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PubMedDate not supplied

[Work capacity and aging].

Maintaining a good work ability depends on satisfactory health and employment status, which is supported by suitable working conditions and correct life styles. From the biological perspective, ageing means a foreseeable progressive and overall deterioration of the various physiological systems, but not of such a kind and severity to consider most people over 50 as too old or unfit for work, as has been shown by several studies that assessed work ability not only in terms of biological age, but of functional age and actual work output. From the physio-pathological perspective, we can observe either illnesses associated with the passage of time or age-related changes that might precipitate diseases, as well as environmental changes that modulate ageing and developmental changes that accelerate or retard ageing. From the practical point of view, it should taken into account that job demands often do not follow the natural biological and functional changes of the individual, consequently the relative work load can be higher in older workers. On the other hand, ageing also means a professional growth in terms of strategic ability, shrewdness, wisdom and experience. The high interindividual variability of physical, mental and social conditions that is observed with the increase in age makes it necessary to adopt flexible and personally tailored measures, as shown by recent surveys in some European countries aimed at reducing age discrimination and work disability, and at promoting work ability by means of actions directed towards both improvement of work organisation and support of psycho-physical conditions of older workers.

Aged↗
PubMed1992

Seroprevalence of HIV infection in rural South Africa.

OBJECTIVES: To establish the prevalence of HIV infection in rural South Africa and to investigate demographic factors that influence this prevalence. DESIGN: An anonymous HIV seroprevalence survey was performed in conjunction with a population-based malaria surveillance programme. SETTING: The rural area of northern Natal/KwaZulu, South Africa. PARTICIPANTS: A total of 5023 black African participants were recruited by malaria surveillance agents during house-to-house visits; each house in an endemic malaria area is visited approximately once every 6 weeks. Participants included 4044 healthy and 979 febrile individuals (i.e., suspected of having malaria). MAIN OUTCOME MEASURES: HIV-1 and HIV-2 serological status, degree of mobility, age and sex. RESULTS: Sixty of the 5023 blood specimens were confirmed to be HIV-1-antibody-positive by Western blot, an overall prevalence of 1.2% (95% confidence interval, 0.9-1.5). None of the specimens was positive for HIV-2 antibodies. After adjusting for age, presence of fever and migrancy, women had a 3.2-fold higher prevalence of HIV-1 infection than men. HIV-1 infection was approximately three times more common among subjects who had changed their place of residence recently (2.9 versus 1.0%, P < 0.01). CONCLUSIONS: The prevalence of HIV-1 infection is higher among women than men resident in rural Natal/KwaZulu, South Africa. This is at least in part the result of oscillatory migration, particularly of men who work in urban areas but have families and homes in rural areas. Migration is associated with a higher prevalence of HIV-1 infection, suggesting that improving social conditions so that families are not separated and become settled in their communities is one way to help reduce the spread of HIV-1.

Adolescent↗
PubMed1992

Differences in height between socially more and less privileged 10 year old Stockholm children born in 1933-1963.

The change of the difference in height between two socially extreme groups of 10 year old Stockholm children born in 1933, 1943, 1953 and 1963 was analysed. Data on height and social conditions were taken from the school health records. The two groups were established on the basis of the father's occupation and the number of children in the family. The height of the 10 year old children in the more privileged group born in 1933, 1943 and 1953 was virtually unchanged, but the height in the less privileged group increased gradually. The difference between the two groups was levelled out in the 1953 cohort. However, it reappeared in the 1963 cohort, mainly as a result of increasing height in the more privileged group and fairly unchanged height in the less privileged group.

Body Height↗
PubMed1999

The mental health status of young Hispanic women residing along the border: a twin cities comparison.

A number of studies report comparisons among ethnic/ racial groups in terms of health attitudes, health practices, and socio-economic and mental health status. Of special concern is the mental health status and coping potential of young women of childbearing age because of the special vulnerability of individuals in this group and the vulnerability of their children. The well-being of future generations is at stake when maladaptive functioning compounded by severe social conditions create a climate for inadequate growth and development for large numbers in a population, even for short periods of time. This paper reports the results of a study examining self concepts and mental health status of two distinct populations within one ethnic group-young Hispanic women living on the U.S. side of the Texas-Mexico border versus a similar sample of young Hispanic women living on the Mexico side. Within each sample, the never-pregnant versus ever-pregnant adolescents were compared. The young women in both groups reported intense feelings related to emotional distress. The young women in Ciudad Juarez reported somewhat more positive feelings related to recent well-being. The El Paso women reported a less traditionally feminine persona (they felt more aggressive, confident, successful, energetic, and successful), yet they experienced less happiness, hopefulness, and life satisfaction. However, neither group could be described as reporting positive mental status and those women who had been pregnant were no different than their never-pregnant counterparts. Rather, the results signal serious problems throughout the two populations. Health care and social service workers must recognize and be prepared to address intense personal distresses in both of these young, Hispanic-female, border populations.

