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PubMed1992

Attitudes of a Mediterranean population to the truth-telling issue.

The attitudes of the Greeks, a Mediterranean population, to the issue of telling the truth to the patient have been studied. There is no clear answer to the question: 'Do the Greeks wish to be informed of the nature of their illness?'. The answer is: 'It depends'. It depends on age, education, family status, occupation, place of birth and residence and on whether or not they are religious people. However, it does not depend on their sex--men and women have similar reactions to the issue of truth-telling. Although the present study shows lower percentages of those who wish to know the truth than studies on other populations, the conclusion is that, emphasising the need for good communication between doctors and patients, doctors should not lie, but should disclose to their patients the part of the truth they are ready to accept.

Adult↗
PubMed2006

Reproductive disorders and pregnancy outcomes among female flight attendants.

BACKGROUND: Occupational exposures in female aircrew may cause adverse pregnancy outcomes and menstrual disturbances. We studied reproductive health among female flight attendants. METHODS: We conducted a cross-sectional health survey among an occupational cohort of current and former flight attendants using a postal questionnaire including items on pregnancy outcome, menstrual characteristics, and infertility. We investigated these factors by occupational status (in service or not). RESULTS: The questionnaire was sent to 3036 women with a response rate of 64% (74% for current and 48% for former flight attendants). Spontaneous abortion rates were similar for pregnancies of women in service and not (12.6 vs. 11.4%; p = 0.58). Induced abortion rates were lower for in-service pregnancies (7.9%) compared with pregnancies of women not in service (21.1%) (p < 0.001). Menstrual irregularities in the year preceding the survey for women under 40 yr were more frequent among current than former flight attendants (20.6% vs. 10.4%, p = 0.02). Fertility problems were reported by 20.6% of respondents. An association between infertility and irregular menstrual cycles was found: odds ratio 1.6; 95% confidence limits 1.1, 2.4. CONCLUSIONS: Active flight attendants had a lower rate of induced abortions than former flight attendants, but the spontaneous abortion rate was similar between the two groups. Active flight attendants reported more menstrual irregularities, which are a risk factor for infertility. Lack of comparison with working women in other occupations precludes a conclusion that flight attendants are at greater occupational risk of reproductive disorders. Future studies of reproductive health in flight attendants should address personal and work-related risk factors in more detail and include comparison occupational groups.

Abortion, Induced↗
PubMed2000

Item bias in indices measuring psychosocial work environment and health.

OBJECTIVES: The main purpose of this study was to demonstrate the relevance of testing indices concerning the psychosocial work environment by item bias or differential item functioning (DIF) analysis. Especially when the work environment for different groups is compared, this kind of construct validation is important. As exogenous variables gender, age, and occupational group were selected. METHODS: Data were taken from a cross-sectional study of Danish employees aged 19-59 years (N=5940). The study was carried out in 1990 and followed-up in 1995. RESULTS: Item bias was demonstrated in all indices when analyzed in relation to gender, age, and occupational groups of the total population. Item bias was much weaker or disappeared as the population was divided into main occupational groups and analyzed in relation to the same exogenous variables. CONCLUSIONS: For a heterogeneous group of employees, gender, age, and occupational status are significant determinants of the response pattern in relation to indices of the psychosocial work environment. It was concluded that, if the psychosocial work environment for different groups is to be compared, indices should always be tested for item bias in relation to the exogenous variables included in the final analyses. Indices should only be used if there is no item bias. If such indices cannot be constructed, it is suggested that researchers either concentrate on constructing indices that are valid in subgroups or report results based on single-item analyses.

Adult↗
PubMed1990

Correlates of Korean immigrants' mental health.

The main objectives of this paper are an empirical investigation of major structural and situational variables related to Korean immigrants' mental health and a theoretical exploration of the meaning of the empirical findings. As part of a larger epidemiological research, the data for this paper derive from diagnostic interviews of 622 Korean immigrants (20 years and older) residing in the Chicago area. Data analyses reveal that, among the respondents in general, those who are married, highly educated, and currently employed in a high-status occupation indicate better subjective mental health (less demoralized and more satisfied with life) than others. Of other variables examined, however, significant gender differences in the correlates of mental health are observed. For the male immigrants, a set of work-related variables is clearly the strongest correlate of their mental health, whereas no such distinctive set of variables accounts for the female immigrants' mental health. Nevertheless, the family life satisfaction and several ethnic attachment variables are moderately related to the female immigrants' mental health. Theoretical implications of these findings are discussed in light of the confluence of ethnic attachment and acculturation on immigrants' mental health.

