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PubMed2006

The role of adolescent social disinhibition expectancies in moderating the relationship between psychological distress and alcohol use and misuse.

We examined the effects of adolescent social disinhibition expectancies and adult psychological distress on alcohol use and misuse in adulthood, using the 1970 British Cohort Study data. Multivariate imputation by chained equations filled in incomplete cases for 7023 men and 6896 women. A propensity to heavy alcohol use and misuse was predicted by social expectations of the releasing effects of alcohol acquired in adolescence (adolescent social disinhibition expectancies). Psychological distress at age 30 increased the likelihood of very heavy alcohol use in men and misuse of alcohol in men and women. An absence of adolescent social disinhibition expectancies protects adults from drinking alcohol. Moreover, among men without these expectancies, psychological distress did not predict heavy alcohol use, whereas this association was present among men with expectations of alcohol. Policies that aim to manage adult alcohol use should be initiated in adolescence. Reduction of psychological distress will prevent both men and women from misusing alcohol.

Adolescent↗
PubMed1996

Psychosocial aspects of accidental injuries--an overview.

This paper reviews the current "state of the art" with regard to psycho-traumatological issues in accidentally injured patients. A MEDLINE search (1985-1995) yielded a total of 135 references, out of which 60 publications were selected and reviewed. The body of knowledge about the psycho-social effects of serious injuries caused by accidents seems to be still limited. There are indications that accidents leave many patients suffering from not only the physical consequences but also considerable psychological problems. A frequent clinical manifestation of such problems is post-traumatic stress disorder (PTSD), but depression, anxiety and the somatoform disorder have also been observed, possibly even more frequently. There have been substantial discrepancies in epidemiological data in the literature, partially because the samples analyzed so far have not been homogeneous enough. It is also obvious that studies have been devoted almost exclusively to disorders and handicaps following (and occasionally prior to) the traumatic event. Seldom has the study focused on patient resources: practically no studies exist on the effects of protective psycho-social factors on the healing process following accidental injuries. More research is needed in order to be able to make predictions on the expected healing of patients during the acute stage of treatment following an accident. These future studies should deliver information on identifying high-risk patients who would require specific psycho-social intervention.

Accidents↗
PubMed2005

A federal perspective on EAPs and emergency preparedness.

Federal Employee Assistance Programs (EAPs) have a long history of intervention in emergency situations, and their role has expanded since September 11, 2001. There is considerable evidence on the importance of organizational factors such as social support in protecting disaster victims from the psychological effects of trauma. The authors recommend that EAPs become integrally involved in organizations' emergency planning processes, so that such supports can be built into all aspects of plans. EA professionals should function as organizational consultants, not simply as helpers who will eventually care for those affected. Two federally based case studies provide examples of EA professionals who have successfully used such an approach in their respective organizations.

Disaster Planning↗
PubMed2005

Father's occupational group and daily smoking during adolescence: patterns and predictors.

OBJECTIVES: We investigated the relationship among father's occupational group, daily smoking, and smoking determinants in a cohort of New Zealand adolescents. METHODS: The longitudinal Multidisciplinary Health and Development Study provided information on adolescents' self-reported smoking behavior and potential predictors of smoking, such as social and material factors, personality characteristics, educational achievement, and individual attitudes and beliefs regarding smoking. Longitudinal logistic generalized estimating equation analyses were used. RESULTS: Adolescents whose fathers were classified in the lowest-status occupational group were twice as likely as those whose fathers occupied the highest-status occupational group to be daily smokers. This high risk of daily smoking among the adolescents from the lowest occupational group was largely predicted by their lower intelligence scores and by the higher prevalence of smoking among fathers and friends. CONCLUSIONS: To prevent socioeconomic differences in smoking, school-based interventions should seek to prevent smoking uptake among adolescents, particularly those of lower socioeconomic status. Programs need to provide positive, nonsmoking role models consonant with the culture and norms of lower-socioeconomic-status groups. Adolescents need to acquire resistance skills and protective behaviors against social pressure and influences.

