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PubMed2006

Social capital, age and religiosity in people who are lonely.

AIMS AND OBJECTIVES: The aims of the study were to (i) investigate age and loneliness, (ii) investigate the association between religiosity and loneliness, and (iii) and explore the relationship between social capital and loneliness. BACKGROUND: Loneliness is the subjective experience of social isolation and is a risk factor for a wide range of health problems including heart disease and depression. Poor self-rated health, domestic violence and poor economic conditions are associated with greater loneliness. DESIGN: The study was a cross-sectional survey of a random sample of adults aged 18 years and over. METHODS: A random sample of 1289 subjects was interviewed by computer-assisted telephone interviewing. This interview included the Loneliness Scale and items from the Social Capital Module of the General Household Survey. FINDINGS: Loneliness is more common in men and people without strong religious beliefs. An income-loneliness gradient is evident. Little support was found for the association between social capital and loneliness. CONCLUSION: The prevalence of loneliness is relatively stable in this population. Loneliness is linked to income and unemployment and as such pathways between socio-economic factors, loneliness and health need to guide interventions and future research. RELEVANCE TO CLINICAL PRACTICE: Loneliness is linked to a range of social and economic factors. Current Health Visiting practice recognizes the importance of tackling the effects of poverty and social deprivation and places community building at the core of much Health Visiting practice. This broad community level approach can usefully transfer into all community nursing and health promotion activity.

Adolescent↗
PubMed1999

Relationship between passive smoking, recurrent respiratory tract infections and otitis media in children.

UNLABELLED: The cause of upper respiratory tract infections (URTI) are multifactorial (enlarged adenoid, environmental conditions, staying at the care centers, smoking parents, allergy). Directly, viral infection causes damage to the ciliary cells and mucociliary clearance in the nasopharynx and Eustachian tube, promotes tubal occlusion and provokes otitis media. Enlarged adenoids reduce ventilation to the nasopharynx, increase accumulation of the secretion and provide a good condition for bacteria. AIMS OF THE STUDY: Evaluation of the factors playing a role in recurrent URTI and otitis media in children. Clinical and histopathological examination of adenoid tissue of children who were passive smokers and children who were not exposed to cigarette smoke. Evaluation of the difference between ciliary-mucous transport among passive smokers and children not exposed to cigarette smoke. METHODS: The analysis of interview questionnaires in 1000 children aged 3-14 years. Histopathological examinations of adenoid tissue excised in the group of children of recurrent upper respiratory tract infections and serous otitis media exposed and not exposed to cigarette smoke. CONCLUSIONS: Among the risk factors for URTI, the most important are: (1) socio-economic conditions; (2) staying at day care centers; and (3) passive smoking. Allergy was confirmed in 35-38% of URTI children. Surgical treatment was undertaken in 11.4-32.5% of URTI children (tonsilloadenoidectomy). Histopathological and ultrastructural evaluation of adenoid tissue in passive smoking children indicates significant differences to children not exposed to cigarette smoke.

Adenoids↗
PubMed1999

Hepatitis virus infection in haemodialysis patients from Moldavia.

BACKGROUND: Although the epidemiology of hepatitis B (HBV) and C (HCV) now seems well established for Western European countries, in Central and Eastern Europe < 50% of all dialysis centres routinely test for hepatitis C antibodies since testing is not available or is not applied to all patients. This study describes the prevalence, risk factors and clinical significance of HBV and HCV infection for the haemodialysis population of the North Eastern region of Romania, Moldavia. METHODS: The presence of HBV antigens was determined with an ELISA kit (Wellcome, Abbot) and HCV antibodies with the ELISA-3 Ortho-HCV, third generation test. The following individual data were collected: gender, age, duration of dialysis, rural/urban domicile, actual and previous HBV status, actual HCV status, known acute, clinically evident hepatitis episodes in the last 3 years, monthly alanine aminotransferase (ALAT) and aspartate aminotransferase (ASAT) levels, complete biochemical hepatic assessment at the time of the study, transfusions for the past 3 years and family history. RESULTS: HBV and HCV prevalences were 17% (stable over the last 3 years) and 75%, respectively; co-infection was seen in 10% of the subjects. Hospitalization (nosocomial infection) for HBV, blood transfusions and duration on dialysis for HCV, emerged as the main risk factors for hepatitis infection. Socio-economic conditions appear to be equally important for HCV infection, since the prevalence was significantly higher among patients from rural, underdeveloped areas than urban areas (80.8 vs 60.3%), and infection was already present in a large proportion of patients (47%) before starting dialysis, without being related to previous disease duration or blood transfusions. HBV and/or HCV was not associated with a worse clinical or biochemical profile at the time of the study. However, infected patients had significantly more previous cytolytic episodes, with higher, transient increases in ALAT and ASAT levels. CONCLUSIONS: HCV infection is endemic among dialysis centres in Moldavia. Apart from previously well-known risk factors for hepatitis infection, our study demonstrates the negative impact of socio-economic underdevelopment. Simple measures such as enforced general asepsia rules, careful disinfection and equipment sterilization, routine testing of patients from economically disadvantaged areas and monthly, serial determination of hepatic enzymes should be the common practice in dialysis centres in Romania.

