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PubMedDate not supplied

[Psychosocial causes and consequences of schizophrenia: opinions of Italians].

OBJECTIVE: Description of opinions on schizophrenia and its psychosocial consequences in a sample of general population. METHODS: The study has been carried out in 29 GP units stratified by geographic area and population density of their catchment areas and randomly selected. Each respondent was asked to read a case-vignette describing a patient who met ICD-10 criteria for schizophrenia, and then to fill the Questionnaire on the Opinions about Mental Illness--General Population's version (QO-GP). RESULTS: Data on 714 respondents were collected. 21% of the sample identified a case of schizophrenia, 66% of depression/anxiety disorder, and 13% of "nervous breakdown". Factors most frequently mentioned as causes of detected disorder were stress (72%), heredity (62%), family difficulties and psychological traumas (45%). More pessimistic opinions about psychosocial consequences of schizophrenia were found among respondents with lower educational level and older age. Respondents who referred the case-vignette to schizophrenia reported more pessimistic opinions about psychosocial consequences of detected disorder. CONCLUSIONS: The results of this study outline the need to plan educational campaigns on mental illnesses, which take into account the socio-cultural characteristics of the target populations.

Attitude↗
PubMed1999

Overweight and Obesity among secondary school children in Central Italy.

Childhood and adolescent obesity prevalence rates have steadily increased in industrialised countries in the last 20 years. Current rates of obesity range between 6 and 30%. Several studies showed that risk factors for weight gain in school age are strongly linked to low physical activity and family environmental factors (parents' education and job, number of family members, number of hours spent on watching television, etc.). In order to plan a nutritional and health educational programme, a study was conducted on the nutritional status of the school age population of the Province of Frosinone, Central Italy, and family factors that can influence it. Three percentage of the school age population of the Province of Frosinone (2053 students) and their families were randomly sampled from the Province school district database. In each of the 12 recruited schools, a meeting with teachers and students was arranged to discuss aims and methods of research and to collect informed consent by students. Each student was interviewed about physical activity, and underwent the following measurements: height, weight, bicipital, tricipital, sub-scapular and over-iliacal skinfolds, sexual development. Students' parents were asked to answer a questionnaire about family structure, parents' educational level and job, parents' height and weight, presence in the family of pathologies as hypertension or diabetes. One thousand three hundred fifty-seven students (66% of the target population) and 1802 parents (66.5% of the responders' population) agreed to enter the study. Students' age range was 8 years (11-19 years; mean age was 14.9, SD, 2.55). Among them 8.4% were considered obese, with a higher prevalence in male population (9.8%) as compared to female population (6.5%). Of these responders, 21.4% were considered at risk of overweight with no statistical difference due to gender. Statistically significant correlations of teenagers' risk of overweight and obesity with nutritional conditions of parents, mother's educational level and amount of weekly physical activity were observed. Number of children in the family, parents' age and job do not appear to be correlated to obesity or risk of overweight. Our results show that, although the prevalence of obesity in the students population in the Province of Frosinone is comparable to other Italian Provinces and lower than other industrialised countries such as USA, the percentage of students at risk of overweight is particularly high. Main risk factors for developing obesity seem to be linked to parents' nutritional conditions, mother's educational level and children's physical inactivity and this should lead to intensify efforts for preventive interventions both at family level (focused on parents) and at school.

Adolescent↗
PubMed1983

Relationship of General Aptitude Test Battery scores to successful employment for epileptics in a rehabilitation setting.

The US Employment Service's (USES) General Aptitude Test Battery (GATB), when used with USES-developed cut-off scores, has been found to be an accurate predictor of successful job performance. In the present study, results of the GATB scores obtained by vocational rehabilitation clients (n = 15) who were successfully placed into permanent employment were evaluated with reference to published GATB norms and cut-off scores. The major finding of this study was that the scores were not accurate predictors of successful employment for this population. Subjects' subtest scores averaged between 1/2 and 2 SD below the published means, with scores on subtests measuring motor speed and dexterity producing the lowest values. Subtests measuring verbal and visual--spatial ability produced relatively higher values. In only 3 instances was successful employment predicted by the cut-off scores. For the entire sample, GATB scores were frequently low enough to indicate poor job performance in nearly all occupations covered by published cut-off scores. Based on the results from the present study, and considering the wide-spread use of the GATB in the United States, a more comprehensive research project is being implemented to adapt GATB material for use with the targeted population.

