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PubMed1989

Psychological concomitants of tobacco and alcohol use in young Australian adults.

Nineteen-year-old subjects in an Australian community sample (N = 1028) reported their tobacco and alcohol use of the previous week, and 598 of them gave similar information 3 years later. The paper examines the demographic (sex, ethnic background, and occupational status) and psychological characteristics (hopelessness, self-esteem, locus of control, and social alienation) of tobacco and alcohol users and nonusers at the ages of 19 and 22, and also of subjects who started or stopped consumption of these drugs over the three year period. Smoking at 22, and particularly having started to smoke between 19 and 22, seems to be associated with feelings of demoralization and social alienation, as is relatively heavy drinking. Moderate drinking of alcohol is however normative for the well-adjusted and socially well-integrated young adult in this culture. The findings imply a need for rather different health-promotion messages related to tobacco and to alcohol.

Adaptation, Psychological↗
PubMed2004

Motor co-ordination in a South Indian population of children.

AIMS: To examine the associations of motor co-ordination in Kerala, South India. METHODS: The Modified Oseretsky Test of motor co-ordination was administered to 1155 representative children during a door-to-door survey of 8-12 year olds. Reading, vocabulary and visuospatial reasoning were measured, as were height and weight. Information on medical history, socio-demographic background and behaviour was systematically collected. RESULTS: Age was the major association of motor incoordination indicating the importance of maturation. Behaviour, vocabulary, visuospatial reasoning, material deprivation, perinatal complications, chronic physical symptoms and occupational status of the father were also independently associated with motor co-ordination. Using sibling pairs, evidence of familial aggregation of motor co-ordination was found.

Age Distribution↗
PubMed1994

Diagnostic assessment of developmental disability: the parents' view.

A self-report questionnaire was used to survey parental recollections and opinions concerning: detection and diagnosis of their child's developmental disabilities; the accessibility, usefulness and the efficacy of generic and specialist services which were offered and utilized by the family during the child's first 5 years from birth; the necessity, utilization and adequacy of current generic and specialist services for the parents and their child. Ninety parents of children who were clients of two New South Wales developmental disability community services at the time of this study were contacted by mail and asked to complete the questionnaire. Eighty parents correctly completed the questionnaire. Parents of children using these two services were selected on the socioeconomic and resettlement differences between these regions (Australian Bureau of Statistics, 1989); descriptive analysis using cross-tabulation tables indicated a significant group difference with regard to the fathers' occupational status and the families' private health-care insurance membership. Group variation was also found with the responses to the availability and adequacy of services. Otherwise parents' experiences in the recognition and diagnostic assessment of their children's developmental disabilities were homogeneous.

Adolescent↗
PubMed1991

Characteristics of patients resistant to antihypertensive drug therapy.

In order to determine the features that characterize refractory hypertension (RH), patients aged less than 65 years in a hypertension clinic were screened. Thirty-six patients on triple drug therapy with a supine diastolic blood pressure (DBP) of greater than or equal to 5 mmHg above an identified target pressure (90-100 mmHg), or a systolic blood pressure (SBP) greater than or equal to 170 mmHg for the last 6 months (greater than or equal to 3 measurements) underwent a thorough clinical investigation. The frequency of renal artery stenosis (RAS) in the RH patients was 30%. The non-RAS patients had a low occupational status, 76% being either manual workers or unskilled non-manual workers (reference group: 42%; P less than 0.01). They were more obese (body mass index (BMI) 28.8 vs. 25.8; P less than 0.01), and had a longer duration of hypertensive disease. RH patients had a higher prevalence of non-insulin-dependent diabetes mellitus (18 vs. 6%; P less than 0.05), and showed a higher prevalence of nervous complaints and mental distress (44% vs. 12%; P less than 0.001) and musculo-skeletal pain (39% vs. 7%: P less than 0.001). It is suggested that refractory hypertension should be investigated and treated bearing psychosocial factors in mind, concurrently with a screening for secondary hypertension.

