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Social cognitive and physical health determinants of exercise adherence for HIV-1 seropositive, early symptomatic men and women.

This study examined social cognitive and physical health factors that might explain variations in exercise adherence in a 3-month supervised exercise intervention for a group of mildly symptomatic, HIV-1 seropositive men and women. The social cognitive predictor variables were outcome expectations and self-efficacy. The physical health predictor variables included CD4+ cell counts, self-report inventories of physical symptoms, and physicians' examinations. Self-report inventories of physical symptoms were associated with physicians' examinations and combined into a composite measure of physical health. Criterion variables included exercise adherence rates, VO2max change, and status as a 'remainder' versus 'drop-out.' The composite measure of physical health emerged as a significant predictor of adherence rate and gave perfect prediction of remainers and a moderate prediction of dropouts. No significant associations were observed between the social cognitive predictors and adherence. Results suggest that for this population physical health status is a better predictor of exercise adherence than either perceived self-efficacy or outcome expectancy.

Journal Article↗

[Intimate partner violence: social and health determinants and responses].

The present study aims to review the problem of intimate partner violence, as well as its causes and consequences. It will also specifically analyze the role of health professionals. In opposition to the classical epidemiological view of risk factors, Heise proposes an ecological framework to study violence against women. This framework analyzes the interplay among the personal, situational and sociocultural factors that combine to cause abuse. Regarding the frequency of intimate partner violence in Spain, in January 2003 there were 2.519 formal complaints and 69 women died between January and November 2003. No geographical patterns in mortality or the incidence of formal complaints of intimate partner violence or among the provinces with the highest incidence of formal complains and those with highest mortality were observed. The only national survey published in Spain was performed by the Women's Institute in 1999, which reported a prevalence of domestic violence of 9.2%. A frequency of 22.8% was found in a primary health care center in Granada. Health services can play a key role in helping victims of domestic violence, since most women contact the health services at some time in their lives. Professionals in administrative or managerial positions can contribute to raising awareness of this health problem, which is one of the main causes of poor health and disability. Evidently, beyond consciousness-raising and early detection campaigns, public health strategies should be designed to prevent this serious health problem the causes of which can be changed.

Battered Women↗

From Kilimanjaro to the Himalayas: studies of health determinants in Third World communities.

Studies in communities in developing countries may seem far from occupational medicine in the UK, but there is much in common. Poverty and inequality, and the lack of control and choices that follow, are important causes of ill health. The methodology described in this paper is based on the concept that measurement should itself contribute to development and empower people. It combines quantitative data from large scale household surveys with qualitative data from focus groups, key informants and institutional reviews. In Nepal, malnutrition in children is seen to be related not only to feeding practices but also to the status of women. In Uganda, highlighting areas of poor service delivery in health and agriculture has initiated dialogue about improving local delivery of these services. In Tanzania, corruption in public services adversely affects everyday life; the survey results are part of an integrated strategy to tackle the problem.

Community Health Services↗

Dental age and dental health determined longitudinally from patient records in three towns in Finland.

The aims of this study were to test the suitability of normal dental records in determining the eruption times of teeth and to compare the retrospective longitudinal DMF values with the statistical cross-sectional means. Patient records for two cohorts (1970 and 1980) were collected from three Finnish towns. The study population comprised 1910 children. The eruption times of the permanent teeth, DMFT and DMFS curves (excluding F due to fractures and M due to orthodontic reasons) were investigated for the year of examination in different study locations. The cross-sectional DMF values were compared to longitudinally calculated data. Tooth eruption was earlier in girls than in boys. However, girls did not have significantly higher DMF values than boys. In all towns, dental health was significantly better in the 1980 cohort than in the 1970 cohort. Comparison of the cross-sectional DMF values in the municipal health center statistics showed that the mean statistics gave considerably higher values than the measured values did after 15 years of age. The inconsistency between measured longitudinal DMF values and the cross-sectional statistical DMF values indicates the importance of creating computer programs for analyzing data longitudinally from normal dental records.

