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PubMed2001

Quality of life and chronic nonmalignant pain.

Chronic nonmalignant pain is a prevalent and costly phenomenon. Chronic pain induces stressors that affect personal and work lives of sufferers. Because of this interference, quality of life is impacted. The purpose of this pilot study was to explore the impact of stressors on the quality of life of adult patients with chronic pain. The framework guiding this study was Neuman's Systems Model based on the concepts of stress and reaction to stress. A descriptive correlational research design was used to compare participants' quality of life according to their health and function; family, psychological, spiritual, and socioeconomic status; and the stressors of age, gender, income, marital and work status, occupation, monthly treatment costs, and type of insurance. Each participant was administered the Ferrans and Powers Quality-of-Life Index and a demographic survey. Results revealed that a higher quality of life was associated with participants who were older, female, and employed, whereas a lower quality of life was associated with participants with a low income, higher treatment costs, and a lack of workmen's compensation insurance. Based on Neuman's model, the implications of chronic pain sufferers' resistance to the negative impact of various stressors are discussed.

Adaptation, Psychological↗
PubMed2002

[Prognosis of schizophrenia from the viewpoint of patients and relatives. An explorative study].

OBJECTIVE: This study is aimed at exploring what schizophrenic patients and their closest relatives expect the further course of the illness will be like and how it can be influenced. METHOD: Problem-centered interviews were conducted with 31 schizophrenic patients and their closest relatives at discharge from hospital treatment. The verbatim transcripts of the interviews were analyzed by means of structuring qualitative content analysis. RESULTS: Most frequently, the respondents expected an improvement of the illness or they were unsure whether the actual recovery from psychosis will persist or whether a further relapse will occur. Less frequently, the respondents were sure that this will be the case or that the illness will take a chronic, eventually deteriorating course. The majority was convinced that the course of the illness can be influenced, by psychiatric treatment as well as by the patients themselves. As concerns the social situation in the near future, particularly changes of the occupational status were hoped for. CONCLUSION: The assessment of the prognosis of the schizophrenic illness by most patients and relatives appears quite realistic. Rather than considering themselves as helpless victims they see opportunities for influencing the further course of the illness. This should have a positive influence on the readiness to use mental health service and to comply with treatment recommendations.

Adult↗
PubMedDate not supplied

[Outpatient orthopaedic rehabilitation: treatment, outcomes and costs as compared to inpatient rehabilitation].

In a parallel design the study examined an outpatient rehabilitation model project for patients of the pension insurance scheme of Rhineland-Palatinate (LVA Rheinland-Pfalz). In 6 centers for the rehabilitation of musculoskeletal diseases patients were assessed at the beginning and at the end of rehabilitation as well as six and twelve months after discharge. In this article the final results concerning therapeutic measures as well as health-related and economic outcomes are presented. Not included are aspects of differential utilization and the perception of the rehabilitation by the clients, which will be published in a separate article. No large differences were found concerning participation in the various therapeutic measures. As measured by the main score and the sub-dimensions of the IRES patient questionnaire, effects of the same magnitude were found for the parallelized samples. Equally, no differences in outcome quality were found concerning the great majority of medical parameters documented in a doctors' questionnaire, the rate of applications for pension, occupational status twelve months after rehabilitation, as well as the reduction of sick-leave. The economic evaluation was carried out only from the perspective of the pension insurance agency. Considerable differences were found in the net costs of rehabilitation: although there are no user charges for patients in outpatient rehabilitation, mean expenditure was about 970 EURO lower than in inpatient rehabilitation. The study findings demonstrate that the concept of interdisciplinary rehabilitation has been realized in the outpatient centers as well and that the centers have reached an effectiveness comparable to that of inpatient rehabilitation. At least those patients who actively choose the outpatient setting gain as much as patients in inpatient rehabilitation.

Adult↗
PubMed2006

Attention-deficit hyperactivity disorder and blood mercury level: a case-control study in Chinese children.

