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PubMed1986

Endometriosis in Lebanon. A case-control study.

To explore some of the risk factors for endometriosis, the authors compared 170 cases with 170 age-matched controls similarly undergoing laparoscopy at the American University of Beirut Medical Center between 1979 and 1981. The findings include a positive association with first-class admissions (odds ratio = 2.77) and a negative association with parity and gravidity. Both associations are consistent with the findings of other studies. There was no association with occupational status, nationality, religion, marital status, or past medical history.

Contraception↗
PubMed1987

Physical training and occupational rehabilitation after aortic valve replacement.

Forty-four patients were tested 2, 6 and 12 months after an isolated aortic valve implantation in order to evaluate the influence of training and vocational assistance on physical work capacity and the rate of reemployment. They were randomly allocated to a training group (A) or a control group (B). Training was carried out from the eighth to the twelfth week after operation and the socio-occupational status was evaluated. Training increased physical work capacity, expressed as cumulated work (CW), by 58 per cent (P less than 0.001), decreased the rate-pressure product (RPP) by 13 per cent (P less than 0.001) and the rate of perceived exertion (RPE) by 13 per cent (P less than 0.001) at the highest comparable work load. The CW was 38 per cent higher in the training than the control group after 6 (P less than 0.02) and 37 per cent after 12 months (P less than 0.025). After one year 81 per cent in group A and 65 per cent in group B were working (NS). Reemployment correlated significantly with the CW and inversely with the duration of sick leave prior to operation. Thus, physical training shortly after aortic valve operation rapidly and persistently improves physical work capacity while return to work is less influenced by training and socio vocational assistance.

Adult↗
PubMed1996

Preferences for intracytoplasmic sperm injection versus donor insemination in severe male factor infertility: a preliminary report.

With the advent of intracytoplasmic sperm injection (ICSI), our programme noted a drop in the number of couples using donor insemination (DI) for severe male factor infertility. Over the first 8 months in which our infertility programme offered both treatments, 27 consecutive couples scheduled for ICSI and 15 consecutive couples scheduled for DI were evaluated Since all patients in our infertility programme beginning in-vitro fertilization (IVF) with planned ICSI or starting DI undergo a semi-structured psychological interview, the psychologist's clinical notes as well as the medical chart were reviewed and coded retrospectively to determine factors related to a couple's treatment choice. Couples who chose IVF-ICSI over DI had a higher occupational status and included husbands with higher educational levels. Their most common motivation was to have the husband's biological child (93% of couples in the ICSI group). The most common motivation for choosing DI (60% of DI couples) was that IVF was not financially affordable. Choice of treatment was not related to psychological adjustment, the husband having prior biological children, or his risk of passing on a genetic defect to offspring. These preliminary data raise the concern that, with the success of ICSI, DI may change in the USA from being an option dictated by semen quality to a second choice treatment utilized for economic reasons.

Adult↗
PubMed2000

Doctors who kill themselves: a study of the methods used for suicide.

Medical practitioners have a relatively high rate of suicide. Death entry data for doctors who died by suicide or undetermined cause between 1979 and 1995 in England and Wales were used to compare methods used for suicide by doctors with those used by the general population. Methods used were analysed according to gender, occupational status and speciality, to assess the extent to which access to dangerous means influences the pattern of suicide. Self-poisoning with drugs was more common in the doctors than in general population suicides (57% vs. 26.6%; OR=3.65, 95% CI 2.85-4. 68), including in retired doctors. Barbiturates were the most frequent drugs used. Half of the anaesthetists who died used anaesthetic agents. Self-cutting was also more frequently used as a method of suicide. The finding that the greater proportion of suicide deaths in doctors were by self-poisoning may reflect the fact that doctors have ready access to drugs, and have knowledge of which drugs and doses are likely to cause death. The specific finding that a large proportion of suicides in anaesthetists involved anaesthetic agents supports this explanation. Availability of method may be a factor contributing to the relatively high suicide rate of doctors. This fact might influence clinical management of doctors who are known to be depressed or suicidal.

Adult↗
PubMed1996

Mental disorder and criminality: male schizophrenia.

This study investigated lifetime prevalence of criminal behavior in a population of male schizophrenia patients. A total of 282 schizophrenia patients was divided into three subgroups (representing schizophreniform disorder, acute schizophrenia, and chronic schizophrenia). The same number of control subjects was drawn from the general population and matched with the patients for sex, age, marital status, occupational level, and community size. The full account of conviction records in the criminal register was used as a measure of criminal behavior. Patients were 5 times more likely to have been convicted of violent crimes, 2 1/2 times more likely to have been convicted of crimes against property, and almost 3 times more likely to have violated drug laws. Criminality rates in schizophrenia depended, however, not only on the type of offense but also on the type or stage of the illness, which contributed to criminal behavior to some extent independently of sociodemographic factors.

