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PubMed2004

Pediatric caustic ingestion and parental cocaine abuse.

OBJECTIVE: To report two cases in which toddlers drank a caustic liquid which their parents had been using to prepare free-base and crack cocaine. DESIGN: Case series. RESULTS: Two toddlers presented with first- and second-degree burns of the oral cavity, pharynx and esophagus from caustic ingestion. The first had drunk ammonia from an unmarked clear plastic container the morning after "a party at a friend's house". The second had drunk potassium hydroxide from a clear plastic container which was labelled "pH UP" and had a small "Danger" sign. Both children were treated with intravenous hydration, steroids, antibiotics and analgesics. Fortunately, neither child suffered long-term physical sequelae. When questioned, the parents of both children admitted to using these alkalis to prepare free-base and crack cocaine. Appropriate steps were taken by social services to protect these children from further neglect. DISCUSSION: Despite federal legislation and public education, pediatric caustic ingestion remains a significant problem. These cases suggest that, in certain cases of pediatric caustic ingestion, caregivers should be questioned regarding possible drug abuse. Larger warning labels and further public education might help prevent many cases of pediatric caustic ingestion.

Ammonia↗
PubMed2003

Multiple predictors of substance-abusing women's treatment and life outcomes: a prospective longitudinal study.

The purpose of this study was to identify client factors that predict treatment and life outcomes of women enrolled in outpatient (OP) and residential (RT) substance abuse treatment. Subjects were 95 women who enrolled in OP or RT from September 1994 through February 1997, remained in treatment a minimum of 3 months, and completed a 12-month assessment protocol. Factor analyses and a series of multiple regression procedures were conducted to examine whether biopsychosocial characteristics at intake predicted treatment outcomes and life outcomes. The results indicated that client intake characteristics explained 27-34% of the variance in OP treatment outcomes and 40-63% of the variance for women in RT. The findings suggest that prediction of women's life outcomes is complex, differs for women in RT and OP treatment, and consists of multiple factors. These risk and protective factors include social support, daily stressors, life satisfaction, partner abuse, substance abuse by self and significant others, psychiatric history, chronic medical conditions, childbirth history, childcare responsibilities, and treatment engagement.

Adult↗
PubMed1996

National research agenda for prevention research. The National Institute of Mental Health Report.

This article reports some of the most promising ideas to emerge from a review conducted by the National Institute of Mental Health of the achievements and prospects for research on the prevention of mental disorders. These ideas are organized around 3 conceptual hubs: the development and transformation of biological and social risk and protective factors across the life span, classifying and relating various approaches to preventive interventions in a single logical system, and concepts about community contexts in which prevention trials are executed. These conceptual hubs clarify the relationship between 3 forms of research in prevention: longitudinal studies of risk, randomized preventive intervention trials, and the implementation of successful interventions as part of routine community practice.

Community Mental Health Services↗
PubMed1982

On the self-serving function of an academic wooden leg: test anxiety as a self-handicapping strategy.

The present study investigated the hypothesis that psychological symptoms may serve a self-protective function by providing an alternative explanation for potential failure in evaluating situations. It was hypothesized that highly test-anxious subjects would report anxiety symptoms in a pattern that reflected strategic presentation of symptoms; more specifically, it was predicted that greater reported anxiety should result when anxiety was a viable explanation for poor performance on an intelligence test and that lower reported anxiety should result when anxiety was not a viable explanation for poor performance. Analysis of state measures of self-reported anxiety supported these predictions. Further analysis indicated that when anxiety was not a viable explanation for poor test performance, high test-anxiety subjects reported reduced effort as an alternative self-protective strategy. These results are discussed in terms of traditional models of symptoms as self-protective strategies, current social psychological models of symptoms, and in reference to recent theory and research about the nature and treatment of test anxiety.

Achievement↗
PubMed1999

Childhood Type 1 diabetes mellitus and parental occupations involving social mixing and infectious contacts: two population-based case-control studies.

