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PubMed1988

Diet and cancer of the stomach: a case-control study in China.

A case-control study focusing on the role of single food items was undertaken in the Heilongjiang area, 241 patients with histologically verified stomach cancer and an equal number of controls (with non-neoplastic diseases) matched by age, sex and area of residence being interviewed during a 2-year period. Questions asked covered economic status, occupation, histories of smoking and drinking, diet and dietary habits and disease history. Data concerning the average frequency and quantity of consumption of single food items were obtained by the same interviewer. An inverse association between the consumption of vegetables and stomach cancer was observed whereas high intake of potatoes and of salted and fermented soya paste appeared to be high-risk factors. Specifically, Chinese cabbage plays an important role in reducing the risk of developing stomach cancer.

Adult↗

PubMed1997

The effects of right-hemisphere brain damage on patients' use of terms of personal reference.

Successful communication depends on social as well as linguistic factors. In conversation, for example, a speaker must often refer to another person. Choosing an appropriate term of personal reference requires a speaker to consider several features of the discourse context, including properties of the persons being referred to and what knowledge is shared between the speaker and his or her addressee. In a pair of similar studies, we examined how right-hemisphere brain-damaged (RHD) patients and nonbrain-damaged control subjects use these different kinds of information in choosing formal (e.g., "Mr. Harding") versus informal ("Oliver") terms of reference for an absent third person. Stimulus vignettes manipulated three variables: the occupational status of the referent, the speaker's familiarity with the referent (i.e., the degree to which the speaker and referent were personally acquainted), and the addressee's familiarity (i.e., the degree to which the addressee and referent were personally acquainted). Relative to the control subjects, the RHD patients showed decreased use of both familiarity variables when choosing formal over informal labels, but apparently preserved sensitivity to the status variable. These results suggest how decreased use of the knowledge shared between a speaker and addressee disrupts RHD patients' discourse and thus contributes to these patients' aberrant interpersonal behavior. In addition. In addition, the results from the second study demonstrated an asymmetry in how female versus male subjects responded to the status manipulation.

Aged↗

PubMed2002

An assessment of factors related to tumor thickness and delay in diagnosis of melanoma in southern Italy.

BACKGROUND: Since survival of patients with melanoma is strongly correlated with the Breslow tumor thickness of the primary lesion, factors that influence stage at diagnosis and delay in diagnosis are considered to be crucial. To test the relationship between tumor thickness and some social and clinical variables (including diagnosis/treatment delay) and the relationship between the diagnosis/treatment delay and some clinical variables, we analyzed data on 530 patients with melanoma from our Institute. METHODS: In the analysis, Breslow tumor thickness was categorized into two categories (< or =1.49, > or =1.5). Three time intervals were examined to evaluate diagnostic delay: patient delay, time from first symptom to seeking medical advice; medical delay, time from first medical consultation to hospital admission; total delay, time from first symptom to resection. The variables evaluated in the analysis were: age at diagnosis, education, occupational status, first symptom, visibility of tumor, anatomic site, and physician who made the initial diagnosis. RESULTS: A significant risk of having a Breslow tumor thickness > or =1.5 mm was noted in patients who had a low level of education (odds ratio 3.0, 95% confidence interval 1.9-5.0) or who were unemployed (odds ratio 1.7, 95% confidence interval 1.1-2.8). With respect to patient delay, a delay >3 months for anatomic locations visible to patients was associated with significant risk (odds ratio 1.7, 95% confidence interval 1.1-2.6); with respect to medical delay, a delay >3 months was associated with a higher risk in patients examined by a dermatologist (odds ratio 2.0, 95% confidence interval 1.2-3.4). CONCLUSIONS: Our results clearly indicate that in Southern Italy poorly educated and unemployed subjects are at risk of being diagnosed at a more advanced stage, and admission to an oncological hospital causes a delay (waiting list) in the time interval related to the doctor (medical delay).

Diagnostic Errors↗

PubMedDate not supplied

Substance use and other psychiatric disorders among 100 American Indian patients.

