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PubMed1994

Social environment and mental health in returning migrant children.

One typical feature of population in Europe is migration, often accompanied with poor integration into the surrounding society. Their significance as risk factors for children's mental health was studied among the 320 school-aged children who returned from Sweden to Finland during the years 1984-85. Every one of the returnees was assigned a non-migrant control from the same class in the same school, matched by age and sex. The data was gathered by questionnaires to parents, children and teachers, concerning family environment, the children's mental health and school achievements (1). The returning migrant boys more often had psychiatric disorders in their teachers' estimations (2) than did the controls and they also scored higher in the self-report scale 'Children's Depression Inventory' (3), but no such difference was found among the girls. The families' poor integration into the society, as measured by the parent's unemployment history, present work situation, membership activities or hobbies and reading of daily newspapers was found to reflect on the child's mental well-being, especially increasing antisocial features in the boys' behaviour. Preventive mental health care in multisectorial cooperation is recommended.

Child↗

PubMed1993

Remediation challenges in treating dysphagia post head/neck cancer. A problem-oriented approach.

A problem-oriented approach to dysphagia treatment was developed for a post head/neck surgery patient with a hematologic condition. Treatment was graded so that a hierarchical approach was used for all problems. Passive and resistive exercises preceded active exercise, and sensory stimulation preceded motion tasks. After 3 mo of treatment using an oral sensory motor stimulation paradigm and graded series of lip and tongue strengthening and motion exercises, swallowing had improved so that total nutritional intake was by mouth and weight was restored to normal. He was able to resume an active social life and to engage in vocational activities and hobbies.

Carcinoma, Squamous Cell↗

PubMed1994

Prevalence of excess lead absorption and associated risk factors in children enrolled in a midwestern health maintenance organization.

OBJECTIVE: To assess the prevalence of lead intoxication in children in a defined low-risk population at the new levels recommended by the Centers for Disease Control and Prevention. DESIGN: During an 11-month period, whole blood lead tests were performed on 4678 children at routine well-child visits at 9 months and 2 years of age. For the last 8 months of the study, parents were asked to complete a prescreening risk factor questionnaire at these visits. The questionnaire and blood lead results were then matched. Data were collected from October 1, 1991 through August 31, 1992. SETTING: The study subjects were all enrolled in Group Health, Inc, a large health maintenance organization. Its 17 staff model clinics serve urban and suburban populations in the Minneapolis-St. Paul area. More than 95% of the population had coverage based on employment, not Medicaid. RESULTS: Results indicated that 2.5% (n = 119) of the children had BPb levels > or = 10 micrograms/dL. Urban clinics had rates of elevated BPb levels three to eight times those of suburban clinics (P < .00001), but the number of elevated BPb levels at the suburban clinics was greater than expected. BPb levels were significantly higher in summer and fall (P < .00001). The prescreening questionnaire addressed five areas potentially associated with risk according to the literature: housing, siblings with lead poisoning, parental hobbies or work involving lead, proximity to highways, and use of cultural medicines. Positive correlations were found between elevated BPb levels and residences built before 1950 (P < .00001). For children living in housing built before 1950, positive correlations were found between elevated blood lead levels and peeling paint (P < .01) or remodeling (P < .0001). CONCLUSIONS: Children who are at low socioeconomic risk but who live in housing built before 1950 are at increased risk for lead poisoning. The risk is greater if the house has peeling paint and especially if there is recent or ongoing renovation. Recommendations based on these results and the Centers for Disease Control and Prevention guidelines are made for screening programs in similar populations, and for the need to increase community awareness concerning this issue.

Child, Preschool↗

PubMed1994

Leisure satisfaction and happiness as a function of leisure activity.