Adult↗
PubMed2000

Urban CO exposure and its health effects on traffic policemen in Ankara.

Carbon monoxide (CO) is an important component of air pollution caused by traffic exhaust fumes. CO can cause chronic poisoning which shows its first symptoms as headaches, blurry vision, difficulty in concentration, and confusion. With the increasing number of vehicles in metropolitan areas of Turkey, the CO level has also increased in the city air as is the case in the capital city of Ankara, especially at certain locations. As far as the effects of CO on humans are concerned, traffic policemen are the population group under risk due to their inhalation of CO-rich air while on duty at the crowded cross-sections of the city. The traffic policemen on duty at these cross-sections are exposed to these high levels of CO for at least 6 h. This study was performed to investigate the traffic policemen (traffic organizers) who are exposed to high concentrations of CO at crowded cross-sections of Ankara City and to find out if chronic CO intoxication exits among this risk group. The CO levels in the ambient air at these cross-sections have also been compared to, and correlated with measurements of CO in the expired air of the target population. Additional factors like smoking, general health status, type of heating systems used at home, etc., have been taken into consideration by evaluating special questionnaires filled out by the policemen. A control group of clerk policemen, who were not engaged in street traffic activities was formed for comparative purposes.

Adult↗
PubMed1987

Fear of AIDS.

A specter is haunting our streets--the specter of AIDS, a remorseless and incurable disease whose nature, transmission and effects still contain elements of mystery. The fear of AIDS is pervasive. Most of us experience this fear as an uneasy but usually abstract awareness of its presence in the society. This awareness, however, may be jolted into something more concrete and immediate when we need to make or react to such decisions as whether our children should attend school with an AIDS victim or whether to require tests for the presence of AIDS antibodies (ELISA test) in food handlers and health workers. But populations at risk of infection with AIDS face a fear of a different quality. For hemophiliacs requiring the transfusion of blood products, for users of contaminated needles, even under certain circumstances for those who engage in heterosexual intercourse, infection with AIDS has to be a real issue. For homosexuals with an active sex life the fear is constant; ways must be found to come to terms with it. In this presentation I shall offer a series of vignettes illustrating reactions to the threat of AIDS that range from the distinctly maladaptive to the appropriately adaptive. I shall discuss some of the psychodynamic mechanisms operative in these cases and make general observations about the fear of AIDS in target populations.

Acquired Immunodeficiency Syndrome↗
PubMed1996

A systematic review of the effectiveness of health service interventions aimed at reducing inequalities in health.

OBJECTIVE: To review the available evidence in order to identify effective interventions which health services alone or in collaboration with other agencies could use to reduce inequalities in health. METHODS: A search of the literature was undertaken using a number of databases including Medline (from 1990), Applied Social Science Index and Abstracts (1987-1994), and the System for Information on Grey Literature in Europe (1984-1994), on a large range of key words. Studies were included if they assessed interventions designed to reduce inequalities in health or improve the health of a population group relevant to the review, and could be carried out by a health service alone or in collaboration with other agencies. Only studies evaluating interventions using an experimental design were included. Papers in any language were considered. In addition, systematic reviews of the research on the effectiveness of health promotion and the treatment of conditions where there are significant health inequalities were identified in order to illustrate the potential for reducing inequalities in health. RESULTS: 94 studies were identified which satisfied all the inclusion criteria and 21 reviews were included. A number of interventions have been shown to improve the health of groups who are disadvantaged by socio-economic class, ethnicity or age and, if properly targeted, could be expected to reduce health inequalities. If a health intervention is being used, there should be evidence that it has an impact on health status. Attention should then be given to the way in which the intervention is delivered and the characteristics of a programme to promote implementation. Characteristics of successful interventions specifically aimed at reducing health differentials include: systematic and intensive approaches to delivering effective health care; improvement in access and prompts to encourage the use of services; strategies employing a combination of interventions and those involving a multi-disciplinary approach; ensuring interventions address the expressed or identified needs of the target population; and the involvement of peers in the delivery of interventions. However, these characteristics alone are not sufficient for success, nor are they universally necessary. CONCLUSIONS: Although it is likely that the most significant contributions to reducing health inequalities will be in improving economic and social conditions and the physical environment, there are interventions which health services, either alone or in collaboration with other agencies, can use to reduce inequalities in health.