One hundred American Indian patients with a Psychoactive Substance Use Disorder (PSUD) were studied with special reference to associated psychiatric disorders. This clinical sample was divided into three groups: PSUD only, PSUD plus an Organic Mental Disorder (OMD), and PSUD plus any other psychiatric disorder. OMD diagnoses included primarily Delirium Tremens and Alcoholic Hallucinosis; cases of Alcohol Amnestic Disorder, Alcohol Dementia, and trauma-induced OMD were also encountered. Other psychiatric disorders included primarily Major Depression and Anxiety Disorder, with smaller numbers of Schizophrenia, Conduct, Sexual, and other Disorders. Demographic and clinical characteristics were compared among these three groups. Those with PSUD+OMD tended to be older, male, and have more DSM-III Axis 3 disorders (American Psychiatric Association 1980) as compared to other patients; those with PSUD+other diagnoses tended to be single and younger. Education and occupational status were not related to the three diagnostic groups. The data were also subjected to MANOVA analysis. Even when corrected for sex, types of substance being abused, Axis 3 health status, and other factors, the three diagnostic groups still bore a significant relationship to age. Those with PSUD+Other psychiatric diagnoses besides OMD tended to be youngest. Those with PSUD-only were intermediate by age, while those with PSUD+OMD tended to be the oldest.

Adolescent↗

PubMed1996

The long-term influence of pulmonary valve regurgitation following repair of tetralogy of Fallot: does preservation of the pulmonary valve ring affect quality of life?

The transannular patch (TAP) repair used in the correction of tetralogy of Fallot (TOF) inevitably causes pulmonary regurgitation. We report herein the results of a long-term follow-up study conducted on 50 patients who had undergone a TAP repair 20-29 years earlier to evaluate the influence of pulmonary regurgitation on their late outcome and quality of life. As a control, 26 patients with an intact pulmonary valve ring and right ventricular outflow patch (RVP) confined to the subvalvular region were also studied. The 25-year survival rates of the TAP and RVP groups were 88.5% and 95.7%, respectively, and the event-free rates at 25 years were 73.3% and 90.9%, respectively. Although the absolute values of these rates were higher in the RVP group, there were no statistically significant differences between the two groups. To assess quality of life, the occupational status, childbearing ability, and late symptoms were evaluated, and found to be comparable between the two groups. Moreover, a treadmill submaximal stress test did not show any differences in exercise capacity between the two groups. In conclusion, the presence of a TAP does not significantly alter the late results or quality of life of patients who have undergone repair of TOF.

Adult↗

PubMed1982

Neuropsychological studies in children with elevated tooth-lead concentrations. I. Pilot study.

In contrast to blood-lead (PbB), tooth-lead concentrations (PbT) provide retrospective information about longterm, cumulative childhood lead-intake. From a basic sample of 458 school age children from the city of Duisburg (FRG), whose lead-concentrations in shed incisor teeth had been measured (means = 4.6 ppm; range: 1.4-12.7 ppm), two extreme-groups of 26 children each (mean age: 8.5 years) with low (means = 2.4 ppm) and elevated (means = 9.2 ppm) PbT were selected. After pair-matching both groups for age, sex, and father's occupational status, these children were tested under double-blind precautions for intellectual performance (German WISC), for perceptual-motor integration (Göttinger Formreproduktionstest = GFT, Diagnostikum für Cerebralschädigung = DCS, Benton-Test), and for gross motor-coordination (Körper-Koordinationstest für Kinder = KTK). Significant (P less than 0.05) inferiority of the lead-children was found in two tests of perceptual-motor integration (increased GFT-errors; lower success rate for DCS). In addition a near significant (P less than 0.1) reduction of 5-7 IQ-points was determined in these children. Although this pilot study has provided some evidence for an association between childhood lead-exposure and neuropsychological impairment, this association cannot yet be considered proven, because the observed effects were discrete and statistically confirmed only in part, and because there was a slight prevalence of perinatal risk factors in the lead group. Further research to clarify the issue is necessary.

Behavior↗

PubMed1992

Prediction of hospitalization within a psychiatric community care system--a five-year study.

