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PubMed1991

Factors antecedent to impaired driving in a Canadian urban sample.

This paper explores factors antecedent to impaired driving in a Canadian urban community. Specifically, it attempts to investigate patterns of association between economic, demographic, social, and personal variables, and frequency of impaired driving. Cross-tabular analysis reveals that sex, age, marital status, employment status, occupation, standard of living, degree of loneliness, boredom, and depression are significantly associated with impaired driving. Multiple regression analysis was performed to determine which of the demographic, economic, social, and personal variables are most important in predicting impaired driving. The results indicate that three variables (standard of living satisfaction, frequency of getting together with friends, and gender) are significant predictors of impaired driving.

Adolescent↗
PubMed1996

Alcohol consumption by undergraduate students.

This study examines a prediction of alcohol consumption in a sample of 212 undergraduate students at a university in Sydney. Data were collected using self-administered questionnaires, given to students in Semesters one and two. During both semesters the college residents reported drinking significantly more alcohol than students living elsewhere, but during vacation the intake of the two groups was approximately equal. Higher alcohol consumption in Semester two was best predicted by higher Semester one intake, followed by more consumption by friends and higher parental occupation status. Female students residing on campus were those most likely to be drinking at hazardous levels. Results also indicated that a significant proportion of residential students were drinking at hazardous levels, and that prevention interventions may need to focus on changing the attitudes and behavior of the social group.

Adolescent↗
PubMed1998

Patterns of drug use among nonmetropolitan and rural adults.

This article examines illegal drug use among adults living in nonmetropolitan and rural areas of the United States using data from the National Household Survey on Drug Abuse. Subjects were classified into three categories by residence: nonmetropolitan-urban, metropolitan-rural, and nonmetropolitan-rural. Respondents indicate about 10% of adults were current users of marijuana or other illegal drugs. Discriminant analysis was used to examine differences among groups of individuals classified as current users, past users, and nonusers. For both marijuana and other illegal drugs, the variables that accounted most for group differences were age, marital, status, employment status, occupation, and income. Only minor differences in drug use were exhibited across the three residential categories. It is recommended that future research on the rural and nonmetropolitan adult population incorporate both structural level measures of socioeconomic and demographic characteristics of localities, and individual level measures of peer influence, work stress, family factors, and psychosocial characteristics.

Adult↗
PubMed2006

Evaluation of thermal water in patients with functional dyspepsia and irritable bowel syndrome accompanying constipation.

AIM: To evaluate the efficacy of water supplementation treatment in patients with functional dyspepsia or irritable bowel syndrome (IBS) accompanying predominant constipation. METHODS: A total of 3872 patients with functional dyspepsia and 3609 patients with irritable bowel syndrome were enrolled in the study by 18 Italina thermal centres. Patients underwent a first cycle of thermal therapy for 21 d. A year later patients were re-evaluated at the same centre and received another cycle of thermal therapy. A questionnaire to collect personal data on social and occupational status, family and pathological case history, life style, clinical records, utilisation of welfare and health structure and devices was administered to each patient at basal time and one year after each thermal treatment. Sixty patients with functional dyspepsia and 20 with IBS and 80 healthy controls received an evaluation of gastric output and oro-cecal transit time by breath test analysis. Breath test was performed at basal time and after water supplementation therapies. Gastrointestinal symptoms were evaluated at the same time points. Breath samples were analyzed with a mass spectometer and a gascromatograph. Results were expressed as T(1/2) and T-lag for octanoic acid breath test and as oro-cecal transit time for lactulose breath test. RESULTS: A significant reduction of prevalence of symptoms was observed at the end of the first and second cycles of thermal therapy in dyspeptic and IBS patients. The analysis of variance showed a real and persistant improvement of symptoms in all patients. After water supplementation for 3 wk a reduction of gastric output was observed in 49 (87.5%) of 56 dyspeptic patients. Both T(1/2) and T-lag were significantly reduced after the therapy compared to basal values [91 +/- 12 T(1/2) and 53 +/- 11 (T-lag), Tables 1 and 2] with results of octanoic acid breath test similar to healthy subjects. After water supplementation for 3 wk oro-cecal transit time was shorter than that at the beginning of the study. CONCLUSION: Mineral water supplementation treatment for functional dyspepsia or constipation accompanying IBS can improve gastric acid output and intestinal transit time.

Adult↗
PubMed2005

Recovery from schizophrenic psychoses within the northern Finland 1966 Birth Cohort.