Antihypertensive Agents↗
PubMed1996

Health seeking behaviour for child illness in rural Guatemala.

Considerable efforts were made in Guatemala to cover rural areas with health centres, and health programmes have been launched to treat and prevent the most important childhood diseases. Despite this, the utilization rate of public health services has reportedly been low throughout the past two decades. How, and how effectively, do mothers resolve the health problems of their children? To gain better insight into health care behaviour, we conducted a health services utilization survey in two highland communities in the department of Sacatepequez in 1992-1993. We asked 324 mothers in two villages whether, and where, they had sought help the last time their children under 5 years of age had suffered from diarrhoea, fever, cough symptoms or worms. Mothers relied on home care in 63-83% of reported episodes and the use of health services-Western or traditional-was consistently low. Although Western health care was easily accessible, it was used in only 8-15% of cases. The only identifiable significant independent determinants of utilization were occupational status of the mother (RR = 1.5 if employed) and overall level of socioeconomic development of the community (RR = 1.7). Inquiry into treatments used revealed that except for worms, which were frequently treated with herbs (31%) or external remedies (20%) alone, modern pharmaceuticals predominated. Antibiotics were the remedy of choice against diarrhoea (63%), antipyretics in case of fever (83%) and cough syrups with expectorants or antitussives against cough (65%). One hundred and twenty-one of the children born after 1975 died; in only 64 cases (53%) was a Western health service consulted between onset of disease and death. No relation was found between attendance and socioeconomic characteristics of the parents, but a positive linear association between duration of the fatal illness episode and age of the child could be identified. Independent sources report a drop in infant mortality of 53 and 35% respectively in the two communities between 1977 and 1991. Our findings seem to indicate that this reduction was achieved despite under-utilization of Western health services.

Adult↗
PubMed1984

Weight, height and weight for height in 6-7-year-old children. I. Relationship with demographic variables.

Relationships between weight, height and weight for height at 6-7 years of age and a number of demographic variables have been studied in data from Infant Welfare Centre and school medical records. In both boys and girls height and weight were significantly related to birthweight. After allowing for birthweight and age no significant relationships were found in either boys or girls between height and any of the demographic variables. However, body mass index differed significantly according to birth order, the number of children in the family and the parents country of birth. No associations were observed between anthropometric measures at 6-7 years and paternal occupational status, maternal age and the number of younger siblings. Comparison of the study group with reference values from America and Australia provided no support for the view that one of these reference standards is more appropriate than the other for assessment of growth in Australian children.

Australia↗
PubMed1994

Factors adversely associated with breast feeding in New Zealand.

Control data from 1529 infants studied in a multicentre case-control study of sudden infant death in New Zealand were analysed to identify factors that might hinder the establishment and duration of breast feeding. Although 1300 infants (85%) were exclusively breast-fed at discharge from the obstetric hospital, this fell to 940 (61%) by 4 weeks. Logistic regression was used to identify factors that might adversely influence breast feeding 'at discharge', 'at 4 weeks' and the overall 'duration' of breast feeding. When adjusted for confounding factors, not exclusive breast feeding 'at discharge' was significantly associated with: twin pregnancy, being a Pacific Islander, mother not bedsharing, subsequent dummy use, birthweight less than 2500 g, heavy maternal smoking, not attending antenatal classes and mother less than 20 years old at first pregnancy. Mothers smoking more than 20 cigarettes a day were nearly twice as likely to not exclusively breast feed on discharge compared to those who did not smoke. A 'dose response' was apparent with the heaviest smokers having the least likelihood of establishing exclusive breast feeding. Being exclusively breast-fed at discharge but not 'at 4 weeks' was associated with: twin pregnancy, admission to a neonatal intensive care unit, subsequent dummy use and not being married. A shorter overall 'duration' of breast feeding was associated with maternal smoking, subsequent dummy use, mother not bedsharing, twin pregnancy, mother less than 20 years old at first pregnancy, low occupational status and not attending antenatal classes. These effects persisted when social and demographic factors, including birthweight, were taken into account.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Art, science and social science in nursing: occupational origins and disciplinary identity.