Adult↗
PubMed1995

Trends in utilization of obstetric care at Wesley Guild Hospital, Ilesa, Nigeria. Effects of a depressed economy.

Perinatal mortality rate (PNMR) at Wesley Guild Hospital (WGH), Ilesa, Nigeria, over a ten-year period was retrospectively analysed. The main objective was to determine the trends in the utilization of obstetric care and PNMR in the face of current economic difficulties in Nigeria and to make suggestions for improvement. The average PNMR over the period was 57.8/1000 births. There was a sharp rise in PNMR in 1985 to a peak of 110/1000 in 1987 (p < 0.0001). This was associated with a decline in utilization of maternity services, probably as a result of the introduction of fees for maternity services late in 1984 and increase in economic hardship in Nigeria. Actions are needed to improve enhanced access to obstetric care for the poor. These actions include: improvement in the economic conditions of the people, emphasis on primary health care (PHC) and early referral of high-risk pregnant women to tertiary units.

Developing Countries↗
PubMed2003

Economic implications of bovine leukemia virus infection in mid-Atlantic dairy herds.

OBJECTIVE: To determine the baseline costs of bovine leukemia virus (BLV) infection, including costs of clinical disease and subclinical infection, in a dairy herd representative of the mid-Atlantic region and compare these costs with the cost of a test-and-manage BLV control program. DESIGN: Stochastic spreadsheet model. SAMPLE POPULATION: A commercial Holstein dairy herd with 100 milking cows. PROCEDURES: A spreadsheet model was developed. The overall cost of infection included the cost of clinical disease (ie, lymphosarcoma [LS]) and the effects of subclinical infection on milk production and premature culling. Model input values and distributions were designed to reflect economic conditions in the mid-Atlantic region. Relative costs of infection and control were calculated for infection prevalences of 20, 50, and 80%. RESULTS: Estimated mean cost to the producer per case of LS was 412 dollars; for a herd with a 50% prevalence of BLV infection, annual incidence of LS was 0.66. Mean annual cost of subclinical infection at a 50% prevalence of infection was 6,406 dollars. Mean annual cost of a test-and-manage control program was 1,765 dollars. The cost of clinical disease and subclinical infection varied substantially with the prevalence of infection, whereas the cost of control varied with herd size. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that a basic BLV control program may be economically beneficial in herds in which the prevalence of BLV infection is > or = 12.5%. Farm-specific considerations may factor prominently when weighing the costs and benefits of an individual BLV control program.

Animals↗
PubMed1987

Ethnomedical treatment of children's diarrheal illnesses in the highlands of Ecuador.

In rural communities in the Ecuadorian Highlands, gastrointestinal disease is the leading cause of death. This paper proposes a model of the world view that specifies the factors that condition illness or health and a traditional taxonomy that relies on certain criteria to categorize three classes of diarrhea. These determine whether ethnomedical or medical treatment will be used to 'cure' a child. The three illness classes: diarrhea produced by supernatural forces, by humoral imbalances, and by 'infection' differ etiologically. The ambient air and its temperatures, the constitution, humoral state and overt personality characteristics (character) of the individual, and the predelictions of the evil spirits that seek to sap their vital essence all figure in the origins of illness. The model of the world view is related to a folk taxonomy, which, it is asserted, provides a charter for families' responses to child illness, that more often than not, are appropriate under the economic conditions they suffer.

Adult↗
PubMed2005

[Association of Hodgkin lymphoma with Epstein-Barr virus in Hungary].