114 subjects rated their happiness, leisure satisfaction, and several dimensions of leisure activity at two points in time. Some personality differences were found between those choosing different kinds of leisure, e.g. self-esteem and voluntary work, cooperativeness and clubs, neuroticism and hobbies rather than sports. Sixty-eight percent of respondents reported being committed to a leisure activity; they found their leisure to be more absorbing, more under control, and more challenging as well as more stressful than those who were not committed to a leisure activity; and they also had greater leisure satisfaction. Leisure satisfaction correlated with happiness, and social aspects of leisure satisfaction predicted happiness in longitudinal analysis.

Adolescent↗

PubMed1994

[Ostriches--an agricultural domestic animal?].

Since more than 100 years ostriches have been used as farm animals in South Africa. At present there are ca. 200 000 ostriches in 350 farms. Well known have been ostrich feathers which had formerly been equally previous (around 1900) as gold. Today, however, ostrich meat and leather are much appreciated. Since more than 10 years experiments with ostriches have been also carried out in other countries of the world, mainly in hot areas e. G. Australia, USA, Israel and Italy. Maybe the African ostrich will soon also belong to the daily life of animals bred and marketed in Germany. Since 1993 ca. 30 ostrich farms (with about 500 animals) have been known in Germany and a further 100 ostrich breeders in neighbouring countries. An additional many interested persons are looking forward to earn money through sales of eggs, chicks and breeding pairs. However, not everybody is farmer, some are rather well-to-do part-time or hobby-farmers who are speculating with these exotic wild birds. Anyway, at present business with breeding stock is booming. South Africa has prohibited the export and there are only few offers over here. A mature breeding ostrich at the age of 2-3 years costs about 10 000 DM. Since the animals use to live in small family units (one cock, two hens) the start of the breeding business begins at ca. 30 000 DM.(ABSTRACT TRUNCATED AT 250 WORDS)

Agriculture↗

PubMed1993

[Quality of life of the patients with continent urinary reservoir].

To improve the quality of life (QOL) of patients requiring urinary diversion, various surgical techniques including those employing a continent urinary reservoir (CUR), such as Kock pouch or Indiana pouch, and those using the conventional ileal conduit have been advocated. In this study we asked patients who had undergone a CUR operation to complete a questionnaire, consisting of 106 questions relating to the QOL during the disease-free period. A total of 81 questionnaires were sent out, and 60 (74.1%) CUR patients responded. The average age was 61 and the male to female ratio was 49 to 11. The time elapsed from the operation was 42 months. Twenty-nine questions addressed the patients physical condition and on the whole it was kept in good quality. Because they were unwilling to show their stoma, they were reluctant to bathe together with family members. However, 59% of them went to a public bathhouse (common in Japan). Other physical abilities related to exercise were not significantly hampered by this operation. Eighty per-cent of them were not bothered by having a stoma. Twenty four questions were related to social life. The operation had a bad influence in 20-30% of them concerning their interaction with friends and hobbies. Twenty two percent of the patients who had a job prior to the operation stopped working. Only a few patients abandoned travelling. Concerning their sex life (7 questions), males suffered impotence at a very high rate, but only 26% of the patients lost interest in sex. Symptoms related to the operation (41 questions) were mild. Overall, 94% of the patients would choose the same operation again if it were required.(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗

PubMed1993

[The epidemiology of parotid tumors. A case control study].

From 1989 to 1991 a case-control study was conducted at the ENT Department of the University of Heidelberg. One hundred and one patients with parotid tumors (84 benign and 17 malignant) were compared with 404 control patients in a matched-pair study design. Using a questionnaire containing 21 sides, all interviews were conducted by the same interviewer. The questionnaire contained such aspects as "professional surroundings and exposure to environmental dusts", "consumption of tobacco and alcohol", "living area", "nutrition", "hobbies" and "social life". Questions about personal and familial diseases, consumption of medicine and exposure to irradiation were also asked. Differences in exposure to occupational dusts were seen. The highest relative risk (RR) for developing a parotid tumor was seen with weekly exposure to nickel during a period of more than 10 years (RR = 6.0; confidence interval, 1.4-25.5). Similar risk was found with exposure to chromium, asbestos and cement dusts (RR chromium = 3.4; confidence interval, 0.9-14.5; RR asbestos + cement = cement 3.0, confidence interval 1.0-8.9). Higher relative risks were also detected in patients exposed to diagnostic dental x-rays.

