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PubMed2005

Functional outcome in young adults with spina bifida and hydrocephalus.

INTRODUCTION: Quality of life was studied in 31 adult survivors of spina bifida, each with Verbal or Performance IQ score over 70. METHODS: Instruments measured physical and occupational function, cognitive/psychological function, somatic sensation, and social interaction in the context of the ability to live independently. RESULTS: Domain group means except motor independence were in the average range (+/- 1 standard deviation). Variability within the group with respect to physical phenotype (high spinal lesions were associated with poorer motor independence) and medical history [a greater number of shunt revisions (> 4) were associated with poorer functional numeracy] was predictive of quality of life. Both spinal lesion level and number of shunt revisions influenced occupational status. DISCUSSION: There was a relation between everyday mathematics, reading skills, and quality of life. The consequences of the physical, medical, and cognitive effects of spina bifida extend into young adulthood and have an impact on quality of life.

Activities of Daily Living↗
PubMed1999

[Need for ambulatory cardiology after-care rehabilitation in the metropolitan area of a large city. Results of the Cologne model of ambulatory cardiologic rehabilitation--phase II].

Within the Cologne Model (CM) of outdoor cardiac rehabilitation (OCR), phase II investigations about the demand for this form of cardiac rehabilitation (CR) after acute cardiac diseases were carried out in three general hospitals, the cardiological and cardiosurgical university hospitals of Cologne. The subsequent questions were investigated: total number of coronary or cardiac operated patients, number of patients with indication for CR, and number of patients corresponding to the restricted indications of CM (age below 65, low risk patient, no cardiac operation). For these groups the acceptance or refusal of CR was checked. Subsequently a sample of patients corresponding to the criteria of CM or of operated patients were confronted with the additional offer of an OCR. The motivation for the acceptance of rehabilitation in specialized hospitals (ICR), OCR or refusal of each kind of CR was inquired. The acceptance of CR in the different groups varied widely. Whereas operated patients in Cologne accept CR in nearly 100% of cases, this is the case in patients after acute myocardial infarction (AMI) in only 50% and in patients after PTCA without AMI in only 5-6%. The analysis of predictors for acceptance brings about that younger patients prefer CR, and if they do, OCR. Patients with the more serious form of disease prefer ICR. Women accept CR more rarely than men, and if they do, they prefer the hospital form. However, this is less gender specific but consequence of the generally more serious form and later onset of CAD in females. Higher educational as well as occupational status favors acceptance of CR and specially OCR. The suspicions that unmarried people prefer OCR and foreigners ICR could not be generally confirmed. Crucial reasons for the form of CR which is accepted or refused are individual ones. ICR is favored by the wish for more safety and better recuperation. For OCR, the comfortable conditions at home with high social support and/or antipathy against hospitals after long clinical treatment are named. Analysis of demand for OCR demonstrates that between 40% in low risk patients (corresponding to CM criteria) and 20% in more serious cases (operated patients) prefer the outhospital form. From these data an estimation of demand for OCR in areas with high population was carried out.

Aftercare↗
PubMed2006

Body piercing, personality, and sexual behavior.

The associations of body piercing with other social characteristics, personality, and sexual behavior were investigated in a population-based sample of young adults, in light of the theory that body piercing has meaning in terms of a corporeal expression of the self. At age 26 years, 966 (95%) of 1019 members of the birth-cohort of the Dunedin Multidisciplinary Health and Development Study were asked about body piercing (at interview) and sexual behavior (questions presented by computer). Assessment of personality traits was conducted at ages 18 or 21 years. In total, 183 participants (9% of the men and 29% of the women) had piercings at a site other than the earlobes. People who lived outside New Zealand or who were of Maori descent were more likely to be pierced, but unemployment and low occupational status were not significantly related to piercing. Women who were pierced, compared with those without piercings, were more likely to have personality traits of low constraint or high negative emotionality. Women with piercings were also more likely to report having had, during the previous year, five or more heterosexual partners (odds ratio, 5.8, 95% CI: 2.3-14.6) or any same-sex partner involving genital contact (odds ratio, 10.3, CI: 2.9-37.2). The associations with sexual behavior in men were weaker and not statistically significant. In this population, body piercing in women was associated with sexual behavior. Having multiple heterosexual partners or any same-sex partner was very rare among women without piercings. The theory of meaning for body piercing was generally supported, offering the possibility of a richer understanding of this phenomenon in the general population.