OBJECTIVE: To investigate the association between blood mercury level and attention-deficit hyperactivity disorder (ADHD) in Chinese children in Hong Kong. METHODS: Fifty-two children with ADHD aged below 18 years diagnosed by DSM IV criteria without perinatal brain insults, mental retardation or neurological deficits were recruited from a developmental assessment center. Fifty-nine normal controls were recruited from a nearby hospital. Blood mercury levels were measured by cold vapor atomic absorption spectrophotometry. RESULTS: The mean ages of cases and controls were 7.06 and 7.81 years respectively. Boys predominated (case = 44 [84.6 %], control = 44 [74.6 %]). There was significant difference in blood mercury levels between cases and controls (geometric mean 18.2 nmol/L [95 % CI 15.4 - 21.5 nmol/L] vs. 11.6 nmol/L [95 % CI 9.9 - 13.7 nmol/L], p < 0.001), which persists after adjustment for age, gender and parental occupational status (p < 0.001). The geometric mean blood mercury level was also significantly higher in children with inattentive (19.4 nmol/L, 95 % CI 13.3 - 28.5 nmol/L) and combined (18.0 nmol/L, 95 % CI 14.9 - 21.8 nmol/L) subtypes of ADHD. Blood mercury levels were above 29 nmol/L in 17 (26.9 %) cases and 6 (10.2 %) controls. Children with blood mercury level above 29 nmol/L had 9.69 times (95 % CI 2.57 - 36.5) higher risk of having ADHD after adjustment for confounding variables. CONCLUSION: High blood mercury level was associated with ADHD. Whether the relationship is causal requires further studies.

Adolescent↗
PubMed2006

[Sociodemographic differences in the participation in "early detection of cancer examinations" in Germany--a review].

In 1971 a statutory programme aiming at the early detection of cancer was established in Germany. Since then, acceptance has been low, especially among men. In 2002, 49 % of the women, but only 20 % of the men entitled to screening, took part in the free preventive medical screening. This paper gives an overview of the research done in Germany between 1973 and 2003, examining the associations of sociodemographic factors with participation in cancer screening. All studies show that participation rates increase steadily with age in men, but decrease in elderly women (55 years and older). Participation rates among women are significantly associated with educational level and occupational status. Among men, however, the relationship between socio-economic status and attendance appears to be less pronounced. Since 1971, participation rates have increased much more among women than among men, but, interestingly, the reasons for the gender differences in attendance rates have not been studied until now. Variables which were identified in international studies as predictors of participation, such as physician's recommendation or marital status, should be acknowledged in future research.

Adult↗
PubMed1986

Increased rate of cytomegalovirus infection among parents of children attending day-care centers.

We screened parents of children from three previously studied day-care centers where children have maintained high rates of cytomegalovirus (CMV) excretion, as well as parents of children not in day-care centers (controls), for antibody to CMV. Longitudinal serologic follow-up of seronegative parents revealed that 14 of 67 with children in the day-care centers acquired CMV, as compared with none of 31 controls (P less than 0.003). All 14 parents who seroconverted had a child who was shedding CMV in saliva or urine. Among the day-care group, acquisition of CMV occurred in 14 of 46 parents of children who shed CMV, as compared with none of 21 whose children did not excrete the virus (P less than 0.0001). There was no correlation between parental seroconversion and sex, race, age, number of years of education, marital status, occupation, or number of children in the home. CMV infection occurred in 9 of 20 parents (45 percent) with a child shedding CMV who was 18 months of age or less at enrollment. We conclude that children often transmit CMV to parents and could be an important source of maternal CMV infection during pregnancy.

Adult↗
PubMed2000

Twenty-four-hour autonomic nervous function in sustained and "white coat" hypertension.

