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The drug use profile (DUP): an instrument for clinical and research evaluations for drug use patterns.

A profile form, similar to that used by the Minnesota Multiphasic Personality Inventory (MMPI), was developed to portray overall patterns of drug usage. It is based upon data collected from 3984 respondents which were subsequently factor analyzed and transformed into standardized T scores. Once developed, the profile was examined for its ability to evaluate both individual and group drug use patterns. Results suggest that the profile is reliable and provides a quick portrayal of clinically important features of a person's drug practices. Mean drug use data can also be plotted on the same profile for specific subgroups. The profile may be further employed to determine the degree of drug use for a single person or a group of drug users, vis-a-vis the general population. Finally, potential uses for the instrument are discussed.

Adolescent↗

Psychotic ideation and receipt of government entitlements among homeless persons in New York City.

OBJECTIVE: This study compared changes in receipt of government entitlements by homeless persons with and without psychotic ideation in New York City between January 1997 and July 1998, a period characterized by changing state government policies and greater bureaucratic monitoring of eligibility. METHODS: In conjunction with an experimental study of the efficacy of social work services provided to homeless persons in Manhattan by a mobile medical van, 25 persons who were assessed as having experienced psychotic ideation in the previous year and 134 nonpsychotic persons were followed up after four months to identify changes in their receipt of Medicaid benefits, Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI), food stamps, and home relief (state welfare for single persons). The social work intervention was designed to help eligible clients gain access to entitlements and substance abuse treatment. RESULTS: The proportion of clients with psychotic ideation who received Medicaid, food stamps, or home relief decreased during the study period, while the proportion of nonpsychotic clients who received these entitlements increased. Little change was observed in receipt of SSI or SSDI by either group. CONCLUSIONS: Psychotic ideation among homeless persons may be a significant factor in access to and maintenance of government entitlements. In the context of an increasingly restrictive and bureaucratic welfare system, providing assistance to homeless persons who have severe psychopathology presents new challenges to service providers.

Adult↗

Are prejudices against disabled persons determined by personality characteristics? Reviewing a theoretical approach on the basis of empirical research findings.

Taking as point of departure the results obtained from research on prejudice, many authors believe that the quality of attitudes toward disabled persons is influenced by the personality structure of the nondisabled. In order to verify this assumption, a secondary analysis of 67 empirical studies was undertaken. These studies referred to different personality variables such as authoritarianism, ethnocentrism, dogmatism, rigidity, intolerance of ambiguity, cognitive simplicity, anxiety, ego-weakness, self-concept, body-concept, aggressiveness, empathy, intelligence, etc. The results can be summarized as follows: Statistical criteria show that single personality traits have relatively little influence on the attitudes towards disabled persons. An adequate evaluation of the research findings is complicated by, at times, considerable methodological problems which arise when applying the proper test instruments to non-clinical populations. Marked correlations are to be found in particular in the case of authoritarianism, ethnocentrism, intolerance of ambiguity, anxiety, and ego-weakness. The intercorrelations, however, between most of the personality variables are rather high, which by cumulation of "extreme" factors may, in fact, sometimes result in particularly unfavorable attitudes toward the disabled. Thus, personality-related research findings to provide certain valuable explanations. Special attention should be devoted to the multiple connections between personality structure and social structure.

Attitude to Health↗

[Resuscitation by laymen?].