Within a comprehensive community care system, we examined which patients became hospitalized during long-term treatment. We studied 60 consecutively admitted, and mainly chronic psychotic patients over 5 years. Full and partial hospitalizations were assessed by means of a hospitalization index. This index was significantly lower in the 2nd to 5th years after admission than in the 1st year. Sociodemographic and clinical characteristics failed to predict hospitalizations during the 1st year. Patients' age, gender and last occupational status were related to hospitalizations in the following 4 years. A better prediction of hospitalizations was allowed by treatment data obtained during the 1st year. It is suggested that long-term prognosis should be based mainly upon experience with a patient in a given care system, rather than on a patient's history and characteristics as known before treatment.

Adult↗

PubMed1992

Cardiomyopathy in infancy: observations in an epidemiologic study.

Cardiomyopathy (Cm), a rare form of cardiac disease in infancy, is receiving increasing attention stimulated by the availability of endocardial biopsy and new forms of therapy. Population-based information on frequency of occurrence, types, and maternal and infant characteristics of this diverse group of heart muscle disorders has been obtained in the course of an etiologic study on cardiovascular disease in infancy. The Baltimore-Washington Infant Study (BWIS) enrolled 2659 infants with heart disease and 2801 control infants between January 1, 1981 and March 31, 1987, a 6-year prevalence of 4.46/1000 live births. Fifty-six infants had cardiomyopathy, in the absence of a structural defect (prevalence 1/10,000). The cases were classified clinicopathologically as follows: dilated Cm (n = 17), hypertrophic Cm (n = 26), tumor (n = 5), endocardial fibroelastosis (n = 5), glycogen storage (n = 1), mucocutaneous lymph node syndrome (n = 1), and infarction (n = 1). Eleven syndromic associations and six metabolic disturbances indicate genetic risk factors. Some of the same syndromes occurred in other infants who had structural cardiac abnormalities. This overlap suggests that embryonic myocardial disease might sometimes be responsible for altered cardiac structures, possibly secondary to hemodynamic changes. Familial myocardial disease occurred in two infants with hypertrophic Cm. The Cm group did not differ by race and sex from controls, but the mothers were of lower educational and occupational status with less private care and with later registration for pregnancy care. The descriptive epidemiology of this population-based case group provides evidence of greater etiologic heterogeneity than has been shown in clinical reports.

Cardiomyopathies↗

PubMed1994

Educational and occupational achievements of brothers and sisters in adoptive and biologically related families.

The study of brothers and sisters from adoptive and biologically related families permits unique analyses of the determinants of young adults' educational and occupational achievements. Brothers and sisters come from the same homes, neighborhoods, and usually schools. Many differences among families are controlled by the study of siblings. In addition, adoptive families influence their children only through the environment they provide, whereas biologically related parents transmit their intellectual and personal characteristics to their offspring genetically as well. Thus, the comparison of models of adult achievements for children from adoptive and biologically related families can inform us about the true effects of family environments, apart from genetic transmission (Scarr and Weinberg, 1978, 1980). In this follow-up study of 450 biologically related and adopted young adults (ages 22 to 30 years), we report on the family resemblances in educational and occupational achievements. Parents' reports were obtained on 97% of the original sample (N = 443), and 77% of the young adults participated in the follow-up study themselves; complete educational and occupational data were available on 303 young adults. Results show that biological sons are more influenced by their family backgrounds than daughters, regardless of genetic relatedness. A second finding is that young women's achievements are not as predictable from their own earlier achievements as are those of their brothers. A third finding is that parents invest in their sons' educational futures, regardless of sons' abilities and achievements, in ways they do not invest in their daughters' postsecondary educations. Sibling correlations and natural mother-adopted child correlations suggest that test scores, high school performance, postsecondary education, and even later occupational status can be influenced by genetic variability in personal characteristics that affect such achievements.

Adoption↗

PubMed1993

[Social class and cardiovascular risk factors in Italian-speaking Switzerland: results of the first Swiss population study MONIKA Project 1985-1986].

The relationship of social class and prevalence of risk factors for cardiovascular diseases was investigated within the Swiss MONICA-project, a cross sectional study of the Swiss-Italian population started in 1985/1986. A representative sample of 984 men and 1014 women ages 35 to 64 was selected, the response rate was 78%. Social class was measured by two indicators, occupational status and education. A significant trend was found in age standardized analysis with higher mean blood pressure and body mass index in lower social classes (p < 0.001). When other confounders for cardiovascular diseases were considered in a multiple regression model, the predictive power of social class was moderate. A significant inverse relationship of cardiovascular risk factors and social class was only found for body mass index (both sexes) and exercise in women which was directly related to higher social class and education. No relationship was found for lipids (cholesterol, HDL-cholesterol), blood pressure and smoking in both sexes. Risk factors for cardiovascular diseases beside obesity do not seem to cluster in lower social classes within the Swiss-Italian population.