Acculturation↗
PubMed1985

Blood pressure and other cardiovascular risk factors of long-term exposure to lead.

The coronary risk profile was studied for 96 heavily exposed lead smelter workers employed between 9 and 45 years and for a reference group not exposed to lead but comparable with respect to age, sex, height, weight, social grouping, occupational status, and alcohol and tobacco consumption. The lead smelter workers had a little higher diastolic blood pressure and significantly more ischemic electrocardiographic changes, and their high-density lipoprotein levels were lower than the corresponding values of the reference group. The lead workers with electrocardiographic changes had higher blood pressures than the referents with corresponding changes. These findings indicate a higher coronary risk profile for the examined lead smelter workers. The study supports the hypothesis of a positive association between lead exposure and arteriosclerosis and high blood pressure.

Adult↗
PubMedDate not supplied

Eating behavior and pregnancy outcome.

The association between clinical eating disorders, maternal body weight, shape, and eating concerns, and the birth of low-birth-weight infants (LBW; less than 2500 g) was investigated using a retrospective case-control study. Eighty-eight women delivering LBW infants were interviewed and then divided into two groups--those delivering term, small-for-gestational-age infants (SGA; 37 or more completed weeks, n = 34) and those delivering premature infants (less than 37 completed weeks, n = 54). There were 86 reference women (CTRL) matched for age, parity, and health insurance status, who delivered babies with birth weights greater than 2500 g. In the week postpartum, women delivering term SGA, premature (PREM), and CTRL infants were interviewed using a semistructured interview. One section of this interview included a modified version of the Eating Disorder Examination (EDE), which retrospectively generated, over the previous 12 months, diagnosis of an eating disorder and maternal "normative" weight and shape concerns. In the 3 months before pregnancy, 32% of SGA women, 9% PREM women, and 5% of reference women were diagnosed as having a clinical eating disorder. Women with a past history of an eating disorder had no greater risk of delivering a low-birth-weight infant. Women delivering SGA infants, reported elevated eating disorder psychopathology postdelivery (Eating Disorders Inventory, EDI) and more disturbances in eating behavior before and during pregnancy. Unique predictors for delivery of a LBW term SGA infant were: low maternal prepregnancy body weight, smoking, low maternal weekly weight gain, and elevated EDI (Bulimia subscale). Unique predictors for delivery of a LBW premature infant were: lower maternal occupational status, vomiting in pregnancy, and lower dietary restraint. Women with disordered eating were shown to be at greater risk of delivering term SGA infants. Predictors of term growth retardation are partly determined by maternal behavior.

Adult↗
PubMed1983

Socio-economic experiences of leprosy patients.

225 adult leprosy patients were interviewed to study their socio-economic experiences, about various aspects of their lives. It was observed that 17.34%, 14.33% and 45.78% of patients experienced negative reactions from their families, spouses and society members, respectively. Out of 79 unmarried patients, 53 (67.1%) attributed leprosy as the only reason for not getting a partner for marriage. Out of 146 married patients, 34 (23.3%) were not living with their spouses; this also included 9 (6.2%) patients, deserted by their partners. Leprosy uprooted 44 (13.55%) patients from their residences, of whom 27 settled in leprosy village/settlement. The occupational status of 104 (46.22%) patients was adversely affected due to leprosy, of whom 43 became dependents and 17 beggars. Monthly income of 115 (51.1%) patients reduced to the extent of 84%, after getting leprosy. The social prejudice and deformities due to leprosy, have played key roles in socio-economic deterioration of patients. The leprosy control programme (LCP) need to be implemented more efficiently and effectively, with active involvement of communities. The socio-medical units, if included in LCP, may be utilized more effectively to prevent the socio-economic dehabilitation of patients, as well to tackle the abnormal psycholygical behaviours of patients.

Adult↗
PubMed1987

Medical, psychological, and social factors associated with back abnormalities and self reported back pain: a cross sectional study of male employees in a Swedish pulp and paper industry.

