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PubMed1987

Family use of health care: United States, 1980.

Information on families' use of health care in 1980 is presented in this report. The data discussed here were gathered in the national household sample of the National Medical Care Utilization and Expenditure Survey. In this sample, information was collected on health problems, health care received, expenditures for care, health insurance, and related topics throughout calendar year 1980 from approximately 6,800 families in the U.S. civilian noninstitutionalized population. (The report entirely excludes families with military heads, even if they have civilian members.) For this report, a family was initially defined as (1) two or more persons living together who were related by either blood, marriage, adoption, or a formal foster care relationship or (2) a single person living outside such relationships. But because these data were collected across an entire year, the important concept of "longitudinal family" was developed. This concept was necessary to deal with the fact that the composition of a family could change over time and that families could come into existence and go out of existence over time. As the data are based on this dynamic concept of families, all measures of the use of health services are calculated in annual rates. Family data are important for understanding the health care system because decisions to seek and use health care are usually family decisions, health care is usually paid for out of family resources, and family distributions for health-related variables differ from the distributions found for individuals. Data on both multiple-person families (families that averaged 1.5 persons or more during the year) and one-person families (families that averaged less than 1.5 persons during the year) are presented in this report. Only findings for multiple-person families, however, are addressed in this section. It is multiple-person families that are usually referred to in discussions of families by both the general public and professional social scientists.

Data Collection↗

PubMed1987

Total family expenditures for health care: United States, 1980.

Information on total family expenditures for health care in 1980 is presented in this report. Total expenditures are the total amounts billed (either actual or imputed) to families whether these amounts are paid out-of-pocket by the family, paid by private health insurance or a public health care coverage program, or remain unpaid. The data discussed here were gathered in the national household sample of the National Medical Care Utilization and Expenditure Survey (NMCUES). In this sample, information was collected on health problems, health care received, expenditures for care, health insurance, and related topics throughout calendar year 1980 from approximately 6,800 families in the civilian noninstitutionalized population of the United States. The survey excluded all individuals who were in institutions or in the military. This report also entirely excludes families with military heads, even if they had some civilian members. For this report, a family was initially defined as (1) two or more persons living together who were related by either blood, marriage, adoption, or a formal foster care relationship or (2) a single person living outside such relationships. Because data on these families were collected across an entire year, the important concept of "longitudinal family" was developed. This concept was necessary to deal with the fact that the composition of a family could change over time and that families could come into existence and go out of existence over time. As the data are based on this dynamic concept of families, all measures of expenditures for care are calculated in annual rates. Family data are important for understanding the health care system because decisions to seek and use health care are usually family decisions, health care is usually paid for out of family resources, and family distributions for health-related variables differ from the distributions found for individuals. This report deals with total expenditures for health care as reported by a sample of consumers of health care. These types of data are limited by the knowledge the respondent has as to the amount of the total bill. For various reasons, which are discussed in detail in the text, the respondent often doesn't know the amount of the total bill. Therefore, the statistics in this report should be regarded as having more limitations than the statistics in two previous family reports: "Family Use of Health Care: United States, 1980" (Dicker and Sunshine, 1987) and "Family Out-of-Pocket Expenditures for Health Care: United States, 1980" (Sunshine and Dicker, 1987).

Age Factors↗

PubMed1987

Family out-of-pocket expenditures for health care: United States, 1980.

Information on out-of-pocket health care expenditures for families in 1980 is presented in this report. The data discussed here were gathered through the national household sample of the National Medical Care Utilization and Expenditure Survey (NMCUES). Information for the year 1980 was collected on health problems, health care received, expenditures for care, health insurance, and related topics from approximately 6,800 families in the U.S. civilian, noninstitutionalized population. All individuals who are in institutions or in the military are excluded from this analysis as are all families with military heads of family, even if they have civilian members. For this report, a family was initially defined as: two or more persons living together who were related either by blood, marriage, adoption, or a formal foster care relationship; or as a single person living outside such relationships. Because these data were collected throughout an entire year, the important concept of "longitudinal family" was developed. This concept was necessary to deal with the fact that the composition of a family could change over time, and that families could come into existence and go out of existence over time. As the data are based on this dynamic concept of families, all measures of health care expenditures are calculated in terms of annual rates. Family data are important for understanding the health care system because decisions to seek and use health care are usually family decisions, health care is usually paid for out of family resources, and family distributions for health-related variables differ from the distributions found for individuals.