AIMS: To test the hypothesis that increased exposure to infections, through parental jobs involving high levels of social mixing, reduces the risk of childhood Type 1 diabetes mellitus. METHODS: Two population-based case-control studies of children diagnosed with Type 1 diabetes mellitus from Yorkshire (0-15 years) and Northern Ireland (0-14 years) included 220 and 189 cases and 433 and 465 controls, respectively. Parental occupations were coded using a standard occupational classification. Each job was allocated to high, medium or low levels of social mixing according to a predefined categorization. Odds ratios (OR) for the risk of childhood Type 1 diabetes were estimated for parental social mixing by age at diagnosis. RESULTS: Childhood Type 1 diabetes mellitus was not associated with high levels of parental occupational social mixing (Yorkshire - mothers: OR 1.07, 95% confidence interval (CI) 0.76-1.50; fathers: 1.15, 0.75-1.76; Northern Ireland - heads of household, usually the father: 0.78, 0.49-1.25). A larger proportion of mothers (39%) compared to fathers (18% Yorkshire, 17% Northern Ireland) had jobs involving high levels of social mixing. Mothers with high social mixing jobs conferred a nonsignificant reduced risk of Type 1 diabetes among children diagnosed under 5 years of age (0.58, 0.24-1.38) compared to those diagnosed at age 5 years and above (1.14, 0.77-1.69). CONCLUSIONS: No association between parental occupational social mixing and the risk of childhood Type 1 diabetes mellitus was detected for all ages combined. Mothers were more likely to have jobs involving high levels of social mixing than fathers. The possible protective effect of maternal high occupational social mixing on children diagnosed below 5 years of age merits further investigation.

Adolescent↗
PubMed2001

How age and daytime activities are related to insomnia in the general population: consequences for older people.

OBJECTIVES: To determine the role of activity status and social life satisfaction on the report of insomnia symptoms and sleeping habits. DESIGN: Cross-sectional telephone survey using the Sleep-EVAL knowledge base system. SETTING: Representative samples of three general populations (United Kingdom, Germany, and Italy). PARTICIPANTS: 13,057 subjects age 15 and older: 4,972 in the United Kingdom, 4,115 in Germany, and 3,970 in Italy. These subjects were representative of 160 million inhabitants. MEASUREMENTS: Clinical questionnaire on insomnia and investigation of associated pathologies (psychiatric and neurological disorders). RESULTS: Insomnia symptoms were reported by more than one-third of the population age 65 and older. Multivariate models showed that age was not a predictive factor of insomnia symptoms when controlling for activity status and social life satisfaction. The level of activity and social interactions had no influence on napping, but age was found to have a significant positive effect on napping. CONCLUSIONS: These results indicate that the aging process per se is not responsible for the increase of insomnia often reported in older people. Instead, inactivity, dissatisfaction with social life, and the presence of organic diseases and mental disorders were the best predictors of insomnia, age being insignificant. Healthy older people (i.e., without organic or mental pathologies) have a prevalence of insomnia symptoms similar to that observed in younger people. Moreover, being active and satisfied with social life are protective factors against insomnia at any age.

Adolescent↗
PubMedDate not supplied

The relationship between prayer, health behaviors, and protective resources in school-age children.

The purpose of this study was to examine (1) the relationship between children's use of prayer as a coping strategy and other protective resources, and (2) whether children who prayed frequently and those who never prayed exhibited different levels of perceived stress and health behaviors. Prayer was found to be positively related to the protective resources of social connectedness and sense of humor. In addition, children who prayed frequently reported significantly higher levels of positive health behaviors than children who never prayed. These two groups of children did not significantly differ in their levels of perceived stress.

Adaptation, Psychological↗
PubMed2006

Work-related life events, psychological well-being and cardiovascular risk factors in male Swedish automotive workers.

AIMS: To analyse the relationship between life events, social support, psychological well-being and cardiovascular risk factors in blue- and white-collar Swedish automotive workers. METHODS: Baseline questionnaire regarding life events, social support, depressed mood and mental strain and smoking habits. Follow-up questionnaire after 5 years included the Psychological General Well-being Inventory to assess various health variables. At baseline and follow-up, anthropometric data were obtained. Blood pressure, blood glucose and serum lipids were measured and smoking habits were surveyed. RESULTS: The blue-collar workers showed a profile indicating increased cardiovascular risk with a higher proportion of smokers, a higher waist to hip ratio and higher triglycerides. They also reported themselves to have worse general health and less emotional self-control, but were less anxious than the white-collar workers. Negative life events, especially those related to work seemed to affect the well-being of the blue-collar workers more adversely than the white-collar workers. Being nervous and depressed at baseline increased the risk of poor psychological well-being at the follow-up. Social support within this 5-year perspective was a factor which predicted psychological well-being in both worker categories. Increase in cholesterol/high-density lipoprotein-cholesterol (HDL-C) ratio was the only cardiovascular risk factor associated with the strain of life events but not with work-related events. CONCLUSION: Over a 5-year period, men who experienced negative, strongly stressful and work-related life events displayed poorer psychological well-being at follow-up regardless of worker category. Social support was protective.

