%, the estimated prevalence of summer seasonal affective disorder was 0.94%, and the estimated prevalence of summer subsyndromal seasonal affective disorder was 2.12%. CONCLUSIONS: The authors conclude that seasonal changes in mood and behavior occur in Japan, but at a lower frequency and with a different profile than in the United States or Europe.

Adult↗
PubMed1987

A ten-year study of civil commitments in Washington State.

A ten-year longitudinal study of all civil commitments was conducted in a mid-sized county in Washington State, beginning with the 1974 effective date of a more stringent commitment law and encompassing the introduction of more lenient criteria five years later. A major finding was the increase in the number of 72-hour detentions and 14-day commitments that preceded by one year the passage of the broader criteria. The number of detentions continued to rise throughout the study period, while 14-day and 90-day commitments rose but less sharply. Data on repeated detentions showed that 21 percent of the patients were detained more than once. This group of recidivists accounted for 45 percent of the total number of detentions.

Commitment of Persons with Psychiatric Disorders↗
PubMed1988

NCSC guidelines for involuntary civil commitment: a workable framework for justice in practice.

A multidisciplinary task force convened by the National Center for State Courts has developed 50 guidelines that contain practical solutions to problems associated with involuntary civil commitment processes; most can be implemented within existing statutory frameworks. The guidelines call for greater cooperation and communication among the mental health, social service, public safety, and justice systems at each step in the commitment process and recommend that these systems form interdisciplinary community coordinating councils to seek expedient remedies to problems in the commitment process. Other guidelines outline the roles of law enforcement officers, lawyers, mental health professionals, and judges in maintaining the continuity of the commitment process and propose measures for improving screening of individuals as they enter the mental health system. Efforts to facilitate implementation of the guidelines are described.

Commitment of Persons with Psychiatric Disorders↗
PubMed1990

Family members' opinions about civil commitment.

As part of a survey of 260 Oregon family members with mentally ill relatives, respondents were asked about their experiences with civil commitment and their opinions about proposed modifications in the commitment statutes. Family members typically described their mentally ill relative as a schizophrenic man in his thirties who had had six psychiatric hospitalizations and was currently being treated with medications at a community mental health center. Three-fourths of the relatives had been committed. A majority (57 percent) of the respondents were in favor of mandatory outpatient treatment and medication after involuntary hospitalization but were not enthusiastic about outpatient commitment without hospitalization. Family members also wanted more education about mental illness, more information about the commitment process, and assignment of a professional to help in the commitment process.

Bipolar Disorder↗