Adolescent↗
PubMed1985

Clinical significance, evaluation, and management of secondary depression in schizophrenia.

Treatment of the chronic schizophrenic patient is often complicated by depressive symptoms that can be difficult to detect. Because of the association between depressive symptoms and poor outcome features, the presence of these symptoms has substantial treatment implications. Treatment issues for depressive schizophrenic patients include selecting appropriate drug therapy, overcoming high rates of noncompliance, dealing with self-doubt and social withdrawal, and protecting patients from recurrent depressive symptomatology, suicide, or psychotic relapse. Controlled studies suggest that neuroleptic therapy is the drug treatment of choice; addition of an antidepressant does not appear to enhance therapeutic efficacy and may be associated with increased adverse effects. Successful treatment also requires the use of assertive case management, community support, family support, and careful patient education.

Adult↗
PubMed2005

Individualism, collectivism, and delinquency in Asian American adolescents.

Although the study of delinquency has previously focused on identifying individual, family, peer, and social risk and protective factors, little empirical research has studied cultural factors and their relations to delinquency. In a large community sample of 329 Chinese, Cambodian, Laotian/Mien, and Vietnamese youths, individualism was positively related to, and collectivism negatively related to, self-reported delinquency, with partial mediation through peer delinquency (PD). Although the percentage of variance in delinquency attributable to individualism-collectivism was small compared to PD, it cannot be discounted as trivial. The results also supported the measurement and structural invariance of these associations across the 4 ethnic groups.

Adolescent↗
PubMed1989

Deinstitutionalization: a public policy perspective.

1. Deinstitutionalization was initiated in an era of social reform to protect the rights of the mentally ill; however, a strong research base was absent and led to major flaws in the policy's implementation. 2. The chronically mentally ill are frequently poor advocates for themselves and, without even the most simple needs fulfilled, end up homeless. 3. The homeless mentally ill require comprehensive support systems with assured continuity of care. An emerging concept to deal with this issue is that of case management. 4. The mental health professional can strive to influence future public policy as patient advocate and nonpartisan educator.

Community Mental Health Services↗
PubMed1997

Social stress and trauma: synthesis and spatial analysis.

In the last decade violence has emerged as a public health issue, with concomitant interest in surveillance and prevention. This paper is an extension of earlier work seeking to expand the ecological analysis of violence across jurisdictional boundaries, sharpen the level of resolution of such analysis, and ultimately inform small area policy applications in terms of public health initiatives for violence reduction. The underlying model is drawn from stress theory and rests on a set of social indicators representing stress in the Baltimore area. In the earlier work, a set of 24 variables describing violence and socioeconomic conditions across some 1358 areas was factor analyzed and the resulting scores were mapped and interpreted. The present paper takes the analysis a step further in an attempt to identify groups of observations with common traits in order to assist public health professionals and other relevant decision-makers in the process of trauma surveillance, response, and prevention. Cluster analysis was used to combine most similar observations in terms of the three orthogonal factors, and the resulting cluster affiliations were mapped in geographic space. Although no spatial contiguity constraint was put on the clustering algorithm, many statistical clusters were also found to constitute geographic clusters. This implies that the process identified neighborhoods or parts of neighborhoods with shared traits in terms of the underlying set of stressors. Analysis of this type could be used by policy-makers to classify neighborhoods in terms of their needs for various services in addition to public health interventions, including policing, fire protection, building inspection, social work, and education.

Cluster Analysis↗
PubMed2005

Bioscience-bioethics and life factors affecting reproduction with special reference to the Indigenous Australian population.