Although some authors report an increase in the rate of successful resuscitation if cardiopulmonary resuscitation is initiated by laymen, no appropriate training is carried out in the Federal Republic of Germany. In a test comprising 647 persons we studied to what extent it is possible to impact first aid know-how to bystanders. 60% were in the position to recognise the presence of distinct signs of respiratory failure and to assess the situation correctly. Only one-third (35%) of the participants, who had taken the first-aid course more than two years before the test, were able to carry out a proper examination of the respiration. The technique of ventilation was definitely deficient. Already one year after the instruction 30% found it difficult to position the head correctly. More than two years after the instruction 39% of the tested persons were able to insufflate a sufficient tidal volume. In a second test 198 emergency medical technicians were examined who had taken part in a cardiopulmonary resuscitation course. Only 53.2% had sufficient theoretical knowledge. 40% could apply efficiently the single-person-method of basic life support and 55% the corresponding two-person-method. These results prove that a once-only instruction of bystanders does not suffice by itself to impart sufficient knowledge for handling the emergency situation. It is, therefore, proposed to introduce compulsory and continuing instruction as a progressive teaching schedule--especially to young people--in first aid and, integrated into this programme, the methods of cardiopulmonary resuscitation.

Female↗

[Evaluation of periodontium status and periodontal needs in persons aged 35-44 years in Poland].

The aim of this study was providing current, objective and comparable with the world literature data on the frequency of occurrence and the intensity of periodontal diseases in the age group 35-44 years. During the surveys the WHO card from 1986 was used. The condition of periodontium the periodontal treatment needs were assessed by CPITN (Community Periodontal Index of Treatment Needs) with use of 621 WHO probe. One thousand three hundred and eighty persons in nine districts of Poland were examined, with regard to three living areas: big cities, small towns and the rural ones. The results of surveys accomplished in Poland indicate that the achievement of the second health purpose, designed by World Health Organization for the year 2000 in the field of periodontal tissues is unattainable. This is because, according to the second health purpose, 75% of the population at the age of 35-44 years ought to have three health sextants, and deep picketing can occur in maximum 5% of the population. Unfortunately, only in 7.1% of persons examined at least three healthy sextants were found. They were disclosed considerably more often in women (9.1%) than in men (5.1%). Deep periodontal pocketing of 6 mm and more were found in 15% of persons examined. They were detected considerably more frequently in men (18.4%) than in women (11.3%). By comparison of data pertaining to individual districts (Tab. 1-5), it turned out that the worst conditions of periodontium occurred in Białostockie, where there was not a single person with healthy periodontium. Better results were recorded in Gdańskie, which must be the effect of systematical health education. Periodontal treatment needs among the persons examined are enormous. Almost 100% of persons require both instruction of brushing teeth and time consuming professional procedures of removal of the concrement on the teeth. Fifteen per cent of the persons need specialized treatment. These proportions varied differently in the surveyed districts, only 5% in Dgańskie and from 21.7% to 23.9% in Białostockie, Wrocłlawskie and Krakowskie. However the proportions of those needs in Poland are much bigger than in other European countries, and differ considerably from the marked second periodontal health purpose for the year 2000.

Adult↗

Tailoring dietary feedback to reduce fat intake: an intervention at the family level.

In this study, we wished to investigate whether the use of tailored nutrition education letters addressed to each family member simultaneously at home could serve as a valuable strategy for nutrition education. Family quartets (both parents and two adolescents, all healthy individuals) were chosen to be the units of intervention. The first aim of our study was to investigate the impact of tailored versus standardized nutrition education on fat intake and on psychosocial determinants of fat intake in families, using a randomized dietary feedback study. Our second aim was to study the differential effect of the tailored nutrition education on different family members. Analyses were conducted among 18 experimental families (n = 72) and 17 control families (n = 68). The tailored intervention was more effective than the nontailored intervention in reducing total and saturated fat intake when all the family members were included (F = 4.0, P < 0.05 and F = 5.9, P < 0.05). However, follow-up analyses revealed that only mothers benefit from the tailored intervention (F = 6.4, P < 0.05 and F = 10.2, P < 0.005). For fathers and adolescents, both interventions resulted in a significant decrease in fat scores. Furthermore, tailored feedback resulted in stronger awareness of personal fat intake and awareness of fat intake of family members. Tailored advice has the potential to communicate the personal need to change. As differences in fat reduction between family members receiving general or tailored nutrition education letters were smaller than expected, future research will have to prove that family-based tailored interventions are more effective than standardized interventions and interventions focusing on a single person. It also needs to be clarified why mothers in particular benefit from tailored feedback.