Adolescent↗
PubMed1979

Obesity in 10-year-olds: an epidemiologic study.

With a multifactorial pathogenetic model (heredity versus environment, central nervous control, energy balance, morphology of the fat tissue), an attempt was made by this study to assess the relative importance of the various factors to the origin of overweight and obesity in school children. From an original sample of 972 children followed longitudinally from the ages of 7 to 16 years, and with retrospective weight data from the first year of life, 550 were selected for this study at age 10. Information concerning the children's habits (physical activity and appetite), social conditions, and parental heights and weights were obtained from the parents by questionnaire (response rate 94%). The major results of a multiple regression analysis were: (1) clear-cut sex differences; heredity and physical inactivity having the greatest explanatory power for both overweight and obesity at 10 years in girls, whereas appetite and environmental conditions were more prominent predictors in boys; (2) an analysis of the main predictors of the variable "change in relative weight between 7 and 10 years"--a variable with possible implications for preventive school programs--indicated that markedly inactive only children from lower class families are particularly at risk of developing obesity during the first years at school; and (3) in the absence of all the risk factors considered in this study, obesity does not occur; at the other extreme, even a high risk score still implies a 50% chance of escaping the fate of obesity.

Adipose Tissue↗
PubMed2001

[Survey in 2000: 3 cases].

BACKGROUND: We report three new cases of patients presenting scurvy. In the year 2000 this rare disease still occurs in France. CASE REPORTS: The three patients, 2 men and a woman respectively 51, 50, and 73 years-old were alcoholics, and lived alone in difficult social conditions. Dietary survey indicated in the 3 cases inadequate vitamin C intake, and a regimen including solely bread, rice, pasta, and packet soup devoid of fresh vegetables and fruit. The cutaneous findings attributed to scurvy were: in the first patient, a woody inflammatory and painful oedema of the left leg associated with perifollicular petechial haemorrhages over the lower limbs, and hyperpigmentation of the facial skin with slate-gray spotty pigmentation of the tongue (pseudo-addisonian hyperpigmentation); in the second patient, an accentuation of a pre-existing acne becoming more inflammatory and extensive; and in the third patient, a diffuse petechial eruption on the abdomen and lower extremities. The diagnosis of scurvy was confirmed by low plasma ascorbic acid levels (< 6 mumol/l). All patients were treated with 1 to 2 g of oral ascorbic acid daily for 2 weeks resulting in rapid and dramatic response. DISCUSSION: Scurvy is a rare disease in industrialized nations. Its incidence is unknown because of absence of total census. Dietary vitamin C deficiency represents the main risk factor exposing for scurvy among adults, often alcoholics and living in social isolation. Cutaneous features supporting the diagnosis of scurvy are described in our observations. The recognition of these cutaneous abnormalities is important because their association can be misleading, and erroneously interpreted as a sign of systemic vasculitis, or connective tissue disease. The diagnosis of scurvy is confirmed by the measurement of plasma ascorbic acid levels. Treatment is simple and based on the administration of vitamin C, which results in dramatic improvement.

Aged↗
PubMed1999

Changes in the epidemiology of ruptured globe eye injuries due to societal changes.

We studied 208 records of patients, who had undergone primary repair of a ruptured globe. A comparison of the periods 1987-1989 and 1993-1995 suggests epidemiological changes as a result of broad changes in occupational and social conditions after the German reunification in 1989. The rate of ruptured globe injuries caused by occupational accidents decreased from 38.8% in the first period to 31.4% in the second. We found an increase in comparable eye injuries as a consequence of leisure activities. Within the years from 1993 to 1995, in occupational accidents, we found a significant decrease in eye injuries in industry while accidents in small companies (e.g. garages, builders and constructors) increased significantly compared to 1987-1989.

Accidents, Occupational↗
PubMedDate not supplied

[Demographic evolution, aging and frailty].

