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PubMedDate not supplied

[Improving the sanitary and epidemiologic surveillance system is a necessary condition for enhancing the efficiency of preventive measures against parasitic diseases].

The paper presents a pattern of the improved sanitary and epidemiological surveillance system against parasitic diseases in Russia at the present stage. A great deal of species of causative agents of parasitic diseases, a great variety of ways and factors of their transmission show that there is a need for its further optimization by taking into account local, natural, climatic and social conditions of the population's life and activities and paying a particular attention to the system's key point, namely to the evaluation of the risk of infection, which is the basis of planning preventive measures against parasitic diseases.

Environmental Monitoring↗
PubMed2000

Life quality vs the 'quality of life': assumptions underlying prospective quality of life instruments in health care planning.

Quality of Life is a broad construct used in health planning, health economics, and medical decision-making. It is also a term that has a long currency in social and sociological literatures. This paper considers the assumptions underlying prospective QL instruments in an historical and contemporary context. It argues that as a tool in health planning and in clinical decision making life quality as a measurement has its origins in the early eugenics literature and the social policies that derived from it in first North America, the primary focus of this paper, and later in Europe. Reference to narrative and social literatures, as well as those involving coping and adaptation, are then used to critique the assumptions underlying this class of QL instruments. It concludes that to the degree now current prospective instruments reflect a purely physical perspective of "disease burden" irrespective of social conditions they create a context that works against life quality, and in some cases, the continuance of persons with physical differences.

Chronic Disease↗
PubMed2005

Adult socioeconomic position and the association between height and coronary heart disease mortality: findings from 33 years of follow-up in the Whitehall Study.

In the Whitehall Study, which followed 17,139 male civil servants over 33 years, the association between tall stature and coronary heart disease (CHD) mortality differed between employment grades. In men without CHD at study entry, the hazard ratio per 15-cm increase in height was 0.77 (95% confidence interval [CI]=0.69, 0.85; P<0.001) for the highest grades, but 0.84 (95% CI=0.69, 1.03; P=.10) for middle and 0.95 (95% CI=0.75, 1.20; P=.65) for low grades, suggesting that childhood and adult social conditions may interact in their influence on coronary risk.

Adult↗
PubMed1985

Brazil: the health care model of the military modernizers and technocrats.

Post-1964 political changes in Brazil had dire implications for the health sector as successive governments pursued economic and social policies which aggravated inequities and benefitted narrow elites. The "military modernizers" embraced a concept of development inimical to basic human needs, an economic model favoring growth over distribution and development over social welfare, and budget priorities favoring vocal, urban middle sectors at the expense of marginal populations. The result was deteriorating health and social conditions among the majority of the population that did not share in the benefits of the "economic miracle."

Brazil↗
PubMedDate not supplied

Domestic violence: changing theory, changing practice.

Despite widespread recognition of domestic violence as a public health problem, many clinicians still have difficulty integrating routine intervention into their day-to-day practice. This is in part because domestic violence raises a distinct set of challenges for both providers and the institutions that shape clinical practice. Domestic violence is a complex social problem rather than a biomedical one; addressing it means asking clinicians to step beyond a traditional medical paradigm to confront the personal feelings and social beliefs that shape their responses to patients and to work in partnership with community groups committed to ending domestic violence. In addition, addressing domestic violence raises important challenges to the health care system itself-to its theoretical models, to the nature of medical training, and to the rapidly changing structure of clinical practice. If we truly want to play a role in preventing domestic violence, rather than just treating its consequences, we must work together to transform both the individual and social conditions that create and support this kind of violence in the first place.

Attitude of Health Personnel↗
PubMed1998

Factors affecting QOL of the home-bound elderly disabled.