This paper forms part of a wider study examining the history and sociology of nursing education in England between 1860 and 1948. It argues that the question of whether nursing was an art, science and/or social science has been at the 'heart' of a wider debate on the occupational status and disciplinary identity of nursing. The view that nursing was essentially an art and a 'calling', was championed by Florence Nightingale. Ethel Bedford Fenwick and her allies insisted that nursing, like other professions, was a 'scientific' and technical enterprise. Social scientists later came to challenge nursing's claim to professionalism by analysing nursing work first within the context of industrial psychology. But they also advocated a rapprochement between nursing, health services and social science research, a challenge which we are in nursing, still striving to meet. This paper argues for a strong coalition of nursing with its former nineteenth century ally, social science, in the continuing struggle for change within nursing and health care policy. Rather than searching for some rarified and purified essence of nursing knowledge, it argues that nurses need to join forces with sociologists and economists in striving to shape the agenda for health services research and provide the evidential basis for health policy transformation more generally.

Art↗
PubMed2005

Case-control study of medical history and idiopathic pulmonary fibrosis in Japan.

OBJECTIVES: A few epidemiological studies have indicated that a patient's past medical history may contribute to the risk of developing idiopathic pulmonary fibrosis (IPF). A relationship between a history of selected disorders and the risk of IPF was assessed in a multicentre hospital-based case-control study in Japan. METHODOLOGY: Included in the study were 104 patients of IPF, aged 40 years or over, who had been diagnosed within the previous 2 years, in accordance with the most recent criteria. Control subjects, aged 40 years or over, consisted of 56 hospitalized patients diagnosed as having acute bacterial pneumonia and four outpatients with the common cold. Adjustment was made for age, gender, region, pack-years of smoking, employment status, occupational exposure and BMI. RESULTS: Medical histories of hypertension, hyperlipidaemia, coronary heart disease, diabetes mellitus, hepatitis C virus infection, tuberculosis, asthma, atopic dermatitis and allergic rhinitis were not statistically significantly associated with the risk of IPF, although cases were more likely to have suffered from allergic rhinitis and less likely to have been asthmatics than control subjects. Having a child with a history of allergic rhinitis, but not of asthma or atopic dermatitis, was significantly related to an increased risk of IPF. CONCLUSIONS: These findings suggest that a genetic predisposition to allergic rhinitis may be associated with an increased risk of IPF.

Aged↗
PubMed2005

Factors associated with glycaemic outcome of childhood diabetes care in Denmark.

AIMS: To study how structure and process of care is associated with outcome assessed by HbA(1c). METHODS: Data for this cross-sectional study originated from the nationwide Danish Registry for Childhood Diabetes and two questionnaires. One questionnaire was sent to all children under 16 years of age with Type 1 diabetes in the year 2000 (N = 1087, response rate 80%). Another questionnaire was sent to the 19 centres in Denmark treating these children (response rate 100%). Simultaneously the children were asked to take a blood sample for central HbA(1c) analysis. Linear mixed models were used for analysis of associations between structure and process indicators and HbA(1c). Age, diabetes duration, sex, ethnicity, family structure and parents' occupational status were included as patient factors possibly affecting HbA(1c). RESULTS: More visits to the outpatient clinic and higher insulin dosage were significantly associated with higher HbA(1c) (P = 0.002 and P = 0.0001, respectively). Increased frequency of blood glucose monitoring (BGM/week) and completed nephropathy screening were significantly associated with lower HbA(1c) value (estimates -0.008 and -0.49, P = 0.02, respectively). The structure indicators were not associated with HbA(1c), but telephone hot-line was positively associated with the process indicator BGM (estimate 4.02, P = 0.04). Children without Danish parents performed BGM significantly less frequently (-7.11, P = 0.0005) and had higher HbA(1c) (0.41, P = 0.06). CONCLUSIONS: Most process indicators were significantly associated with HbA(1c), indicating relevant action of staff on glucose regulation. The structure indicators were not associated with outcome, necessitating more detailed studies on the influence of staffing resources, treatment strategies and targets in childhood diabetes management.