INTRODUCTION: The occurrence of Epstein-Barr virus associated Hodgkin's lymphoma shows considerable variation from continent to continent and from country to country but in Hungary no such investigations have been performed so far. AIM: The authors analyse the presence of Epstein-Barr virus and the type of latency in histologic samples taken from Hodgkin's disease patients. METHOD: They have analyzed the presence of virus using PCR, in situ hybridisation and immunohistochemistry. RESULTS: Out of 109 cases, 61 patients (56%) showed virus positivity by PCR while latent membrane protein 1 positivity was found in 47 cases (43%). As regards to gender ratio, 53% female and 58% male patients were virus positive by PCR. Epstein-Barr virus association did not show any alteration in children (1-14 years) when compared to that of adults (out of the 10 children 6 were positive by PCR). As regards to the lifestyle of Epstein-Barr virus positive patients, the incidence of smoking and the ratio of poor social conditions were significantly higher. Mixed cell type was the most frequent (65%) in these patients and Epstein-Barr PCR virus positivity was highest in this type (60%), primarily in age groups 11-20 and over 51 years. Epstein-Barr virus PCR positivity was 52% in nodular sclerosis (negative cases cumulated in the age group 15-30 years), other histologic subtypes could not be evaluated due to the small number of cases. On examining Hodgkin's lymphoma and Epstein-Barr virus association disease models, they could not categorize their patients into any of them though characteristic patient groups could be more or less observed also in their material. This may be explained by the socioeconomic differences of the population living under different economic conditions. CONCLUSION: These results indicate that Epstein-Barr infection may play an important role in the development of Hodgkin's lymphoma in Hungary, too.

Adolescent↗
PubMed1975

[Zur beruflichen Rehabilitation schizophrener Patienten].

The article reports on the results of vocational rehabilitation efforts in 399 schizophrenic patients. The criterion for assessing the rehabilitation outcome was a regular job for at least three months after discharge from the hospital - which was achieved in 51% of the schizophrenics as compared to 63% of the control group. In the majority of cases good rehabilitation results could be achieved only by placement in a job which, compared with the previous position, required less skills. In analysing the rehabilitation success in its relation to different variables it was noted that the diagnostic assignment to paranoid types of schizophrenia was positive whereas the opposite was found in the cases of hebephrenic courses and defective conditions. As a rule, better success could be achieved with older patients, which is attributed to vocational stabilisation before the onset of the disease. More effective than the correlation with diagnostic and psychopathological data was the examination of the relationship between success and the variables 1) social background and 2) attitudes. Very negative factors turned out to be social origin and milieu conditions, economic and family situations, the states of unemployment at the time before admission and an insufficient adjustment to the training programme. No correlation could be found between success and a longer history of employment. Social isolation could be largely eliminated through the therapeutic family milieu offering identification possibilities. In addition, the study revealed the importance of a continuous psychosocial follow-up care.

Adaptation, Psychological↗
PubMed1980

Malignant melanoma: social status and outdoor work.

The incidence of, and mortality from, malignant melanoma of skin in whites are strongly influenced by socio-economic conditions. Professional and administrative workers have the highest rates of all. Clerks and salesmen have higher rates than skilled manual workers, who have higher rates than unskilled workers. Women, when classified by the occupation of their husbands, show a similar relationship to social status. The biases of incidence data from systems of cancer registration, and mortality data from death certificates are different, and the consistency of the data from different periods and from different populations suggests that the relationship is real. The bulk of the data is from Britain, but there is sufficient from the U.S. to indicate that the effect is not restricted to one country. No consistent increase in risk was found in outdoor workers compared with indoor workers of similar socio-economic status.

Administrative Personnel↗
PubMed1986

Oral health patterns in a Swedish county population aged 65 and above.

The aims of the study were to survey oral health and related conditions in the population of non-institutionalized elderly people in Orebro County, Sweden, and to analyze the relative importance of certain factors within the oral health pattern. A random sample was taken of 500 non-institutionalized individuals, stratified according to age (65-74/75+) and residence (densely-populated areas/rest of county). Out of these subjects 305 were examined clinically; 158 interviewed by telephone. Totally 46% were edentulous; 35% in age group 65-74, 63% in age group 75+; 36% of the men were edentulous, 53% of the women. The lowest prevalence of edentulousness (9%) was found among married/cohabiting men in group 65-74 years, densely-populated areas. The mean number of remaining teeth in dentulous subjects was 17.1 in group 65-74 densely-populated areas; 10.1 in group 75+ rest of county. Regarding dental status the group 65-74 densely-populated areas consistently showed the best values, the group 75+ rest of county consistently showed the poorest values. Two subgroups diverged from the general pattern: the men in group 65-74 rest of county often showed poorer values than the others in aged 65-74; the men in group 75+ densely-populated areas often showed better values than the others aged 75+. The periodontal conditions were good or fairly good. Only 4% of the teeth had periodontal pockets 6 mm or deeper. Measured radiographically, about half of the teeth had 80% or more of the original bone level intact; 87% of the teeth had 60% or more of the original bone level remaining. Only 28% of the subjects had no periapical destruction. Ten percent of the teeth showed periapical destructions - 27% of root filled teeth; 6% in teeth without root fillings. Eighteen percent of the teeth were root filled - 27% of maxillary teeth, 11% of mandibular teeth. The root fillings were evaluated "not acceptable" in 69% of the teeth. Periapical destructions were more frequent in teeth with "not acceptable" root fillings as compared to those "acceptable" root filled. Socio-economic conditions were highly correlated with a number of dental parameters. In men those who were not married or cohabiting showed the poorest values; in women the differences were smaller but the highest prevalence of edentulousness was found in widows.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗
PubMedDate not supplied

Public mental health. II: The psychological dimension.