Adult↗

PubMed1999

[Is pastoral care psychotherapy?].

Whilst pastoral work is aimed at the consciousness of men, the duty of the psychotherapist is to turn the subconscious into the conscious. After clarifying the situation in his inner world the patient should be able to take free decisions. The psychotherapist is not responsible for the decision made by the person, which means that the conscious area is the responsibility of the individual. The psychotherapist must not manipulate the conscious parts just as the clergy must not manipulate the subconscious. So whilst there is a difference in both areas that must be maintained, that difference is less than the two have in common. The common aim or goal is: 1. The basis of both areas is a 'Socratic optimism' rooted in the fact that pastoral work and psychotherapy want the person to discover his or her own truth which cannot be told to him or her. However, it can be found by the person with assistance. 2. Both are characterised by a pragmatic individualism that says that it is worth listening to a single person for days, weeks, months or years until it is ascertained what the soul suffers from. 3. Both are convinced that the truth of a person cannot be described in moral categories. Social and ethical standards don't help but they may reflect the symptoms and the distress of the person. 4. Taking into consideration the dimension of the subconscious in pastoral duty as well, human decisions and activity can be understood much better.

Consciousness↗

PubMed1998

Gender, marital status and ethnicity. A Swedish retrospective study of criminality, morbidity and mortality among victims of non-fatal firearm injuries.

OBJECTIVE: To study gender and ethnic aspects in a population consisting of patients treated for non-fatal firearm injuries at public hospitals in Stockholm, Sweden, during a period of 21 years. DESIGN: Retrospective study. Ethnicity was defined as being a foreign-born individual or a native Swede. The morbidity and criminality data were analysed with unconditional logistic regression and the mortality data were analysed by a proportional hazard model. RESULTS: Females and foreign-born persons were more often victims of attempted murder than males or native Swedes. Attempted suicide was more common among native Swedes. Male patients, single persons and Finnish immigrants treated for a firearm injury all showed an increased risk of being registered for criminality or committing a violent crime. There was no difference between native Swedes and foreign-born persons concerning the number of hospitalisations during the follow-up period. Living alone and being of male gender were associated with an increased risk of hospitalisation. Firearm victims, independently of ethnicity, had an increased mortality rate compared to a Swedish population; the standardised mortality ratio (SMR) for males was almost 3 and for females almost 8 compared to the SMR of 1 for the whole Swedish population. CONCLUSION: Firearm victims constitute a population at risk from social, psychological as well as from medical points of view. The present study shows an association between gender, ethnicity, criminality, and morbidity among firearm victims underlining the importance of ethnic- and gender-specific violence prevention strategies.

Criminology↗

PubMed2001

Detection of diverse hepatitis C virus (HCV)-specific cytotoxic T lymphocytes in peripheral blood of infected persons by screening for responses to all translated proteins of HCV.

Broadly directed hepatitis C virus (HCV)-specific cytotoxic T lymphocytes (CTL) have been identified from liver-infiltrating lymphocytes but have been more difficult to assess in peripheral blood of infected persons. To enhance the detection of CTL from peripheral blood mononuclear cells (PBMC), we cocultured PBMC with autologous Epstein-Barr virus-transformed B-lymphoblastoid cell lines that had been infected with recombinant vaccinia virus constructs so that they expressed the entire translated polyprotein of HCV-H, a type 1a strain. These stimulated cells from HCV-infected as well as exposed seronegative persons were then cloned at limiting dilution and tested for HCV-specific CTL activity using a standard (51)Cr release assay. HCV-specific CTL were detected in PBMC from seven of nine persons with chronic hepatitis, including five of seven in whom CTL had previously been detected from liver biopsy specimens but not PBMC. In a single person with chronic HCV infection, CTL directed against as many as five different epitopes were detected in peripheral blood and were similar in specificity to those detected in liver tissue. This technique was used to evaluate eight subjects identified to be at high risk for HCV exposure due to continued injection drug abuse; no evidence of CTL in PBMC was found. We conclude that CTL can be detected in PBMC from the majority of persons with chronic HCV infection but are present at lower levels or absent in exposed but persistently seronegative persons. The high degree of concordance of HCV epitopes identified from liver and PBMC suggests that this strategy is a reasonable alternative to liver biopsy for characterizing the CTL response to HCV in chronically infected persons.