Adolescent↗

[A study of depressive state and background factors in community-dwelling older persons].

In order to maintain and improve the mental health of elderly people living in the community, a cross-sectional survey was conducted to elucidate their depressive state and its background factors. Subjects were elderly persons living in the community who were able to fill in the questionnaire themselves. The study used the self-recording questionnaire sheets used in the Kahoku Longitudinal Aging Study by Matsubayashi et al and the Zung Self-rating Depression Scale (SDS). Out of 2,379 elderly persons who were able to fill in the questionnaire by themselves in the community, 2,361 (99.2%) returned the questionnaire sheets. After removing inadequate responses, analysis was possible for 1,181 (49.6%) (542 males (average age 72.3 +/- 5.5) and 639 females (average age 73.0 +/- 6.3). Degree of depressive state as evaluated by SDS was normal for 731 persons (61.9%); mild, 240 (20.3%); moderate, 181 (15.3%); and severe, 29 (2.5%). The average age became higher as the SDS became high, of being indicating the seriousness of the depressive state (p = 0.0155), with the ratio women significantly higher (p = 0.0077). Among those with severe SDS, the ratio of single persons was high (p < 0.001) as well as those who were non-drinkers (p = 0.0015), without regular habit of walking (p < 0.001), or without work (p < 0.001). The ratio of those receiving medication regularly was also significantly high (p = 0.0022). As for the relation of SDS with various of the scores, the higher the SDS score became, the scores for ADL, information-related function, functional and emotional support network, family relationship, friendship, economic condition became significantly lower (p < 0.001, respectively). In logistic regression analysis using the background factors for SDS as explanatory variables, factors such as being women (odds ratio, 1.73; 95% confidence interval, 1.10-2.72). ADL (0.80; 0.69-0.93), emotional support network (0.88; 0.81-0.96), friendship (0.98; 0.96-0.99) were significant independent contributing factors. As for the relation between SDS and subjective senses, the more serious the SDS score became, the scores for feelings of healthiness and satisfaction became significantly smaller (both p < 0.001). For prevention and amelioration of the depressive state of elderly persons living in the community, attempts should be made to improve the background factors which were clarified by the present study by efficiently utilizing health, medical and welfare services and following the future course with a positive attitude.

Activities of Daily Living↗

Clamydial antibody in sera of patients with trachoma.

Serum samples were taken in 1987 from 118 patients with trachoma seen in the Department of Opthalmology of the Gonder College of Medical Sciences, Gonder, Ethiopia, patients being staged according to MacCallan (II, III, IV), and classified in categories of different degrees of inflammation according to Dawson et al. Sera were investigated with the microIF test, using Chlamydia trachomatis serotypes A, B, C and partially D as antigens. Healthy Ethiopian students (n = 14), patients with chlamydial urogenital infections (n = 100), salpingitis (n = 47), and D-seronegative individuals (n = 574) served as controls. Patients with trachoma with severe inflammation showed significantly higher chlamydial antibody titres (greater than or equal to 1:128) against serotype A (p less than 0.05), B (p less than 0.01), and C (p less than 0.01) than patients with trivial, mild or moderate inflammatory symptoms. There was little correlation between MacCallan stages and chlamydial antibody titres, probably due to persistence of antibodies. In the control group of Ethiopian students only single persons were found to react with C. trachomatis serotypes A, B, and C in high titres; the geometric mean varied from x = 1:17 to x = 1:25 and distinctly differed from trachoma patients (x = 1:65). The individuals of other control groups showed high antibody titres against serotype C only in single cases and low geometric mean values.

Adolescent↗

Falls among elderly people living at home: medical and social factors in a national sample.