Adolescent↗
PubMed1982

Cancer patient accessions into clinical trials: a pilot investigation into some patient and physician determinants of entry.

This study investigated the external validity (or generalizability of results) of randomized clinical trials in cancer. Tao ECOG lung cancer chemotherapy protocols active in the early 1970s were studied using a case-control design. All lung cancer patients of the four specified cell types resident in Monroe County during the ECOG study period were identified from the Rochester Regional Tumor Registry. All of the patients entered into either protocol ("ECOG cases") and a random sample of the nonprotocol cases were examined by medical records review. Thirty-seven percent of the nonprotocol cases were determined to have been eligible for either of the two ECOG protocols, but not entered ("eligible controls"). A comparison of the ECOG cases (n = 65) and the eligible controls (n = 109) revealed that (1) ECOG cases were more likely than eligible controls to have been diagnosed at a hospital which participated in the University of Rochester Cancer Center's medical oncology program; (2) ECOG cases were of higher occupational status than eligible controls; (3) duration from diagnosis to protocol entry for ECOG cases was longer than duration from diagnosis to earliest date of eligibility for eligible controls. The implications of these findings for the conduct of cancer clinical trials are discussed.

Aged↗
PubMed2000

Effect of home and hospital delivery on long-term cognitive function.

We examined the relation between place of birth and cognitive function in young adult life in a historical cohort study based upon birth data from the computerized Danish Medical Birth Registry and cognitive function as measured at time of drafting for military service in two Danish counties. The cohort included 4,296 Danish conscripts born between 1973 and 1976, 123 born at home and 4,173 born in hospital or at a birth clinic. Cognitive function was measured by the Boerge Prien test in men, 18 to 20 years of age. The highest possible score is 78. The mean Boerge Prien test score was 43.1 for conscripts born in specialized hospital departments, 2.4 higher for conscripts born in a birth clinic (95% confidence interval = 0.9-4.0), and 2.1 lower for conscripts born at home (95% confidence limits = -3.8 to -0.4) after adjusting for birth weight, length at birth, birth order, gestational age, maternal age, and marital and occupational status. Our findings raise the possibility that home birth can lead to lower cognitive function in adulthood; however, from our data we could not distinguish between planned and unplanned births at home.

Adult↗
PubMed1993

Predictors of psychologic distress one year after spinal cord injury.

This study investigated predictors of psychologic distress at 1 year after injury. The brief symptom inventory, a symptom checklist that provides an overall index of distress, was administered to 119 spinal cord-injured patients. All patients had diagnoses of recent, traumatic SCI and had been admitted for initial inpatient rehabilitation between 1985 and 1990. Results showed levels of psychologic distress to be significantly higher 1 year after injury when compared with results obtained on admission and at discharge from the inpatient rehabilitation program. The prevalence rate for elevated distress after injury was 28%. Significant predictors of psychologic distress 1 year after injury included level of distress at admission, neurologic completeness of SCI, type of rehabilitation insurance payor (catastrophic v noncatastrophic), occupational status before SCI and participation status in an inpatient independent living program. A multiple regression model with nine independent variables was specified that explained 63% of the variance in psychologic distress measured after injury.

Adaptation, Psychological↗
PubMed1990

Childhood sexual abuse among chronic pain patients.

Recent literature indicates a relationship between history of sexual abuse and subsequent psychological and social dysfunction. Less thoroughly examined are the possible abuse-related physical effects. This article examines the prevalence of sexual abuse among 135 chronic pain patients. History of abuse for all patients was determined during initial interview. Twenty-eight percent reported child sexual abuse, with history of victimization more significant for women (39%) than men (7%). The abused and nonabused groups of women differed on such variables as marital status, occupation, history of rape and substance abuse, and age of hospitalization. The relationship between sexual abuse and chronic somatic reactions was discussed.

Adult↗
PubMed1997

The effects of oral versus written instructions on parents' recall and satisfaction after pediatric appointments.

This study explored the differential effects of written versus oral instructions on parents' recall of information and satisfaction after pediatric appointments. Ninety-six parents completed descriptive information and satisfaction ratings, and four pediatricians completed ratings concerning the complexity level of the appointment. After the appointment, parents were randomly assigned to the Written condition (to receive a transcription of the pediatrician's instructions) or Oral condition (verbal instruction only). Parents were telephoned 5 to 7 days later to report their recall of instructions and satisfaction with the appointment. For the Oral condition parents only, more previous appointments with a given pediatrician were associated with greater parental satisfaction and recall of instructions, and more previous appointments and more time spent with the pediatrician were related to fewer forgotten instructions. Parental characteristics, such as age, number of children, and occupational status, were associated with satisfaction and accurate recall. Implications of these findings are discussed.