BACKGROUND: It is unknown whether "white coat" hypertension, also known as isolated clinic hypertension, shares similarities in pathophysiologic background with sustained hypertension. Therefore we evaluated 24-hour autonomic nervous function in sustained and white coat hypertension. METHODS: We selected 12 patients with sustained hypertension (clinic blood pressure >/=140/90 mm Hg and daytime blood pressure >135/85 mm Hg) and 12 patients with white coat hypertension (clinic blood pressure >/=140/90 mm Hg and daytime blood pressure <135/85 mm Hg) from patients undergoing ambulatory blood pressure monitoring and 12 normotensives for study inclusion. Groups were matched for age, sex, and body mass index and had similar dietary pattern and occupational status (civil servants with sedentary jobs). Subjects underwent noninvasive 24-hour monitoring of blood pressure, R-R interval of the electrocardiogram, body position, activity rate, and ambient temperature. Power spectral analysis of R-R intervals was performed with an autoregressive model to obtain the low-frequency component, the high-frequency component, and their ratio. Subjects also collected 24-hour urine samples for examination of norepinephrine and epinephrine excretion by high-performance liquid chromatography. RESULTS: Work and sleep time, body position, ambient temperature, and activity were not different among the groups. Daytime, nighttime, and 24-hour low-frequency/high-frequency ratios were significantly higher in patients with sustained hypertension than in patients with white coat hypertension (3.4 +/- 0.45 vs 2.65 +/- 0.45, 2.35 +/- 0.60 vs 1. 82 +/- 0.45, and 3.04 +/- 0.45 vs 2.4 +/- 0.35, respectively, P <. 05). Urinary norepinephrine excretion (53 +/- 12 microg vs 29.5 +/- 6 microg; P <.05) and vanillylmandelic acid excretion (4.45 +/- 0.6 mg vs 3.1 +/- 0.55 mg; P <.05) during the 24 hours were significantly higher in patients with sustained hypertension than in those with white coat hypertension. There was no difference between those with white coat hypertension and normotensives concerning the aforementioned parameters. CONCLUSIONS: Our findings indicate whole-day sympathetic overactivity in sustained hypertension but not in white coat hypertension, suggesting that these conditions show some differences in pathophysiologic background.

Adult↗
PubMed2004

Hepatitis A and B infection and vaccination in a cohort of homosexual men in Sydney.

OBJECTIVES: To determine the prevalence and incidence of hepatitis A (HAV) and B (HBV) infection and vaccination in HIV-negative homosexual men in Sydney, and associated risk factors. METHODS: An open prospective cohort study was conducted among a community-based sample of HIV-negative homosexual men in Sydney in 2001-02. Participants underwent a face-to-face interview, regarding demographics, sexual behavioural risk factors and sexually transmitted infections, and blood samples were collected. They were followed annually. RESULTS: Nine hundred and three men completed a baseline interview by the end of 2002. Among them, 68% were seropositive to hepatitis A. The seroprevalence of prior hepatitis B infection was 19%, and 53% had serological evidence of HBV vaccination. Younger men were much more likely to be seronegative, with 48% and 46% of <25-year-olds being seronegative to HAV and HBV respectively. In multivariate analysis HAV and HBV infection were associated with increasing age, greater number of lifetime sex partners and HBV infection was also associated with previous sexually transmitted infections. HAV vaccination was associated with increasing age, greater number of lifetime sex partners, overseas travel in the last year and self-reported anogenital warts. HBV vaccination was associated with higher occupational status, greater lifetime number of sex partners and previous sexually transmitted infections. CONCLUSION: Substantial proportions of gay community-attached young homosexual men are still at risk of HAV and HBV infection. This study points to a need for vaccination strategies which ensure high levels of hepatitis A and B immunity in young sexually active gay men.

Adult↗
PubMed2004

How well do Australian women comply with dietary guidelines?

OBJECTIVE: To investigate the proportion of middle-aged Australian women meeting national dietary recommendations and its variation according to selected sociodemographic and behavioural characteristics. DESIGN: This cross-sectional population-based study used a food-frequency questionnaire to investigate dietary patterns and compliance with 13 commonly promoted dietary guidelines among a cohort of middle-aged women participating in the Australian Longitudinal Study on Women's Health. SETTING: Nation-wide community-based survey. SUBJECTS: A total of 10,561 women aged 50-55 years at the time of the survey in 2001. RESULTS: Only about one-third of women complied with more than half of the guidelines, and only two women in the entire sample met all 13 guidelines examined. While guidelines for meat/fish/poultry/eggs/nuts/legumes and 'extra' foods (e.g. ice cream, chocolate, cakes, potatoes, pizza, hamburgers and wine) were met well, large percentages of women (68-88%) did not meet guidelines relating to the consumption of breads, cereal-based foods and dairy products, and intakes of total and saturated fat and iron. Women working in lower socio-economic status occupations, and women living alone or with people other than a partner and/or children, were at significantly increased risk of not meeting guidelines. CONCLUSIONS: The present results indicate that a large proportion of middle-aged Australian women are not meeting dietary guidelines. Without substantial changes in their diets, and help in making these changes, current national guidelines appear unachievable for many women.