BACKGROUND: Because of widely disparate findings from follow-up studies, the likelihood of recovery from schizophrenia remains controversial. We report the extent of recovery from schizophrenia in a population-based cohort. METHOD: Subjects with psychotic disorders were recruited from the Northern Finland 1966 Birth Cohort. Of the 91 subjects who agreed to participate, 59 were diagnosed with schizophrenia and 12 were diagnosed with schizophrenia spectrum disorders (schizophreniform psychosis, schizoaffective or delusional disorder) by DSM-III-R criteria. Diagnoses were established by interviewing the subjects, checking the Finnish Hospital Discharge Register, and reviewing their medical records. To assess recovery, we used the Clinical Global Impressions; the Positive and Negative Syndrome Scale; the Social and Occupational Functioning Assessment Scale; and information about psychiatric hospitalizations, use of antipsychotic medication, and occupational status. RESULTS: Only 1 subject (1.7%) with DSM-III-R schizophrenia and 3 subjects (25%) with schizophrenia spectrum disorders fully recovered; 1 schizophrenia subject (1.7%) and 2 schizophrenia spectrum subjects (16.7%) experienced partial recovery. CONCLUSION: The data indicate that, at least until age 35, complete recovery from schizophrenia is rare, and the prognosis for the disorder is far more serious than suggested by some follow-up studies.

Adult↗
PubMed1997

An outbreak of Crimean-Congo hemorrhagic fever in the United Arab Emirates, 1994-1995.

A multi-faceted investigation was conducted in the United Arab Emirates to characterize the epidemiologic and ecologic factors underlying an outbreak of Crimean-Congo hemorrhagic fever (CCHF) noted in November 1994 among abattoir workers. A chart review was conducted among hospitalized suspected cases of viral hemorrhagic fever with onset between January 1994 and March 1995 coupled with serologic testing of available specimens for the presence of virus antigen and IgG and IgM antibodies by ELISA. Livestock handlers and animal skin processors were interviewed and tested for the presence of IgG antibody. Sera from imported and domestic ruminants were examined for antibody for CCHF virus, and ticks collected from these animals were tested with an antigen-capture ELISA. Thirty-five suspected cases of CCHF were identified (case fatality = 62%). Livestock market employees, abattoir workers, and animal skin processors accounted for 16 (57%) of 28 cases with known occupational status. Serologic evidence of past asymptomatic infection was noted in 12 (4%) of 291 livestock and abattoir workers but in none of the controls. Nineteen (7%) of 268 animals were positive for CCHF virus antibodies by ELISA including 12 ruminants from Somalia and Iran and five indigenous camels. One Hyalomma impeltatum and two H. excavatum from Somali cattle and one H. anatolicum from a Somali goat were positive for CCHF virus antigen.

Adolescent↗
PubMed2000

Specific psychiatric morbidity among diabetics at a Nigerian General Hospital.

BACKGROUND: In Nigeria, with a rising incidence of diabetes mellitus (DM), there are no controlled studies of specific psychiatric morbidity among sufferers. OBJECTIVE: To assess the prevalence of specific psychiatric disorders and general cognitive impairment in patients with diabetes mellitus. METHOD: Using Wing's Present State Examination and the Mini-Mental State Examination, we assessed the prevalence of specific psychiatric disorders and cognitive impairment among 100 DM patients attending an out-patient clinic, in comparison with a matched non-clinic sample; and examined the relationship between psychiatric morbidity and clinical variables. RESULTS: They were predominantly males (66%), mean age 43.0 years, mean duration of illness, 7.7 years and in low level occupations. Only 11 of the patients had sexual dysfunction (11%) and psychiatric symptoms (31%). Psychiatric diagnosis (ICD-10) were, generalised anxiety (6%) and mild depressive disorder (4%). Two had subjective memory disturbance. Insulin-dependent patients had significantly more widespread psychiatric symptoms than the non-insulin dependent. Psychiatric symptomatology was significantly associated with low occupational status, duration of illness and sexual dysfunction. CONCLUSION: Health education, subsidizing the cost of treatment, and physicians' sensitivity to the emotional condition of patients, will help to relieve psychic distress and make for more adequate management.

Adolescent↗
PubMedDate not supplied

Antibiotic prescribing patterns for sore throat infections in a university-based primary care clinic.