Adult↗

PubMed1978

An involvement and overtness measure for lesbians: its development and relation to anxiety and social zeitgeist.

The relationships among anxiety, degree of overtness in homosexuality, involvement in homosexuality, and occupational status were investigated to test prevalent hypotheses relating homosexuality and neuroticism. Sixty-three acknowledged lesbians completed the Manifest Anxiety and Defensiveness Scale (MAD), the Lesbian Degree of Involvement and Overtness Scales (DIOS), and a biographical data sheet. Reliability and validity indices for the DIOS are presented. Some findings were that anxiety was not related to degree of involvement in homosexuality, that anxiety was related to degree of overtness in low- but not in high-status lesbians, and that the social Zeitgeist at the time of first lesbian activity was related to degree of overtness but not to degree of involvement in homosexuality. The results are discussed in terms of the relationship between social desirability and a hostile society. Additionally, comparisons of anxiety levels in homosexual and heterosexual women are presented and discussed. The results are interpreted as lending support to the emerging view of the homosexual as nonneurotic.

Adult↗

PubMed1990

Study design and description of patients.

A West German multicentre study (eight centres) of PKU was designed in 1976. The subjects of the study are the differential diagnosis, factors influencing the therapeutic outcome, and the extension of dietary therapy into adolescence. Between 1978 and 1984, 165 patients were enrolled, of whom 38 were of non-German nationality. The educational and occupational status of the West German parents were comparable to the population of the Federal Republic of Germany. In the central data bank located at the University Childrens Hospital in Heidelberg, data from recurrent medical examinations and from biochemistry, dietetics, neurology, psychometry and demography were collected. The differential diagnosis of the elevated plasma Phe level in the newborn period resulted in the detection of 2 patients with a PTPS-deficiency, and of 163 with an apo-enzyme defect. Depending upon the magnitude of the Phe levels during the first weeks of life, preliminary treatment groups were formed. They were revised at the age of 6 months with a protein challenge. The levels of Phe during the protein challenge resulted in three types of response. Of these, type III can apparently forgo dietary restrictions resulting in plasma Phe concentrations of around 10 mg/dl. Preliminary results of the whole study are now presented.

Electroencephalography↗

PubMed1983

[Can sex differences in the psychiatric institution career of alcoholics be identified?].

All patients residing in the catchment area ("sector") of the Psychiatric Clinic of Hanover Medical School who had been hospitalized due to alcoholism or drug dependence for the first time in their lifes and had been discharged over the period January 1, 1973, to December 31, 1978, were followed through December 31, 1979. Age was the major determinant of rehospitalization. Patients up to age 40 were rehospitalized more frequently than patients 40 and over. Sex differences in the psychiatric institutional career of alcoholics were small and inconsistent. A relatively large probability of rehospitalization was noted for men and women with high occupational status, failed to reach significance, however. This might be due to confounding by age but together with results of other studies also supports the notion that societal role expectations determine the psychiatric institutional careers of alcoholics.

Adult↗

PubMed2005

[The importance of social relationships for the association between social inequality and health among the aged].

OBJECTIVES: To analyse whether the association between social inequality and health among the aged is mediated through social relationships (differential exposure hypothesis). Moreover, it is examined whether the association between social relationships and health is stronger in lower socio-economic groups (differential vulnerability hypothesis). METHODS: The analyses are based on a telephone survey of 682 older people (> or = 60 years) living in a private household in Germany. Education, income and occupational status are utilised as indicators of the socio-economic status. Quantitative (social contacts) as well as qualitative indicators (emotional support) of social relationships are used. Respondents were asked how often they meet their friends and relatives. Emotional support was measured by an instrument assessing the availability of a confidant and the perceived adequacy of the emotional support received. Self-rated health, depression (CES-D) and functional limitations are introduced as health indicators. RESULTS: Multiple logistic regression analyses show that the mediating effect of social relationships on the association between socio-economic status and health (self-rated health, depression and functional limitations) among the aged is weak. Results concerning the differential health impact of social relationships in different socio-economic groups are inconsistent. DISCUSSION: Results do not support the differential exposure hypothesis saying that social inequalities in health can be explained by social relationships. Results do not support the differential vulnerability hypothesis either as there is no evidence for a stronger association between social relationships and health in lower socio-economic groups.