The demand for equality of recognition or respect is the dominant passion of modernity. The 20th century experienced a giant leap in technological inventiveness and ruthless use of technological power. In the 21st century, human welfare and environmental wellbeing demand fundamental political appraisal. We have the means, if we choose, to eradicate poverty and to responsibly protect the global environment. However, economic, political and cultural systems act to differentially allocate the benefits and risks for growth between socioeconomic groups. For example, it is a matter of pride that the neonatal mortality rate in affluent societies has dropped substantially since the late 1970s. However, the level of infant mortality (three times the national average) and low birthweight (13%) among the Indigenous Australian population is the highest in the country. With hindsight we now know that is the inevitable legacy of Australia's colonial history. Chronic physical and psychological stress is recognized as an important etiological factor in many lifestyle diseases of the cardiovascular, immune and reproductive systems. Diseases of adaptation are further advanced by non-adaptive lifestyle choices, depression, alcoholism and other drug dependencies. This review describes the principles of bioscience ethics and targets equity issues as they affect human reproduction across generations with particular reference to the Indigenous population of Australia. The review also considers ways we may advance global and cultural maturity from the Indigenous Australian perspective and proposes an ecologically based model of preventative care. If we are to embrace fundamental social change and protect future children without threatening parents' basic freedoms, then new beliefs and priorities--based on a compassionate understanding of biological systems--must evolve from the general public. Belief in human rights arising from a sense of human dignity is a collective outcome originating from individual commitment. The golden rule; that is, Nature's principle of reciprocity, is fundamental in bridging the gap between knowledge and effective action.

Australia↗
PubMed2004

"Fundamental causes" of social inequalities in mortality: a test of the theory.

Medicine and epidemiology currently dominate the study of the strong association between socioeconomic status and mortality. Socioeconomic status typically is viewed as a causally irrelevant "confounding variable" or as a less critical variable marking only the beginning of a causal chain in which intervening risk factors are given prominence. Yet the association between socioeconomic status and mortality has persisted despite radical changes in the diseases and risk factors that are presumed to explain it. This suggests that the effect of socioeconomic status on mortality essentially cannot be understood by reductive explanations that focus on current mechanisms. Accordingly, Link and Phelan (1995) proposed that socioeconomic status is a "fundamental cause" of mortality disparities-that socioeconomic disparities endure despite changing mechanisms because socioeconomic status embodies an array of resources, such as money, knowledge, prestige, power, and beneficial social connections, that protect health no matter what mechanisms are relevant at any given time. We identified a situation in which resources should be less helpful in prolonging life, and derived the following prediction from the theory: For less preventable causes of death (for which we know little about prevention or treatment), socioeconomic status will be less strongly associated with mortality than for more preventable causes. We tested this hypothesis with the National Longitudinal Mortality Study, which followed Current Population Survey respondents (N = 370,930) for mortality for nine years. Our hypothesis was supported, lending support to the theory of fundamental causes and more generally to the importance of a sociological approach to the study of socioeconomic disparities in mortality.

Adult↗
PubMed2006

One year of smokefree bars and restaurants in New Zealand: impacts and responses.

BACKGROUND: New Zealand introduced a smokefree bars and restaurants policy in December 2004. We reviewed the data available at December 2005 on the main public health, societal and political impacts and responses within New Zealand to the new law. METHODS: Data were collected from publicly available survey reports, and from government departments and interviews. This included data on smoking in bars, attitudes to smokefree bars, bar patronage, socially cued smoking, and perceived rights to smokefree workplaces. RESULTS: The proportion of surveyed bars with smoking occurring decreased from 95% to 3% during July 2004-April 2005. Between 2004 and 2005, public support for smokefree bars rose from 56% to 69%. In the same period, support for the rights of bar workers to have smokefree workplaces rose from 81% to 91%. During the first ten months of the smokefree bars policy, there were only 196 complaints to officials about smoking in the over 9900 licensed premises. The proportion of smokers who reported that they smoked more than normal at bars, nightclubs, casinos and cafés halved between 2004 and 2005 (from 58% to 29%). Seasonally adjusted sales in bars and clubs changed little (0.6% increase) between the first three quarters of 2004 and of 2005, while café and restaurant sales increased by 9.3% in the same period. Both changes continued existing trends. Compared to the same period in 2004, average employment during the first three quarters of 2005 was up 24% for 'pubs, taverns and bars', up 9% for cafés/restaurants, and down 8% for clubs (though employment in 'pubs, taverns and bars' may have been affected by unusually high patronage around a major sports-series). The proportion of bar managers who approved of smokefree bars increased from 44% to 60% between November 2004 and May 2005. Bar managers also reported increased agreement with the rights of bar workers and patrons to smokefree environments. The main reported concerns of the national and regional Hospitality Associations, in 2005, were the perceived negative effects on rural and traditional pubs. CONCLUSION: As in other jurisdictions, the introduction of smokefree bars in New Zealand has had positive overall health protection, economic and social effects; in contrast to the predictions of opponents.