Age Factors↗
PubMed1974

A cervical cytology campaign using a computerised age-sex register.

The computerised age-sex register of the population attending a small health centre was used to generate invitations to women aged from 25 to 64 years to attend for a cervical smear. The campaign took place over about three months and was accompanied by appropriate publicity measures.Replies were received from 80.7 per cent of those to whom invitations were sent. Of those who replied, 11.5 per cent refused the test and of those who accepted 7.6 per cent failed to attend. The cost of the campaign was about pound2,280, or pound2.71 for each of the 842 smears taken. Of the publicity measures used, posters appeared to be more effective than evening paper publicity or handbills.Just over 70 per cent of the women in the target population had a cervical smear during the campaign or in the preceding three years. It is not possible from the available data to assess whether this coverage rate justifies the costs of the campaign.

Adult↗
PubMed1992

The Washington Heights-Inwood Healthy Heart Program: a third generation community-based cardiovascular disease prevention program in a disadvantaged urban setting.

The Washington Heights-Inwood Healthy Heart Program (WHIHHP) is part of the New York State Healthy Heart Program, which comprises eight community-based programs in different areas of the state. WHIHHP is directed at a population of approximately 200,000 people, predominantly Hispanic and of low socioeconomic status, living in northern Manhattan in New York City. The initial 3 years of experience are presented. Six potential barriers to diffusion of the community-based disease prevention model in disadvantaged inner city communities are discussed: (a) issues of scale and complexity; (b) adaptation of this model to a "community" without geopolitical boundaries or infrastructure; (c) linguistic and cultural diversity; (d) competing problems; (e) the role of evaluation; and (f) sustainability of the program in a poor community. Strategies for addressing obstacles to model adoption are also described, including program legitimization, building program infrastructure, setting realistic expectations, focusing on one risk factor at a time, defining target population segments, and emphasizing a small number of communication channels. Finally, research issues related to the diffusion of the community-based model are discussed, specifically: (a) Does the model work in disadvantaged urban settings? (b) What are the program effects on social class gradients for risk factors? (c) What are the barriers to program adoption in such settings? (d) What changes in the model will facilitate adoption in such settings? (e) What are the best methods for conducting formative evaluation in such programs? (f) What is the best way to select communities that may be ready to adopt the model? Our initial experience implementing this model in a disadvantaged urban setting supports the feasibility of model adoption. Unanswered questions about efficacy in such settings and regarding research issues related to model diffusion will require additional research investment.

Adolescent↗
PubMed1998

A follow-up of enuresis from childhood to adolescence.

OBJECTIVE: To determine the prevalence and treatment of enuresis in a national population-based follow-up study of children aged 8-14 years, to evaluate possible factors that enhance or hamper the attainment of continence and to examine the relationships between enuresis and psychiatric disturbance. SUBJECTS AND METHODS: An initial study was carried out in 1989 as part of the Finnish Child Psychiatric National Epidemiological Study. Three types of questionnaires were used; the Rutter Scale A for completion by parents, including a question about enuresis, the Rutter scale B for completion by teachers and the Children's Depression Inventory (CDI), completed by the children. Parents were also asked about demographic and family issues, teachers about school achievements and children about additional psychosomatic symptoms. In a follow-up in 1995, the target population comprised all previous enuretics and their controls, matched by age, gender, class and school, in the first phase of the study. Replies were received from 315 enuretic boys and 186 girls, with the corresponding values for controls being 310 and 183. The parents were asked about the adolescents' present enuresis and for permission for a treatment trial, if needed. The adolescents completed the CDI, and a questionnaire about enuresis, previous treatments and possible willingness for a treatment trial. They also reported basic somatic data, their life events and living habits. RESULTS: In the initial study, the enuretic children had higher total and subscores as reported by parents, teachers and themselves, except for emotional items reported by the teachers. Additionally, a significantly greater proportion of these children soiled, had sleeping difficulties and difficulties in falling asleep. Enuretic boys had more frequent nightly arousal and early morning waking, while the enuretic girls had more nightmares than non-enuretic girls. At 14 years old, the parents reported that 13 adolescents were enuretic; from the children's replies, nine boys and seven girls were enuretic. CONCLUSIONS: The prevalence of enuresis in those previously enuretic was surprisingly low, probably because of the efficient treatment methods, conditioning and medication. There were evident connections between childhood enuresis and mental well-being.

