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PubMed1997

Hip fracture and osteoporosis in a XIIth Dynasty female skeleton from Lisht, upper Egypt.

Osteoporosis and complications arising from loss of bone mass have been present in human populations for thousands of years. However, reports of this disease in antiquity remain uncommon. The purpose of this report is to describe an important case of osteoporosis in ancient Egypt because of its intrinsic interest and to provide perspectives on factors contributing to this condition today. The case providing the focus for this report is from Lisht, Upper Egypt and is dated to the XIIth Dynasty (1990-1786 B.C.). Methods used to characterize the pathology include gross anatomical study, radiology, and radiographic measurements. Observations, measurements, and indices all indicate osteoporosis complicated by fracture of the femoral neck and compression fractures of some vertebrae. The Lisht case adds to a small corpus of reports on osteoporosis and complicating factors of this disease in antiquity. Long-term survival of an extracapsular fracture of the femoral neck in this case is remarkable and may reflect supportive social conditions.

Egypt, Ancient↗
PubMed2003

[Patient record from the Copenhagen General Hospital in 1855].

Hospital monographs frequently describe the buildings and the leading staff but rarely the patients. However, the 1980s and 1990s called attention to the importance of the perspective of patients of the past. The chapter reports an examination of the quality and extent of information retrieved through a systematic search of patient records from the Copenhagen General Hospital, extending back to 1855. The charts illuminated the social conditions of the patients in addition to their illnesses and the treatments characteristic of the day. Analyzing the state of medical practice revealed in the records, the author tested whether hospitals in reality were no more than gateways to the afterlife. Comparisons among hospitals showed the extent to which treatments varied across institutions. Correlations between the evidence of the patient charts and the ideals of the professional literature at the time revealed the differences between theory and practice. The records yielded important insights into the daily lives of patients admitted 150 years ago. They generally were younger and of lower social class. For reasons of poor hygiene, poor housing, and poor nutrition, they fell victim to the classical diseases of the crowded urban environment, including lung, skin and venereal diseases. Of these, tuberculosis killed most patients admitted to hospital.

Denmark↗
PubMed1988

Measuring patient satisfaction with life in a long-stay psychiatric hospital.

A survey of patient satisfaction with physical and social conditions was carried out in the long-stay wards of a large inner city psychiatric hospital in London, Britain. Patient satisfaction was assessed by means of an administered questionnaire which was developed specifically for this purpose. Factor analysis identified eight components of patient satisfaction. Of 143 eligible patients, 104 (73%) successfully completed the interview. Responses showed that patients were generally satisfied with life in the hospital, although levels of satisfaction varied significantly among wards. The factors causing greatest dissatisfaction related to failure to be treated as individuals and to feelings of isolation and apathy. Our findings showed that patients can express views about their conditions which should be useful in planning improvements in care. The questionnaire proved a simple and effective method of measuring satisfaction and may be useful to others concerned with improving the quality of the environment of patients.

Adult↗
PubMed2004

[The structure of self-rated health among older adults: the Bambuí health and ageing study (BHAS)].

OBJECTIVE: To determine factors associated with self-rated health among older adults, considering five dimensions: sociodemographic variables, social support, lifestyle risk factors, health status, and access to/use of healthcare services. METHODS: Of the 1,742 older adults (> or =60 years) living in the town of Bambuí (southeastern Brazil), 1,516 (87.0%) participated in the study. Information was obtained by means of standardized interviews and physical and laboratory exams. RESULTS: Self-rated health as good/very good, reasonable, and poor/very poor was reported by 24.7%, 49.2%, and 26.1% of subjects, respectively. The following characteristics showed independent positive associations with worse self-rated health: social ties (dissatisfaction with social network, attendance to clubs and associations), health status (symptoms of depression/anxiety in the last two weeks, sleeplessness in the last 30 days, greater number of prescribed medications used in the last 30 days), and access to/use of healthcare services (complaints when seeking medical care, greater number of medical appointments in the last 12 months, greater number of hospital admissions in the last 12 months). An independent negative association was found with monthly family income (<2.0 vs. > or =4 minimum wages). CONCLUSIONS: Our results show that self-rated health among older adults is multidimensional in structure, being influenced by socioeconomic conditions, social support, health status (with emphasis on mental health), and access to/use of healthcare services. This structure resembles the definition of health adopted by the World Health Organization (an individual's "physical, mental and social well-being").