Falls are the most common accidents among the elderly, and while medical risk factors are well known, less is known about the association of falls with social factors. The aims of this study were to estimate the incidence rate of falls in a national, representative sample of Israeli elderly and to examine the association of falls with selected medical and social factors. A special national survey conducted in 1985 by the Israel Central Bureau of Statistics showed that among a representative sample of 3,494 community-dwelling elderly persons aged greater than or equal to 65, 24% reported a fall in the past year; the rate was 16% among men and 31% among women. The majority of falls reported happened out of doors. Of those who fell 37% subsequently visited the emergency room. Analyses adjusted for age and sex showed that single persons, particularly women, living alone reported falls at a higher rate than their married counterparts. Analyses adjusted for age, sex and mobility level showed that frequency of social interaction was inversely related to reported falls. Use of sleeping pills, problems with vision, and mobility restrictions were associated with falls in age- and sex-adjusted analyses. Advanced age (greater than 75 years) was associated with repeated falls that occurred both in the home and outdoors.

Accidental Falls↗

[Comprehensive computer-assisted management of a cardiology department].

We are proposing a personal computer local network system for collecting data and managing of both cardiovascular in- and outpatients. The six PCs used as work stations are located in the following areas: reception desk, ergometry, holter, echocardiography, secretarial and coronary care unit and cardiology department. Starting from a commercially available DBMS program, an "Iceberg" applied program was first made in a single personal computer and then transferred to a local network. The tree-structured data base includes the cardiopathies list, the vasculopathies list, some cardiovascular clinical data and all information regarding cardiological instrumental tests. The data are descriptive, numeric, date, text and comment. The operative program allows us to change the data base without the help of the software house staff, so the system is adaptable to cardiological departments with different instrumental equipment and sections. The report of instrumental tests and the issuing of the discharge letter are made with the local work station, with simultaneous compiling, storing and printing. It is then possible, using any work station, to restore and print quickly a summary of all data concerning each patient. This summary permits us, in nearly all cases, to identify the patient's history and present condition, as well as the diagnostical steps taken.

Cardiology↗

The nursing home patient--a burn-prone person. An epidemiological study.

During the 6 years between 1980 and 1985, 39 nursing home patients were admitted to the Hvidovre Burns Unit in Copenhagen with accidental burns. These patients accounted for 20 per cent of all burn patients above the age of 69 years admitted during this period. The median age of the patients was 80 years. Two-thirds of them suffered from burns of less than 15 per cent of their total body surface area. The mortality rate was 64 per cent. All patients were burned in single-person accidents, most often while sitting alone in their own living room, and smoking materials were involved in 85 per cent of the injuries. Senility, hemiplegia and other neurological diseases with tremor or paresis were frequently present in the victims. Several preventive measures are proposed, including smoking under supervision, use of flame-resistant aprons of adequate size, flame-resistant materials in chairs, etc., and installation of smoke detectors in rooms where patients smoke. A possible relation between the marked incidence of these accidents during weekends or holidays, at a time when staff numbers are reduced in the nursing homes, is discussed.

Aged↗

Comparative distribution of the serotypes of Enterococcus faecalis isolated from the urine of patients with urinary tract infections and the feces of healthy persons as determined by the slide agglutination reaction.

In 1992, we reported a new scheme for identifying 21 distinct serovars of E. faecalis by the bacterial agglutination reaction. In this study we isolated strains of E. faecalis from the urine of patients with urinary tract infections and serotyped. We also serotyped strains of E. faecalis isolated from the faces of healthy persons. The results showed that serovars 2, 7, 1 and 3 were the major serotypes a distribution on strains of E. faecalis isolated from patients. Serovars 2, 1 and 13 were the major serotypes of the fecal strains isolated from healthy persons. Single serovars were typable of all strains of E. faecalis isolated from patients in 80.6% (395/496) and in 62.4% of the fecal strains. Examination of the hemolytic zone around colonies on horse/sheep blood agar plates showed that beta-hemolytic strains on horse blood agar plate isolated from patients had 36.1% for all isolated strains from patients and 8.3% for fecal strains isolated from healthy persons.