Adult↗

PubMed1993

Perforating injuries: causes and risks are changing. A retrospective study.

We reanalyzed all 384 records of perforating injuries primarily admitted to the University Eye Hospital of Freiburg during the years 1981-1983 and 1987-1989. Complete data could be obtained from 369 records. Injuries from 1987-1989 were compared with those from 1981-1983 with regard to the cause and extent of the perforation as well as sex, age, occupation, and activity of the patient at the time of injury. The following significant trends were observed. Seat-belt legislation in 1984 was extremely beneficial for the prevention of penetrating occular injuries, especially among women aged 16-25 years. Of 39 injuries to women, 17 (43%) were related to traffic accidents in 1981-1983 as opposed to only 1 of 16 injuries (6%) in 1987-1989. Therefore, the male/female ratio increased from 4.1 to 9.6 (P = 0.006). Perforations during traffic accidents declined from 26% (52/199) to 11% (19/170). The number of occupational injuries remained constant, although their proportion increased from 42.7% (85/199) in 1981-1983 to 50% (85/170) in 1987-1989. High-risk activities at work as well as during leisure time changed from hammering to work with rotating machines (drills, lathes) and wires. The incidence of agricultural injuries rose from 4% to 9% (from 8 to 15). Injuries during leisure activities remained constant (66 vs 62). Among this group, injuries related to a hobby increased, whereas perforations occurring during visits to pubs or festivities decreased. Pediatric injuries remained constant and were responsible for 15.6% and 14.7%, respectively, of all injuries (age, < or = 15 years).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1996

Leisure-time physical activity among US adults. Results from the Third National Health and Nutrition Examination Survey.

BACKGROUND: The prevalence of no leisure-time physical activity (LTPA) among US adults is estimated to be between 24% and 30%. Such information, however, usually does not include prevalence estimates for non-Hispanic blacks, Mexican Americans, and the elderly. OBJECTIVE: To assess the prevalence of participation in leisure-time physical activity among US adults. METHODS: Between 1988 and 1991, 9488 adults aged 20 years and older were interviewed in their home as part of the third National Health and Nutrition Examination Survey. A clinic examination in a mobile center was also included. Mexican Americans, non-Hispanic blacks, and the elderly were oversampled to produce reliable estimates for these groups. Questions were asked about the type and frequency of physically active hobbies, sports, and exercises. RESULTS: The prevalence of no LTPA for US adults aged 20 years or older from 1988 through 1991 was 22%. The rate was higher in women (27%) than in men (17%). Mexican-American men (33%) and women (46%) and non-Hispanic black women (40%) had the highest rates of no LTPA. Participation in moderate to vigorous LTPA five or more times per week decreased with age, with the largest decreases observed among non-Hispanic black men and women. In almost all subpopulations, gardening and/or yard work and walking were stated as the two top LTPAs of choice. CONCLUSIONS: Many Americans are inactive or irregularly active during their leisure time. Rates of inactivity are greater for women, older persons, non-Hispanic blacks, and Mexican Americans. Intervention strategies meant to promote lifetime physical activities among all Americans represents a major health priority.

Adult↗

PubMed1996

Identification of children at risk for lead poisoning: an evaluation of routine pediatric blood lead screening in an HMO-insured population.