Activities of Daily Living↗
PubMed2001

A 10-year follow-up review of patients who underwent Leksell's posteroventral pallidotomy for Parkinson disease.

OBJECT: The clinical condition of patients with Parkinson disease (PD) who had undergone posteroventral pallidotomy (PVP) between 1985 and 1990 was evaluated at a mean of 10 years postsurgery. These patients were part of a larger series described in the first paper on Leksell's PVP that was published in 1992. METHODS: Thirteen consecutive patients who had undergone pallidotomy at the University Hospital of Northern Sweden were tracked. Hospital and clinic records that had been updated regularly by the patients' various neurologists, geriatricians, and other clinicians were reviewed. Emphasis was placed on assessing the evolution of PD symptoms after surgery, and changes in the general health and social condition of the patients. The mean follow-up duration was 10.5 years (range 3-13.5 years). Five patients underwent a total of seven subsequent surgeries for their PD, 4 months to 11 years after the initial pallidotomy. The mean Hoehn and Yahr stage was 3 at the first surgery and 3.7 at the last follow-up review (p < 0.005). Dosages of levodopa and dopamine agonists were increased in all patients, without recurrence or induction of dyskinesias contralateral to the pallidotomy. Contralateral tremor, if it was initially controlled by surgery, remained improved. However, most patients exhibited a gradual recurrence of akinesia and an increase in gait freezing. Cognitive decline and presentation with diseases unrelated to PD were not uncommon. CONCLUSIONS: The long-term effect of PVP on dyskinesias was not only curative but also appeared to be prophylactic. Contralateral tremor was improved in the majority of patients, although additional surgeries for PD were needed in some patients. Further progression of axial and akinetic symptoms, and an eventual decline in cognition together with other concomitant illnesses, contributed to increased disability in several patients.

Adult↗
PubMed1999

The breast or the bottle? Determinants of infant feeding behaviors.

Although various trends have placed breastfeeding in and out of vogue, in the twentieth century the greater availability of human milk substitutes mandates that a woman choose her infant's feeding method. It appears that intrapsychic factors or life experiences, as well as certain social conditions, influence that choice. For example, the economic state of society historically has had significant impact on the role of women and the value placed on woman's unique biologic contributions. Likewise, personality and attitudinal factors also may act as potential mediators of observed differences between lactating and nonlactating mothers in their mother-infant interactions. Finally, once the decision to breastfeed or bottle-feed has been made and carried through, additional physiologic mechanisms may mediate conscious behavioral intentions. The phenomenon of human lactation, then, is sensitive to a variety of interrelated factors that can be grouped as follows: (1) individual personality, (2) social forces, and (3) psychophysiologic mechanisms. An in-depth understanding of the specific factors that affect a woman's decision to breastfeed will have far-reaching implications for future educational and interventional programs.

Attitude↗
PubMed2004

Behavioral and cardiophysiological responses of common marmosets (Callithrix jacchus) to confrontations with opposite-sexed strangers.

Common marmosets exhibit under captive conditions socially monogamous propensities. During confrontation with opposite-sexed stranger, in the presence of the pairmate, common marmosets often respond aggressively. However, in the absence of their mates, males actively solicit contact and even sexual interactions with strange females whereas mated females are indifferent to strange males. In the present study behavioral and cardiophysiological responses of pairmates of six established pairs of common marmosets were recorded during confrontation with an opposite-sexed stranger (1) in the presence or (2) in the absence of the familiar pairmate. Systolic and diastolic blood pressure, heart rate as well as locomotor activity were recorded telemetrically through peritoneally implanted transmitters. Behavioral responses were videotaped and in addition, urine samples from the female individuals were analyzed for their estrogen concentrations to monitor their ovarian cycles. The cardiophysiological values did not differ significantly between the two confrontation conditions. However, compared to baseline, heart rate values of both sexes and in males also blood pressure values, were significantly higher during confrontations. Hence, confrontations with an opposite-sexed conspecific clearly affect cardiophysiological parameters. Between confrontees affiliative behaviors could not been recorded but aggressive and sexual behaviors occurred.