The 20th century will be remembered for its technological and scientific discoveries and for the exceptional changes in the demographic structure brought about by these and the improved economic and social conditions; in fact, the reduction in the birth rate and a fall in the death rate have caused an increase in the population of the elderly. Today the elderly population represents about 20% of the total and is much more heterogeneous than in the past, with several classes of the elderly: the young elderly from 64 to 74; the old elderly from 75 to 84, the very old from 85 to 100 and the oldest old who are living around a century. The aging of the population has brought out several problems of the elderly, among the "frailty", the effects of which increase as the years pass and which regards about one half of the very old. Frailty is a reduction of the body's ability to maintaine global homeostasis and is caused by a reduction of the functional reserves of all the organs and apparatus which occurs with aging. Screening the frail elderly with a careful multidimensional assessment is important to prevent health problems and to promote good health and it is a good parameter in evaluating the management of the geriatric assistance network and thus health and social costs.

Adolescent↗
PubMed1975

Some considerations in the formulation of psychiatric diagnoses.

This paper attempts to show that psychiatric diagnosis depends to a significant degree on not only the patient's presenting symptoms but also on the psychiatrist's psychosocial biases. The importance of a psychiatric diagnosis is seen in terms of the potential social restrictions and prejudices that can be a consequence of a person labeled with a mental illness. Also, current treatment techniques and valid statistics for research are based on reliable and consistent psychiatric diagnoses. A study of 267 cases from a major psychiatric hospital revealed over 12 per cent discrepancy between the official discharge diagnosis and a resident's training report diagnosis that is used only for teaching purposes. This discrepancy is statistically significant and the paper attempts to elucidate some of the characteristics of the special population that had its diagnosis made less severe on discharge. Of the 267 charts surveyed, 33 patients had their diagnosis changed from a psychotic diagnosis on the resident's training report to a neurotic or characterological diagnosis on the official discharge summary. In addition, interviews were arranged with the 18 psychiatric residents who had been involved in changing the diagnosis of target group patients. The results obtained from these interviews definitely confirm that psychiatric diagnoses are changed due to social conditions unrelated to the psychopathological state. From the demographic data of the patient groups, a pattern evolved showing that men were generally more protected than women, that black males were more protected than black females, that unskilled laborers and those on the lower end of the socioeconomic scale were more protected than professionals, and that housewives were less protected than other categories. A number of conclusions were made by the authors concerning the data. The authors hope that these findings will enable other mental health workers to be more aware of their psychosocial biases that may be influencing their diagnostic skills.

Attitude of Health Personnel↗
PubMed2005

[Social inequalities in cesarean section rates in primiparae, Southern Brazil].

OBJECTIVE: To investigate the effect of social inequalities in cesarean section rates among primiparae having single pregnancy and delivering in maternity hospitals. METHODS: The study was carried out in Southern Brazil in 1996, 1998 and 2000. Data from the Live Birth National Information System were used to estimate annual rates and crude and adjusted odds ratios (OR) of cesarean sections according to social conditions (maternal age and education, newborn skin color/ethnicity and macro-regions), duration of pregnancy, and number of prenatal visits. RESULTS: The overall cesarean section rate was 45%, and above 37% in all macro-regions. Increased rates were seen among native and black mothers, aged 30 years or more, living in metropolitan, river valley and mountain macro-regions and having attended to more than six prenatal visits. Crude and adjusted OR show that cesarean rates were negatively associated with all categories of skin color/ethnicity when compared to white newborns, particularly those of native Brazilian (ORadj=0.43; 95% CI: 0.31-0.59), and they were positively associated with higher maternal education (ORadj=3.52; 95% CI: 3.11-3.99), older age (ORadj=6.87; 95% CI: 5.90-8.00) and greater number of prenatal visits (ORadj=2.16; 95% CI: 1.99-2.35). The effects of age and education were partly mediated by the greater number of prenatal visits among higher educated older women. The OR varied among macro-regions but were greater for the wealthier mountain region. CONCLUSIONS: High rates of cesarean section rates in Southern Brazil are a public health concern. They are associated with social, economic and cultural factors which can lead to misuse of medical technology during labor and delivery.

Adult↗
PubMed1985

Social factors and puberty in female rats.

The effects of postweaning social conditions on the age of puberty were studied in female rats from an early- and a late-maturing strain. The postweaning living conditions consisted of the presence or absence of an adult rat (intact or gonadectomized male, or intact female), or of bedding soiled by adult males. The infantile females exposed to these conditions were caged either singly or with three peers. Puberty was studied in terms of first ovulation, verified always by ovarian histology. Females of the late-maturing strain living without peers reached puberty about 2 days earlier than females that grew up in groups of four, irrespective of the presence or absence of an adult animal. In neither strain was puberty accelerated by the presence of intact males or the soiled bedding of such males. These results do not support the view that in the rat pheromones from adult males enhance puberty in females, contrary to what is known to happen in the mouse.