OBJECTIVES: To estimate the prevalence of elevated blood lead levels in children receiving well-care checkups; and to evaluate the effectiveness of certain key risk factors in detecting children at higher risk for elevated blood lead levels. DESIGN: Cross-sectional study. SETTING: Two facilities of the Kaiser Permanente Medical Care Program (KPMCP) health maintenance organization (HMO), northern California region. PATIENTS: Six hundred thirty-six children, aged 12 to 60 months, who were seen at four KPMCP facilities in two subregions for a well-care checkup from September 1991 through August 1992. INTERVENTIONS: Blood samples were collected from each child and analyzed for lead content. Participating parents completed a questionnaire that included questions recommended by the Centers for Disease Control and Prevention (CDC) about the child's and the parents' lead exposure via home, workplace, and hobbies. RESULTS: Ninety-six percent of the children had blood lead levels under 10 micrograms/dL. Blood lead levels declined with increasing age and were higher for black children compared with whites. Age of residential housing, mother's education, and residence in an old house with peeling paint had low sensitivity and positive predictive value for identifying children with blood lead levels over 10 micrograms/dL. CONCLUSION: Universal routine screening for elevated blood lead levels in children in an employed, HMO-insured population is not warranted on grounds of prevalence. Responses to CDC questions do not effectively identify high-risk children in this population.

Child, Preschool↗

PubMedDate not supplied

Quality of life and care in Parkinson's disease.

Seventy-two parkinsonian patients attending a subregional movement disorder clinic completed a novel questionnaire designed to examine their quality of life and care. Significant problems with housing, travel, holidays and hobbies were identified. Financial difficulties due to premature retirement and the complex benefit system were found. Many carers were ill but, even when hospitalised, patients were cared for in the community by friends and relatives. Few patients had been referred for paramedical therapies, in spite of considerable disability in some cases. Aids and adaptations were commonly in use without advice from an occupational therapist. The specialised clinic and Parkinson's disease nurse advisor were welcomed by many patients. Most were satisfied with their hospital care and general practitioner, but follow-up arrangements with general practitioners were variable. It is suggested that further research concentrates on the roles of physiotherapy, speech therapy, nurse advisors and social workers in the management of Parkinson's disease, and on the value of increased carer support, including respite care.

Aged↗

PubMed1995

Long-term prognosis of major depression in old age: a comparison with prognosis of dysthymic disorder.

The 5-year prognosis of 42 elderly patients with major depression (mean age 73.2 +/- 6.3 years for men and 73.0 +/- 7.3 years for women) is described. Furthermore, the clinical outcome of elderly patients with major depression is compared to that of 199 elderly patients with dysthymic disorder (mean age 69.9 +/- 7.2 years for men and 71.3 +/- 7.7 years for women) described in a previous article. Twelve percent of patients with major depression recovered, 26% still had depression after 5 years, 12% had possible dementia, 45% had died, and 5% could not be contacted. The outcome did not significantly differ between the sexes or the two age groups (65-74 and 75+). A poor clinical outcome of patients with major depression was related to a greater number of diagnosed diseases, strong feelings of restlessness, and higher sexual interest at the beginning of the follow-up. A poor prognosis was also found for the patients whose functional abilities and hobby activities declined during the follow-up. A poor prognosis tended to be related to absence of hypertension, frequent trembling of hands, low activity in listening to music, and high activity in watching TV at the onset, and to absence of malignant disease and occurrence of a high number of negative and positive life events during the follow-up period. Thirty-six percent of dysthymic patients recovered, 26% still had depression after 5 years, 9% had possible dementia, 25% had died and 4% could not be contacted. The outcome of dysthymic patients did not significantly differ between the sexes or the two age groups (65-74 and 75+). The clinical outcome of dysthymic patients tended to be more favorable than that of patients with major depression. The factors related to a poor outcome differed between patients with major depression and dysthymic patients.

Activities of Daily Living↗

PubMedDate not supplied

[Bacterial destruction of algal organic matter with glucose formation].

