The responsibility of the dental profession in reducing exposure to ionizing radiation.
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Dentistry↗
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Results for “Social Protection”
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Measuring costs from permitted gaming: concepts and categories in evaluating gambling's consequences.
This paper addresses the methodology of cost-benefit analysis as applied to policy alternatives regarding legally sanctioned gambling in its various forms. Existing economic studies regarding the social costs of gambling are reviewed and critiqued. Distinctions are made between definitions of social costs that are defined as actions which result in negative changes in aggregate social wealth (the "narrow" definition), and those which also include internal nonmarket costs that are borne by individual gamblers and their immediate families and acquaintances (the "broader" definition). This distinction is important because of its bearing on economic policies that are primarily concerned with economic efficiency versus policies that are more paternalistic, which attempt to protect individuals from self-damage or self-destruction by restricting their ranges of choice. Whether societies choose to prohibit or severely restrict permitted gambling, or allocate substantial resources to mitigate its negative side effects, rests largely on which of these perspectives regarding social costs they find more appropriate. Finally, the issue of social protection through restrictions on the availability of gambling to the entire population, versus a strategy tailored toward identifiable "problem" gamblers, is discussed.
Behavior, Addictive↗
The relationship of the Marlowe-Crowne Scale and its components to defensive preferences.
Two lines of recent research have interpreted the Marlowe-Crowne Social Desirability Scale (MC-SDS) as a measure of either need to avoid social disapproval or need to protect and maintain vulnerable self-esteem. In addition, it has been suggested that two component (Attribution and Denial) scores derived from the MC-SDS are differentially related to defensiveness. The present study tested several hypotheses regarding the relationship of the MC-SDS and its components to relative preference for five classes of defensive responses, as measured by the Defense Mechanisms Inventory. Results among females best supported a disapproval-avoidance interpretation of the MC-SDS. while no support was found for the proposed differential validity of the attribution, and denial components. Support for such differential validity was, however, obtained among males. Results for this group suggest that high denial component scorers will opt for protecting vulnerable self-esteem even in the face of possible social disapproval, while high attribution scorers are primarily concerned with avoiding such disapproval. Implications for use of the MCSDS and its components as measures of defensiveness are discussed and suggestions for additional research are presented.
Journal Article↗
Social determinants and inequalities in urban health.
Social and environmental factors are health determinants, in association with behavior, biological factors, and health services. Whereas socioeconomic characteristics (age, gender, ethnicity, social status) describe individuals, social determinants work through broader policies that are influenced by governments. The relation between health and four social areas is discussed. Social capital, measured as social networks and social support, appears to be protective in developing some heart disease and mental illnesses; job control at work is also found to protect against heart disease; early life experiences affect both biological and social development; and the degree of income inequality within societies correlates with health status. The Independent Report on Inequalities in Health, published in the United Kingdom in 1998, is also reviewed. The report (a) briefly describes inequalities in health by social class, sex, and ethnicity; (b) reviews the literature on policy areas that affect health; (c) includes a section indicating relatively little inequality of access or provision in the National Health Service; and (d) makes 132 recommendations. Social determinants is a new area of research having the potential to link epidemiology and environmental sciences at small area level.
Epidemiology↗
SARS transmission among hospital workers in Hong Kong.
Despite infection control measures, breakthrough transmission of severe acute respiratory syndrome (SARS) occurred for many hospital workers in Hong Kong. We conducted a case-control study of 72 hospital workers with SARS and 144 matched controls. Inconsistent use of goggles, gowns, gloves, and caps was associated with a higher risk for SARS infection (unadjusted odds ratio 2.42 to 20.54, p < 0.05). The likelihood of SARS infection was strongly associated with the amount of personal protection equipment perceived to be inadequate, having <2 hours of infection control training, and not understanding infection control procedures. No significant differences existed between the case and control groups in the proportion of workers who performed high-risk procedures, reported minor protection equipment problems, or had social contact with SARS-infected persons. Perceived inadequacy of personal protection equipment supply, infection control training <2 hours, and inconsistent use of personal protection equipment when in contact with SARS patients were significant independent risk factors for SARS infection.
Case-Control Studies↗
[Conceptual models of child mistreatment: a biopsychosocial approach].
INTRODUCTION: Currently, the concept of child maltreatment extends over any dysfunction in the parent-child relationship, including in its diagnosis all different forms in which parental dysfunction takes place (from the classic child abuse to subtle types of psychological maltreatment). METHODOLOGY: Review of original articles of Child Abuse and Neglect in 1991-1996, and of other articles cited in this period in that journal. Search of documents in the Spanish literature on this topic. RESULTS: Several studies carried out in Spain have shown a prevalence rate of 1.5%, although it is widely recognized that this figure is an underestimate. The view of child maltreatment as a psychosocial phenomenon which causes severe consequences in the child's integrated development, has produced conceptual models which explore the relationships among risk and protective factors involved in the occurrence of child maltreatment. The main risk factors are younger parents, anxiety and depression symptoms, monoparental family, and economic stress. Social support has a protective effect. CONCLUSION: A better understanding of the dynamics of protective and risk factors for child abuse is needed in order to carry out effective interventions in prevention and intervention programs against child maltreatment.