Animals↗
PubMed2003

The precautionary principle within European Union public health policy. The implementation of the principle under conditions of supranationality and citizenship.

The present study examines the precautionary principle within the parameters of public health policy in the European Union, regarding both its meaning, as it has been shaped by relevant EU institutions and their counterparts within the Member States, and its implementation in practice. In the initial section I concentrate on the methodological question of "scientific uncertainty" concerning the calculation of risk and possible damage. Calculation of risk in many cases justifies the adopting of preventive measures, but, as it is argued, the principle of precaution and its implementation cannot be wholly captured by a logic of calculation; such a principle does not only contain scientific uncertainty-as the preventive principle does-but it itself is generated as a principle by this scientific uncertainty, recognising the need for a society to act. Thus, the implementation of the precautionary principle is also a simultaneous search for justification of its status as a principle. This justification would result in the adoption of precautionary measures against risk although no proof of this principle has been produced based on the "cause-effect" model. The main part of the study is occupied with an examination of three cases from which the stance of the official bodies of the European Union towards the precautionary principle and its implementation emerges: the case of the "mad cows" disease, the case of production and commercialization of genetically modified foodstuffs. The study concludes with the assessment that the effective implementation of the precautionary principle on a European level depends on the emergence of a concerned Europe-wide citizenship and its acting as a mechanism to counteract the material and social conditions that pose risks for human health.

Animals↗
PubMedDate not supplied

Health problems encountered by dying patients receiving palliative home care until death.

Many of the studies reviewing the needs of the dying patient have used specified time points rather than following the patients through the last span of their lifetime, until death. This prospective study, using clinical records and nursing anecdotes, examined the health problems encountered by dying patients receiving home care from referral to home care until death. Thirty-two subjects were recruited in the study. The clinical records were content-analyzed using the Omaha system, and the anecdotes of the nurses were used to illuminate the numerical findings. This study reveals that patients who were discharged home were living in good environmental and social conditions. The physical symptoms were generally well controlled, except for dyspnea. The psychological aspects caused the most concern to patients, families, and healthcare professionals. The severity of the psychological signs and symptoms was moderate at the time of the initial visits, but improved toward the final visits. Understanding the needs of palliative home care patients can facilitate the healthcare team to plan care to support "good dying" of these patients.

Adult↗
PubMed1994

Aetiology of peptic ulcer: a prospective population study in Norway.

STUDY OBJECTIVE: To analyse simultaneously the effect of several risk factors for peptic ulcer. DESIGN: Cohort study where all patients with new or incident peptic ulcers in a well defined population were registered for a seven year period. The follow up started with a comprehensive health survey including a questionnaire on diet, lifestyle, psychological and social conditions, and health. Relative risks, both sex specific and separate, for gastric and duodenal ulcers were estimated from proportional hazard regression analysis. SETTING: A population based survey conducted in the municipality of Tromsø, northern Norway. PARTICIPANTS: In 1980, a total of 21,440 men and women, aged 20 to 54 years and 20 to 49 years respectively, were invited to participate. A total of 14,667 people attended and returned the questionnaire. MAIN RESULTS: A total of 328 people had their first peptic ulcer in the follow up period. Age, cigarette smoking, first degree relatives with peptic ulcer, and low educational level were shared risk factors for peptic ulcer in both men and women. In men, frequent upper respiratory infections increased the risk of gastric ulcer and drinking a great deal of milk increased the risk of duodenal ulcer. None of the other dietary variables, including coffee and alcohol consumption, contributed significantly to the risk. Use of analgesics was not a risk factor, and none of the psychological indicators analysed carried any significant risk. CONCLUSIONS: Age, inheritance, and cigarette smoking are all important risk factors for peptic ulcer. The increased risk associated with low educational background indicate that social strains, comprising lifestyle and diet habits, are part of the multifactorial aetiology of peptic ulcer. No support was found for the assumption that peptic ulcer disease is a psychosomatic disorder. This study did not support the view that duodenal and gastric ulcers have different aetiologies-rather it showed a similarity in risk patterns.

Adult↗
PubMed1999

Forebrain arginine vasotocin correlates of alternative mating strategies in cricket frogs.