The increase in the number of bacteria, the rate of destruction of organic matter, and the rate of glucose assimilation with analysis according to Wright and Hobbie were determined during 205 days in two bottles containing water from the Rybinsk Reservoir; one of the bottles contained also 25 mg of dry algal cells per one litre. During this period in the control, 39% of the initial amount of the organic matter was destructed (12 mg C per litre), and 4.6% of glucose was formed from this quantity. In the experimental series, 85.6% of the initial amount of the organic matter underwent destruction (from 12.5 mg C per litre), and 48.5% of glucose was formed from this amount.

Bacteria↗

PubMed1995

Surgical treatment of intracranial arteriovenous malformations with an analysis of cost-effectiveness.

Decision making with cerebral AVMs is one of the most difficult aspects of neurosurgical practice. A diversity of factors, such as the size and location of the AVM; the patient's age, medical, and neurologic condition; and his occupation, hobbies, and expectations, as well as his psychological makeup, must be considered. In addition, a thorough understanding of the natural history is necessary. There is no possible substitution for individual case-by-case analysis since every AVM and every patient is different. Currently, we have excellent information about the natural history of cerebral AVMs. It appears that they bleed at a rate of 3 to 4% per year whether they have bled before or not. The risk of rehemorrhage after a hemorrhage is only slightly higher during the first year (6%), and after that it is the same as for AVMs that have not bled. The serious morbidity associated with each hemorrhage is about 30% and the mortality about 12.5%. Modern surgical results indicate that all but the very large cerebral AVMs and those AVMs that involve critical deep structures, such as the internal capsule and the brainstem, can be excised with satisfactory results. For grade I to IV AVMs (Spetzler and Martin grading system (51)) a combined morbidity and mortality rate of less than 10% can generally be expected. The surgery of grade V AVMs is accompanied by very substantial morbidity and generally should not be recommended, except for patients who have a significant pre-operative deficit or who have had multiple hemorrhages or a gradually progressing deficit. There are many different causes of morbidity accompanying surgical excision of cerebral AVMs. Of these, probably the most important is faulty surgical judgment, although technical problems do arise frequently, even for the most experienced surgeons. Pre-operative embolization is a significant source of morbidity and mortality, and it should be used only when it is expected that the combined morbidity and mortality of embolization and surgery is less than the risk for surgery alone. Surgical excision of "operable" cerebral AVMs, preceded by embolization in selected cases, is highly cost-effective when compared to observation alone or to a policy of surgery for large- and medium-sized lesions and radiosurgery for small (< 3 cm) lesions. This conclusion assumes that an experienced team performs the surgery and embolization, as well as the selection of patients for surgery with or without embolization. Operable small (< 3 cm) AVMs should be treated by surgical excision; when compared to radiosurgery or observation alone, surgical excision is highly cost-effective and very efficacious in prolonging quality-life expectancy. This conclusion assumes that an experienced cerebrovascular surgeon makes the judgment of operability (selection for surgery) and then performs the operation.

Cost-Benefit Analysis↗

PubMed1996

The epidemiology of scleroderma among women: assessment of risk from exposure to silicone and silica.

OBJECTIVE: To investigate the relationship between exposure to silicone (including breast implants) and silica and the development of scleroderma (systemic sclerosis, SSc) among women. METHODS: A population based case-control study was conducted among women in Michigan. 274 confirmed cases of SSc diagnosed between 1985 and 1991 were identified by contacting rheumatologists, hospitals, and a scleroderma support group. These cases and 1184 controls were interviewed by telephone to ascertain past exposures to silicone or silica. RESULTS: Silicone in the form of breast implants was not associated with significantly increased risk of SSc (adjusted odds ratio, 1.30; 95% confidence interval, 0.27 to 6.23). Among 20 other potential silicone exposure surveyed, self-reported exposure to silicone based glues, sealants, and caulks, manufacture or repair of windows or windshields, repairing or frequently using photocopy machines, consumption of simethicone-containing antacids, and implanted medication delivery pumps were significantly associated with SSc. However, blinded assessment of all job and hobby descriptions in terms of their potential for silicone exposure failed to support the first 3 associations, antacid consumption may have been confounded by esophageal dysmotility before the diagnosis of SSc, and other silicone containing device categories (pacemakers, central nervous system shunts, other shunts and catheters) were not significantly associated with SSc. Surgically implanted metallic fixation devices were associated with significantly reduced risk for SSc. No association was detected between SSc and silica dust exposure. CONCLUSION: Consistent with other studies, we found no increased risk of SSc among women with silicone breast implants, equivocal evidence of risk from other silicone exposures, and no evidence of risk from silica exposure.