Alienation, which is the source of much violence, is widespread throughout the world, deriving from and connected with adverse social and economic conditions. It is a state of estrangement from society often associated with bitterness and resentment; these exacerbate conflict and lead to war and other types of violence. Alienation is the antithesis of compassion and other feelings on which the good society is based. It is partially maintained by a web of psychological falsehoods, knots, relating to: awareness, happiness, identity, permanence, separateness, guilt and inferiority, and violence. These knots foster confused thinking that makes us more vulnerable to alienation. Unravelling the knots and cutting through the web of psychological falsehoods helps to release the human potential for positive, peaceful and non-violent action. Medicine can best contribute to weakening wide-spread alienation through the development of public mental health, working at the interface with the social, economic and cultural actors in the development of civil society.

Awareness↗
PubMed1993

[Marriage trends in Finland and Hungary].

"The study compares marriage trends of Finland and Hungary, using marriage tables of Finnish males and females born between 1939 and 1965 as well as those of Hungarian males and females born between 1939 and 1968." A major change in marriage behavior in Finland during the 1960s is attributed to changing social and economic conditions, particularly migration to the major cities. "Due to the changes a new marriage pattern is being shaped in Finland's population which is typical of postindustrial societies. In the youngest cohorts of Finnish females the average age at first marriage is likely to exceed 26 years, and at least 25 per cent of them remain ultimately unmarried. In the younger Hungarian cohorts significant decrease in first marriages can similarly be pointed out." (SUMMARY IN ENG AND RUS)

Cohort Studies↗
PubMed2001

Should nutritional status evaluation be included in the initial needs assessment of leprosy patients with disability prior to socio-economic.

Because of the large numbers of leprosy patients with disability and the limited resources available, it is important that socio-economic rehabilitation (SER) is targeted towards those who are most in need. Towards this purpose, current assessments of leprosy patients prior to initiating SER include the evaluation of income, assets and household possessions. Conspicuously absent is the nutritional assessment of the patient. In the absence of weight loss associated with illness, population studies indicate that undernutrition reflects poor socio-economic conditions. In this study of 151 cured leprosy patients with disability, 57% of the patients were found to be undernourished using body mass index (kg/m2) derived from body weight and height, and 10% of the patients were severely undernourished (grade III). Undernutrition in the patients was poorly though significantly correlated with personal income (r = 0.18, P < 0.05). Total household income, reported amount of money spent on food and estimated cereal intakes were not correlated with the BMI of the patient, possibly due to reporting bias and other methodological issues. We propose the inclusion of nutritional status evaluation by anthropometry as part of the initial screening of leprosy patients prior to instituting SER. We believe that this simple and objective evaluation can add to the assessment of 'threat' of economic deprivation or actual economic 'dislocation', and thus help in the prioritization of leprosy patients for SER.

Adult↗
PubMed1999

Ascaris-Trichuris association and malnutrition in Brazilian children.

This work was designed to evaluate the role of intestinal parasites on nutritional status in three rural areas of Brazil. A total of 520 children aged 1-12 years were studied through a questionnaire concerning housing, socio-economic conditions and a 24-h food intake recall. Measurements of weight and height were also performed, and three stool samples were collected on consecutive days for parasitological analysis. Scores of the standard deviation (z-scores) for the weight-for-height and height-for-age were used to characterise the growth profile. A high prevalence of intestinal parasites was detected, with Giardia lamblia (44%), Endolimax nana (43%), Ascaris lumbricoides (41%) and Trichuris trichiura (40%) being the most prevalent. Eleven per cent of the children were classified as showing stunting. Inadequate daily caloric intake was observed in 78% of the population and the proportion of those with inadequate protein intake was 34%. Logistic regression analysis was employed for the multivariate study. Stunting was significantly associated with estimators of low economic income, inadequate protein intake and polyparasitism, especially the association between Ascaris lumbricoides and Trichuris trichiura.

Analysis of Variance↗
PubMed1994

Influence of nutritional intake on 6-year mortality in an Italian elderly population.