Age Factors↗

PubMed2004

[Social inequality and smoking behavior in Germany].

Data of the National Health Survey 1998 are used to analyze the impact of alternative indicators of social inequality on smoking of the 18- to 79-year-old population in Germany. The members of socially disadvantaged groups not only smoke more frequently, they show also lower rates in smoking cessation. This is most obvious in middle age while only small differences can be observed at older ages. Multivariate analyses evidence primarily education as a determinant of smoking among men and women. The effects of income and occupational status are fairly small. The results point out that health inequalities can partly be explained by different smoking habits and, therefore, underline the necessity of a differentiated and group-specific tobacco prevention and tobacco control policy.

Adolescent↗

PubMed2003

Traumatic events, migration characteristics and psychiatric symptoms among Somali refugees--preliminary communication.

BACKGROUND: Each refugee group experiences specific migration and resettlement experiences. There are no epidemiological data on risk factors for psychiatric symptoms among adult Somalis in the UK. METHODS: We interviewed a community sample of 180 Somalis. We assessed the relationship between symptoms of psychosis (BPRS), anxiety and depression (SCL-90) and suicidal thinking (BDI) and migration-related experiences such as traumatic events, immigration difficulties, employment and income. RESULTS: Anxiety and depression was incrementally more common with each pre-migration traumatic event (OR per trauma event = 1.31, 1.06-1.62, p = 0.01). Shortages of food, being lost in a war situation, and being close to death and suffering serious injury were each related to specific psychiatric symptoms. Suicidal thinking was more common among Somalis who were unemployed before migration and those using qat in the UK. CONCLUSIONS: War-related experiences, occupational status before migration and current Qat use are risk factors for psychiatric symptoms among Somali refugees.

Adult↗

PubMed2006

Core features of repeated suicidal behaviour: a long-term follow-up after suicide attempts in a low-suicide-incidence population.

BACKGROUND: The aim of this article was to study repeated suicidal behaviour in a low-incidence population to elucidate robust risk factors. METHODS: A cohort of first-ever suicide attempters from 1960 to 1982 on the Faroe Islands was followed up for a minimum of 20 years. The cohort was initially characterized in psychiatric and social terms. RESULTS: The incidence of suicidal behaviour for the cohort years (age 15 years and older) was 37.9 per 100,000 per year (95% confidence interval 31.5-45.1). It was associated, as expected, with gender, age, residence, marital status, occupation, diagnosis, previous psychiatric admission, alcohol intoxication and the method and planning of the act. Factors of the index episode predicting repetition at 5 years were gestures and alcohol intoxication and at 20 years were physical methods, suicide letter and alcohol intoxication. CONCLUSIONS: Alcohol intoxication and the level of determination behind the suicide attempt emerge as targets for prevention. Alcohol intoxication at the initial episode seems to be a strong long-term as well as short-term risk factor.

Adolescent↗

PubMed1997

[Lumbar fusion in adults--dorsal or combined ventral/dorsal approach?].

A retrospective study was conducted to compare the results of posterior with combined anterior/posterior lumbar fusion in adults. Seventy-six consecutive posterior cases fused with pedicle screws and 46 combined cases were included and followed for at least 2 years. Subjective assessment was based on the Visual Analogue Scales, Waddel Disability and Impairment Score and the GBB for objective quantification of complaints. Furthermore, a thorough clinical examination was done and X-rays including flexion/ extension radiographs, were taken. Questions were asked about the occupational status as well. Pain decreased significantly more in the combined cases than in the posterior fusion cases. In one case a lesion of the common iliac vein occurred during a retroperitoneal approach. Only about half the patients working preoperatively returned to work again. In conclusion, the benefit of better pain relief after combined fusion must be regarded in relation to a higher complication rate due to a second approach.

Adult↗