Alcohol Drinking↗
PubMedDate not supplied

Racial residential segregation: a fundamental cause of racial disparities in health.

Racial residential segregation is a fundamental cause of racial disparities in health. The physical separation of the races by enforced residence in certain areas is an institutional mechanism of racism that was designed to protect whites from social interaction with blacks. Despite the absence of supportive legal statutes, the degree of residential segregation remains extremely high for most African Americans in the United States. The authors review evidence that suggests that segregation is a primary cause of racial differences in socioeconomic status (SES) by determining access to education and employment opportunities. SES in turn remains a fundamental cause of racial differences in health. Segregation also creates conditions inimical to health in the social and physical environment. The authors conclude that effective efforts to eliminate racial disparities in health must seriously confront segregation and its pervasive consequences.

Black or African American↗
PubMed2004

Effects of functional restoration versus 3 hours per week physical therapy: a randomized controlled study.

STUDY DESIGN: Randomized parallel-group comparative trial with a 6-month follow-up period. OBJECTIVE: To compare, in chronic low back pain patients, the effectiveness of a functional restoration program, including intensive physical training, occupational therapy, and psychological support to an active individual therapy consisting of 3 hours physical therapy per week during 5 weeks. SUMMARY OF BACKGROUND DATA: Controlled studies conducted in the United States showed a benefit of functional restoration in patients with low back pain, especially on return to work. Randomized Canadian and European trials had less favorable results. In France, there has been up to now no randomized study. Controlled studies suggested a positive effect of functional restoration programs. METHODS: Eighty-six patients with low back pain were randomized to either the functional restoration (44 patients) or the active individual therapy (42 patients) program. One person in each group never started the program. Two patients did not complete the functional restoration program, and one was lost to follow-up at 6 months. The mean number of sick-leave days in the 2 previous years was 6 months. RESULTS: After adjustment on the variable "workplace enrolled in an ergonomic program", the mean number of sick-leave days was significantly lower in the functional restoration group. Physical criteria and treatment appreciation were also better. There was no significant difference in the intensity of pain, the quality of life and functional indexes, the psychological characteristics, the number of contacts with the medical system, and the drug intake. CONCLUSIONS: This study demonstrates the effectiveness of a functional restoration program on important outcome measures, such as sick leave, in a country that has a social system that protects people facing difficulties at work.

Absenteeism↗
PubMed2004

What I learnt from studying epilepsy: epileptology and myself.

My life work with epilepsy has allowed me to learn a great deal. As an old soldier, I would like to give an account of some important milestones in my lifetime learning. The first factor that linked me to epilepsy was listening to a lecture delivered by Dr Yushi Uchimura on 'The pathogenesis of Ammon's horn sclerosis' at a conference of the Japanese Society of Neurology (now Japanese Society of Psychiatry and Neurology) in 1928 when I was a 4th year medical student at Tokyo University. The following year, I started to study under Dr Uchimura at the Department of Psychiatry, Hokkaido University School of Medicine. Another factor that linked me to clinical care and research of epilepsy as a psychiatrist was my encounter with the two volumes of 'Selected Writing of John Hughlings Jackson' edited by J. Taylor. Jackson's greatest asset and contribution to modern epileptology include (i) the discovery of 'Jacksonian epilepsy', (ii) 'conceptual revolution of epilepsy' by recognizing transient mental disorders as seizures, (iii) modern definition of epilepsy by defining epileptic seizures as discharges in the gray matter, and (iv) discovery of 'new epilepsy' (now temporal lobe epilepsy). In 1940, I reported clinical courses indistinguishable from schizophrenia in epilepsy cases. Through my studies, I disputed the then prevailing interpretation of this condition as epilepsy complicating schizophrenia, and proved that these cases were in fact epileptic mental disorders caused by epilepsy. Many patients with epilepsy require medical care as well as rehabilitation and welfare support. We need to further promote the facilities for rehabilitation and employment in the community for persons with epilepsy, such as co-operatives and welfare worksites. The issues that epileptology and epilepsy face in the 21st century is to realize the goals of liberating epilepsy from social stigma and protecting all the citizen's rights for persons with epilepsy.