A medical, psychological, and sociological study of 391 male employees in a Swedish pulp and paper industry was performed in 1961. Factors associated with back pain and back abnormality were investigated. Univariate analyses showed associations of back pain with occupational status, low education, duration of employment, low performance on cognitive tests, and neuroticism. Back abnormalities evaluated on the basis of physical examination showed in principle the same associations but the strength as well as the significances were stronger. Multiple logistic regression analyses using data for manual workers showed that neuroticism and duration of employment were directly associated with back pain. The same two variables and low performance on one of the psychological tests were directly associated with back abnormalities. Age showed no direct association with back pain or back abnormalities. Strong associations between back pain and back abnormalities with both perceived health and general working capacity and the doctor's evaluation in the same areas were demonstrated.

Absenteeism↗
PubMed2005

Health-related quality of life in urban surgical emergency department patients: comparison with a representative German population sample.

BACKGROUND: Patients in emergency departments show a high prevalence of substance use. Quality of life is associated with substance use as well as socioeconomic status. Little is known about quality of life in substance-abusing young patients with minor trauma. METHODS: An investigation in an Emergency Department in an inner city university hospital was conducted during 8 months. Overall, 1,596 patients completed the SF-36 and an established SES-questionnaire and were screened for substance use (harmful alcohol consumption (>or= 8 points in men and >or= 5 points in women on the Alcohol Use Disorders Identification Test (AUDIT), smoking and illicit drug use). Results were compared with a representative German population sample (German Federal Health Survey 1998). RESULTS: Median age of participants was 32 years and 61.8% were male. Mean physical component summary score (PCS) of the Short Form-36 Health Survey (SF-36) was 53.4 +/- 8.3 points and significantly higher than the age and gender-stratified German Federal Health Survey-data. Mean mental component summary score (MCS) was 47.9 +/- 10.0 points and significantly lower than the age and gender-stratified German Federal Health Survey-data. In Emergency Department patients, prevalence of substance use was high and harmful alcohol consumption and illicit drug use were strongly associated with impaired mental health. Education and occupational status were strongly positively associated with physical health. CONCLUSION: We conclude that there is a high prevalence of substance use in young patients with minor trauma and mental quality of life is impaired. Screening and brief intervention strategies to reduce substance-use associated disorders should consider these findings.

Adult↗
PubMed1991

Occupational physical demands, knee bending, and knee osteoarthritis: results from the Framingham Study.

We sought to assess occupational joint use and osteoarthritis (OA) longitudinally in a large population with multiple occupations. Subjects were members of the Framingham Heart Study cohort followed over 40 years with occupational status assessed at the beginning of the Heart Study [from Examination 1 (1948-51) through Examination 6 (1958-61)] and knee OA assessed by weight bearing knee radiograph at Examination 18 (1983-85) when mean age of subjects was 73 years. Each subject's job was characterized by its level of physical demand and whether the job was associated with knee bending. Odds ratios (OR) testing the association of job demand with OA were adjusted by logistic regression for age, body mass, knee injury history, smoking, and educational level. Men whose jobs required knee bending and at least medium physical demands had higher rates of later radiographic knee OA (at least definite osteophytes) than men whose jobs required neither (43.4 vs 26.8%; OR of OA = 2.22, 95% CI 1.38, 3.58). Rates of severe radiographic OA (osteophytes and joint space narrowing) and of bilateral radiographic OA were also significantly increased in these men. Few women had jobs requiring knee bending or that were physically demanding and these jobs were generally unassociated with later radiographic OA. Only a small number of men (n = 28) had symptomatic knee OA, and we could not confirm that it was associated with occupation in men. Thus, among men, occupations which combine knee bending and physical demands may be an important cause of radiographic OA.

Aged↗
PubMed2000

Sexually transmitted infections and use of sexual health services among young Australian women: women's health Australia study.

Our objective was to examine associations between self-reported sexually transmitted infections (STIs) and sociodemographic, lifestyle, health status, health service use and quality of life factors among young Australian women; and their use of family planning and sexual health clinics and associations with health, demographic and psychosocial factors. The study sample comprised 14,762 women aged 18-23 years who participated in the mailed baseline survey for the Australian Longitudinal Study on Women's Health, conducted in 1996. The main outcome measures are self report of ever being diagnosed by a doctor with an STI, including chlamydia, genital herpes, genital warts or other STIs, and use of family planning and sexual health clinics. The self-reported incidence of STI was 1.7% for chlamydia, 1.1% genital herpes, 3.1% genital warts, and 2.1% other STIs. There was a large number of demographic, health behaviour, psychosocial and health service use factors significantly and independently associated with reports of having had each STI. Factors independently associated with use of family planning clinic included unemployment, current smoking, having had a Pap smear less than 2 years ago, not having ancillary health insurance, having consulted a hospital doctor and having higher stress and life events score. Factors independently associated with use of a sexual health clinic included younger age, lower occupation status, being a current or ex-smoker, being a binge drinker, having had a Pap smear, having consulted a hospital doctor, having poorer mental health and having higher life events score. This study reports interesting correlates of having an STI among young Australian women aged 18-23. The longitudinal nature of this study provides the opportunity to explore the long-term health and gynaecological outcomes of having STIs during young adulthood.