Adolescent↗
PubMed1991

Duration and correlates of post-partum abstinence in four sites in Zaire.

Data on 2223 women with a child less than 25 months of age from four sites of two regions in Zaire were analyzed. The univariate correlates of current abstinence were determined on this population. A sub-sample of 778 women was then drawn for the development of multivariable model of predictors of the duration of abstinence. The median duration of abstinence in the two urban and two rural sites ranged from 4.5 to 8.8 months. The final multivariable model showed that low socio-economic status, rural residence, more living children, prolonged duration of breastfeeding and non-Zairian nationality were all important predictors of prolonged duration of abstinence. The relationship of duration of abstinence to that of amenorrhea is also important. While approx. 18% of the women included in this analysis continued to abstain for at least one month beyond the resumption of menses, the vast majority who did resume relations represent a target population for utilization of an alternate means of pregnancy prevention.

Adult↗
PubMed2001

Prognostic factors for influenza-associated hospitalization and death during an epidemic.

To predict which patients with current high-risk disease in the community may benefit most from additional preventive or therapeutic measures for influenza, we determined prognostic factors for influenza-associated hospitalization and death in a general practice-based case-control study among this segment of the vaccine target population with high influenza vaccination rates. In 103 general practices followed during the 1996/7 influenza epidemic, cases were either hospitalized, or died due to influenza, bronchitis, pneumonia, diabetes, heart failure or myocardial infarction. Age- and gender-matched controls were randomly sampled from the remaining cohort. Information was collected by review of patient records. In total, 119 cases and 196 matched controls were included. Of the cases, 34, 25 and 4% were hospitalized for acute pulmonary and cardiac disease and diabetes, respectively, and 37% died. Multivariate conditional logistic regression analysis revealed that presence of chronic obstructive pulmonary disease, heart failure, previous hospitalization, high GP visiting rate and polypharmacy were independent prognostic factors. Several non-modifiable determinants can be used to ensure targeting additional preventive or therapeutic measures at the most vulnerable segment of the vaccine target group.

Adult↗
PubMed2006

Characteristics of homeless HIV-positive outreach responders in urban US and their success in primary care treatment.

Homeless HIV+ persons with persistent mental illness and substance use disorders need services, but are hard to reach and enrol into treatment. Connecting them to services is a major challenge of the AIDS epidemic. This report describes characteristics of homeless HIV+ substance abusers who responded to outreach and enrolled in integrated treatment services. The target population was urban, homeless, HIV+ individuals with substance dependence and/or mental illness diagnoses. Health and physical functioning were measured using a refinement of the Medical Outcomes Study Health Survey. Questions based on the PRIME-MD measured subjects' mental health status. Outreach occurred at shelters, soup kitchens, and on the streets. The outreach team consisted of a nurse, substance abuse counsellor, and a formerly homeless person. Outreach contacted 3,059 individuals; 1,446 entered the clinic, 110 of 206 eligible candidates enrolled in the study, and 82.7% of study participants completed 12-month follow-up interviews. Enrollees exhibited 5th percentile composite health scores. They reported heavy street drug use and unmet service needs particularly for housing and financial assistance. Outreach successfully recruited targeted individuals into treatment. They stayed in treatment and demonstrated improvements on measures of physical and mental health 12-months later.