Many observations agree on the existence, in older ages, of nutritional deficiencies secondary to dietary intake. This study investigated to what extent dietary intake of calories, protein, iron and vitamins influences the 6-year mortality in an elderly population living at home. To prevent the confounding effect of non-dietary factors, such as gender, functional and health status, socio-economic conditions and health risk habits, these variable have also been considered. The dietary intake was calculated comparing the content of nutrients in self-reported, 24-hour diet, with the 1980 Recommended Dietary Allowances (RDA) obtaining a percentage for each nutrient. The percentage difference from the RDA was tested on 6-year mortality using a bivariate regression model. The intake of protein, vitamin A, thiamin, niacin, vitamin B6 and folate was significantly related to mortality: subjects with a lower dietary intake of those nutrients had a higher risk of death. When nutrient intake was tested in a multiple regression model, adjusted for non-dietary potential confounders, only folate was an independent predictor of mortality. This study shows that most of the dietary nutrient's intake is related to socio-economic and physical factors.

Age Factors↗
PubMed1994

Height and the risk of acute myocardial infarction in Italian women.

The relationship between body height and risk of acute myocardial infarction (AMI) was investigated in a case-control study conducted in Northern Italy on 429 women with AMI under age 75 and 863 controls in hospital for acute conditions, unrelated to known or potential risk factors for coronary heart disease. Compared to women in the highest tertile of height, the relative risks (RR) adjusted for age were 1.1 (95% confidence interval, CI, 0.9-1.5) for the intermediate tertile, and 1.3 (95% Cl 1.0-1.8) for the lowest tertile. The trend in risk was significant (chi 1(2) = 3.89, P = 0.05). Adjustment for several potential confounding variables, including age, body mass index, education, smoking habits, family history of AMI, history of diabetes, hypertension and hyperlipidaemia did not materially modify these estimates: the RR for the highest vs the lowest tertile was 1.4 (95% CI 1.0-1.0). The association was stronger in elderly women, i.e. in earlier generations, and in heavier ones. This positive association is discussed in terms of socio-economic conditions, since low stature may be related to poor living conditions and unfavourable environmental factors in childhood and adolescence among earlier generations of Italian women.

Adolescent↗
PubMed2000

Socio-economic support for good health in rural Malawi.

OBJECTIVE: To study the socio-economic support for good health among subsistence farmers in rural Malawi. DESIGN: A cross-sectional survey. SETTING: Lungwena, a rural area with 17,000 inhabitants in southern Malawi. PARTICIPANTS: Seven hundred and ninety five pregnant women who attended the antenatal clinic at Lungwena Health Centre between June 1995 and September 1996. INTERVENTIONS: Interviews about socio-economic conditions. Measurements of cultivated land areas and distances between home and the local health centre. MAIN OUTCOME MEASURES: Proportion of households lacking literate adults, adequate water source and sanitation, easy access to modern health care or food security. RESULTS: Only 14% of the interviewed women could read and write and half of the households had no literate members. Every fifth household was lacking both an access to safe drinking water and a proper sanitary facility. The distance to the health centre was more than 5 km among half of the households and only 37% had enough land to grow food for all family members. When other potential means of obtaining food were taken into account, 27% of the households had no food security. Numerous households were lacking more than one socio-economic prerequisites of good health: three or more were missing from a quarter of the families. CONCLUSIONS: Socio-economic prerequisites of health were commonly missing in Lungwena. Subsequent health interventions should strengthen the investments into general poverty alleviation.

Adult↗
PubMed1997

Influence of host related factors on the antibody response to trivalent oral polio vaccine in Tunisian infants.

The low efficiency of trivalent oral polio vaccine (TOPV) in inducing protective antibody titres to polio3 is a problem of great importance in many regions of the world. A prospective study was conducted in 121 Tunisian infants aged 3 months during routine immunization with TOPV under carefully controlled conditions. Seroconversion rates to polio1, polio2 and polio3, one month after the third dose, were 94.7, 100 and 89.5%, respectively. The kinetics of the antibody response showed delayed and more difficult responses to polio3 compared to polio2 and polio1. The following host related factors, previously suggested to interfere with the immune response, were assessed: maternal antibodies; breast-feeding; concurrent enteric infections; and other illnesses. The main factor associated with the lack of seroconversion was concurrent infection with non-polio enteroviruses (NPE) which was found in 50% of non-responders to polio1 and/or to polio3 during the vaccination protocol whereas no NPE was isolated in vaccine responders. The other studied factors seemed not to interfere in the infants according to the locally adopted vaccination schedule and to the specific socio-economic conditions.

Antibodies, Viral↗