Adult↗
PubMed2005

Employment outcomes and PTSD symptom severity.

A diagnosis of chronic war-related posttraumatic stress disorder (PTSD) has been linked consistently to poor employment outcomes. This study investigates the relation further, analyzing how symptom severity correlates with work status, occupation type, and earnings. Study participants were male Vietnam veterans with severe or very severe PTSD who received treatment in the Department of Veterans Affairs system (N = 325). Veterans with more severe symptoms were more likely to work part-time or not at all. Among workers, more severe symptoms were weakly associated with having a sales or clerical position. Conditional on employment and occupation category, there was no significant relation between PTSD symptom level and earnings. Alternative PTSD symptom measures produced similar results. Our findings suggest that even modest reductions in PTSD symptoms may lead to employment gains, even if the overall symptom level remains severe.

Adult↗
PubMed2005

Characteristics associated with neuropathy and/or retinopathy in a hospital outpatient diabetic clinic.

BACKGROUND: The incidence of diabetes is increasing worldwide and with it the risk of diabetic complications. The aim of this study was to characterise parameters associated with neuropathy and/or retinopathy in a hospital outpatient diabetic clinic population. METHOD: A structured questionnaire addressing diabetes related factors and demography was administered to a cross-sectional sample of patients (n = 290) with type 1 and type 2 diabetes attending a hospital diabetic outpatient clinic. Additional clinical measures were obtained from patient medical files and computerised records. Logistic regression analysis was used to identify characteristics associated with the presence of complications. RESULTS: When controlling for other predictors, increasing age (P < 0.01), type 1 diabetes (P = 0.05), longer duration of diabetes (P < 0.01), increased serum triglyceride levels (P = 0.03), HbA1c (>8%; P = 0.03), self-reported low physical activity levels (P = 0.05) and being a smoker (P = 0.01) were positively related to retinopathy and/or neuropathy. Patients within the study population had reasonably well controlled BP and serum lipids, thus explaining the absence of these particular variables from the list of predictor parameters. Other factors including diabetes knowledge, home blood glucose monitoring, gender, body mass index, clinic attendance and occupational status were not significantly associated with retinopathy or neuropathy in the present study population. CONCLUSIONS: Pharmacists and other health practitioners who are in a position to be involved in the care and management of patients with diabetes should raise awareness of complications, particularly amongst patients who present with the above risk factors and provide necessary counselling and advice as required.

Adult↗
PubMed2001

The case for responsibility of the IT industry to promote equality for women in computing.

This paper investigates the relationship between the role that information technology (IT) has played in the development of women's employment, the possibility of women having a significant influence on the technology's development, and the way that the IT industry perceives women as computer scientists, users and consumers. The industry's perception of women and men is investigated through the portrayal of them in computing advertisements. While women are increasingly updating their technological skills and know-how, and through this process are entering some positions in the workplace traditionally occupied by men, these achievements are not mirrored in their social and occupational status. The computer industry and higher education have worryingly low numbers of women, while the possibility of women influencing the development of computer technology is just emerging in feminist research. This paper argues that, though the IT industry, through their self-regulatory codes, subscribes to equal treatment of sexes, races and persons with disabilities, the industry nevertheless paints a stereotyped picture of inequality when portraying men and women in computer advertisements. As long as such a perception of women prevails within the industry, it will stand as a barrier to women having equal access to computer technology. If advertisements influence the way society perceives major social constructs and issues, then the computing industry has a social responsibility to portray men and women in an equal and non-stereotypical fashion.

Advertising↗
PubMedDate not supplied

Seroprevalence of Chlamydia pneumoniae antibodies in a young adult population sample living in Verona. European Community Respiratory Health Survey (ECRHS) Verona.