Adolescent↗
PubMedDate not supplied

The distribution of multiple sclerosis in Sardinia.

The incidence of M.S. in Sardinia has been found to be the highest in Southern Italy. On "prevalence day", October 21st, 1971, the incidence was 12.48/100,000 inhabitants, whereas the rates in Campania and in Puglia, (regions of Southern Italy at the same latitude as Sardinia) the rates were 3.3 and 4.0 respectively. In the present study, a significant female predominance was found, the rates for women and men being 15.88 and 9.03 respectively. The incidence of MS in the study area was found to be significantly higher both in areas with a cool humid climate and in communities with the lowest socioeconomic conditions. A significantly higher incidence was computed for communities with less than 5,000 inhabitants. MS incidence had no correlation with the occupational status and dietary habits, which are uniformly distributed throughout the island. The disease started at au average of 27.3 years and its duration on "prevalence day" was 13.4 years. The age of onset was found to be low in comparison with other population studies in Europe and in North-Central Italy. The age-specific curves of onset and on "prevalence day" showed two peaks, one in the second-third decade and one in the forth-fifth decade. Most of the patients with an earlier onset showed a complete disappearance of the symptoms after the first bout.

Adolescent↗
PubMed1987

Exposure to vinyl chloride monomer: report on a cohort study.

In 1980 a prospective exposed/non-exposed cohort study was initiated in France by the Institut National de la Santé et de la Recherche Médicale (INSERM U 287) to evaluate the association between mortality and cancer morbidity and occupational exposure to vinyl chloride monomer (VCM). Eleven hundred VCM exposed subjects and 1100 VCM non-exposed controls matched for age (+/- 2 years), plant, and physician were included and followed up over a five year period for vital, health, and occupational status. The percentages of deaths observed among the exposed (1.8%) and non-exposed subjects (1.6%) did not differ. Eighteen (1.6%) and 15 (1.4%) cases of cancer were reported among exposed and non-exposed subjects, respectively (NS). One case of angiosarcoma of the liver occurred among the exposed group; six cases of lung cancer occurred among exposed subjects and two among non-exposed subjects (NS). The percentage of diseases of the circulatory system was higher (p less than 0.02) in the exposed group than in the non-exposed group: this difference was explained mainly by the high incidence of Raynaud's disease (p less than 0.006). The percentages of diseases of the respiratory system did not differ between the two groups.

Adult↗
PubMed1993

Seasonal variation in leisure time physical activity.

In this paper seasonal variation in leisure time physical activity for exercise is studied and quantified with regard to several popular exercise activities and taking the respondents gender, occupational status, and age into consideration. The analysis concerns data collected by telephone in Scotland between January 1989 and March 1992. Data from 7,202 male and 9,284 female respondents is used in the analysis; cosinor analysis using GLIM is applied. Considerable seasonal variation was found affecting both outdoor and indoor activities. During the peak phase in July, 32% of the respondents reported exercising for at least 20 min three or more times during the previous week, in the winter period this decreased to 23%. Older respondents were found to exercise more later in the year and also showed seasonal variation to a larger extent than younger respondents. This is particularly so for those respondents who exercise at a relatively high frequency.

Adolescent↗
PubMed2006

Increased absence due to sickness among employees with fibromyalgia.