Adolescent↗

PubMed1996

[Is the term "dependence" appropriate?].

The term dependence is found in the International Classification of Diseases-10 only in conjunction with the diagnosis of a dependent personality disorder and the substance-related syndrome. Nowhere dependence not related to a substance is mentioned. At present we encounter in the press and professional literature frequently comments on dependence in relation to gambling, work, television, sports activities or some hobby. From the medical aspect it is a dominating idea, i.e. rather a phenomenon within the framework of an extended standard than a symptom from the field of psychopathology. The author recommends to avoid the use of the term "dependence not related to a substance" to prevent psychiatrization of common activities..

Behavior, Addictive↗

PubMed1996

[Social status of visually handicapped patients in new combined federal Germany--a comparison with the status before 1990].

In the wake of German unification, great social change has taken place in some fields. To estimate the impact of these changes on the state of rehabilitation of people with low vision, a standardized questionnaire about their social situation was sent to those 134 adult graduates of the School for People with Low Vision in Thuringia who had already been interviewed in 1989. 56 completed questionnaires could be evaluated, and the data was compared with the data collected in 1989. While there was almost no change concerning medical rehabilitation, an interesting development in the field of financial and social benefits has taken place: Even though the number of people who qualified for support had increased from 41.1% (1989) to 62.5% now, a closer look showed that this had mainly been caused by financial benefits (such as unemployment pay, housing subsidy, etc.) linked to the social decline of the examined group of disabled people. Accordingly, the number of employed people with low vision had decreased from 98.2% in 1989 to 60.7% today. Nevertheless all respondents seem to be secure financially (increase of the net income per month and household for 48.2% of the respondents) and fortunately 78.6% lived in their own flat (compared to only 64.3% in 1989). The general liberalization of public life in the new German Laender is reflected by the fact that 19.6% of the people with low vision felt able to make new friends and that traveling (with 50%) ranked second among the hobbies mentioned. The views people with low vision hold relative to the general living conditions illustrate a general uncertainty in the wake of the changes in the entire social system (statement: "Everything has become insecure"--55.4%), but also reveals that better economic background conditions are appreciated.

Adolescent↗

PubMed1996

Skin problems in sugar artists.

Sugar artistry is a growing profession amongst bakers and confectioners and an increasingly common hobby in amateur cooks. The main work consists of manual manipulation of sugar which is formed into figures and objects for table and food decoration. The sugar must be warmed up to 50 degrees C in order to be liquid and malleable and so the artists suffer from diverse thermally induced skin problems on their hands. Such changes have not to date been reported in the dermatological literature. In this study we report our experience in 50 Swiss sugar artists who have suffered from skin problems. The study took the form of a questionnaire survey. The response rate was 30 out of 50. Twenty-six reported no chronic skin disorder. Four suffered from a palmar vesicular relapsing type of chronic eczema. The main skin problems on the hands during work with hot sugar were increased sweating, seen in 20 out of 30 (67%), and burning with erythema and blistering, seen in 12 out of 30 (40%). Most participants (83%) were highly irritated by the skin problems during their work, and applied a protective cream before working with sugar, or wore rubber gloves. Topical therapy with a preparation containing 10% aluminium chloride hexahydrate, used once daily for 3 weeks, evaluated in 14 participants, decreased sweating in 10 (71%) and reduced the thermally induced erythema in one (7%).

Aluminum Chloride↗