Biopsy↗

PubMed2006

'I was like a wild wild person': understanding feelings of anger using interpretative phenomenological analysis.

This paper is concerned with illuminating how emotion (anger) and emotion-related phenomena such as feelings, thoughts and expressions appear to the individual person. In particular, it focuses on the role of feelings in emotion experience. It does this through the qualitative analysis of interview material from a single person case study using interpretative phenomenological analysis. The paper examines how the participant feels and experiences anger, the defining characteristics of anger episodes, and how the typical pattern of these episodes is disrupted by life-changes. The findings are examined in light of phenomenological ideas and the utility of these ideas for psychology's understanding of emotion argued for.

Adult↗

PubMed1988

The Chernobyl accident. Transport of radionuclides to man living in northern Sweden.

The pathways of 131I, 134Cs and 137Cs from the Chernobyl fallout to man were followed in the county of Västerbotten, Sweden. Reported airplane measurements had shown that the ground deposition of 137Cs was 3-40 kBq/m2 with hot spots with more than 80 kBq/m2. Multiplying with a factor of 0.6 gave the 134Cs deposition and an approximate factor of 20 the 131I ground deposition. The effective dose equivalent from 131I became low, less than 0.1 mSv, as the cows were stabled. The 137Cs activity concentration in different types of food was measured in approximately 8,000 samples. The most important sources of Cs intake in man were lake fish, elk (European moose) and reindeer. Variations with time was studied in detail for four types of lake fish. Whole-body measurements on more than 250 persons showed that no group of people on average received more than 1 mSv from food during the first year after the Chernobyl accident. However, single persons eating large amounts of reindeer meat received up to 2.5 mSv. People buying all their food in ordinary provision-shops got less than 0.1 mSv from the food during the first year. The present level of 90Sr activity concentration in man will only give an effective dose equivalent of 0.004 mSv/year, most of it being a result of the atmospheric nuclear bomb tests.

Accidents↗

PubMed1985

Personalized nursing: an effective intervention model for use with drug-dependent women in an emergency room.

The study indicates that nurses can affect stress and drug use in addicted women. At the 8-week posttest, daily drug cost and daily heroin costs had gone down for the experimental group. However, at the 6-month posttest, daily drug cost and daily heroin cost for the experimental group increased, although it did not reach its initial pre-intervention levels. The increase in drug costs at 6-month followup is probably a result of the lack of nursing intervention after the 8-week period. Interestingly, both the drug costs and heroin costs of the control group went down at 6 months. In other words, the control group decreased use also, only at a slower pace. What accounted for this decrease in use by the control group at 6 months? Several speculations are offered. The single Personalized Nursing Intervention counseling in the ER may have had an impact on the client. Controls who had had the single intervention in the ER were receptive to followup and were easily found. (Originally the single intervention in the ER was not part of the design. However, about 20 clients who had not had Personalized Nursing Intervention in the ER but who just answered the initial questionnaire were never found for followup. Because of the followup and ethical considerations, project staff members instituted the single ER intervention.) Another speculation is that of "burnout," a phenomenon that can be seen in both experimental and control groups. The mean age of the total population was 28.5, number of times arrested was 7.25, and age at first drug use was 16. It appeared that the following factors evoked a desire for change in these women: 1) leading a drug lifestyle for so many years, 2) the approach of age 30, 3) entrance into adolescence of their own children, and 4) the ER episode. Personalized Nursing Intervention could be considered a catalyst toward lifestyle change. Examination of daily drug cost and the Ireton emotional distress score showed trends indicating that the experimentals with network participation made larger gains than the control group or experimentals without networks. Further study on the use of client networks in treatment is indicated.