Adolescent↗
PubMed1994

A case-control study of ulcerative colitis in Japan.

To determine whether risk factors of ulcerative colitis among Japanese are the same as those observed in other countries, we conducted a case-control study in Japan in 1988-90. Patients selected for the study were receiving financial aid for treatment of the disease; an equal number of population-based controls matched by age and sex were selected. Smoking decreased the risk of the disease (odds ratio = 0.30; 95% confidence interval, 0.16-0.56), and stopping smoking increased the risk (odds ratio compared with those who had never smoked = 1.44; 95% confidence interval, 0.73-2.85). In those who drank alcoholic beverages > or = 5 days a week, disease development was less likely than in others (odds ratio = 0.49; 95% confidence interval, 0.30-0.81). In addition, difficulties in human relations at work, a family history of asthma, a medical history of surgical procedures, and personality traits such as nervousness, anxiety, and obsessive behavior were also considered risk factors. Although some findings are similar to those in former studies, a few findings are different: surgical procedures, occupational status, and a family history of the disease. To clarify whether the differences are consistent will require other case-control studies.

Adult↗
PubMed1976

The fate of the untreated alcoholic. Toward a natural history of the disorder.

Eighty-three male alcoholics were administered a structured interview when they appeared at a large general hospital for treatment of a variety of disorders. These represent 83 consecutive cases. None received treatment aside from brief "drying-out" but all were accepted as participants in a research program. Seventy-three (88 per cent of the sample) were located for a 3-year follow-up; five of these were not seen at the 1-year follow-up, and 10 were known to be dead. This paper focuses on 58 of the alcoholics who were seen at all three evaluations, and the 10 who were known dead. The data are presented as indicating the long term results of, at best, a mild or minimal intervention with male alcoholics. A small, but significant improvement was noted on several life-adjustment scales between the initial and 1-year evaluation (OYE), but no further improvement was seen between OYE and the 3-year evaluation (TYE); 19 percent were abstinent for 1 year and 10 per cent for the full 3-year period. The best predictor of TYE abstinence was OYE abstinence, but only for the extremes, i.e., no abstinence or total abstinence. Abstinence success was also related to a tendency to use community resources, lower number of mental hospitalizations, higher occupational status, higher global rating and, curiously, lower interpersonal adjustment rating. The group using Alcoholics Anonymous showed no better outcome than the group using no community resources at all. The mortality rate was 12 per cent over the 3 years or slightly more than 4 per cent a year. The suicide rate was about 4 per cent over the 3 years. The ratings for those dying showed a pattern of more admitted drunken arrests and heavy recent drinking superimposed on lighter overall drinking for the past year. The study demonstrates that even untreated alcoholics can be traced and effective follow-up studies completed. Results also indicate that over long time periods and left to their own devices, many alcoholics do seek out some form of help. But such assistance tends not to be sustained or intensive and a good portion of it is nonprofessional and nonmedical. Moreover, a surprisingly substantial number (31 per cent) of hospital-identified alcoholics apparently neither seek out nor receive any help at all after their initial identification; yet their self-reported life-adjustment ratings do not differ significantly from those who do seek help. The no-help receivers may be the most critical group of all to follow, as they are trule untreated. It would be important to determine how consistent in fact they are in their avoidance of help, what accounts for that behavior, and whether their ultimate fate is different from those who regularly seek assistance.

Alcohol Drinking↗
PubMedDate not supplied

Antecedents of nursing school attrition: attitudinal dimensions.

In an attempt to identify attitudinal orientations that might be used as indicators of attrition, demographic, academic performance, and attitudinal data on 261 students enrolled in the Woodruff School of Nursing at Emory University, Atlanta, between 1968 and 1972, were studied. Traditional measures of scholastic aptitude were not found to be good indicators. The higher the father's educational attainment, the more likely attrition was to occur. The higher the mother's occupational status, the less likely attrition was to occur. Attitudinal measures used in the study seemed to have little direct impact on attrition.

Attitude↗
PubMed1981

Psychological depression and 17-year risk of death from cancer.

Psychological depression, measured in 1957-1958 by the Minnesota Multiphasic Personality Inventory at the baseline examination of 2,020 middle-aged employed men, was associated (p less than 0.001) with a twofold increase in odds of death from cancer during 17 years of follow-up. The association did not vary appreciably in magnitude among the early (1958-1962), middle (1963-1968), and later (1969-1974) years of follow-up, persisted after adjustment for age, cigarette smoking, use of alcohol, family history of cancer, and occupational status, and was apparently not specific to any particular site or type of cancer. This result, predicted in advance on the basis of findings by other investigators, is consistent with the hypothesis that psychological depression is related to impairment of mechanisms for preventing the establishment and spread of malignant cells.

Adult↗
PubMedDate not supplied

Personality and risk of cancer: 20-year follow-up of the Western Electric Study.