The purpose of this study was to clarify the factors affecting the quality of life (QOL) of the elderly home-bound patients. Data were collected from 56 chronically disabled elderly persons (mean age of 76.7 years) who needed a long-term home-based care. They were assessed on QOL, range of activity, functional capacity, and capacity of family care functioning as well as socio-economic condition. The QOL was evaluated by using Philadelphia Geriatric Center Morale Scale (PGC Morale Scale). The activities of daily living (ADL) and handicaps were evaluated by the Barthel index and the ESCROW profile, respectively. The capacity of family care functioning was also recorded according to the "Family Care Scale" developed by Hamamura. As a result, there was a significant difference between PGC Morale Scale score and Barthel index score (P < 0.05), and we found a negative correlation between PGC Morale Scale score and ESCROW score (P < 0.05). It was also revealed that the factors affecting the QOL of the home-bound elderly disabled were determined by the motivation, functional capacity, and capacity of family care functioning (P < 0.05). These results suggest that in order to improve their QOL, ADL must be improved, therefore, rehabilitation should be continued to maintain their function after discharging from hospitals and that we should take these factors into consideration, such as living environments and social conditions of the family care. The results also indicate how the patient's independence in the daily life influences social and economic status, and consequently it affects the quality of life.

Activities of Daily Living↗
PubMed2006

Financing mental health services in low- and middle-income countries.

Mental disorders account for a significant and growing proportion of the global burden of disease and yet remain a low priority for public financing in health systems globally. In many low-income countries, formal mental health services are paid for directly by patients out-of-pocket and in middle-income countries undergoing transition there has been a decline in coverage. The paper explores the impact of health care financing arrangements on the efficient and equitable utilization of mental health services. Through a review of the literature and a number of country case studies, the paper examines the impact of financing mental health services from out-of-pocket payments, private health insurance, social health insurance and taxation. The implications for the development of financing systems in low- and middle-income countries are discussed. International evidence suggests that charging patients for mental health services results in levels of use which are below socially efficient levels as the benefits of the services are distributed according to ability to pay, resulting in inequitable access to care. Private health insurance poses three main problems for mental health service users: exclusion of mental health benefits, limited access to those without employment and refusal to insure pre-existing conditions. Social health insurance may offer protection to those with mental health problems. However, in many low- and middle-income countries, eligibility is based on contributions and limited to those in formal employment (therefore excluding many with mental health problems). Tax-funded systems provide universal coverage in theory. However, the quality and distribution of publicly financed health care services makes access difficult in practice, particularly for rural poor communities.

Developing Countries↗
PubMedDate not supplied

[Preventive effect of social support on mortality among elderly population: a longitudinal study].

BACKGROUND: The main objective of this study is to analyze the relationship between social support and the mortality among a non-institutionalized population cohort age 60 or above residing in Barcelona studied throughout the 1996-1999 monitoring period for the purpose of analyzing the relationship between the social support and the mortality of this cohort. METHODS: In 1996, a telephone survey was conducted of 755 individuals (316 males and 439 females) who had been surveyed in the 1992 Barcelona health survey and who, were age 60 or above that year. The questionnaire included socio-demographic, morbility and health condition, social support and social network-related variables. The deaths during the 1996-1999 period were recorded. Logic regression was used for analyzing the social support-mortality relationship. RESULTS: The deaths for the period in question totaled 55 individuals (5.9% of the females and 9.2% of the males). Among the variables reflecting social support, for the males solely the situation of living with someone was found, in the bivariate analysis, to have a significant relationship to the mortality, which was higher for those males who lived with other family members, but not with their wives or female partner (OR = 3.7; IC 95% 1.4-9.6). Among the females, the existence of support from neighbors, the size of the family network, the number of contacts with the community network and the situation of living with someone else were related to the mortality in the bivariate analysis, although in the multivariate logic regression, solely the support of neighbors (OR = 3.6; IC: 1.1-11.1) was found to have a significant relationship. CONCLUSIONS: The results are consistent with prior studies revealing a relationship between the social support variables and the mortality. The relationship between the different social support variables and the possible prevention mechanisms should be taken up in future studies.

Age Factors↗
PubMed2007

Cooperation and conflict in microbial biofilms.