Adult↗

PubMed1976

The homeless person and the psychiatric services: an Edinburgh survey.

A representative sample (R.S.) of 79 subjects living in Edinburgh common lodging houses was compared with a clinical series (C.S.) of 44 patients from the same type of resisence. C.S. patients were more likely to be out of work, to be under 55 years of age, and to have been married as some time. They had spent much shorter times in lodging houses, in Edinburgh and at their current address. Alcoholism was rather more often diagnosed in the C.S., and personality disorder much more often. Schizophrenia tended to be found more in the R.S. The C.S. obtained higher Personal Illness and 'Character Disorder' scores. It is concluded that those subjects presenting to the psychiatric services are a highly selected group quite unrepresentative of homeless single persons in general.

Catechol O-Methyltransferase↗

PubMed2005

When things don't add up: the role of perceived fungibility in repeated-play decisions.

Previous research on repeated-play decisions has focused on choices with fungible outcomes. We investigated the perceived fungibility of outcomes over repeated plays of risky prospects in several situations, as well as the relationship between perceived fungibility and preferences for taking risks in those situations. Perceived fungibility varied substantially across participants and situations, with outcomes experienced by different people (e.g., medical outcomes for different patients) receiving lower scores than outcomes experienced by a single person. Higher perceived fungibility was associated with more favorable evaluations of repeated plays of risky prospects with positive expectations. Additionally, perceived fungibility moderated the effect of repetition, such that the increased attractiveness of repeated plays relative to a single play was diminished when perceived fungibility was low. Although evaluating the overall distribution of outcomes is arguably rational when monetary outcomes accrue to one person, treating each play as a separate event may be more appropriate when outcomes are not viewed as fungible.

Choice Behavior↗

PubMed2006

Using simulation for training and to change protocol during the outbreak of severe acute respiratory syndrome.

INTRODUCTION: During the 2003 severe acute respiratory syndrome (SARS) crisis, we proposed and tested a new protocol for cardiac arrest in a patient with SARS. The protocol was rapidly and effectively instituted by teamwork training using high-fidelity simulation. METHODS: Phase 1 was a curriculum design of a SARS-specific cardiac arrest protocol in three steps: planning the new protocol, repeated simulations of this protocol in a classroom, and a subsequent simulation of a cardiac arrest on a hospital ward. Phase 2 was the training of 275 healthcare workers (HCWs) using the new protocol. Training involved a seminar, practice in wearing the mandatory personal protection system (PPS), and cardiac arrest simulations with subsequent debriefing. RESULTS: Simulation provided insights that had not been considered in earlier phases of development. For example, a single person can don a PPS worn for the SARS patient in 1 1/2 minutes. However, when multiple members of a cardiac arrest team were dressing simultaneously, the time to don the PPS increased to between 3 1/2 and 5 1/2 minutes. Errors in infection control as well as in medical management of advanced cardiac life support (ACLS) were corrected. CONCLUSION: During the SARS crisis, real-time use of a high-fidelity simulator allowed the training of 275 HCWs in 2 weeks, with debriefing and error management. HCWs were required to manage the SARS cardiac arrest wearing unfamiliar equipment and following a modified ACLS protocol. The insight gained from this experience will be valuable for future infectious disease challenges in critical care.

Canada↗

PubMed1998

Partner relationships, functioning, mood and global quality of life in persons with spinal cord injury and traumatic brain injury.