Adolescent↗

Supply and demand factors in occupational health; determinants of self-reported compliance with the work place related requirements of the German Work Safety Law.

The study evaluates the extend to which West German company doctors reported that they carried out the workplace related activities as required by the German Work Security Law 'ASiG'. Postal questionnaires were completed by 502 of West German company doctors. About one third of those who responded, reported that they carried out the requirements of the German Work Safety Law with regard to workplace-related prevention. Multivariate analysis was applied to discover the factors that influenced compliance. We conclude that investment in supply-side factors (doctors' qualifications, experiences and recourses) are not enough to bring about compliance. More important are the demand-side regulations which directly address the health and safety culture of the companies.

Germany↗

Risk factors and health determinants in older Italians.

BACKGROUND AND AIMS: According to a WHO estimate, 50% of the total burden of diseases in men and 25% in women for the EURO-A group (which includes the highly developed countries of the WHO European Region) are attributable to unhealthy life-styles. The aim of the present study was to analyze anthropometric, biochemical and behavioral risk factors using data from the Italian Longitudinal Study on Aging (ILSA), a population-based study of older Italians initiated in 1992 to study those chronic conditions and attendant risk factors that contribute most substantially to morbidity, disability and mortality. METHODS: In this descriptive study, we calculated the means and distribution of risk factors in a sample of 5632 Italian subjects aged 65-84 by gender, age class and geographic area, and identified the proportion of these subgroups at higher risk. Analyses include data from the first (1992-93) and second (1995-96) examinations of this cohort. RESULTS: Over 64% of older Italian participants were overweight in 1992. More than 70% had blood pressure in the borderline or definitely hypertensive range, and almost one-third had hyperlipidemic serum cholesterol levels, including subjects receiving treatment for these conditions. Based on Body Mass Index, more women than men were obese (27 vs 15%) and more women than men were hyperlipidemic in all age classes (38 vs 23%). Approximately 13% of the sample had glucose levels exceeding the recommended 126 mg/dL. Men were found to consume on average about 41 grams of alcohol daily and women 17 g/d. Lastly, we found that approximately 20% of men and 8% of women were smokers in 1992 but that smoking tended to diminish with age. CONCLUSIONS: As the Italian population rapidly ages, the burden of disease and disability is increasing, necessitating more focused, immediate and effective prevention programs. We have identified a number of critical concerns ripe for intervention. The results of this study can better focus such efforts and help guide long-term health planning and policy.

Aged↗

Psychosocial, behavioural, and health determinants of successful smoking cessation: a longitudinal study of Danish adults.

OBJECTIVE: To examine the factors that determine whether or not smokers become long-term quitters, and to study whether determinants of successful cessation differ with levels of motivation to stop. DESIGN: In a cohort of men and women, aged 30-60 years at first examination in 1982/1984, smoking behaviour was evaluated from questionnaires at baseline and at follow up 10 years later. SETTING: County of Copenhagen, Denmark. PARTICIPANTS: 2554 subjects from the original sample of 4581 were successfully followed. This study deals with the 1365 subjects who were smokers at the first examination. MAIN OUTCOME MEASURE: Smoking status (abstinent for one year or more) at follow up. RESULTS: At follow up 15% of the baseline smokers had been abstinent for one year or more. In multivariate analysis, successful smoking cessation was associated with older age, high social status, low prior tobacco consumption, baseline motivation to stop smoking, and having a non-smoking spouse/cohabitant. The same result was obtained when the analyses were repeated separately for smokers with and without motivation to stop. CONCLUSIONS: Smokers motivated to stop are more likely to quit and remain abstinent than smokers with no such motivation. Age, social status, spouse/cohabitant's smoking behaviour, and the daily consumption of tobacco predict success in smoking cessation, irrespective of smokers' former motivation to stop.