UNLABELLED: The aim of the study was to evaluate the prevalence of antibodies to Chlamydia pneumoniae in a random population sample of 369 young adults (aged 20-44 years), living in Verona, Italy. IgG and IgM titers were measured by micro-immunofluorescence. IgG antibodies, greater or equal to 16, were found in 104/177 (58.8%) men and 76/192 (39.6%) women (p < 0.001). No relationship was found between IgG seropositivity, age, social class, education and family size. Factors positively associated with IgG seropositivity included smoking (p < 0.001), occupational status (employed vs unemployed: p = 0.02; students vs unemployed: p < 0.01) and living area (suburban [65.0%] vs urban area [45.3%]: p = 0.03). The geometric mean of IgG titers was higher in students (GM: 26.05) than in both employed (GM: 11.02) and unemployed persons (GM: 4.80) (p < 0.01 and p < 0.001, respectively). IgG titres > or = 512 and/or IgM titers > or = 16 (suggestive of a recent C. pneumoniae infection) were found in 39 subjects (10.6%). Recent infection was more frequent in spring (14.9%), with no significant variation in the other seasons (mean prevalence 6.7%) (p < 0.01). Recent infection was also associated with cigarette smoking. On the other hand, no significant association was found between respiratory symptoms and serologic evidence of recent infection. IN CONCLUSION: 1) the prevalence of antibodies to C. pneumoniae in young adults from Verona is similar to that found in European countries, and therefore, in Europe, it seems not related to latitude or climate; 2) male sex, tobacco smoking, employment status and living in a suburban area are independent risk factors of infection; 3) the infection is subclinical in most cases.

Adult↗
PubMed1993

Alcohol and drug use among motor vehicle collision victims admitted to a regional trauma unit: demographic, injury, and crash characteristics.

This study examined the incidence of alcohol and drugs in a sample of seriously injured motor vehicle collision victims, and differences related to pre-crash use of alcohol and/or other drugs on demographic variables, injury severity measures, and crash variables. The sample selected were all motor vehicle collision admissions to the Regional Trauma Unit at the Sunnybrook Health Science Centre in Toronto, Ontario, over a 37-month period (N = 854). Prospective demographic and injury-related information were collected from hospital charts, and crash data were collected from motor vehicle collision police reports. Blood samples were routinely collected on admission and tested for blood alcohol concentration (BAC). We found 32.0% of the BAC-tested motor vehicle collision admissions and 35.5% of drivers tested positive for blood alcohol. The drivers' mean BAC on admission was found to be 145.2 mg/100 ml, and the mean estimated BAC at crash time was 181 mg/100 ml. Drug screens were performed on a two-year subsample (n = 474), of whom 339 were drivers. Drug screens revealed that 41.3% of drivers tested positive for other drugs in body fluids, and 16.5% were positive for alcohol in combination with other drugs. Other than alcohol, the drugs most frequently detected in the drivers were cannabinoids (13.9%), benzodiazepines (12.4%), and cocaine (5.3%). Investigation of differences on demographic, injury, and crash characteristics related to precrash use of alcohol and/or drugs yielded significant findings. In the drug screened sample we found sex, admission type, and occupant status were related to precrash alcohol use. Also, use of drugs was found to interact with admission type and mean BAC on admission. Elapsed time was found to be significantly different for BAC by other drug use, with a greater length of elapsed time found for the subjects testing other drug positive but BAC negative. We found that BAC-positive drug-screened drivers were significantly more likely to be male, involved in a single-vehicle collision, not wearing a seat belt, ejected from the vehicle, and travelling at higher speeds than BAC negative drivers. No significant differences were found between BAC and/or other drug use on injury severity measures.

Accidents↗
PubMed1985

Psychosocial implications of malocclusion: a 15-year follow-up study in 30-year-old Danes.

Long-term psychosocial effects of malocclusion should be studied longitudinally from childhood to adulthood in orthodontically untreated populations. In 1965-66, the occurrence of morphologic traits of malocclusion was recorded in 977 Danish adolescents who had no access to organized orthodontic care. In a follow-up study 15 years later, a questionnaire was mailed to the subjects; this contained general questions about body image and specific inquiries concerning self-perception and social implications of dental appearance. The response rate was 86%. Ten percent had received orthodontic treatment. In the remaining individuals, only one entry among thirteen items of body image--the teeth--was rated significantly less satisfactory by subjects with malocclusion at adolescence than by subjects without malocclusion at adolescence. The lowest ratings were observed in subjects with extreme maxillary overjet, extreme deep bite, and crowding. Highly significant differences were found between the two groups (subjects with and without malocclusion) in recalling adolescent awareness of malocclusion, dissatisfaction with the appearance of the teeth, and unfavorable appearance of the teeth compared with those of peers. Schoolmates' teasing occurred seven times more often in the presence of malocclusion. Differences were less marked in the perceptions of the same individuals in adulthood. However, in both adolescence and adulthood unfavorable perceptions of the teeth were expressed significantly more often by subjects with extreme maxillary overjet, extreme deep bite, and crowding. No association was found between malocclusion and present occupational status. It was concluded that certain malocclusions, especially conspicuous occlusal and space anomalies, may adversely affect body image and self-concept, not only at adolescence but also in adulthood.