The aim of this study was to assess and compare spinal cord injured (SCI) and traumatic brain injured (TBI) persons and people from the general population concerning partner relationships, functioning, mood and global quality of life. One hundred and sixty seven SCI persons, 92 TBI persons and 264 controls participated in the study. The median age was: SCI persons 33 years (range 19 to 79 years), TBI persons 40 years (range 20 to 70 years), and controls 31 years (range 19 to 79 years). Age at injury ranged among SCI persons from 14 to 76 years (Md 28 years), and among TBI persons from 16 to 56 years (Md 32 years). Half of the SCI group (51%), 58% of the TBI group and 59% of the controls had a stable partner relationship at the time of the investigation. Many of these SCI and TBI relationships (38% and 55% respectively) were established after injury. Both SCI and TBI persons showed significantly more depressive feelings compared with the controls. Perceived quality of life (global QL rating) was significantly lower in the SCI group compared with the controls, whereas the ratings of TBI persons and controls did not differ significantly. SCI and TBI persons did not differ significantly in level of education, perceived quality of life or distress. In all three groups, global quality-of-life ratings were significantly lower among single persons compared to those with a partner relationship. It was concluded that both SCI and TBI appear to affect overall quality of life and mental well-being negatively. The number of partner relationships contracted after injury among both SCI and TBI persons indicates, however, that the injury is not a major barrier to establishing close partner relationships. Being in good spirits, that is, lack of depressive feelings has a profound impact on the perception of a high quality of life in all three groups. For the SCI and TBI persons, a high level of physical and social independence were further positive determinants of a perceived high quality of life.

Activities of Daily Living↗

PubMed1988

Common inheritance of susceptibility to colonic adenomatous polyps and associated colorectal cancers.

We studied 670 persons in 34 kindreds by flexible proctosigmoidoscopic examination (60 cm) to determine how frequently colorectal adenomas and cancers result from an inherited susceptibility. Kindreds were selected through either a single person with an adenomatous polyp or a cluster of relatives with colonic cancer. The kindreds all had common colorectal cancers, not the rare inherited conditions familial polyposis coli and nonpolyposis inherited colorectal cancer. Likelihood analysis strongly supported the dominant inheritance of a susceptibility to colorectal adenomas and cancers, with a gene frequency of 19 percent. According to the most likely genetic model, adenomatous polyps and colorectal cancers occur only in genetically susceptible persons; however, the 95 percent confidence interval for this proportion was 53 to 100 percent. These results suggest that an inherited susceptibility to colonic adenomatous polyps and colorectal cancer is common and that it is responsible for the majority of colonic neoplasms observed clinically. The results also reinforce suggestions that first-degree relatives of patients with colorectal cancer should be screened for colonic tumors. This evidence of an inherited susceptibility to a cancer with well-recognized environmental risk factors supports the hypothesis that genetic and environmental factors interact in the formation and transformation of polyps.

Adenomatous Polyposis Coli↗

PubMed2001

Hypertension among attendants of primary health care centers in Al-Qassim region, Saudi Arabia.

OBJECTIVE: The aims of the present work were to determine the prevalence of hypertension among attendants of primary health care centers in Al-Qassim region, Kingdom of Saudi Arabia. Also to investigate sociodemographic associates, and assess awareness among hypertensives. METHODS: Through cluster sampling 30 primary health care centers were selected. Forty attendants were chosen randomly from each center. A questionnaire inquiring sociodemographic characteristics and awareness was completed by interview with each participant. Using standardized methods the blood pressure, height and weight were measured. RESULTS: The study sample amounted to 1114 persons, 338 (30%) were hypertensives (blood pressure >140/90), 24% stage 1, 4% stage 2 and 2.5% stage 3. The prevalence increased with age. It was higher in males (33%), single persons (44%), illiterate (33%), merchants (45%) and obese persons (35%). Age above 40 years, illiteracy, overweight and obesity were independently associated with hypertension with statistically significant value. Less than one 4th (23%) of hypertensives were aware of their hypertension. CONCLUSION: Hypertension is a major public health problem. A routine measurement of blood pressure of all attendants of primary health care centers with periodic examination of those aged more than 40 years particularly overweight and obese persons should be implemented.

Adult↗

PubMed2005

By which name should I call thee? The consequences of having multiple names.