Adult↗
PubMed1998

A long follow-up on prostate specific antigen density and prostate biopsy.

OBJECTIVE: To determine prostate specific antigen density (PSAD) in a risk population without evidence of prostatic cancer, and to assess the long-term usefulness of PSAD as a parameter for determining the need for a prostatic biopsy in patients with a normal digital rectal examination (DRE) and transrectal ultrasound (TRUS). METHODS: The records of 582 patients referred to the clinic between February, 1992 and February, 1994 were studied retrospectively. All these patients with lower urinary tract symptoms (LUTS) were evaluated based on the following parameters: digital rectal examination, serum PSA levels, prostate volume measured using transrectal ultrasound and PSAD. Prostatic biopsy was performed on 431 patients who had a serum PSA level greater than 4.0 ng/mL. A total of 299 patients (69.3%) had PSA levels between 4.0 and 10.0 ng/mL and represented the target population. The study had two parts, in the first one cancer was diagnosed just by one biopsy and in part II, the patients with negative biopsy in part I were followed for a two-year period and required 2 or 3 biopsies for diagnosis. Of the total of patients who had a negative prostate biopsy in part I of the study, 269 were followed for a period of two years with repeated prostate biopsies. RESULTS: Overall prostate cancer was detected in 22/299 (13.9%) patients, 6/105 (5.7%) with PSAD up to 0.15 and 16/194 (8.2%) with PSAD over 0.15 (p = 0.569). CONCLUSION: PSAD is a useful indicator in decreasing the number of negative biopsies in patients with benign prostatic hyperplasia. However, in a long-term follow-up the PSAD (cutoff level 0.15) was unable to predict which patients had a positive biopsy. According to our results, 5.6% of patients with prostate cancer will be missed using the PSAD criteria.

Adult↗
PubMed2006

Self-reported prostate cancer screening in Austria.

OBJECTIVES: The prevalence of self-reported participation and frequency of prostate cancer screening (digital rectal examination (DRE), prostate-specific antigen (PSA)) in Austrian men aged 40-79 years in the year 2005 is reported. METHODS: In a population-based cross-sectional study, a representative sample of 500 men was asked whether they ever had heard of early detection of prostate cancer by DRE or PSA test and, if so, whether they had ever had a prostate cancer screening test during their life, and if so the number of tests and the type of physician. RESULTS: Overall, the prevalence of self-reported prostate cancer screening was 55.8% (23.7% DRE only). The highest prevalence was observed in the age group of 60-69 years with 68.8% (28.1% DRE only). The highest prevalence of PSA tests was observed in the age group 70-79 years (40.9%). About 75% of the screening tests were performed by urologists. CONCLUSIONS: More than half of the target population (men aged 40-79 years) have had at least one prostate cancer screening test. Nearly one-third of men have already had one or more PSA tests. One-fifth of the PSA tests were requested by general practitioners or internists.

Adult↗
PubMedDate not supplied

The clinical performance of NORPLANT implants over time: a comparison of two cohorts.

This paper reports on a study that compared the clinical performance of NORPLANT implants in two separate but similar cohorts: 200 NORPLANT users from 1975 through 1978, when the method was first introduced in the clinic, and 212 users in the same population from March 1982 through December 1983. Two different cohorts of Copper T IUD users were included as controls. Continuation rates, at one and two years of use, were significantly higher in the second group of NORPLANT users (88.1 vs. 60.5 and 76.5 vs. 40.8, respectively). Statistically significant differences between the NORPLANT cohorts were observed in discontinuation due to bleeding, amenorrhea, other medical causes, total medical causes, and personal reasons. No differences in clinical performance of the IUD were observed between the two control groups. The higher continuation rate in the second group of implant users is attributed to greater confidence and experience among the clinic staff between 1982 and 1983, and greater knowledge of and familiarity with the method among those in the target population. The study also shows that the first clinical trials of a new contraceptive method may not provide an accurate picture of that method's ultimate performance.