Biofilms, in which cells attach to surfaces and secrete slime (polymeric substances), are central to microbial life. Biofilms are often thought to require high levels of cooperation because extracellular polymeric substances are a shared resource produced by one cell that can be used by others. Here we examine this hypothesis by using a detailed individual-based simulation of a biofilm to investigate the outcome of evolutionary competitions between strains that differ in their level of polymer production. Our model includes a biochemical description of the carbon fluxes for growth and polymer production, and it explicitly calculates diffusion-reaction effects and the resulting solute gradients in the biofilm. An emergent property of these simple but realistic mechanistic assumptions is a strong evolutionary advantage to extracellular polymer production. Polymer secretion is altruistic to cells above a focal cell: it pushes later generations in their lineage up and out into better oxygen conditions, but it harms others; polymer production suffocates neighboring nonpolymer producers. This property, analogous to vertical growth in plants, suggests that polymer secretion provides a strong competitive advantage to cell lineages within mixed-genotype biofilms: global cooperation is not required. Our model fundamentally changes how biofilms are expected to respond to changing social conditions; the presence of multiple strains in a biofilm should promote rather than inhibit polymer secretion.

Biofilms↗
PubMed1996

Self-enhancing effect of social feedback on cognitive task performance.

The influence of feedback on the cognitive task performance of individuals with high and low self-esteem was assessed (Coopersmith Self-Esteem Inventory, Form A). A median split technique segregated each group (30 adults with mental retardation and 30 MA-matched controls) into high and low self-esteem individuals. All subjects performed two memory tasks (easy, difficult) but were randomly assigned to only one of three feedback conditions (social, computer, and no feedback). Findings indicated that social feedback can alter the normally positive relation between self-esteem and cognitive task performance.

Adult↗
PubMed2004

Validation of a modified version of the Gijon's social-familial evaluation scale (SFES): the "Barcelona SFES Version", for patients with cognitive impairment.

The aim was to validate an abbreviated version of the Gijon's social-familial evaluation scale (SFES) (Barcelona-SFES version), on patients with cognitive impairment. A group of 34 patients with cognitive impairment, admitted to an intermediate-long-term-care facility, were analyzed. Mean age was 80.2 +/- 7.4 years. Gijón's SFES was abbreviated and only the first three item groups corresponding to family conditions, social contacts and assistance from the social network were selected. Barcelona-SFES version had a range score between 3 to 15 points, in which low scores identify older patients who live with their family, have good contacts, and participate in community activities. In contrast, high scores identify older persons who live alone and have poor social support and little participation with community activities. Three social risk categories were established according to the Barcelona-SFES score: low social risk (>/= 7 points), intermediate social risk (8-9 points) and high social points). Validation criteria used in the present study were: predictive value of Barcelona-SFES score of post-discharge destination (home or institution), and patient's (or family's) request for a definitive institutionalization in a nursing home. There were 9 patients with low social risk (26.4 %), 8 with intermediate social risk (23.5 %) and 17 with high social risk (50 %). A significant relationship between Barcelona-SFES scores and post-discharge destination was found. Eighty percent of patients discharged to an institution(nursing and residential homes), they had high social risk SFES scores (>/= 10) Also, a significant correlation was found between the number of patients for which a definitive institutionalization request was performed and the Barcelona-SFES scores. Fifteen (88.2 %) of the 18 patients for whom the request was done, were in the high social risk group. The lowest scores from SFES were predictive of home discharge, while the highest scores were predictive of a definitive institutionalization.

Aged↗
PubMed2004

Physical, mental and social factors associated with frequent attendance in Danish general practice. A population-based cross-sectional study.

Knowledge of which factors are prompting patients to seek primary care is important to the ongoing effort to improve management in general, and management of frequent attenders (FAs) in particular. We conducted a cross-sectional population-based study with the aim at examining associations between physical, mental and social factors and frequent attendance in general practice. We collected questionnaire and registry data in the County of Aarhus (630,000 inhabitants), Denmark. Half of the county general practices (132 practices, 220 GPs) were selected randomly. FAs were defined as the top 10% attenders over the past 12 months. A questionnaire including SF-36 and questions about physical and mental health and social conditions was sent to age and gender stratified samples of FAs and non-FAs from these practices. Impairments (SF-36) associated with frequent attendance were physical in 54-71% (prevalence difference (PD): 16-33%, adjusted prevalence ratio (adj. PR): 1.1-1.7), mental in 58-70% (PD: 17-25%, adj. PR:1.1-1.4) and social in 40-59% (PD: 13-28%, adj. PR:0.9-1.5). Among FAs, 46-88% had used three or more different drugs (PD: 26-39%, adj. PR:1.5-2.3) and 27-41% had been referred one or more times to outpatient specialists (PD: 4-19%, adj. PR:1.2-2.5). Although our data cannot determine the direction of causality, they clearly demonstrate that FAs carry a large burden of physical, mental and social impairments which underpins the complexity and heterogeneity of the problems which they present. The results make clear that biopsychosocial management is a core issue in FA management in general practice.