BACKGROUND: Recent studies reveal that a high percentage (over 50%) of episodes for upper respiratory tract infections (URTIs) are treated with antibiotics, regardless of appropriateness or the necessity for prescription. We identified antibiotic prescriptions in a primary health care centre (PHC) and evaluated their suitability for sore throat infections. We also explored whether symptoms, signs, diagnosis and antibiotics prescribed differed by gender. PATIENTS AND METHODS: We collected data on all patients visiting the centre over a period of 12 weeks with a main complaint of sore throat who were prescribed antibiotics after taking a blood count and throat culture. Patients older than 16 years of age were included in the study irrespective of sex, nationality, marital status, occupation or location of residence. The chi square (chi2) statistical test was used in comparing categorical variables. A P value of < 0.05 was considered significant. RESULTS: During the period of study, 579 patients with URTIs presented to the health centre, from which 339 patients with a sore throat were enrolled. Of the study group, 48.7% (165) were male and 51.3% (174) female, with the majority of patients being under 30 years old (54.3%). Throat cultures were positive in 56 patients (16.5%). Most of patients were diagnosed as having pharyngitis (22.7%), and the most frequently prescribed medicine was an oral penicillin (39.1%). Two hundred eight-six patients (84.4%) had 2 or fewer Centor criteria. CONCLUSIONS: Throat cultures were positive in only 16.5% of the patients prescribed antibiotics. This indicates that physicians in the health centre of the university are prescribing antibiotics inappropriately and inconsistently. This also highlights the need for more prescriber education, especially as the range of medications available to the general practitioner for prescribing increases.

Adolescent↗
PubMed1989

Follow-up of stress-management courses.

A study was made of the effects of stress-management courses on 595 men and women (mean age, 45 +/- 11 years) from one to seven years after they had attended such courses. The course (six 1.5-h sessions) included relaxation training, rational thinking and priority setting and assertiveness training. Evaluation comprised the Paul stress inventory of perceived stress and a questionnaire that dealt with stress and related behaviour and coping skills. The results indicated a substantial reduction in perceived stress immediately after the course which persisted until follow-up; satisfactory persistence in the use of learned coping skills; good reception of the course; and that decreases in perceived stress predicted changes in life-style, a reduced use of stress-related medications and an increased use of relaxation training. Extensive research, including controlled studies, on stress-management courses for Australians is recommended, as a basis for the development of courses which serve the needs of groups that differ in age, health status, occupation, education, and ethnic origin.

Adaptation, Psychological↗
PubMed1991

Screening for melanoma: a community survey of prevalence and predictors.

Australian cancer councils recommend the practice of regular self screening of the skin or screening by another person for signs of melanoma and other skin cancers. They also recommend that medical practitioners screen adult patients annually. This study examined the prevalence and predictors of self screening (or screening by another person) and screening by a general practitioner in 1344 individuals from randomly selected households. The results indicated that 48% of the sample either regularly checked their own skin or had it checked by another person (such as a spouse), and 17% had been screened by a general practitioner in the preceding 12 months. Overall, this indicates that 50% of the sample had their skin adequately screened as recommended. Individuals were less likely to have been screened if they were male; of lower occupational status; unemployed or too ill to work; and had only a primary school education. Those who had only basic medical insurance were also less likely to have been screened. A higher prevalence of screening was reported in individuals at greater risk of developing melanoma, in those who perceived themselves as more susceptible to developing melanoma, and in those who believed that there were greater benefits associated with the early detection of melanoma. The implications of these results for the development of effective public health education programmes, and for increasing the role of general practitioners in the education and screening of the public, are discussed.

Adolescent↗
PubMed1999

Smoking and mental health: results from a community survey.

OBJECTIVE: To assess the relationship of smoking with depression and anxiety symptoms and with risk factors for depression. DESIGN AND SETTING: A community survey conducted in Canberra in 1997. PARTICIPANTS: 2725 persons aged 18-79 sampled from the electoral roll. MAIN OUTCOME MEASURES: Smoking was investigated in relation to psychiatric symptoms (anxiety, depression, alcohol misuse), sociodemographic characteristics (age, sex, education, occupational status), social stressors (divorce, unemployment, financial difficulties, negative life events, childhood adversity), personality (extraversion, neuroticism, psychoticism), and social support (family and friends). RESULTS: Smokers had more depression and anxiety symptoms, more stressors and lower socioeconomic status compared with non-smokers. The association between smoking and psychiatric symptoms persisted even when stressors, socioeconomic characteristics and other factors were statistically controlled. CONCLUSIONS: Smoking is associated with poorer mental health. In helping patients to give up smoking, doctors need to be aware that some may have underlying mental health problems that require attention.