Commerce↗
PubMed1987

Exploitation of the insane in the New World. Benoni Buck, the first reported case of mental retardation in the American colonies.

Documenting the early history of mental illness in North America is complicated by the absence of colonial institutions specializing in the care or management of the insane. However, during the first half of the 17th century, a single authority existed in England, the Court of Wards and Liveries (1540-1660), with responsibility for appointing guardians for the mentally disabled. In 1637, Benoni Buck, a man with severe mental retardation, was referred to this court from Jamestown, Va. The ensuing conflict over Benoni's custody exposed a contradiction between the economic and political exigencies of a new order and the social obligation to protect the mentally ill. Benoni Buck is almost certainly the first case of mental disability reported from the English colonies. The case thereby represents a minor landmark in the history of mental illness in America; May 1987 marks the 350th anniversary of the first petition for guardianship.

England↗
PubMed2003

The relationship of unions to prevalence and claim filing for work-related upper-extremity musculoskeletal disorders.

BACKGROUND: Unionization has been found to be related to higher filing of workers' compensation (WC) claims, but the extent of the relationship and the relationships to other variables have not been previously reported. METHODS: Telephone interviews were conducted with both a population-based and WC-based samples of musculoskeletal disorder (MSD) cases. RESULTS: Workers at unionized facilities were 5.7 times (95% CI 2.5-13.1) more likely to file a claim for WC, despite a comparable rate of MSD cases. Higher filing was also associated with several measures of MSD severity (1.8-14.1 odds ratios), economic sector (OR = 10.1 for manufacturing), hourly (vs. salary) wages (OR = 2.6), and for having a personal physician (OR = 2.5). Unions appeared to have a protective effect on social effects of work-related MSD. CONCLUSIONS: Unions appear to improve filing of work-related MSD, particularly for less severe conditions. The higher filing does not appear to be a case of "moral hazard," but rather improved and earlier reporting, as is advocated by early intervention approaches to reducing MSD.

Case-Control Studies↗
PubMed2000

How Well Does Brazil's Environmental Law Work in Practice? Environmental Impact Assessment and the Case of the Itapiranga Private Sustainable Logging Plan.

/ The Itapiranga Sustainable Logging Plan provides an example of how Brazil's licensing system functions for logging companies in the state of Amazonas. Two questions need to be dealt with: "How sustainable can logging in the Amazon be?" and "What and how effective are existing legal mechanisms to deal with logging projects?" The environmental impact assessment (EIA) and environmental impact statement (EIS, known as the RIMA in Brazil), present relatively detailed accounts of biodiversity and the need to adopt conservation strategies to protect it. However, social and health impacts are only superficially addressed. The economic sustainability of the operation over multiple cycles is not demonstrated. The multidisciplinary teams responsible for the EIA and EIS (RIMA) reports are hired by the project proponent, an arrangement inherently carrying the risk of biasing the result. Logging reduces biodiversity, releases greenhouse gases and inflicts social and health costs. These impacts reduce the ability of Amazonian forests to provide environmental services and to supply food and livelihood security to local populations. The reports inflate positive effects such as employment: the estimated number of jobs was cut by more than half in a revision made after the EIA and EIS (RIMA) had been approved. Not only do the reports need to be more realistic in assessing both positive and negative consequences of proposed projects, but better means are needed to ensure that promised mitigatory measures are enforced in practice. Many of the lessons that can be drawn from the Itapiranga Plan are not unique to logging projects and apply to licensing of development activites generally in Brazil and elsewhere.