Aggression↗
PubMed1985

The psychological impact of severe acne.

The extent to which severe acne affects patients' personality and emotional life is still undetermined. The personality factors of neuroticism, psychosomatic condition, social extraversion, and self-defensive attitude were tested, as well as the social anxiety, in a group of forty patients with severe acne. They were more neurotic, more concerned about their bodily functions, and had a lower self-defensive attitude than a normal population. Their anxiety level was also significantly elevated. A subgroup of twelve patients with conglobate acne were treated with isotretinoin. After one year, when the disease had been brought under control effectively, they were retested. The personality factors had not changed consistently. A decrease of anxiety, which did not reach a level of significance, was found. We conclude that the personality and emotional life of patients with severe acne are affected. This aspect of their condition should receive proper attention as part of their treatment.

Acne Vulgaris↗
PubMed1999

Return of the past: the policy of the SED and the laws against homosexuality in Eastern Germany between 1946 and 1968. Sozialistische Einheitspartei Deutschlands.

In 1968 the Government of Eastern Germany adopted a New Penal code of the GDR. In the new code, there was no Paragraph 175-the paragraph in the German Penal code punishing homosexuality. So-called "mere" homosexuality (consensual sexual activities between two adult men) was no longer punishable. With the repeal of Paragraph 175 the efforts started in 1952 to eliminate the legal discrimination of homosexuals in the GDR came to a provisional end. Through analysis of recently available files the author describes the political and social conditions which resulted in the reform being delayed until 1968. He also pointed out that the legal solution to the question of homosexuality was an instrument of politics and subjected to the power interests of the Sozialistische Einheitspartei Deutschlands (Socialist Unity Party, SED). The delay in the reform of decriminalization of homosexuality established a trend which aimed to control sexual behavior in the interests of the socialist utopia of the new "socialist humanity." Individuals and groups which diverged from this model character were to be led toward sexual "normality" by maintaining the threat of legal punishment. In other words: In the GDR, as in other countries where state socialism became the ruling system, the overthrow of the bourgeois society was not accompanied by sexual revolution. The relationship between respectability and socialism shows clearly how effectively bourgeois morality has penetrated all layers of the population.

Adult↗
PubMed1999

[Evaluation of anxiety and depression in patients with vascular brain damage].

In 90 patients with vascular damage to the CNS an assessment was carried out of the intensity of anxiety on the basis of Anxiety State and Trait Inventory, of the degree of symptom intensity of depression syndrome on the basis of Hamilton Depression Scale and of personality and socioeconomic conditions on the basis of history data in' and Eysenck Personality Inventory. In the studies the hemispheric laterality of brain damage was taken into account. The results were analysed statistically comparing them with those obtained in the control group of healthy men aged 18-24 years. On the basis of the studies and calculations the following conclusions were drawn: 1--the intensity of anxiety and depression in patients treated for vascular CNS damage is greater than in the control group. 2--statistically higher depression intensity was found in patients with left hemisphere damage as compared with the group with right hemisphere damage. 3--in patients living in good social conditions and regarding their family relations as good, the intensity of anxiety and depression was statistically lower than in the group of patients with poor family and socioeconomic conditions.

Adult↗
PubMed1983

The effects of the community environment on chronic psychiatric patients.