Adult↗
PubMed2000

Panel recommends significant changes to federal law against discrimination.

In a report released on 23 June 2000, the Review Panel tasked by the federal Minister of Justice with reviewing the Canadian Human Rights Act made some welcome recommendations for improving the Act and the way the Canadian Human Rights Commission functions. Three are of particular significance: the recommendation that "social condition" be added to the prohibited grounds for discrimination listed in the Act; the recommendation that the Canadian Human Rights Commission should have, under its governing legislation, the duty to monitor and report to Parliament and the UN Human Rights Committee on the federal government's compliance with international human rights treaties regarding economic, social, and cultural rights; and the recommendation that "gender identity" should be expressly added to the Act as a prohibited ground of discrimination.

Canada↗
PubMed1995

Infants of Mexican immigrants. Health status of an emerging population.

Previous studies suggest that infants of Mexican immigrants have favorable birth outcomes despite their high socioeconomic risks. These favorable outcomes have been associated with a protective sociocultural orientation among immigrants. A sample of 708 infants of Mexican origin was assessed to determine whether such health advantages at birth are sustained at 8 to 16 months of age, or alternatively, whether their health deteriorates because of adverse socioeconomic conditions. A a cross-sectional survey was conducted in San Diego County to determine whether the child was healthy or ill (the latter indicating a history of serious infectious disease) and the factors associated with this outcome. Among infants born without serious medical problems, 74% remained healthy. For 26% of the infants, their health status was eroded by social conditions. Factors associated with illness were large households, barriers to care, and maternal characteristics including smoking, pregnancy complications, and employment. Women born in Mexico who were newcomers to the United States and spoke Spanish exclusively were more likely than non-newcomers to have ill children. In this population, one fourth of Latino infants of immigrants were at high risk for serious infectious disease despite using preventive care.

Adolescent↗
PubMed1998

Social loafing under fatigue.

In 2 experiments, 64 male students worked almost continuously for 20 hr without sleep under varying social conditions. In Experiment 1, participants worked either individually or as a group. As hypothesized, performance deteriorated over time, especially in the group condition, which allowed participants to loaf. In Experiment 2, all participants worked in groups. They were instructed that public feedback would be provided either on the group result only or on the individual results of all group members. As expected, when individual results were made public, performance deteriorated less. Overall, the data suggest that fatigue increases social loafing. However, both individualizing the task and providing public individual feedback seem to counteract these effects.

Adult↗
PubMed2000

Activity of the hypothalamic-pituitary-adrenal axis is altered by aging and exposure to social stress in female rhesus monkeys.