Journal Article↗
PubMed2006

Psychosocial evaluation of candidates for living related kidney donation.

Living kidney donation has raised practical and ethical questions since renal transplantation became possible 50 years ago. Nevertheless, living donors are a common source for badly needed organs in the pediatric population. The safety and well being of the living donor are important concerns. Among the risks of living donation are those of a psychological and social nature. To protect these donor interests, psychosocial evaluations of donors are done at some transplant centers, but there is a lack of consistency regarding standardization of the evaluation, the content of the evaluation, and the role of the interviewer. Goals of the overall living donor evaluation for kidney transplantation at The Children's Hospital of Philadelphia, and the components of the psychosocial evaluation protocol in particular, are presented. The protocol's strengths are discussed, including the standardization of evaluations for all potential donors; the broad spectrum of psychosocial domains assessed; the psychometric measures administered; the systematic handling of negative results and some donors' desire to opt out; and the protection of confidentiality. Future directions with regard to long-term psychosocial outcomes and research protocols are discussed.

Adolescent↗
PubMedDate not supplied

Social relations as determinant of onset of disability in aging.

The purpose of the study was to analyze whether social relations are related to onset of disability among old people at 1.5 year follow-up and whether these relations vary by age and gender. The study is based on baseline and 1.5 year follow-up data on 1396 older non-disabled adults. Social relations were measured by questions about diversity in social relations, social participation, satisfaction with social relations and instrumental social support. Onset of disability was described as developing need of help in at least one of six mobility activities. The results showed that a large diversity in social relations and high social participation were important factors for maintaining functional ability among the 75-year-old men and women, while social support was a risk factor for functional decline among the 80-year-old men. The present study suggests that being "embedded" in a strong network of social relations provides protection against disability by reducing risk of developing disability.

Activities of Daily Living↗
PubMed2004

[Espace Santé Jeunes, a medical care unit for vulnerable youth].

Adolescents, especially belonging to vulnerable groups, feel excluded from the health system. Indeed, they lack their own care service, between the child protection and the "social help" consultations. For five years now, the Espace santé jeunes (Young People Health Center) has tried to help them to regain control over their body, and to take care of their own health. Some patients only need to be reassured about their "normality", whereas others suffer from severe pathologies that were never treated before.

Adolescent↗
PubMed2005

Shaken baby syndrome: a biomechanics analysis of injury mechanisms.

Traumatic infant shaking has been associated with the shaken baby syndrome (SBS) diagnosis without verification of the operative mechanisms of injury. Intensities for SBS have been expressed only in qualitative, unsubstantiated terms usually referring to acceleration/deceleration rotational injury and relating to falls from great heights onto hard surfaces or from severe motor vehicle crashes. We conducted an injury biomechanics analysis of the reported SBS levels of rotational velocity and acceleration of the head for their injury effects on the infant head-neck. Resulting forces were compared with experimental data on the structural failure limits of the cervical spine in several animal models as well as human neonate cadaver models. We have determined that an infant head subjected to the levels of rotational velocity and acceleration called for in the SBS literature, would experience forces on the infant neck far exceeding the limits for structural failure of the cervical spine. Furthermore, shaking cervical spine injury can occur at much lower levels of head velocity and acceleration than those reported for the SBS. These findings are consistent with the physical laws of injury biomechanics as well as our collective understanding of the fragile infant cervical spine from (1) clinical obstetric experience, (2) automotive medicine and crash safety experience, and (3) common parental experience. The findings are not, however, consistent with the current clinical SBS experience and are in stark contradiction with the reported rarity of cervical spine injury in children diagnosed with SBS. In light of the implications of these findings on child protection and their social and medico-legal significance, a re-evaluation of the current diagnostic criteria for the SBS and its application is suggested.

Acceleration↗