Epilepsy↗
PubMed2000

Effect of counselling mothers on their children's exposure to environmental tobacco smoke: randomised controlled trial.

OBJECTIVE: To test the efficacy of behavioural counselling for smoking mothers in reducing young children's exposure to environmental tobacco smoke. DESIGN: Randomised double blind controlled trial. SETTING: Low income homes in San Diego county, California. PARTICIPANTS: 108 ethnically diverse mothers who exposed their children (aged <4 years) to tobacco smoke in the home. INTERVENTION: Mothers were given seven counselling sessions over three months. MAIN OUTCOME MEASURES: Children's reported exposure to environmental tobacco smoke from mothers in the home and from all sources; children's cotinine concentrations in urine. RESULTS: Mothers' reports of children's exposure to their smoke in the home declined in the counselled group from 27.30 cigarettes/week at baseline, to 4.47 at three months, to 3.66 at 12 months and in the controls from 24.56, to 12.08, to 8.38. The differences between the groups by time were significant (P=0.002). Reported exposure to smoke from all sources showed similar declines, with significant differences between groups by time (P=0.008). At 12 months, the reported exposure in the counselled group was 41.2% that of controls for mothers' smoke (95% confidence interval 34.2% to 48.3%) and was 45.7% (38.4% to 53.0%) that of controls for all sources of smoke. Children's mean urine cotinine concentrations decreased slightly in the counselled group from 10.93 ng/ml at baseline to 10.47 ng/ml at 12 months but increased in the controls from 9.43 ng/ml to 17.47 ng/ml (differences between groups by time P=0.008). At 12 months the cotinine concentration in the counselled group was 55.6% (48.2% to 63.0%) that of controls. CONCLUSIONS: Counselling was effective in reducing children's exposure to environmental tobacco smoke. Similar counselling in medical and social services might protect millions of children from environmental tobacco smoke in their homes.

Adult↗
PubMed1980

Confidentiality in the National Health Service and in the service for sexually transmitted diseases.

The principles of medical confidentiality have been laid down by the Department of Health and Social Security to protect patients from unauthorised disclosure of confidential information, whether it is stored in traditional medical notes or in computers. Special arrangements have been made for the records of patients with sexually transmitted diseases since the inception of the service in 1916. In these cases medical secrecy is protected by statute law. Special regulations exist to allow disclosure of certain details to doctors, or persons employed under the direction of doctors, to facilitate contact tracing and treatment. Confidentiality is maintained in the specialty by the storage of records in the clinics, the refusal to allow information to be given outside the clinics except in special circumstances, the training of the clinic staff, and the absence of any central record of patients.

Attitude of Health Personnel↗
PubMed2004

Melanin pigmentation in mammalian skin and its hormonal regulation.

Cutaneous melanin pigment plays a critical role in camouflage, mimicry, social communication, and protection against harmful effects of solar radiation. Melanogenesis is under complex regulatory control by multiple agents interacting via pathways activated by receptor-dependent and -independent mechanisms, in hormonal, auto-, para-, or intracrine fashion. Because of the multidirectional nature and heterogeneous character of the melanogenesis modifying agents, its controlling factors are not organized into simple linear sequences, but they interphase instead in a multidimensional network, with extensive functional overlapping with connections arranged both in series and in parallel. The most important positive regulator of melanogenesis is the MC1 receptor with its ligands melanocortins and ACTH, whereas among the negative regulators agouti protein stands out, determining intensity of melanogenesis and also the type of melanin synthesized. Within the context of the skin as a stress organ, melanogenic activity serves as a unique molecular sensor and transducer of noxious signals and as regulator of local homeostasis. In keeping with these multiple roles, melanogenesis is controlled by a highly structured system, active since early embryogenesis and capable of superselective functional regulation that may reach down to the cellular level represented by single melanocytes. Indeed, the significance of melanogenesis extends beyond the mere assignment of a color trait.