Adolescent↗
PubMed1991

Acquisition of blood and injection phobia and anxiety response patterns in clinical patients.

The ways in which blood phobics (N = 81) and injection phobics (N = 56) had acquired their phobias were retrospectively investigated. The patients were required to answer a questionnaire concerning: (a) the origin of the phobia, with items relevant for conditioning experiences, vicarious experiences and experiences of negative information/instruction; (b) physiological reactions; (c) anticipatory anxiety; and (d) negative thoughts while in the phobic situation. In addition background data on marital and occupational status, family history of phobia, fainting history, and severity of the phobia were obtained. Furthermore, the patients' behavioral, physiological, and cognitive-subjective reactions during the behavioral test were assessed. The results showed that a majority (52%) of the patients attributed the onset of their phobias to conditioning experiences, while 24% recalled vicarious experiences, 7% instruction/information and 17% could not remember any specific onset circumstances. There was no significant relationship between ways of acquisition and anxiety components, nor did conditioning and indirectly acquired phobias differ in severity.

Adolescent↗
PubMedDate not supplied

Social factors in alexithymia.

Social characteristics of alexithymic individuals were examined in a population-based study of 2,682 middle-aged men from Eastern Finland. Alexithymia, referring to difficulties in identifying and verbally describing inner feelings, was assessed using the Toronto Alexithymia Scale (TAS). Men whose high TAS score suggested reduced ability in verbal emotional expression were more often unmarried and had low levels of social contacts and acquaintances. Education, income, and occupational status were inversely related to the TAS score. These associations remained statistically significant after adjustment for confounding factors. The results suggest that alexithymia could be viewed not only as a psychological phenomenon, but also partly as a socially determined one.

Adult↗
PubMed1980

Return to work after head injury: a review of post-war studies.

The literature on occupational resettlement after head injury is confounded by varying standards of clinical severity and social outcome. A comparison of eleven key studies in the light of the authors' own research yielded a success rate ranging from 50 to 99 per cent, but this was based on superficial evidence. A more searching enquiry is needed, using objective methods and avoiding the technical inadequacies of most previous work. This would be unlikely to challenge the importance of age and length of post-traumatic amnesia as determinants of return to work, but should lead to a better understanding of other factors such as previous occupational status, cognitive deficits and personality changes.

Adult↗
PubMed1982

Multivariate analysis of smoking and other risk factors for obstructive lung diseases and related symptoms.

Multivariate analyses of the relationship of risk factors and respiratory symptomatology in a longitudinal epidemiologic study of airways obstructive disease in a white community population has yielded some consistent findings. Diagnosed airway obstructive diseases and functional impairment appear to be related to a set of risk factors which include age, smoking, a history of acute respiratory illness, chronic cough and phlegm, and to some extent, social status, occupational exposures, and alcohol consumption. Smoking definitely appears to be related to productive cough. It also appears to be related, though not necessarily directly, to AOD and lung function impairment. The complexity of the relationships were clarified by the analysis using multivariate techniques.

Adolescent↗
PubMed1989

Interpersonal behavior and cardiovascular reactivity in pharmacologically-treated hypertensives.