Age-related changes in glucocorticoid negative feedback inhibition of hypothalamic CRF and pituitary ACTH are observed in rodents. Attempts to study similar effects in humans have produced mixed results due in part to the difficulty in matching older subjects on social and lifestyle variables. The present study used female rhesus monkeys as a model for women by comparing young adult (n = 20) to old (n = 20) females to test the hypotheses that the hypothalamic-pituitary-adrenal axis is altered in older animals and that this difference is exacerbated by exposure to social stress. The effects of age on the response to two doses of dexamethasone and two doses of CRF were assessed in females living in a stable social environment (control) and in socially stressed females removed from their group and housed temporarily in a remote, nonsocial environment (separated). The suppression of serum cortisol was not different between the two doses of dexamethasone. Before dexamethasone administration (2100 h), serum cortisol was significantly higher in old control females than in either young or old separated females, who were not different from one another. The young control females had baseline cortisol concentrations significantly lower than all other groups. Serum cortisol was suppressed approximately 75% below baseline values in all groups by 10 h after dexamethasone administration. Age significantly affected serum cortisol after dexamethasone, as the old control group showed a release from suppression 19 h posttreatment compared to the young control group and compared to the separated groups. Social condition had a significant effect on the responses of serum cortisol and plasma ACTH to CRF administration. At baseline (0930 h), serum cortisol was significantly higher in young controls compared with older controls, with both separated groups having intermediate values. Similarly, plasma ACTH at baseline was significantly higher in young controls compared to all other groups. Social separation significantly diminished the elevation of both serum cortisol and ACTH after stimulation with either dose of CRF. Control females showed a prolonged increase in plasma ACTH through 60 min and an increase in serum cortisol through 120 min after CRF. In contrast, these hormones either declined by 60 min or did not increase in socially separated females after CRF administration. These data suggest that the circadian rhythm in serum cortisol may be affected by aging, as levels were higher in the evening and lower in the morning in old control compared to young control females. The effect of age on the response to dexamethasone treatment among the control groups lends support to the hypothesis that the sensitivity of glucocorticoid negative feedback diminishes with aging. Although age did not affect the response to CRF, social separation diminished the elevation in both serum cortisol and plasma ACTH. Whether this effect was due to stress-induced down-regulation of pituitary CRF receptors remains to be determined.

Aging↗
PubMed1994

Of markets, technology, patients and profits.

In this paper I: (1) Describe something of the present situation in the United States and briefly contrast this with the state of affairs in other nations of the industrialised world. I emphasise health care but also allude to other social conditions: health care is merely one institution of a society and, just as do its other institutions, the system of health care reflects the basic world-view of that society. (2) Sketch the world-view and the philosophy which underwrites the use of a market system in distributing what are acknowledged to be critically important social goods like health care and higher education. I show that a well-functioning market can indeed be useful when it comes to distributing some, but not when distributing other goods. (3) Suggest that when competition and the market are used to 'regulate' health care, technology--instead of being used to benefit patients--is apt to be used primarily to maximise individual profit: it becomes a weapon between what is often painted as 'warfare' among health care providers and institutions. I argue that this state of affairs is based on an undue emphasis upon the demands of individual freedom to the detriment of the community. Finally (4) I suggest an alternative approach to balancing individual with communal interests, an approach which is neither based on a predominance of one with neglect of the other, nor on a dialectic balance between them, but rather upon an approach which sees both individual and communal interests as modifying forces in a complex homeostatic balance.(ABSTRACT TRUNCATED AT 250 WORDS)

Beneficence↗
PubMed2006

Population divergence in plasticity of the AVT system and its association with aggressive behaviors in a Death Valley pupfish.

Behavioral differences can evolve rapidly in allopatry, but little is known about the neural bases of such changes. Allopatric populations of Amargosa pupfish (Cyprinodon nevadensis) vary in aggression and courtship behaviors in the wild. Two of these wild populations were recently found to differ in brain expression of arginine vasotocin (AVT)--a peptide hormone shown previously to modulate aggression in pupfish. These populations have been isolated for less than 4000 years, so it remained unclear whether the differences in behavior and neural AVT phenotype were evolved changes or plastic responses to ecologically dissimilar habitats. Here, I tested whether these population differences have a genetic basis by examining how aggressive behavior and neural AVT phenotype responded to ecologically relevant variation in salinity (0.4 ppt or 3 ppt) and temperature (stable or daily fluctuating). Pupfish from Big Spring were more aggressive than pupfish from the Amargosa River when bred and reared under common laboratory conditions. Morphometric analysis of preoptic AVT immunoreactivity showed that the populations differed in how the AVT system responded to salinity and temperature conditions, and revealed that this plasticity differed between parvocellular and magnocellular AVT neuron groups. Both populations also showed relationships between neural AVT phenotype and aggression in the rearing environment, although populations differed in how aggression related to variation in magnocellular AVT neuron size. Together, these results demonstrate that the pupfish populations have diverged in how physical and social conditions affect the AVT system, and provide evidence that the AVT system can evolve quickly to ecologically dissimilar environments.

Aggression↗