Agglutination Tests↗

Personality traits and disorders among transsexuals.

A group of transsexuals, 9 biological men and 10 women, was assessed according to clinical DSM-III-R diagnosis and a self-report instrument for Axis II diagnoses based on the Structured Clinical Interview for DSM-III-R (SCID screen). A control group of 133 individuals was assessed by the same instrument. Combined with a functional criterion according to the Global Assessment of Functioning, the SCID screen showed good agreement with clinical Axis II diagnoses. The overall proportion of Axis II criteria fulfilled, proportion of criteria fulfilled for every single personality disorder and number of personality disorders were calculated from the modified version of the SCID screen. Personality disorders, mainly within cluster B, were identified among 5 of 19 transsexuals, and a majority had multiple personality disorders. Among controls, no personality disorder was identified. Personality traits as measured by the SCID screen revealed significantly more subthreshold pathology among transsexuals than controls in 8 of 12 personality categories. The proportion of overall Axis II criteria fulfilled was 29% among transsexuals versus 17% among controls. Sex differences among transsexuals, the usefulness of the SCID screen and diagnostic problems in DSM-III-R with respect to gender identity disorders are discussed.

Adult↗

The epidemiology of sick leave in an urban population in Malmö, Sweden.

The epidemiology of sick leave was studied in the city of Malmö, Sweden, (230,000 inhabitants). Every current and completed sick-leave episode during the year of 1985 was collected for 124,411 persons aged 16 to 65, who were registered with the National Health insurance scheme in 1985. Absence rate, absence incidence, absence prevalence and absence duration were analyzed in relation to age, sex, marital status, nationality, income and place of residence. Absence rate (mean value) in the total population was 25.5 days with a median of three days. The absence rate increased by age. High absence rates were seen for females, single people and some immigrant groups. This was even true for residential areas characterized by a higher proportion of single-person households and households on social welfare, of unemployed and people with a low income and a foreign background. The absence rate gives limited information as to the epidemiology of sick leave. Through adding absence incidence, absence prevalence and absence duration it was possible to get a more comprehensive picture of the phenomenon. Sex-differences in absence rate for instance were mainly explained by differences in absence incidence and prevalence, while differences in absence rate regarding nationality were explained by differences in absence duration. This is an important step towards a better understanding of the factors behind sick leave.

Absenteeism↗

Allomonal effect of breath contributes to differential attractiveness of humans to the African malaria vector Anopheles gambiae.

BACKGROUND: Removal of exhaled air from total body emanations or artificially standardising carbon dioxide (CO2) outputs has previously been shown to eliminate differential attractiveness of humans to certain blackfly (Simuliidae) and mosquito (Culicidae) species. Whether or not breath contributes to between-person differences in relative attractiveness to the highly anthropophilic malaria vector Anopheles gambiae sensu stricto remains unknown and was the focus of the present study. METHODS: The contribution to and possible interaction of breath (BR) and body odours (BO) in the attraction of An. gambiae s.s. to humans was investigated by conducting dual choice tests using a recently developed olfactometer. Either one or two human subjects were used as bait. The single person experiments compared the attractiveness of a person's BR versus that person's BO or a control (empty tent with no odour). His BO and total emanations (TE = BR+BO) were also compared with a control. The two-person experiments compared the relative attractiveness of their TE, BO or BR, and the TE of each person against the BO of the other. RESULTS: Experiments with one human subject (P1) as bait found that his BO and TE collected more mosquitoes than the control (P = 0.005 and P < 0.001, respectively), as did his BO and the control versus his BR (P < 0.001 and P = 0.034, respectively). The TE of P1 attracted more mosquitoes than that of another person designated P8 (P < 0.021), whereas the BR of P8 attracted more mosquitoes than the BR of P1 (P = 0.001). The attractiveness of the BO of P1 versus the BO of P8 did not differ (P = 0.346). The BO from either individual was consistently more attractive than the TE from the other (P < 0.001). CONCLUSIONS: We demonstrated for the first time that human breath, although known to contain semiochemicals that elicit behavioural and/or electrophysiological responses (CO2, ammonia, fatty acids) in An. gambiae also contains one or more constituents with allomonal (~repellent) properties, which inhibit attraction and may serve as an important contributor to between-person differences in the relative attractiveness of humans to this important malaria vector.