The nominal competitor effect suggests that, when a person has two names associated with them, recall of either name is more difficult than if they just had one name. Drawing on a connectionist framework, this effect could arise either if multiple names were represented as being connected to a single person identity node (PIN), or if multiple names were represented as being connected via one-to-one links to multiple PINs. Whilst the latter has intuitive appeal, results from two experiments support the former architecture. Having two names connected to a single PIN not only gives rise to a nominal competitor effect (Experiment 1), but also gives rise to a familiarity enhancement effect (Experiment 2). These empirical results are simulated using an extension of Brédart, Valentine, Calder, and Gassi's (1995) connectionist architecture, which reveals that both effects hold even when the association of both names to the PIN is unequal. These results are presented in terms of a more complete model for person recognition, and the representation of semantic information within such a model is examined.

Adolescent↗

PubMed1999

Isolation of centrosomes from Spisula solidissima oocytes.

We have described methods for the preparation of lysates and isolation of centrosomes from parthenogenetically activated oocytes of the surf clam, S. solidissima. Although oocyte availability is seasonal, between June and August as much as 2 liters of lysate can be generated by a single person. Since lysate can be stored frozen at -80 degrees C with no apparent loss in centrosome-dependent microtubule nucleation, this is a convenient system for year-round experimentation. On average, per milliliter of frozen-stored lysate, 2 or 3 x 10(6) centrosomes can be obtained at 3000- or 4000-fold purification by sucrose-density gradient centrifugation. Centrosome fractions typically contain 6.0 x 10(-12) g of protein per centrosome (Vogel et al., 1997) and 140-200 micrograms of protein is usually obtained from a single run involving six sucrose-density gradients (12 ml of lysate). One person can easily run three preparations in a day, and thus 420-600 micrograms of centrosome protein could be prepared daily. Therefore, based on the effort of one individual, as much as 20-40 mg of centrosome protein could be prepared per year. Another convenient feature of the system is that once centrosomes are isolated, they can be stored in high sucrose media at -80 degrees C for years with little or no loss in microtubule nucleation potential. Once isolated, centrosomes can be used for protein analysis, ultrastructural studies, or in functional reconstitution assays (Vogel, 1997). In addition, these preparations offer the isolation of sufficient quantities of centrosome proteins to be used as antigens for generating centrosome-specific antibodies or for obtaining protein sequence for the purpose of antibody production or the design of oligonucleotide primers for isolating cDNA fragments coding for centrosome proteins. Thus, the preparations described offer a biochemical approach for defining centrosome composition. The methods described for immunofluorescence analysis of asters assembled in lysates offer rapid and convenient preparations for screening antibodies for centrosome localization and specificity. Finally, the ability to prepare large quantities of homogeneous centrosomes should enhance ultrastructural studies since many centrosomes can be sectioned and analyzed simultaneously by EM, avoiding the problem of having to hunt through sections of single cells to find a single centrosome for analysis. In addition, colloidal gold localization studies, using antibodies and EM to pinpoint the relative location of individual proteins, could be carried out on populations of centrosomes in the same preparation simultaneously, thus drastically expanding the quantity of data gathered. In conclusion, the clam oocyte system described here offers the potential for a combined structural and biochemical approach for identification of novel centrosome proteins and elucidation of the molecular basis of microtubule nucleation, centrosome assembly, and centrosome function.

Animals↗

PubMed1992

[The social network of families of HIV infected patients].

This paper is focused at the social network of families of HIV-infected persons. 13 families were interviewed in a depth-psychological oriented semi-structured manner. The evaluation took place primarily according to a qualitative manner. The central result is that families with HIV-infected members inform more seldom other persons out of the informal social network in comparison to former coping tasks like haemophilia, dependence of drugs or homosexuality, events which happened before the HIV-infection. Accordingly to that only some single persons or whole families use informal help for their coping process with HIV-infection. The infected themselves claim more often professional psychosocial help, sometimes some relatives do it, seldom the whole family. We mostly find the familial tendency of social retreat and of coping with the burdens without help from the outside. This tendency is forced by distrust, social anxieties and projective separation of familial conflicts in order to maintain familial stability.

Adaptation, Psychological↗