Australia↗
PubMed2005

Shiftwork experience, age and cognitive performance.

Changes of alertness and cognitive efficiency has been suggested in people whose circadian rhythms are disrupted, e.g. night or shift-workers. Data from field and laboratory studies have demonstrated short-term cognitive disturbances related to circadian rhythm disruption. By contrast, little is known about the long-term consequences of chronic sleep deprivation, as can be observed with shift-work, on cognitive abilities. The present paper is aimed at evaluating, on a large cross-sectional sample of workers, the long-term influence of shift-work on verbal memory and speed performances. Participants were 3,237 workers aged 32, 42, 52, and 62 years of various occupational statuses included in the VISAT (Aging, Health and Work) cohort. Data collected by questionnaires included items on working hours and shift-work and sleep disorders. Cognitive abilities were assessed using neuropsychological tests. Current male shift-workers had lower cognitive performance than never exposed workers. In the same population, memory performance tended to decrease with increasing shift-work duration. Among former shift-workers, the cognitive performance of the participant having stopped shiftwork more than 4 years ago seemed to be increased, suggesting a possible reversibility of effects. In conclusion, this study demonstrated that cognitive functioning tends to be impaired by a long-term exposure to SW. As found by other authors, neuropsychological performance tends to decrease with the increases in the duration of exposure to SW.

Adult↗
PubMed1989

Prevalence and sociodemographic variance of type A behavior in Finnish preadolescents, adolescents, and young adults.

The prevalence and sociodemographic variance of Type A behavior was studied among 1,721 preadolescents, adolescents, and young adults in Finland. The AFMS questionnaire (Type A behavior questionnaire for the Finnish Multicenter Study), as self-rated and assessed by mothers, and the Hunter-Wolf A-B Rating Scale (HWolf) were used. There was considerable variation between measures: On the AFMS boys scored higher, whereas on the Hwolf girls scored higher. In contrast to earlier findings, Type A behavior was more prevalent among rural subjects than among urban subjects. Economic and occupational status of the family were of no importance. The notion that the Type A behavior pattern characterizes urban, middle-to upper-class males was not validated in this group of Finnish children and young adults.

Adolescent↗
PubMed1992

Mothers with hostile, Type A predisposing child-rearing practices.

The authors examined characteristics of Finnish mothers (N = 924) who use hostile child-rearing practices (i.e., they ignore the child, are punitive and irritable, and perceive the child as a burden), practices that have been shown (Räikkönen & Keltikangas-Järvinen, 1992) to predispose children to Type A behavior. The results of this study indicate that two factors--Type A behavior in the mothers and the mothers' sociodemographic background (low occupational status, low educational level and young age)--increase the probability of the mothers' treating their children in a hostile manner. Also, the mothers of boys in this study reported more hostile child-rearing practices than the mothers of girls did.

Adult↗
PubMed1996

Relationship of religion and perceived social support to self-esteem and depression in nursing home residents.

This study is an examination of the relationship of religiosity and perceived social support to depression and self-esteem in nursing home residents. Answers to questionnaires administered to 83 nursing home residents indicated that perceived social support from family, public religious activity, and length of stay in the home were related to self-esteem and to depression. Past occupational status was also associated with self-esteem. Health status and having a choice in selecting the nursing home were negatively related to depression. Intrinsic religiosity and the resident's perceived social support from friends were not significantly related to depression or self-esteem.

Aged↗
PubMed1980

Cardiovascular responses to emotional stress (quiz interview) in post-myocardial infarction patients and matched control subjects.