Child↗
Social networks and marital status predict mortality in older women: prospective evidence from the Study of Osteoporotic Fractures (SOF).
OBJECTIVE: To assess the relationship between social network size and prospective mortality risk among a large sample of older, Caucasian women. METHOD: The study included 7524 Caucasian community-dwelling women, age 65 or older (mean age = 74.1), who participated from four U.S. communities. Study participants completed a protocol that included anthropomorphic and health assessments at baseline and the Lubben Social Network Scale at year 2. We followed participants for an average of 6 years after they had completed the year-2 assessment. We used hospital records and a copy of the participant's official death certificate to document mortality and cause of death in accordance to ICD-9 revision codes. RESULTS: A total of 1451 deaths (19.3% of sample) were observed over follow-up, 215 (3.4%) due to cardiovascular causes. Higher social network scores were a robust predictor of lower multivariate-adjusted mortality (RR = 0.92, 95% CI = 0.86-0.98), controlling for age, comorbid disease, body mass, smoking, depression, and education. However, social network benefits were attenuated after controlling for marital status. Married participants showed lower total (RR = 0.83, 95% CI = 0.74-0.94) and CVD (RR = 0.59, 95% CI = 0.43-0.81) covariate-adjusted death rates compared with unmarried participants. CONCLUSIONS: Social network scores and marriage were each associated with reduced prospective mortality risk among older women. The relationships shown here suggest that much of the protection afforded by larger social networks in older women results from marriage rather than other forms of social relationships. Mechanisms at the physiological or behavioral level explaining social relationship benefits remain important areas for future research.
Aged↗
Social capital as a predictor of adolescents' sexual risk behavior: a state-level exploratory study.
This exploratory study assessed the state-level association between social capital, poverty, and income inequality and adolescents' sexual risk and protective behaviors. A cross-sectional design using state-level correlations was employed. Seven outcome measures from the national 1999 Youth Risk Behavior Surveillance Survey were used. For females and males, social capital was significantly associated with five of the seven outcome measures (all associations p < 01). For females, the amount of variance explained by these correlations ranged from 23% to 45%; the range for males was 20% to 52%. Poverty was not a significant predictor of any outcome variable. Income inequality was a significant predictor of birth control usage among females, but in multivariate regression analyses, only social capital retained significance. Findings provide preliminary evidence that social capital may have a profound influence of adolescents' sexual risk and protective behaviors. Social capital was inversely correlated with sexual risk behaviors and positively correlated with protective sexual behaviors. Further and more comprehensive research involving social capital and adolescents is warranted.
Adolescent↗
Behavioral antecedents of coronary heart disease and atherosclerosis.
Over 50 epidemiologic, clinical, and experimental studies of behavioral influences on atherosclerosis and CHD have been reviewed; of these investigations, no more than five were published prior to 1975. Despite some inconsistencies and occasional conceptual and methodologic problems in the studies comprising this relatively young literature, the preponderance of available evidence indicates that psychosocial variables play a significant role in coronary disease. To summarize briefly, the Type A behavior pattern has been found predictive of new CHD in nearly all prospective studies of initially healthy individuals, and therapeutic modification of Type A has been shown to reduce risk of recurrent nonfatal MI. Among most prospective studies of post-MI patients and of persons at heightened risk for CHD due to elevations in traditional risk factors, however, Type A has not been found to predict, respectively, recurrence of MI or initial clinical events. Additionally, Type A individuals have shown more extensive coronary artery atherosclerosis on angiographic examination than Type Bs in a minority of studies, and, generally, only where Type A behavior has been measured by the SI. It is noted that many of these clinical studies may be faulted, though, for their use of small and heterogeneous patient samples and for possible biases in the selection and recruitment of subjects. In contrast to the globally defined Type A pattern, a high potential for hostility and an inability or unwillingness to express anger (anger-in) have emerged as significant predictors or correlates of coronary disease in all epidemiologic and clinical studies in which these variables have been examined. These consistent results suggest that a predisposition to hostility and anger, and the inhibited expression of such feelings, represent a "toxic" component of the Type A pattern. Several recent prospective investigations indicate also that high levels of life stress and possession of poor or inadequate social resources are predictive of CHD. The concepts of life stress, social network, and social support, as well as relationships among these variables, are not well-understood, however, and much additional work is needed to identify specific pathogenic and protective attributes of the social environment. In addition to studies of the psychosocial antecedents of CHD in human beings, there now are several published studies of behavioral influences on the development of coronary lesions in animal models.(ABSTRACT TRUNCATED AT 400 WORDS)
Arteriosclerosis↗
Risk modifying effect of social capital on measures of heavy alcohol consumption, alcohol abuse, harms, and secondhand effects: national survey findings.