Journal Article↗

[Rehabilitation of foreign workers: myths and reality].

In terms of chances for a successful professional reintegration of a worker who has fallen victim of an accident or an illness, there are no significant differences between Swiss workers and foreign workers. This viewpoint is based on a survey of limited representation. Two groups of 65 and 50 patients from the French speaking part of Switzerland were questioned. The results clearly warn against generalizations, prejudices and clichés. It is wrong to rashly judge a whole cultural or ethnic group only upon one negative experience made with a single person of that group. On the other hand, it is rather significant that the chances for a successful reintegration become smaller for Swiss and foreign workers, the longer it takes to introduce the necessary measures after the beginning of an illness or a handicap. The causes of chronification and interdependence between complex circumstances and conflict situations must be taken appropriately into account with interdisciplinary cooperation. If cases with serious problems can be singled out early, the risk of total disability of the patient can be avoided.

Acculturation↗

[Reporting new HIV cases in Catalonia, Spain: is technical consensus feasible?].

OBJECTIVE: To describe the process performed in Catalonia (Spain) to design an information system for monitoring new cases of HIV infection. METHODS: A survey was used to evaluate perception of the need for notification of HIV infection by health care professionals (n = 106), as well as their opinions of the various possibilities for the implementation of the notification system. As a result of this evaluation, a specific technical report defining the objectives and technical characteristics of the new notification system was produced. The feasibility of the system in health centres was evaluated through discussions with health care professionals, health authorities and Non-Governmental Organizations, and a second survey was designed to evaluate the use of a personal identification code (PIC) from the individual health card (IHC). This process took plabe between 1998 and 2000. RESULTS: A total of 84.5% of the health care professionals believed that HIV notification should be mandatory and confidential; 90.4%, were of the opinion that notification would enable identification of the epidemiological characteristics of infected individualos, and 75% believed that these individuals would have to be identified by name. Finally, 66% of the health care professionals believed that the use of the PIC from the IHC would be feasible as the personal identifier in HIV notification. A final proposal was draw up and 1 January, 2001 was set as the date to initiate the pilot phase of the new HIV notification system. CONCLUSIONS: Most of the health care professionals surveyed expressed the need for notification of HIV infection, and for such notification to receive institutional endorsement. They also believed that, as with other diseases of individualized mandatory reporting, notification should be carried out with a single personal identifier. The information obtained from notification of HIV infection is essential for the optimal planning of preventive programs and the provision of health services. The main difficulties observed were that HIV infection has not been included among the diseases of mandatory reporting, as well as the low implantation of the PIC in the hospitals' clinical registries. All the sectors involved have an important role to play in creating the conditions necessary for the notification system of new cases of HIV infection to be feasible and useful.

Consensus↗

Trace-element concentrations in blood samples from welders of stainless steel or aluminium and a reference group.

The concentrations of 17 trace elements (e.g., copper, cobalt, iron, manganese, chromium, silicon and magnesium) were determined in whole blood samples of 81 persons working with different welding methods on stainless steel or aluminium and 68 nonwelders. Inorganic spark source mass spectrometry was used for the chemical analyses. The data were analyzed by the SIMCA method for pattern recognition (discriminant analysis). No differences were found between the five groups, either in the average levels of the trace elements or in the correlation structures between the trace elements. Thus no blood concentration data on the analyzed elements and collected from a single person contained any information with respect to exposure to the welding fumes investigated.

Aluminum↗