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PubMed1994

[Alarming admission rates for schizophrenia in migrants from Surinam, the Netherlands Antilles and Morocco].

OBJECTIVE: To compare first admission rates for schizophrenia in the four largest immigrant groups to the Netherlands (from Surinam, the Netherlands Antilles, Turkey and Morocco) with those of the Dutch population. DESIGN: Analysis of data from the national psychiatric register. METHOD: The frequencies of first admission (compulsory or not) for schizophrenia in 1990 were subdivided according to age, sex and country of birth. The figures were plotted against the numbers of immigrants living in the Netherlands on January 1st, 1990. The frequencies were compared with the chi2 test. RESULTS: Rates for immigrants from Surinam and the Netherlands Antilles were 2-5 times higher than those for Turkish immigrants and for the native-born population. Rates of first admissions for young male immigrants from Morocco were also increased but rates for female Moroccan immigrants and for immigrants from Turkey were not. Proportions of compulsory first admissions for young male immigrants were not increased. For young Surinam-born females, however, this proportion was increased. CONCLUSION: These results agree with those of British studies reporting an increased incidence of schizophrenia among Afro-Caribbean immigrants to the UK.

Adolescent↗
PubMed1993

[Acculturation, stress and mental health in Lebanese immigrants in Montreal].

This cross-sectional study examined the effect of immigration and acculturative stress on the mental health of a sample of 197 Lebanese immigrants in Montreal. An Orthogonal Model of Cultural Identification was used to determine whether the acculturation style adopted by immigrants had any effect on mental health or on acculturative stress. Results revealed no significant differences in psychological distress between the Lebanese sample and a comparative group of Quebec native-born. Among the indices of acculturative stress, adaptation problems alone predicted psychological distress. Finally, acculturation styles did not have any effect on psychological distress or on acculturative stress indices, with discrimination excepted. Individuals who adopted the Assimilation style reported less discrimination than those in the Ethnocentric and Integration groups. Results are discussed with reference to findings reported in the literature on Canadian studies.

Acculturation↗
PubMed1993

Patient and physician characteristics associated with perceived quality of care.

This study was undertaken to describe patient and physician sociodemographic characteristics that might be associated with the patient's perception of the quality of care rendered by his or her physician. A random telephone survey of 685 adult Kentucky residents showed that self-health assessment correlated positively, while patient education correlated negatively, with perceived quality of care. Perceived physician origin was related to the respondent's perceptions of quality of care, with native-born physicians perceived as supplying higher quality of care than their foreign-born counterparts. Cultural and communication issues might explain differences in perceived quality of care.

Clinical Competence↗
PubMed1997

A comparison of US-born African-American and African-Caribbean psychiatric outpatients.

This study compares US-born African Americans with African Caribbeans attending an urban psychiatric outpatient clinic on various items pertaining to sociodemographics, psychiatric history, current psychiatric illness, and physical health. A structured chart review was performed on a sample comprised of 135 native-born African Americans and 91 African Caribbeans who had attended the clinic during an 11-year period. A total of 28 clinical variables were examined. Nine clinical variables were found to significantly differentiate the two groups in bivariate analysis, and these were entered along with three demographic control variables into a logistic regression analysis. Seven variables attained significant independent effects. African Americans were differentiated from African Caribbeans on history of greater alcoholic abuse or dependence, presence of more delusions, worse health, longer history of previous outpatient treatment, and greater clinical improvement at 6 months. African Caribbeans were found to have a greater frequency of depression and aggressivity. These data underscore the importance of examining intraracial differences in mental illness as well as pointing to the potential benefits of using intraracial comparisons to interpret interracial analyses.

Adult↗
PubMed1997

Women in US medicine: the comparative roles of graduates of US and foreign medical schools.