STUDY OBJECTIVE: To examine associations between social capital and individual risk for alcohol abuse and harms and identify protective effect mechanisms. DESIGN: Multilevel multivariate analysis with individual level data from a national panel survey of drinking and a contextual measure of social capital reflecting college mean aggregate reports of student volunteerism. Outcomes include heavy episodic (binge) drinking, frequent drinking, frequent drunkenness, diagnosable alcohol abuse, intentional drunkenness, acquisition of binge drinking, harms, secondhand effects from others' drinking. SETTING: United States, 119 four year colleges. PARTICIPANTS: Representative samples of youth ages 18-24 surveyed in 1997 and 1999 using an anonymous mailed questionnaire (total n = 27 687). MAIN RESULTS: Students from colleges with higher levels of social capital reported reduced risks for binge drinking (adjusted OR 0.38, 95% CI 0.20 to 0.69, p = 0.002), frequent drunkenness (adjusted OR 0.58, 95% CI 0.34 to 0.98, p = 0.04), acquisition of binge drinking in college (adjusted OR 0.48, 95% CI 0.24 to 0.95, p = 0.03), and alcohol abuse (adjusted OR 0.55, 95% CI 0.34 to 0.91, p = 0.02) in multilevel multivariate analyses that controlled for individual volunteering, the measure on which social capital was based. Higher levels of social capital protected against multiple drinking related harms (adjusted OR 0.51, 95% CI 0.29 to 0.90, p = 0.02) and secondhand drinking effects (adjusted OR, 0.30, 95% CI 0.16 to 0.58, p = 0.0003). Significant cross level interactions exist between fraternity/sorority membership and social capital for measures of risky drinking. Harm reduction primarily reflects consumption modification. CONCLUSIONS: Social capital exerts strong protective effects on alcohol abuse and harm in college including among high risk students.
Adolescent↗
Predicting emotional response to unsuccessful fertility treatment: a prospective study.
The predictive value of a comprehensive model with personality characteristics, stressor related cognitions, coping and social support was tested in a sample of 187 nonpregnant women. The emotional response to the unsuccessful treatment was predicted out of vulnerability factors assessed before the start of the treatment. The results indicated the importance of neuroticism as a vulnerability factor in emotional response to a severe stressor. They also underlined the importance of helplessness and marital dissatisfaction as additional risk factors, and acceptance and perceived social support as additional protective factors, in the development of anxiety and depression after a failed fertility treatment. From clinical point of view, these results suggest fertility-related cognitions and social support should receive attention when counselling women undergoing IVF or ICSI treatment.
Adaptation, Psychological↗
Social support and oxytocin interact to suppress cortisol and subjective responses to psychosocial stress.
BACKGROUND: The presence of social support has been associated with decreased stress responsiveness. Recent animal studies suggest that the neuropeptide oxytocin is implicated both in prosocial behavior and in the central nervous control of neuroendocrine responses to stress. This study was designed to determine the effects of social support and oxytocin on cortisol, mood, and anxiety responses to psychosocial stress in humans. METHODS: In a placebo-controlled, double-blind study, 37 healthy men were exposed to the Trier Social Stress Test. All participants were randomly assigned to receive intranasal oxytocin (24 IU) or placebo 50 min before stress, and either social support from their best friend during the preparation period or no social support. RESULTS: Salivary free cortisol levels were suppressed by social support in response to stress. Comparisons of pre- and poststress anxiety levels revealed an anxiolytic effect of oxytocin. More importantly, the combination of oxytocin and social support exhibited the lowest cortisol concentrations as well as increased calmness and decreased anxiety during stress. CONCLUSIONS: Oxytocin seems to enhance the buffering effect of social support on stress responsiveness. These results concur with data from animal research suggesting an important role of oxytocin as an underlying biological mechanism for stress-protective effects of positive social interactions.
Administration, Intranasal↗
Coping style and preterm labor.
Psychometric tests (State-Trait Anxiety Index and Utrechtse Coping Lijst) were administered to 23 primigravidae hospitalized for preterm labor and to 22 controls in order to investigate whether women with and without preterm labor present a different coping style or (in) effectiveness of this coping and whether the coping style predicts duration of hospitalization and gestational age at delivery. No significant differences in trait anxiety nor in coping style were found between women with and women without preterm labor. However, within the group of women with preterm labor, coping mechanisms are important predictors of course and outcome of the preterm contractions. Palliative coping and social support seeking are protective mechanisms while active coping has an adverse effect upon outcome: an older gestational age at the moment of delivery is for 44% predicted by a higher social support seeking and a lower active coping.