Adult↗

Social and health determinants of the efficiency of cotton farmers in Northern Côte d'Ivoire.

This article assesses the role of malaria and some social determinants on the agricultural development and more precisely on efficiency in the context of cotton crop in the Korhogo region in the North of Côte d'Ivoire. Data envelopment analyses (DEA) was first applied for the purpose of calculating relative efficiencies in production. A Tobit regression model was then used to explain the variation in the DEA scores and check the hypotheses that the efficiency deviations between farmers can be explained by the disparity of malaria morbidity rate among the farmers and their family, by social cohesiveness and cultural behaviour. Field data were collected by the authors between March 1997 and February 1998 on 700 rural households living in three rice production systems differently exposed to the malaria risk. Two malaria indicators were used for the active (11-55 years old) family members of the farm: Plasmodium falciparum infection rate and high parasite density infection rate. The DEA model was applied on the sub-sample of cotton growers (about one third of the households of the full sample). Results of the different DEA and Tobit models (depending of the production process hypothesis) show that high parasite density infection has a direct and indirect negative effect on efficiency in the cotton crop. They also show that more cotton growers in the village improve efficiency, although villages where cotton is growing more widespread have weaker social cohesion.

Agriculture↗

Environment of oocyte and embryo determines health of IVP offspring.

In vitro embryo production (IVP) enhances the number of offspring from a single female and offers the possibility of accelerated genetic progress in animal husbandry. However, it also leads to a low but unacceptable percentage of anomalies in the offspring. The aim of this paper is to introduce the three speakers at this afternoon session who will speak about the demands of culture conditions and the endometrial environment to support normal embryonic development without effects on the embryonic genome. It will be argued that the in vitro conditions should mimic precisely the oviductal contributions to homeostatic mechanisms within the embryo. The further normal development can be guaranteed at synchrony in development of both endometrium and embryo. If that is not the case one can expect disturbances of gene expression, in particular of imprinted genes. However, it cannot be excluded that some processes might have started already in the cytoplasm of the oocyte. Since the oocyte was not planned to be a separate subject in this symposium, this introduction is also aimed to ask attention for the selection of cumulus-oocyte-complexes (COCs) and the conditions around oocyte maturation in vitro. The optimal quality of both the oocyte and maturation medium are prerequisites for an undisturbed cytoplasmic maturation. It has been argued that the exclusion of COCs from atretic follicles, the abjuration of the use of serum and high O2 tension in the gas phase might help to reduce the proportion anomalies in the offspring after synchronous transfers. In human IVF, in vivo matured oocytes are used with no great problems. But before IVP, including oocyte maturation in vitro (IVM) and a longer lasting embryo culture (IVC), will be introduced into the human assisted reproduction, it is important to think about the ins and outs of the potential causes for deviations.

Animals↗

Simulation of impact test for determining "health" of percutaneous bone anchored implants.

There is an ongoing requirement for a clinically relevant, noninvasive technique to monitor the integrity of percutaneous implants used for dental restorations, bone-anchored hearing aids, and to retain extra-oral prostheses (ear, eye, nose, etc). Because of the limitations of conventional diagnostic techniques (CT, MRI), mechanical techniques that measure the dynamic response of the implant-abutment system are being developed. This paper documents a finite element analysis that simulates a transient response to mechanical impact testing using contact elements. The detailed model allows for a specific interface between the implant and bone and characterizes potential clinical situations including loss of bone margin height, loss of osseointegration, and development of a soft connective tissue layer at the bone-implant interface. The results also show that the expected difference in interface stiffness between soft connective tissue and osseointegrated bone will cause easily measurable changes in the response of the implant/abutment system. With respect to the loss of bone margin height, changes in the order of 0.2 mm should be detectable, suggesting that this technique is at least as sensitive as radiography. A partial loss of osseointegration, while not being as readily evident as a bone margin loss, would still be detectable for losses as small as 0.5 mm.

Computer Simulation↗