Adolescent↗
PubMed2006

The association of meat intake and the risk of type 2 diabetes may be modified by body weight.

AIM: To investigate the association between meat intake and incidence of type 2 diabetes (type 2 DM) in a large cohort of middle-aged women. DESIGN, SUBJECTS AND METHODS: Incident cases of type 2 DM were identified during an average of 4.6 years of follow-up in a prospective cohort study of 74,493 middle-aged, Chinese women (mean age +/- SD =51.7+/- 8.97 years). Participants completed in-person interviews that collected information on type 2 DM risk factors such as dietary factors and physical activity in adulthood. Anthropometric indices were measured. Dietary intake was assessed using a validated food frequency questionnaire (FFQ). We included in the current analysis 70,609 women who had no prior history of type 2 DM at study recruitment and who had valid dietary data. The association of type 2 DM with unprocessed meat intake (g/day) and the frequency of consumption of processed meat was evaluated using the Cox model with adjustment for age, kcals/day, body mass index (BMI), waist to hip ratio (WHR), vegetable intake, smoking, alcohol consumption, physical activity, income level, education level, occupation status, and history of hypertension and chronic disease at baseline. PRINCIPAL RESULTS: We identified 1972 incident cases of type 2 DM during a total of 326,581 person-years of follow up. Intake of unprocessed meat, particularly poultry, was associated with a decrease in the risk of type 2 DM in this cohort. The fully adjusted relative risks (RRs) for quintiles of total unprocessed meat intake were 1.00, 0.78, 0.83, 0.74, and 0.83 (P for trend: <0.01). When the joint effect between meat intake and BMI categories was evaluated, high intake of total unprocessed meat appeared to be associated with an increased risk of type 2 DM among obese women but a reduced risk among lean women (P value for the interaction tests = 0.05). Processed meat consumption was positively associated with the risk of type 2 DM. The adjusted RR was 1.15 (95% 1.01-1.32) in women consuming processed meats compared to those who did not consume processed meats (P=0.04). CONCLUSIONS: Processed meat intake was positively associated with the risk of type 2 DM. There was an indication that the effect of unprocessed meat intake on type 2 DM may be modified by BMI.

Journal Article↗
PubMed1990

Quality-of-life changes and hearing impairment. A randomized trial.

OBJECTIVE: To assess whether hearing aids improve the quality of life of elderly persons with hearing loss. SETTING: Primary care clinics at a Bureau of Veterans Affairs hospital. PATIENTS: One hundred and ninety-four elderly veterans who were identified as being hearing impaired from a screening survey involving 771 consecutive clinic patients. Of the original 194, 188 (97%) completed the trial. INTERVENTION: Subjects were randomly assigned to either receive a hearing aid (n = 95) or join a waiting list (n = 99). MAIN ENDPOINTS: A comprehensive battery of disease-specific and generic quality-of-life measures were administered at baseline, 6 weeks, and 4 months. MEASUREMENTS AND MAIN RESULTS: Persons assigned to the two groups were similar in age, ethnicity, education, marital status, occupation, and comorbid diseases. At baseline, 82% of subjects reported adverse effects on quality of life due to hearing impairment, and 24% were depressed. At follow-up, a significant change in score improvements for social and emotional function (34.0; 95% CI, 27.3 to 40.8; P less than 0.0001), communication function (24.2; CI, 17.2 to 31.2; P less than 0.0001), cognitive function (0.28; CI, 0.08 to 0.48; P = 0.008), and depression (0.80; CI, 0.09 to 1.51; P = 0.03) was seen in subjects who received hearing aids compared with those assigned to the waiting list. Six drop-outs (three per group), no crossovers, and no significant changes in cointerventions were seen. Average, self-reported, daily aid use in the hearing aid group was 8 hours. CONCLUSION: Hearing loss is associated with important adverse effects on the quality of life of elderly persons, effects which are reversible with hearing aids.

Aged↗
PubMed1993

Women's participation in community health education: an empirical study.

This study identifies reasons for participation in community health education and determines if selected sociodemographic variables correlate with reasons for participation. The subjects were women (N = 400) who had attended hospital-based health education programs in a midwest urban area. An instrument was developed containing 36 items describing the concept "reasons for participation." Factor analysis revealed six interpretable factors: social acceptance, professional/personal advancement, personal insight, personal satisfaction, fulfillment of responsibilities, and self-enrichment. Age, marital status, occupation, number of children, educational attainment, and family income correlated with three of the six factors.