Adolescent↗
PubMed1996

Transition from the early 40s to the early 50s in self-directed women.

How does personality type moderate personality change in middle age? Answers to this question were sought with three observer-based measures of self-directedness (autonomy, hypersensitivity, and willfulness) scored from the California Q-set when the participants in the Mills longitudinal study were age 43. From their early 40s to early 50s, high scorers on autonomy (healthy self-directedness) increased on California Psychological Inventory measures of impulse control and agency, and continued their involvement in high-status occupational careers. Despite increases in impulse control, the hypersensitive women had not increased in agency and expressed boredom in major social roles. In their early 50s, high scorers on willfulness increased in agency but not impulse control. In social roles, they perceived themselves as stimulating and creative.

Adult↗
PubMed1997

Whose diet has changed?

The same questions about diet were asked in two community-based surveys conducted in the Hunter Region of New South Wales in 1983 and 1994. There were substantial changes in diet over the period; for example, the proportion of respondents who reported using low-fat or skim milk increased from 25 per cent to 51 per cent, the proportion eating meat fewer than five times a week doubled from 21 per cent to 42 per cent and the proportion eating fewer than three eggs per week increased from 55 per cent to 80 per cent. In both surveys, women reported eating a healthier diet than men, and older people and those of higher socioeconomic status reported better diets than younger people or people with less education or lower status occupations. The surprising finding was that over the 11-year period the changes in patterns of food consumption were remarkably similar across all strata of the population. The conclusions are that wide-spread dietary change is possible. However, the changes in the last decade related mainly to reducing the risk of cardiovascular disease; similar behavioural changes to reduce the risk of diet-related cancer are required.

Adult↗
PubMed1998

Predictors of GP service use: a community survey of an elderly Australian sample.

As part of a study of an elderly community-dwelling Australian population, predictors of general practitioner (GP) service use were identified. The sample of 897 persons, aged 70 years or older and living in Canberra and Queanbeyan, were interviewed about their health and well-being. Data on the number of GP visits in the following 12-month period were obtained from the Health Insurance Commission. There were important gender differences in the prediction of both contact and volume of service use. Need variables (physical health in men, and disability and anxiety in women) were the most important predictors. Men who were older or who had lower occupational status used more medical services, as did women with less education or higher levels of extraversion. Men with lower social support were less likely to contact a GP, but social support was not related to volume of service use for either men or women. Since at most 21% of the variance in the volume of GP service use could be explained, despite the wide range of predictors considered and the different statistical approaches adopted, better measures of service use and predictors need to be developed.

Activities of Daily Living↗
PubMed1989

Family ecology and child characteristics that predict young children's educational television viewing.

This study investigated how sociological variables, program access, family attributes, and child characteristics influence children's viewing of the most well-established educational television program in the United States--"Sesame Street." 2 cohorts were followed from ages 3 to 5 and 5 to 7, respectively. Each family kept a diary of television viewed during 5 1-week periods over 2 years. Interviews and testing sessions were conducted before and after the 2-year period. "Sesame Street" viewing increased from age 3 to a peak between the ages of 3 1/2 and 4; thereafter, viewing declined. This developmental change appeared to be a function of age-correlated life events and perceived age appropriateness of the program rather than of ontogenetic cognitive change. Individual differences were primarily a function of family ecology--opportunities to view and characteristics of other viewers--rather than of family demographics or individual child attributes. Maternal employment and the amount of time children attended child care or preschool were negatively related to viewing. The presence of older siblings reduced viewing; the presence of younger siblings increased it. Viewing was unrelated to parent education or occupational status, child gender, child's vocabulary level, involvement in television, or interest in print and other media. Parental encouragement to watch the program was positively related to viewing for 3-5-year-olds.

Age Factors↗
PubMed1991

Effects of day care and maternal teaching on child educability.