Animals↗
PubMed1999

Befriending as an intervention for chronic depression among women in an inner city. 1: Randomised controlled trial.

BACKGROUND: Earlier work on the protective role of social support in onset and course of depressive disorder suggested that its provision might be relevant for outcome. AIMS: To evaluate volunteer befriending as an intervention among women with chronic depression in inner London. METHOD: A randomised controlled trial, with a waiting list control design, with outcome measured as Present State Examination (PSE)-based full or partial remission after one year. RESULTS: A statistically significant effect upon remission was found for befriending. Other treatments monitored naturalistically did not relate to remission, nor did initial duration of chronic episode or comorbidity, but there was an association with initial PSE score. The findings are discussed in relation to standard drug-trial results and to another befriending intervention with the elderly. CONCLUSIONS: The results are not unpromising. Additional trials with less restricted intake conditions, and in more naturalistic general practice settings, might confirm volunteer befriending as a useful adjunct to current treatments.

Adult↗
PubMedDate not supplied

[The Health, Well-Being, and Aging ("SABE") survey: methodology applied and profile of the study population].

This document outlines the methodology of the Salud, Bienestar y Envejecimiento (Health, Well-Being, and Aging) survey (known as the "SABE survey"), and it also summarizes the challenges that the rapid aging of the population in Latin America and the Caribbean imposes on society in general and especially on health services. The populations of the countries of Latin America and the Caribbean are aging at a rate that has not been seen in the developed world. The evaluation of health problems and disability among older adults in those countries indicates that those persons are aging with more functional limitations and worse health than is true for their counterparts in developed nations. In addition, family networks in Latin America and the Caribbean are changing rapidly and have less capacity to make up for the lack of protections provided by social institutions. The multicenter SABE study was developed with the objective of evaluating the state of health of older adults in seven cities of Latin America and the Caribbean: Bridgetown, Barbados; Buenos Aires, Argentina; Havana, Cuba; Mexico City, Mexico; Montevideo, Uruguay; Santiago, Chile; and São Paulo, Brazil. The SABE survey has established the starting point for systematic research on aging in urban areas of Latin America and the Caribbean. Comparative studies of these characteristics and with this comparative nature should be extended to other countries, areas, and regions of the world in order to expand the knowledge available on older adults.

Aged↗
PubMed2004

Child maltreatment in families experiencing domestic violence.

This study examined the association between physical domestic violence (PDV) and reported child maltreatment in a cohort of children at risk for maltreatment. Participants were 219 6- to 7-year-old children and their caregivers. PDV was measured by combining caregivers' self-reports and children's reports, while child maltreatment was based on state Division of Social Services Central Registry records. Among 219 child-caregiver pairs studied, 42 (19.2%) had at least one maltreatment report in the 2 years following the interviews. PDV consistently predicted child maltreatment, with adjusted odds ratios ranging from 2.96 to 3.46. In addition, we investigated interactions between PDV and other predictors of child maltreatment. Among Aid to Families with Dependent Children (AFDC) participants, PDV was highly associated with child maltreatment. However, this pattern was not observed among subjects who did not have AFDC. There is an increased incidence of child maltreatment reports in families experiencing PDV. AFDC participation intensified the probability of child maltreatment in the presence of PDV. Findings also suggest that in households experiencing PDV, social supports may protect children from maltreatment.

Adult↗
PubMed1989

Australian adolescents' perceptions of their parents.

We examined the characteristics of a self-report measure for assessing perceptions of parents, the Parental Bonding Instrument (PBI), in an adolescent community sample (N = 2,147; mean age = 15.4 years). Using factor analysis, three PBI dimensions were identified--the original Care factor and two Protection factors: perceived social control and personal intrusiveness. Important sex differences were found which were not evident in the two factor structure recommended by Parker [1,2]. Relative to sons, daughters saw their fathers as more personally intrusive and their mothers as less socially controlling and much more caring. Overall, adolescents perceived mothers as more caring but more personally intrusive than fathers. Adolescents who saw their father as uncaring and their mother as controlling tended to have the least positive psychosocial profiles.

Adolescent↗