The question of where to place the chronically mentally disabled in the community is essential in this era of brief hospitalization practices. This report examines the effects of the social conditions of the environment on the length of stay in the community for a sample of 119 multiple admission schizophrenics in New York City. Patients returned to a variety of family and non-family living arrangements in poor and depressed areas of the city. The relationship between characteristics of the living arrangements and the patients' clinical functioning and rate of rehospitalization was examined. The findings show that there is no significant differential effect of the type of living arrangement on rehospitalization or clinical functioning, and that these factors did not contribute significantly to the prediction of successful adjustment. However, the socio-emotional characteristics of the environment--i.e. social support and interpersonal stress-together are stronger predictors of outcome than are available out-patient treatment programmes. The findings emphasize the importance of environmental variables as factors independent of the effect of treatment on rehospitalization.

Adolescent↗
PubMed1983

[Definition of the stress concept and its use in various areas of medicine].

The triphasic adaptation reaction of the organism to every kind of demand, originally described by Selye, is a normal adaptation phenomenon which does not evoke any pathologic appearances in the healthy man, but on the contrary fulfills functions furthering the functional capacity. In man not biological, but frequently repeated, long-lasting psychosocial loads stand in the foreground, which may lead to gradually increasing phenomena, when a stress sensitivity and unfavourable social conditions are present. Hereby the changes in the biological field have secondary character. Far more decisive are disturbances of the behaviour which appear in psychosocial permanent loads which may lead to an increase of the risk factors for numerous diseases. When demands are insufficiently managed and a stress sensitivity is present a pathogenic stress may develop and evoke a chronic pathological process.

Adaptation, Psychological↗
PubMed2000

The effect of social dominance on fattening and food-caching behaviour in Carolina chickadees, Poecile carolinensis.

Subordinates often have to wait for dominants to obtain food. As a result, their foraging success should be less predictable and they should therefore maintain a higher level of energy reserves compared with dominants. A corollary of this prediction is that subordinates should gain mass earlier in the day and maintain higher mass than dominants. We tested these predictions with captive Carolina chickadees. In two different experiments (one where birds were given ad libitum access to food and the other with food access limited to 60 min/day), we formed social flocks of two previously unfamiliar birds and compared their energy management (body fat and food caches) while they were in the flock with energy management when housed alone. Results from both experiments failed to support the predictions. Of all the parameters of body mass and food caching we measured only the following results were significant: (1) On the ad libitum food schedule, both subordinates and dominants accumulated more mass over the day when in a flock compared with when they were solitary, and there were no differences in mass gain between dominants and subordinates. (2) When analysed separately, dominants showed a higher evening mass in the flock compared with the solitary condition, a trend that runs opposite to the prediction. Our results suggest that when in favourable foraging conditions, social interactions might cause dominant and subordinate birds to accumulate more energy reserves as a result of competition. On the other hand, if food supply is limited, both dominants and subordinates may be forced to maintain similar fat reserves as an insurance against increased risk of starvation. Copyright 2000 The Association for the Study of Animal Behaviour.

Journal Article↗
PubMed1988

Fertility and child spacing among the urban poor in a third world city: the case of Calcutta, India.

The author examines the fertility behavior of the urban poor in India. "On the basis of data from 180 slum households in Calcutta, India, the paper indicates that in a situation where material and social conditions are comparable, cultural and demographic variables play a major role in influencing reproductive behavior. In this case study, caste and family type are shown to have a significant effect on the numbers of surviving children. As regards child spacing, the woman's age is of paramount importance."

Age Factors↗
PubMed1990

Social cues influence growth and sexual maturation of the male musk shrew (Suncus murinus).

Musk shrews were maintained from weaning (20 days of age) for 20 or 40 days in one of several social conditions. In Exp. 1, young males housed with adult females gained more weight and had heavier sex accessory organs than did young males housed with an adult male or reared alone. In Exp. 2 this same pattern of accelerated growth and sexual maturation was found when males were reared directly with an adult female or in a split cage where a wire barrier served to separate the male and his adult female cagemate. In Exp. 3, males were reared in cages containing clean or soiled bedding: soiled bedding was taken once every 5 days from the cage of an adult male, or a female. Under these conditions differences in the weights of reproductive tissues showed minimal variation with housing condition after 20 days of treatment. At that time males reared in soiled bedding taken from the cage of an adult female had accelerated development compared with control males. In Exp. 4, males were housed alone or in a split cage with an adult female which was separated by a wire mesh or a solid, opaque barrier. Males separated by a solid barrier from their female cagemates for 40 days had reproductive tissue weights equivalent to those measured in males reared alone. Taken together these results suggest that the presence of an adult female has dramatic effects on body growth and development of reproductive target tissues in young male musk shrews. Male-female social interactions could play an important role in the timing of puberty in this opportunistically breeding tropical mammal.