In cricket frogs, Acris crepitans, sexually active males can switch between calling and noncalling (satellite) mating strategies and injections of the neuropeptide arginine vasotocin (AVT) stimulate calling behavior. We report here that this behavioral variation of animals under field conditions is associated with variations in AVT-immunoreactive (AVT-ir) staining in distinct brain nuclei. In both calling and satellite males, one AVT-ir brain region was found in a continuous string of cells between the medial amygdala and the nucleus accumbens (ACC). Satellite males possessed significantly more AVT-ir staining in the brain (cells and fibers) than calling males at the level of the ACC, although not in the medial amygdala. This difference in AVT-ir staining in the ACC can, in part, be explained by differences in the density of staining within the cells and in cell size. In addition, satellite males had significantly higher AVT-ir staining in the fibers medial to the ACC than calling males. Because other studies have demonstrated that AVT stimulates calling behavior, a plausible hypothesis is that calling males are releasing more AVT from neurons in the ACC, depleting reserves within the cells, and that the released AVT elicits calling behavior. AVT immunoreactivity levels are also higher in the ACC in both calling and satellite males than in female cricket frogs, which do not call. Satellite males may therefore have AVT reserves that might allow them to call depending on the social conditions.

Animals↗
PubMedDate not supplied

Transporting values by technology transfer.

The introduction of new medical technologies into a developing country is usually greeted with enthusiasm as the possible benefits become an object of great anticipation and provide new hope for therapy or relief. The prompt utilization of new discoveries and inventions by a medical practitioner serves as a positive indicator of high standing in the professional community. But the transfer of medical technology also involves a transfer of concomitant values. There is a danger that, in the process of adopting a particular technology, the user takes for granted the general utility and desirability of the implements and procedures under consideration without recognizing the socio-cultural peculiarities of the adopting country. A sensitivity to the social conditions and cultural traditions is important so that the emergence of new values can be examined critically and the transfer of necessary technology can be effected smoothly. In the Philippines, efforts to boost patronage of transplant technology appear to have overlooked this need for socio-cultural sensitivity. Legislative fiat cannot be used to override deep-seated values. There is a need to be more sensitive to the possible confrontation of values that the transfer of technology brings in order to avoid the erosion of indigenous socio-cultural values and minimize the intrusiveness of beneficial medical technology.

Altruism↗
PubMed1995

Social and related implications of DNA fingerprinting and other new DNA technologies.

The discovery of the structure DNA at the beginning of this half of the century, and the recognition that it is virtually the universal genetic material, made it imperative for man, sooner or later, to apply this knowledge for unexpected ends. Genetic engineering, DNA fingerprinting, sequencing of whole genomes (be they of man, plants or microorganisms), or exploitation of the differences between the DNA of the male and the female (for example, of the X and the Y sperm) have thus all been historical imperatives. Today, many such predicted technologies are a reality or have come close to being so. Such DNA-based technologies have enormous social implications, discussed in this article. The impact of these technologies on different societies is likely to be different, in view of the different social conditions that prevail, and the different historical background and cultural traditions. In India, for example, the use of DNA fingerprinting could prevent the large-scale exploitation of women, and several kinds of litigation. On a global scale, the availability of this technique and its refinement to a stage where it would become virtually foolproof could act as a deterrent to certain kinds of crime. There will also be unprecedented benefits to agriculture but also new problems that will need to be faced and resolved. Wisdom demands that we prepare ourselves for a large-scale application of the new DNA technologies that are a historical imperative, understand the problems that are likely to arise, and plan to cope with them before they descend on us in full force.

Agriculture↗
PubMedDate not supplied

[The aged among Gypsies].

In former investigations in the changes in elder people's life the importance of general social conditions, for instance their economic conditions, has been shown. So for instance the often reported loss of functions of the elders in the highly industrialized western cultures and the seperation from the family can not be observed in other cultures in the same extent. Several investigations among Gypsies as an autonomous cultural group have made evident that, more often than in western cultures, elder Gypsies live in the same household with their grown-up children. Also old Gypsies take a number of functions and tasks in the family and clan, that in part even become more important with their growing age. The fact that almost all German Gypsies (Sinti) have settled and their growing integration into German society suggested, that there might be a change in the situation and importance of old Gypsies. In our investigations in 64 German Gypsy families we found the three-generation-household clearly changed. But in the same time grown-up children and their parents try to live as close as possible. More than half of the interviewed persons lived in direct neighborhood of their parents resp. their grown-up children. It could be also demonstrated, that old Gypsies still have a great importance in conserving and mediating old traditions. So in spite of some external changes no real local or social isolation of old Gypsies could be found in this investigation.

Aged↗