Adult↗
PubMed1997

[Effect of cytokines on the growth of human B-cell precursors, purified and in the presence of stromal (CD13+) components].

As reproducible models for examining human early B-cell progenitors (BCPs) are poorly developed, the cells and molecules regulating their growth and differentiation are still incompletely characterized. We used a recently published short term culture system, using immunomagnetic beads and negative selection, in order to isolate an early BCPs enriched population from human fetal tissues that support further studies on B cell proliferation or differentiation events. This purified population was incubated with or without human recombinant Interleukin-4 (rIL4), and its capability to proliferate and differentiate was followed. We found that rIL4 did not induce either proliferation or differentiation of purified human BCPs. Furthermore in the presence of stromal cells (CD13+) it was able to enhance cy mu + cells and to induce the expression of surface Ig (sIg), surface CD22 on in vitro TdT + CD19 + CD10 + sIg-fetal liver cells. Human recombinant interleukin-7 (rIL-7) promoted the proliferation and the clonal growth of Tdt + CD19 + CD10 + fetal BCPs, confirming its critical role at early stages of human B lymphopoiesis. Furthermore rIL7 also induced growth of CFU-GM when unseparated fetal tissues or myeloid/monocytic contaminated BCPs were used as a target populations, probably by indirect mechanism. Transforming growth factor -beta (TGF-beta 1) partially inhibited the stromal cell-dependent rIL4 induced differentiation and rIL7 clonal growth and proliferation of fetal BCPs. Our study contributes to elucidate the growth factor requirements that characterize normal human B-cell ontogeny, suggesting another mechanism for the linkage between lymphopoiesis and myeloid/macrophagic micro-environment. The in vivo implications of this study are discussed.

B-Lymphocytes↗
PubMedDate not supplied

[Prevalence of physical activity and its relationship to sociodemographic variables and lifestyles in the age 18-65 population of Pamplona, Spain].

BACKGROUND: Current scientific knowledge upholds the possibility of considering a cause-effect relationship to exist between the degree of physical activity and the onset of different diseases. Des pite this, physical activity is not a very well-rooted practice among the population, which is progressively becoming more sedentary. This study is aimed at describing the prevalence of sedentarism among the population of Pamplona, as well as ascertaining what factors have the greatest bearing thereon. METHODS: A cross-sectional study was conducted by means of a postal survey on a significant sample of the age 18-65 population of Pamplona. The survey used included an evaluation of the degree of physical activity based on the Paffenbarger physical activity questionnaire. A bivariate and multivariate analysis was made using logic regression. RESULTS: A total of 76.6% of the females have a sedentary lifestyle, whilst this percentage drops to 56.7% among males. Sedenta rism increases with age, up to 80.3% of males and 86.3% of females being respectively sedentary in the oldest age group. CONCLUSIONS: The sociodemographic factors such as sex, age, formal education, occupation and marital status seem to be determi ning factors of the sedentary lifestyle, while smoking and being overweight or obese are not. Among the young, the females not having a college education and married men who are smokers seem to be target populations for promoting physical activity.

Adolescent↗
PubMed1995

Self-injurious behavior: pathophysiology and implications for treatment.

BACKGROUND: Self-injurious behavior (SIB) is a common clinical problem that affects a diverse group of patients and populations. Little is known about the underlying pathophysiology and pharmacologic treatment of SIB. METHOD: The authors selectively reviewed the clinical literature on SIB and related aggressive/impulsive behaviors, with the aim of formulating provisional guidelines for pharmacotherapy. RESULTS: The serotonergic system is most directly implicated in the pathophysiology of SIB and related behaviors. While there is no well-established "drug of choice" for SIB, the identification of specific subgroups of SIB patients and associated symptoms such as psychosis permits the rational selection of medication. Serotonin selective reuptake inhibitors, other serotonergic agents, antipsychotics, beta-blockers, and opiate antagonists all play a role in the treatment of SIB. CONCLUSION: SIB is not a single entity and may have different pharmacologic treatments, depending on the associated symptoms and target population. Medications that act on the serotonergic system appear to be the most promising.

Humans↗