Adult↗
PubMed1999

[The social and work-related impact of multiple sclerosis].

OBJECTIVE: To analyse the repercussion of the disease in social and occupational status of multiple sclerosis patients. To describe the frequency with these patients are faced to architectural barriers in their own home. PATIENTS AND METHODS: We addressed a postal survey to 250 patients previously evaluated in our multiple sclerosis unit. Clinical data were recorded in the EDMUS database. RESULTS: A hundred and sixty patients answered the questionnaire. Mean age was 39.2 +/- 11.9 years. Mean duration of the disease was 10.05 +/- 8.4 years. Twenty-one per cent of patients were in progressive phase of the disease. Eighty-nine patients (55.6%) were unemployed. Unemployed patients had arrived to a moderate disability level (EIS > or = 3) before than employed patients. Only 17% of patients older than 50 years were employed vs. 63% of those among 26-35 years. Only EIS and years of school attendance were independently related to the unemployment status. Forty per cent of patients referred household income greater to $8,000/year. Thirty-six per cent of patients with severe disability (EIS > 6) was living in a floor with stairs and without lift. Forty-four per cent of patients with EIS > 6 had architectural barriers in their bathroom. CONCLUSIONS: More than half of multiple sclerosis patients were unemployed. Only the degree of disability and educational level were related in a independent way with unemployment status. Many patients unable to walking unaided had architectural barriers at home.

Adult↗
PubMed1975

Smoking behaviour and respiratory health in teenage sample: the rotorua lakes study, 1.

A survey in a New Zealand high school compared boys and girls, Maori and European, aged 13 to 15 years, and found differences in smoking habits. Smoking was most prevalent in Maori students of both sexes, and least in European girls, who appeared to be most influenced by home factors such as father's occupational status and older siblings' habits. Maori students and European boys showed relationships rather to the habits of the peer group. Findings were comparable with earlier studies suggesting little secular change in the smoking habits of this age group. Current smokers in all sex/race groups had higher current respiratory morbidity scores than non-smokers and ex-smokers, and smoking partly accounted for racial differences in morbidity.

Adolescent↗
PubMed1999

Evaluation of a smoking cessation programme that uses behaviour modification.

AIM: To obtain an up-to-date measure of the end-of-course success rate of the Isis Stop Smoking Programme and to determine which demographic, socioeconomic and behavioural factors were predictors of success in the programme. METHOD: Data from a questionnaire completed at the outset of course participation were available for 1016 Isis participants. The data were statistically analysed. RESULTS: "Success" was defined as having consumed no cigarettes during the final 24 hours of participation on the Isis Programme. The overall success rate at completion of the programme was 69% of participants. For both males and females, the number of cigarettes consumed on beginning the programme was the strongest predictor of success. Other predictors were commitment to quitting, nicotine yield of the usual cigarette, number of years of smoking and age. Young females had a particularly good success rate. Participants were categorised according to the New Zealand Socioeconomic Index of Occupational Status. Professional and technical workers were the most successful quitters and the unemployed, self-employed and students had particularly low success rates. CONCLUSION: Assuming proportionality of recent end-of-course success rates with comparable figures from the late 1970s, the proportion of Isis participants who continue to be non-smokers one year from completing the course would be approximately 33%. Further investigation to confirm this is warranted.

Adolescent↗
PubMed2000

Depressive symptomatology during pregnancy: evidence for an association with decreased fetal growth in pregnancies of lower social class women.

The relationship between depressive symptom scores on the Center for Epidemiological Studies Depression Scale (CES-D; L. S. Radloff, 1977) at each trimester of pregnancy and a decrement in either fetal growth or gestational duration was evaluated among 666 pregnant women. There was no association overall, but among 222 women from lower occupational status households, each unit increase on the CES-D at 28 weeks gestation was associated with a reduction of 9.1 g (95% confidence interval [CI] = -16.0, -2.3) in gestational-age-adjusted birth weight. When missing data were multiply imputed, the estimate was -4.6 g (95% CI = - 10.7, 1.5). CES-D score was unrelated to fetal growth or gestational duration in analyses among other potentially high-risk subgroups: smokers, women with a history of adverse outcome, and women with social vulnerabilities. These results raise the possibility that among lower status women, depressive mood may be associated with restricted fetal growth.

Adult↗