Psychologic depression as measured by the Minnesota Multiphasic Personality Inventory (MMPI) in a cohort of 2018 middle-aged men employed at the Western Electric Company in 1957-1958 was positively associated with 20-year incidence and mortality from cancer. The association with incidence was apparent only during the first 10 years of follow-up, but the association with mortality was observed for the full 20 years of follow-up. The association persisted after adjustment for age, number of cigarettes smoked, alcohol intake, occupational status, family history of cancer, body mass index, and serum cholesterol. The association did not appear to be stronger for one type of cancer than another, but the power of this study to detect differences among types of cancer was limited by small numbers. However, the association did appear to be stronger with risk of fatal cancer than with total incidence. No association was noted between other variables measured by the MMPI or Cattell 16 Personality Factor Inventory and subsequent incidence or mortality from cancer. Specifically, the data did not support the hypothesis that psychologic repression, as measured by Welsh R scale in the MMPI, would be associated with risk of cancer. These results are consistent with previously reported results that have suggested that psychologic depression might promote the development and spread of malignant neoplasms.

Depression↗
PubMed1997

Risk factors for bladder cancer: a case-control study in northeast China.

A case-control study of risk factors for bladder cancer was carried out in Heilongjing Province, China. Between May 1989 and May 1990, 217 histologically confirmed cases of bladder cancer and 254 controls with non-neoplastic and non-urine system disease were recruited. Individuals were interviewed in the wards of six major hospitals. Controls were matched by sex, age and area of residence. Information was collected concerning economic status, occupation, histories of smoking and consumption of alcohol, use of tea, the taking of analgesics, dietary histories and previous diseases. Odds ratios (ORs) were calculated from stratified analysis and conditional logistic regression models. Increased risk was observed with increasing times per year and number of years of saccharine use. Compared with non-users, the use of saccharine for more than 19 times per year, and for more than 15 years, the adjusted ORs were 3.9 (95% CI = 1.8-8.67) and 5.1 (95% CI = 2.3-11.6), respectively. Statistically significant associations were also found for diseases related to the urinary system (OR = 2.8; 95% CI = 1.1-7.6). Increased consumption of fruit and vegetable may reduce the risk of bladder cancer. Cigarette smoking had no effect on the risk of bladder cancer in both genders. There was no association between the consumption of alcohol or tea, or types of water supply, with bladder cancer risk.

Adult↗
PubMed2005

Do immigrants have an increased prevalence of unhealthy behaviours and risk factors for coronary heart disease?

BACKGROUND: Although previous research has demonstrated a high risk of coronary disease in immigrants, the prevalence of unhealthy behaviours and risk factors is less known. The aim of this study was to investigate whether unhealthy behaviours and risk factors for coronary disease are more common in immigrants than in Swedish-born individuals. METHODS: Between 1 January 1996 and 31 December 2002 a simple random sample of the population was drawn and interviewed face to face. Eight immigrant groups in Sweden and a Swedish-born reference group, aged between 27 and 60 years, were studied. A log-binomial model was used to analyse the cross-sectional association between country of birth and unhealthy behaviours as well as coronary disease risk factors. RESULTS: Many of the immigrant groups showed higher risks of smoking, of physical inactivity and of obesity than Swedish-born individuals in age-adjusted models. On also adjusting for the level of education, occupational status and social network, the differences in risk persisted in the majority of groups. However, the over-risks of physical inactivity in Finnish and south European immigrant men and of diabetes in Finnish and Turkish immigrant women disappeared. CONCLUSIONS: The high prevalence of unhealthy behaviours and risk factors for coronary disease in many immigrant groups might be a lifestyle remnant from their country of birth or might be brought about by a stressful migration and acculturation into a new social and cultural environment. Nevertheless, it is important in primary healthcare to be aware of a possible preventable increased risk of unhealthy behaviours and risk factors for coronary disease in some immigrants.

Adult↗
PubMed2007

Smoking rate trends in U.S. occupational groups: the 1987 to 2004 National Health Interview Survey.

OBJECTIVE: It is unknown if the gap in smoking rates observed between United States blue- and white-collar workers over the past four decades has continued into the new millennium. METHODS: The National Health Interview Survey is a nationally representative survey of the US civilian population. Smoking and current occupational status were assessed over survey periods 1987 to 1994 and 1997 to 2004 (n= 298,042). RESULTS: There were significant annual reductions in smoking rates for all adult US workers in both survey periods. Several blue-collar groups had greater annual smoking rate reductions in the most recent survey period relative to the earlier survey period. However, the majority of blue-collar worker groups had pooled 1997 to 2004 smoking rates in excess of the 24.5% smoking prevalence noted for all workers. CONCLUSION: Development of effective smoking prevention strategies specifically targeting blue-collar groups is warranted.

Adult↗