Adaptation, Psychological↗
Do social programmes contribute to mental well-being? The long-term impact of unemployment on depression in the United States.
BACKGROUND: Important evidence about the mental health effects of unemployment exist; however, little is known about the possible protective effects of various social interventions or about their long-term impact. This study examines the long-term consequences that different types of social programmes, i.e. entitlement and means-tested benefits, might have as regards ameliorating a negative mental health impact of unemployment among women and men. METHODS: Multiple regression models were used to analyse panel data collected in the National Survey of Families and Households in 1987 and 1992. In all 8029 individuals interviewed in both 1987 and 1992 were included in the analysis. A depression index was created from the responses to 15 items from the Center for Epidemiological Studies' Depression Scale-D (CES-D) which were included in the survey. RESULTS: The receipt of government entitlement benefits by unemployed women is associated with a reduction of depression symptoms in the long term. Men and women not working and receiving means-tested or welfare benefits are more likely to report depression in both the short and long term. CONCLUSIONS: The study underscores the need for monitoring the impact of welfare reform on mental health.
Depressive Disorder↗
Recall of family factors in social phobia and panic disorder: comparison of mother and offspring reports.
Previous research has indicated that adults with various anxiety disorders, especially social phobia, recall their parents as excessively protective and controlling and as low in socialization. However, it is not clear whether such results would be supported by parents. In the present study subjects with social phobia, panic disorder, and nonclinical subjects and their mothers were given parallel measures of maternal control, socialization, and offspring early introverted behaviors as well as several questions relating to two early major life events and family size. Anxious offspring reported the usual high maternal control and low paternal socialization and mother supported the data on socialization. On control, mothers provided mixed results, disagreeing on a more standard measure, but showing agreement on a more operationalized measure. The data were more consistent for social phobia than for panic disorder. In terms of early life factors, both anxiety disorders were associated with fewer friends and more introverted behaviors, while family size and two major life events did not differentiate groups.
Adult↗
Living arrangements, social integration, and change in functional health status.
Limited prospective data have examined the association between living arrangements and emotional wellbeing. The authors assessed whether older women living with a spouse were less likely to experience a decline in mental health, vitality, or physical function compared with women living alone or with nonspouse others. The association between living arrangement and 4-year change in functional health status was examined prospectively among 28,324 women aged 60-72 years in the Nurses' Health Study. After adjustment for age, baseline function, comorbid conditions, and health behaviors, women living alone had lower risk of decline in mental health (relative risk (RR) = 0.73, 95 percent confidence interval (CI): 0.65, 0.81) and vitality (RR = 0.72, 95 percent CI: 0.65, 0.80) compared with those living with a spouse. Contact with friends and relatives and level of social engagement were significantly protective against a decline in mental health among women living alone but not among women living with a spouse. These results suggest that women living independently are neither socially isolated nor at increased risk for decline in functional health status. In fact, these women actually fare better on measures of psychologic function than do women living with a spouse.
Activities of Daily Living↗
Women's resources and use of strategies as risk and protective factors for reabuse over time.
Using a longitudinal and ecological approach, we investigated the relationships between women's material and emotional resources and strategies and their ability to stay safe over time in a sample of 406 help-seeking African American women. The multivariate analysis demonstrated that social support served as a protective factor and resistance strategies as risk factors for reabuse during a 1-year period. It also showed an interaction between social support and history of violence such that for participants who had experienced the most severe violence, social support did not serve as a protective factor; however, for the other participants, those with the least amount of social support had a 65% predicted probability of reabuse during the next year, compared to a 20% predicted probability for women reporting the highest level of social support. Policy and programmatic implications of these findings are discussed.
Adult↗
Social support increases in the year after inpatient treatment of depression.
High levels of social support are reported to protect against major depressive episode (MDE), but little is known about how social support changes during MDE. In this study, we measured total social support and four subtypes of social support in 75 psychiatric inpatients at the time of admission and one year later. The four subtypes of social support were tangible support, affectionate support, positive social interaction, and emotional/informational support. The majority of the sample were women (81%) with a mean age of 53.7+/-14.9 years. The severity of depressive symptoms improved over the year and was accompanied by a significant increase in two types of social support -- positive social interaction, and emotional/informational support. There was no significant change in tangible support or affectionate support. Linear regression showed that changes in all four subtypes were correlated with changes in depressive severity after adjustment for age, gender, and baseline clinical characteristics. While Instrumental Activities of Daily Living (IADL) scores also improved throughout the period of observation, and while the change in IADL scores were significantly associated with changes in social support, change in IADL scores were no longer significantly associated with change in social support after adjustment for change in depression severity. These results suggest that supportive relationships improve after psychiatric hospitalization for MDE, and these changes are best explained by reduction in depression severity.
Activities of Daily Living↗