Two groups of matched mother-child pairs, a day care sample (N = 38) and a home reared sample (N = 38) participated in a study testing mothers for degree of decentred teaching and children for degree of decentred educability. The children were seven years old. Mother and child were tested in separate settings, thus preventing interdependency among scores. The study used a matched-pair design with control of five background variables; age of the child, mother's educational level, mother's occupational status, family SES level, and type of family. The results showed strong positive effects of both day care experience and maternal teaching on child educability. Day care experience improved the educability of children independent of the mother's teaching strategy and gender of the child.

Achievement↗
PubMed1998

Neuropsychological analysis of the visuomotor problems in children born preterm at < or = 32 weeks of gestation: a 5-year prospective follow-up.

Forty-six intellectually normal children born preterm (< or =32 weeks of gestation) without major neurological disabilities and a control group of term children matched for age, sex, and parental educational and occupational status were assessed at the age of 5 years using neuropsychological tests emphasizing perceptual and visuomotor functions. The results show that in terms of cognitive functions these preterm children are a very heterogenous group, but many of them still have problems in visuospatial and sensorimotor functions. The preterm children achieved lower mean scores in tests where coordination and voluntary control of hands in combination with tactile, kinaesthetic, and visuospatial perception were needed. They had most difficulty with drawing directions of lines and in integrating two or more forms. They also had problems with 3-dimensional constructions as well as visual perception of rotated shapes or slopes of lines.

Child, Preschool↗
PubMed2000

Descriptive terms for women attending antenatal clinics: mother knows best?

OBJECTIVE: To determine the noun for 'women who attend antenatal clinics' that is most accepted by the women themselves. DESIGN: Cross sectional study. SETTING: Consultant-led antenatal clinics in Cornwall. POPULATION: All women attending consultant-led antenatal clinics over a two-month period. METHODS: The women were surveyed by written questionnaire. MAIN OUTCOME MEASURES: The first, second and third choices of descriptions offered to women attending antenatal clinics. Secondary outcome measures include the relation of maternal age, gestation, civil status, occupation and obstetric history to the individual's choice of description. RESULTS: Questionnaires were received from 446 women, constituting 13% of the antenatal population of Cornwall. Their median age was 28 years and median gestation 22 weeks; 255 (57%) had one or more children and 289 (65%) were married. The most popular choice of description was 'patient' (39% of first choices made), whereas the most accepted description was 'pregnant woman' (26% of totalled second and third choices). While women who selected 'patient' as first choice were slightly younger (mean 27.5 years) than the remaining women (mean 28.4 years), the choice of 'pregnant woman' was not related to any of the other recorded characteristics of the respondents. Commercial terms that consistently were selected least included 'client', 'consumer' and 'customer'. CONCLUSION: Some professional bodies and government organisations have criticised the use of the term 'patient' to describe antenatal women. In this, the largest study to investigate what the women themselves would choose, 'patient' is the most favoured term.

Adolescent↗
PubMed1988

Obstetric profiles of immigrant women from non-English speaking countries in South Australia, 1981-1983.

Obstetric profiles of non-English speaking immigrant women in South Australia are presented to assist in planning for health services. They were derived from perinatal data routinely collected by midwives and neonatal nurses. The characteristics of 5,675 immigrant women were compared with those of a random sample of approximately 5% of Australian-born women who delivered babies in 1981-1983 in South Australia. This study demonstrates that immigrant women tended to be urban dwellers and to deliver their babies in large metropolitan hospitals. They were less often from unemployed families but more often from those of low occupational status. They were older, with fewer teenagers and single women among them. They were of higher parity, and tended to commence antenatal care later. They had lower incidences of pregnancy hypertension and induced labour, but were more likely to have anaemia, antepartum haemorrhage and a Caesarean section. There were also important differences between the 7 largest immigrant groups. For example, the very high Caesarean section rate (36%) in Filipino women is of concern. Also, the mean birth-weight of babies of Vietnamese women was 263g lower than that of babies of Australian-born women. Support services need to be logistically located and address the findings of this study in a culturally acceptable way.

Adult↗