In this investigation, 30 male post-myocardial infarction patients and 30 male control subjects matched according to age and occupation were given a 12-minute tape-recorded stress quiz described by Schiffer et al. Cardiovascular responses (electrocardiogram, heart rate, systolic, blood pressure, and diastolic blood pressure) to emotional stimuli were monitored in a laboratory setting at rest before the quiz and at two-minute intervals during the quiz. Heart rate and blood pressure values were significantly higher during the quiz than at rest for both patient and control groups. There was a significantly higher response for diastolic pressure and a significantly lower response for heart rate in the patient group compared with the control group. In the analysis for occupational status in the entire population, systolic pressure was significantly higher for the executives than for non-executives. Subgroup analyses of patients with angina, hypertension and/or ECG changes (N = 12) revealed a significantly higher diastolic pressure response than found in either the patients without these symptoms (N = 18) or in the controls (N = 30). In comparison to exercise test results, the emotional stress test (quiz) elicited somewhat more PVC's but less ST segment depression. These results support previous reports suggesting that emotional stress testing may be a valid tool in the diagnosis of coronary heart disease and in determining the physiological mechanisms which underlie the association between emotional stress and coronary heart disease.

Adult↗
PubMed1982

Shortening the Speech Sounds Perception Test.

Statistical means of shortening the Speech Sounds Perception Test were examined. Stepwise multiple regression analyses indicated that a 30-item version correlated quite highly with the 60-item version. Group means for representative clinical groups were presented, but no strong differences emerged using either version. Inclusion of length of stay and number of previous admissions as covariates did little to enhance the predictive validity of either form. Finally, the correlation of the 30-item test with demographic variables showed that age correlated most, followed by occupational status. these results were interpreted as indicating that the 30-item version could be used while maintaining the clinical utility of this test.

Adult↗
PubMed2006

Effectiveness of vocational rehabilitation following acquired brain injury: preliminary evaluation of a UK specialist rehabilitation programme.

PRIMARY OBJECTIVE: To report the outcome of 232 clients undertaking Rehab UKs Vocational Rehabilitation Programme, over three consecutive years, in three centres across the UK. METHODS AND PROCEDURES: Data regarding demographic characteristics of participants, type and severity of acquired brain injury were collected on admission to the programme. The duration of the vocational programme and occupational status on discharge is also reported. INTERVENTIONS: A description of the vocational programme is given including selection and admission criteria, main components of the programme, monitoring and evaluation frameworks. RESULTS: Forty-one per cent of participants were discharged into paid competitive employment, with a further 16% gaining voluntary work and 15% taking up mainstream training or education. The remaining 28% were referred to other services or withdrew from the programme. CONCLUSIONS: Vocational rehabilitation offering educational and experiential learning opportunities is effective in enabling participants with severe acquired brain injuries to return to paid employment.

Adolescent↗
PubMedDate not supplied

Work ability and job demands of aging white- and blue-collar workers in 1981 and 1996.

This study compared perceived work ability and job demands in 1981 and 1996. Two samples of municipal workers were formed by matching according to location (eastern Finland), occupational status (white- and blue-collar jobs), gender (men), and age (> or = 45 years). In 1981, 50 white-collar (mean age 51 [SD 3] years) and 214 blue-collar (mean age 51 [SD 4] years) workers responded. In 1996, the corresponding numbers were 43 and 54, respectively, the mean age being 50 [SD 4] years for both groups. Perceived work ability and psychological resources changed very little from 1981 to 1996, but there seemed to be a trend towards a more positive view of future work ability. General and mental job demands, in particular, seemed to be increasing among white-collar workers. The observed differences in work ability and job demands were systematically more positive among blue-collar workers than among the white-collar workers.

Aging↗
PubMed1999

Baseline Differences in Social Support Among Treatment-Seeking Alcoholics With and Without Social Phobia.

Differences on demographics and seven measures of social support between matched, treatment-seeking alcoholics with and without social phobia (SP and NSP groups, respectively) were examined. The groups did not differ on most demographic variables, although the SP group (n = 397) had a lower occupational status and had fewer years of education (both p's <.01) than the NSP group (n = 397). On social support measures, the SP group had less perceived social support from friends and had a lower performance on the social behavior role scale than the NSP group (both p's <.001). The two groups were unexpectedly more similar than different on the measures of interest in this study; however, the differences identified are meaningful for treatment planning. It is important to ascertain the quantity and sources of social support which are available to these clients in order to maximize positive treatment outcomes.

Journal Article↗