The feminization of US medicine has occurred historically through two separate phenomena: the increase in the number of female graduates of US medical schools and the in-migration of female graduates of foreign medical schools. Reported here are the findings regarding gender on specialty choice, employment setting, and specialty board certification of 55,031 and 191,723 graduates of foreign medical schools and US medical schools, respectively. Graduates of foreign schools were subdivided into those who were foreign-national international medical graduates (IMGs), naturalized US citizen IMGs, and native-born US citizen IMGs at the time of entry into the US medical system. Statistically significant differences between women and men as well as among groups of medical graduates were found, with women in each medical graduate group proportionately overrepresented in primary care specialties, underrepresented in medical and surgical specialties, and underrepresented in both solo practice and group practice settings. Foreign-national IMG women were especially overrepresented in pathology, radiology, and anesthesiology, and in certain employment settings such as public hospitals and the Veterans Administration. The findings provide a basis for further study of the causes and consequences of the observed differences.

Female↗
PubMedDate not supplied

Status of imported malaria in a control zone of the United Arab Emirates bordering an area of unstable malaria.

A concerted malaria eradication programme in the United Arab Emirates has reduced local transmission to only a very few small foci in the country. The Al Ain district is now a consolidation zone. However, transmission across the undemarcated border with Oman continues. Malaria imported by the large immigrant work force from major disease endemic areas remains a large burden. An added threat is the appearance of chloroquine-resistant Plasmodium falciparum principally from Sudan and Pakistan but increasingly amongst Omani cases seen in the hospitals and clinics in Al Ain. The implications of re-introduction of malaria and the establishment of chloroquine resistance, particularly for non-immune residents and visitors, are emphasized.

Animals↗
PubMed1989

Reproductive health of Asian women: a comparative study with hospital and community perspectives.

A comparative study of Asian and non-Asian women's reproductive health was performed. The hospital case notes of 48 Asian and 51 non-Asian women, matched for age, were examined. Asian women had shorter stature, bigger families, booked later for antenatal care, and were less likely to have a cervical smear taken. Of the above, 30 Asian and 24 non-Asian women were interviewed in their homes. Many Asian women had difficulties with the English language and a low literacy rate which gave rise to communication barriers during health care. Their knowledge of procedures and tests such as amniocentesis, self examination of the breast etc. was comparatively low. Fewer Asians attended parent-craft classes or did post-natal exercises. Many disliked, and some refused, vaginal examination by male doctors. Despite equal access, Asian women were less well informed and made lesser use of services. Lack of knowledge and difficulties of communication, rather than negative attitudes, may explain Asian women's lesser use of services and to some extent the poor outcome of pregnancy observed in many studies.

Adult↗
PubMed1997

Interacting factors affecting illegitimacy in preindustrial northern England.

Illegitimacy in a historic, single community at Penrith, Cumbria (1557-1812), has been studied using aggregative analysis, family reconstitution and time series analysis. This population was living under extreme conditions of hardship. Long, medium and short wavelength cycles in the rate of illegitimacy have been identified by time series analysis; each represents a different response to social and economic pressures. In a complex interaction of events, the peaks of the cycles in wheat prices were associated with rises in adult mortality which promoted an influx of migrants and a concomitant rise in illegitimacy. The association between immigration and illegitimacy was particularly noticeable after the mortality crises of the late sixteenth and early seventeenth centuries. Children of immigrant families also tended to produce illegitimate offspring. Native and immigrant families responded differently to extrinsic fluctuations, and variations in their reproductive behaviour were probably related to access to resources.

Emigration and Immigration↗
PubMed1991

Teenage pregnancy in Scotland: trends and risks.

Teenage pregnancy, considered to be associated with social and medical risks, is seen as a growing problem. Population based information from the Registrar General (Scotland) and Notification of Abortion permitted an analysis of the trends in the numbers, rates and outcomes of pregnancies among women aged less than 20 years. In addition, clinical information is available on all deliveries in Scottish hospitals from the standard hospital discharge document permitting analysis of the association of defined complications with age. Contrary to current perceptions, pregnancies and births among teenagers are not more frequent in 1988 when compared to 1975. There has been, however, a large increase in births to single women, a group with particular problems. The obstetric risks when compared to older women, are small and probably socially, not age related. These include a slightly higher rate of pre-term delivery and low birthweight and a later presentation for specialist antenatal care. The proportion of pregnancies affected by neural tube defects which are terminated is lower among women under 20. These medical risks are small, however, compared to the well-documented social and economic problems which will have long term and indirect effects on health.

Abortion, Induced↗
PubMed1998

Condom use among Aboriginal people in Ontario, Canada.