This study examined the interpersonal behavior and concomitant cardiovascular reactivity (CVR) of hypertensive patients whose resting blood pressure was controlled by antihypertensive medication. Thirty hypertensive and 30 normotensive subjects matched for age, sex and occupational status were recruited from an industrial setting. The groups were compared on measures of interpersonal behavior, blood pressure and heart rate while they engaged in both role-played (RP) and naturalistic interactions (NI) requiring positive and negative assertion. Interpersonal behavior of the groups was generally similar, with two exceptions: hypertensives made fewer requests for new behavior in the negative RP and verbalized more praise statements in the positive NI. There were no differences between the groups on measures of CVR during interpersonal interactions. Overall effectiveness during scenes requiring negative assertion was associated with increased cardiovascular reactivity, especially for hypertensives. The interpersonal behavior and cardiovascular responses of patients taking beta-blocker medication did not differ from those taking diuretics. These findings are discussed with regard to methodological considerations pertinent to the assessment of interpersonal behavior and the issue of heterogeneity among hypertensives.

Adrenergic beta-Antagonists↗
PubMed1992

Impact of emotional content on discourse production in patients with unilateral brain damage.

A picture story task was developed to examine expression of emotion via the verbal/lexical channel. The task elicited discourse with either emotional, visual-spatial, or neutral content and was administered to right brain-damaged (RBD), left brain-damaged (LBD), and normal control (NC) right-handed adults. Subjects were matched for gender, age, education, and occupational status. The brain-damaged groups were matched for months post-CVA onset and were similar with respect to intrahemispheric site of lesion. While the number of words produced was equivalent for each of the subject groups, the RBDs and LBDs expressed quantitatively less content than did the NCs. When content differences were examined within each subject group, there were no differences for LBDs and NCs, but the RBDs showed a selective deficit when producing emotional content. This finding suggests a special role for the right hemisphere in the production of emotional content in verbal discourse.

Adult↗
PubMed1991

Stressful life events and Graves' disease.

The role of stressful life events in the onset of Graves' disease (toxic diffuse goitre) is controversial. However, the numerous early clinical reports that supported such an association were not adequately controlled and specificity of the diagnosis could be questioned. Later studies have not shown a causal relation, but these studies were small, did not have proper controls, or epidemiological methods were inappropriate. To assess possible associations between life events, heredity, social support, and Graves' disease, we have done a population-based case-control study in a defined area with about 1 million inhabitants. Over 2 years, 208 (95%) of 219 eligible patients with newly-diagnosed Graves' disease and 372 (80%) of all selected matched controls answered an identical mailed questionnaire about marital status, occupation, drinking and smoking habits, physical activity, familial occurrence of thyroid disease, life events, social support, and personality. Compared with controls, patients claimed to have had more negative life events in the 12 months preceding the diagnosis, and negative life-event scores were also significantly higher (odds ratio 6.3, 95% confidence interval 2.7-14.7, for the category with the highest negative score). Individuals who had relatives with thyroid disease (especially first-degree and second-degree relatives) were more likely to have Graves' disease (3.6, 2.2-5.9). Slightly more patients than controls were divorced (1.8, 1.0-3.3) and reported a less frequent intake of alcohol (0.4, 0.2-0.8). When results were adjusted for possible confounding factors in multivariate analyses, risk estimates were almost unchanged. These findings indicate that negative life events and hereditary factors may be risk factors for Graves' disease.

Adult↗
PubMed1990

Four-year follow-up of twenty-four first-episode manic patients.

Twenty-four first-episode manic patients were followed to investigate the 4-year outcome after recovery from a manic episode. Patients had no documented previous manic or depressive episodes. The presence of psychotic features during the index episode and a history of alcoholism were statistically significant predictors of a shorter time in remission. Low occupational status at baseline predicted poor global social adjustment at 4 years. Also, a larger correlation among outcome measures was found at 48 than at 6 months. The importance of controlling for presence of multiple episodes in outcome studies is emphasized.

Bipolar Disorder↗
PubMed1989

The effects of torture and political repression in a sample of Chilean families.

This paper analyzes the sociological and psychological characteristics of 24 families before, during and after suffering direct repression. The sample is from families who received assistance from a multi-professional health team in Santiago de Chile. Direct repression includes one or several of the following acts against one or more family members: detention, kidnapping, disappearance, exile, imprisonment, intimidation. All our cases were tortured. After describing the repressive events suffered, the paper examines the impact of repression on social mobility of the families and on the occupational status of adult members. In the last section the authors discuss individual and group behavior changes and adjustments, and variations in the interpersonal relations within the families.

Chile↗