Androgens↗
PubMed2003

A model for tool-use traditions in primates: implications for the coevolution of culture and cognition.

Inspired by the demonstration that tool-use variants among wild chimpanzees and orangutans qualify as traditions (or cultures), we developed a formal model to predict the incidence of these acquired specializations among wild primates and to examine the evolution of their underlying abilities. We assumed that the acquisition of the skill by an individual in a social unit is crucially controlled by three main factors, namely probability of innovation, probability of socially biased learning, and the prevailing social conditions (sociability, or number of potential experts at close proximity). The model reconfirms the restriction of customary tool use in wild primates to the most intelligent radiation, great apes; the greater incidence of tool use in more sociable populations of orangutans and chimpanzees; and tendencies toward tool manufacture among the most sociable monkeys. However, it also indicates that sociable gregariousness is far more likely to produce the maintenance of invented skills in a population than solitary life, where the mother is the only accessible expert. We therefore used the model to explore the evolution of the three key parameters. The most likely evolutionary scenario is that where complex skills contribute to fitness, sociability and/or the capacity for socially biased learning increase, whereas innovative abilities (i.e., intelligence) follow indirectly. We suggest that the evolution of high intelligence will often be a byproduct of selection on abilities for socially biased learning that are needed to acquire important skills, and hence that high intelligence should be most common in sociable rather than solitary organisms. Evidence for increased sociability during hominin evolution is consistent with this new hypothesis.

Animals↗
PubMed2002

[Jewish medical practitioners in 14th and 15th century Munich].

Contemporary sources reveal little information about the social conditions of Jewish medical practitioners in 14th and 15th century Munich. Due to the concurrence on the local "medical market" none of the five Jewish doctors named in the documents could practice for a longer period in teh late medieval city. Unlike their co-religionists in several cities of Westphalia, where physicians and surgeons were lacking, no Jewish medical practitioner was ever employed by the Magistrate of Munich. Thus, all of them seemed to have hoped for an employment at the court of the Bavarian Dukes. But with the exception of Jacob of Landshut, physician to the Bavarian Dukes Steven III. and Albrecht III. during the second half of the 14th century, whose medical career and social environment can roughly be retraced, no Jewish doctor seems to have been in service of the court for a longer time.

Germany↗
PubMed2002

Epidemiological investigation of sudden infant death syndrome infants--recommendations for future studies.

In recent years the study of infant care practices within the sleeping environment has proved to be the single most important set of observations for reducing the risk of Sudden Infant Death Syndrome (SIDS). To further reduce the number of deaths and resolve the debate on safe infant care practice, a closer scrutiny of this environment is required. However, anecdotal observation from uncontrolled death-scene investigations and a reluctance to diagnose SIDS because of adverse social conditions or circumstantial evidence at the time of death is undermining future research. To investigate SIDS now means investigating the wider umbrella of all Sudden Unexpected Deaths in Infancy (SUDI) because of the potential for misdiagnosis. In trying to find out why SIDS infants die we have increasingly been forced to search for why infants survive in the first few months of life and it is this comparative component of epidemiological observation that has saved so many lives. A death-scene investigation is vital to any planned future investigation of SIDS but equally essential is a sleep-scene investigation of surviving infants to put any findings into context. SIDS infants are no longer scattered across the social strata and the cot is not the only environment in which they are found, social deprivation and use of the parental bed are now more discernable. Future studies should therefore reflect these changes with a second control group of surviving infants more closely matched to the type of environment in which SIDS infants might be found.

Case-Control Studies↗