BACKGROUND: Little is known about the effect of fibromyalgia on absence due to sickness in working populations. OBJECTIVE: To examine the risk of absence due to sickness among employees with fibromyalgia. METHODS: A prospective cohort study with 1-year follow-up of recorded and certified absence due to sickness after a survey of chronic diseases among 34 100 Finnish public sector employees (27 360 women and 6740 men) aged 17-65 years at baseline in 2000-2. RESULTS: 20 224 days of absence due to sickness for the 644 employees with fibromyalgia and 454 816 days for others were documented. Of those with fibromyalgia, 67% had co-occurring chronic conditions such as osteoarthritis, rheumatoid arthritis, depression or other psychiatric disorders. Compared with employees with none of these chronic conditions, the hazard ratio (HR) adjusted for age, sex and occupational status was 1.85-fold (95% confidence interval (CI) 1.53 to 2.18) for people with fibromyalgia alone and 2.63-fold (95% CI 2.34 to 2.96) for employees with fibromyalgia with coexisting conditions. The excess rate of absence due to sickness was 61 episodes/100 person-years among people with fibromyalgia alone. Among employees with musculoskeletal and psychiatric disorders, secondary fibromyalgia was associated with a 1.4-1.5-fold increase in risk of absence. CONCLUSION: Fibromyalgia is associated with a substantially increased risk of medically certified absence due to sickness that is not accounted for by coexisting osteoarthritis, rheumatoid arthritis or psychiatric disorders.

Age Factors↗
PubMed1984

Occupational stress, health-related behavior, and blood pressure: a 5-year follow-up.

The association of occupational stress factors and health-related habits with blood pressure and blood pressure change over a 5-year follow-up was studied in 388 Finnish white-collar and blue-collar workers. The occupational stress factors consisted of noise level, discomfort due to noise, monotony, and self-suppression of opinion. Behavioral variables included the frequency of mild intoxication, leisure-time physical activity, cigarette smoking, relative weight, and change in weight. In the cross-sectional study, only relative weight was positively associated with both the systolic and diastolic blood pressure. For the prediction of blood pressure change, multiple linear regression showed that in the total sample none of the nine variables was a statistically significant predictor of systolic blood pressure change over the follow-up period. The change in weight was the most significant predictor (P less than 0.001) of diastolic blood pressure change, followed by intoxication (P less than 0.01). Further analyses by sex and occupational status showed that among female white-collar workers, intoxication was the strongest predictor of both systolic and diastolic blood pressure changes. In this group, the total model explained 34% of the variability in systolic and 27.7% in diastolic blood pressure change. In other groups and in the total sample, the proportions explained were markedly smaller. Also, in some subgroups, self-suppression, noise, and physical activity were significant predictors of blood pressure change. It is concluded that in comparison with reduction of weight, the other behavioral and stress factors studied seem to be of minor importance in the prevention of high blood pressure in normal populations, even if these factors may be relevant in some susceptible subpopulations or in populations whose exposure levels are extreme.

Adult↗
PubMedDate not supplied

Reliability of record linkage in the Swedish Cancer-Environment Register.

The Swedish Cancer-Environment Register (CER) is intended to be used for studies on occupational cancer. CER was established by a computerized record linkage between the Swedish National Cancer Register (SCR) for 1961-1973 and the 1960 Population and Housing Census (PH 60) in order to obtain information on occupation, occupational status, economic activity (industry), place of work, domicile, etc. that might be useful for epidemiologic studies on cancer. Accurate inter-register linkage at individual level necessitates high quality of identification in both registers. The hit completeness in this respect was evaluated as 98.8 per cent, a figure regarded as acceptable for most studies based on the CER. Since a hit between SCR and PH 60 did not guarantee accuracy, the reliability of the record linkage was studied in random sample. With the aid of local and national population registries, 0.45 per cent (95% confidence interval 0.21-0.86%) false linkages were revealed in the sample. The CER was in 1982 supplemented with data notified to the SCR 1974-1979, and the hit completeness was 99.2 per cent for the total period. There are good grounds for assuming a lower rate of false linkages for the later period.

Computers↗
PubMed1991

Effect of domestic and occupational roles on morbidity and mortality.

This study examines the effect of labor force participation, occupational status and domestic roles on morbidity and mortality among women and men over a 15-year period. The main research questions address the long-term effects of multiple roles. Does the combination of domestic and work roles result in adverse health effects, or provide some health advantage? The study population was randomly selected from among members of a large HMO and were part of a household interview conducted in 1970-71. Medical records for the two years prior to the interview and for 15 years after the interview for the cohort members are linked with the survey data. The findings show that for women there is some longevity advantage in paid employment. Overall, the combination of employment and domestic roles apparently poses no health threat to women, and may provide some advantage. Multiple roles are unrelated to mortality and morbidity outcomes among men.

Adult↗