A survey of 658 Aboriginal men and women living in 11 reserve communities in Ontario, Canada, was utilized to collect data on patterns of condom use. Individuals who had sexual intercourse in the previous 12 months were included in the analysis (n=400). Descriptive statistics and multiple logistic regression were used to analyse condom use in the previous 12 months. Eight per cent always, 31% sometimes, and 61% never used condoms. Rates of condom use differed with the number of sex partners in the last year, age, gender, having a steady sex partner, and marital status. Multiple logistic regression revealed that people most likely to use condoms were under the age of 30, male, did not have a long-term steady sex partner, had more than one sex partner, worried about pregnancy, were knowledgeable about HIV/AIDS, and were not embarrassed to obtain condoms. Condom users who were knowledgeable about HIV/AIDS and who knew someone with HIV/AIDS were more likely to always use condoms. The most common reason for not using a condom was 'I was with my steady sex partner'. These results have implications for STD prevention efforts and for future research of sexual and STD preventive behaviour among Aboriginal people.

Adolescent↗
PubMed1993

Ethnicity as a risk factor for consultations in primary health care and out-patient care.

OBJECTIVE: To determine the influence of ethnicity, defined as foreign-born people, on consultation rates, admissions and prescriptions in out-patient care and primary health care. DESIGN: Prospective study of attenders at four different caregivers during seven consecutive weeks in 1988. Age-and sex-standardized relative risks and odds ratios with 95% confidence interval were calculated. SETTING: A suburban area in Lund, a city located in the south of Sweden, with 28% foreign-born people. SUBJECTS: This population (N = 5085) made 1,348 consultations. MAIN OUTCOME MEASURES: Ethnic group and consultation rates of the local primary health care centre, the emergency department, hospital out-patient department, and private care, admissions to specialist care, prescriptions, and certified sick leave. RESULTS: Swedes made fewer age-and sex-standardized visits to the emergency department (RR = 0.69(0.48-0.99)) while the foreign-born people showed an opposite non-significant trend (RR = 1.37(0.95-1.99)). Latin Americans (RR = 1.60(1.02-2.51)) visited the local Primary Health Care centre in the residential area more than expected, while people born in Asia and Africa consulted the Primary Health Care centre less than expected (RR = 0.44(0.28-0.69)). There were no differences between Swedes and foreign-born people in being put on the sick-list, but foreign-born people were given significantly fewer prescriptions (RR = 0.07(0.03-0.19)) than Swedes. Foreign-born people, Latin Americans, and non-Swedish Scandinavians were referred significantly more often to hospital than other groups. CONCLUSIONS: There were important differences in consultations between Swedes and foreign-born people. It seems important to study these differences further to find out if they were due to morbidity or cultural differences in order to be able to meet the demands and needs of different ethnic groups.

Africa↗
PubMed1992

Birth spacing and child mortality in a Caribbean population.

Ten independent variables were used to predict death before the first birthday for 4411 births that took place from 1878 to 1976 to 978 women of native ancestry on the island of St. Barthélemy. Significant predictors of death include the death of the mother within a year, the birth year, multiple birth, whether the preceding child also died before 1 year of age, and whether the next child was conceived before the index child was 1 year old. Unlike most prior studies, birth-spacing variables were only weakly related to death in the first year. The relative absence of contraceptive techniques to control birth spacing in the study population and the use of vital records rather than survey data distinguish this project from others and may account at least partly for the unusual findings.

Birth Intervals↗
PubMed1991

Impaired cell-mediated immunity in Papua New Guinean infants.

Immune function was studied in Papua New Guinea highland infants with pneumonia, healthy highland controls and expatriate controls under the age of 15 months. Delayed-type hypersensitivity to tuberculin was depressed in highland pneumonia patients and highland controls as were CD4/CD8 T-lymphocyte ratios. The differences between highland and expatriate infants were more pronounced after 6 months of age, suggesting an environmental effect. Serum immunoglobulin and complement concentrations were higher in highland infants than in expatriate controls. Indices of nutritional status were similar in highland and expatriate infants but iron deficiency was more common in the highland infants in the study.

CD4-CD8 Ratio↗